To meet the specific education needs of ethics committee members (primarily full-time healthcare professionals), the Regional Ethics Department of Kaiser Permanente Northern California (KPNCAL) and Washington State University’s Elson Floyd School of Medicine have partnered to create a one-academic year Medical Ethics Certificate Program. The mission-driven nature of the KPNCAL-WSU’s Certificate Program was designed to be a low-cost, high-quality option for busy full-time practitioners who may not otherwise opt to pursue additional education.

This article discusses the specific competency-focused methodologies and pedagogies adopted, as well as how the Certificate Program made permanent changes in response to the global pandemic. This article also discusses in detail one of the Program’s signature features, its Practicum—an extensive simulated clinical ethics consultation placing students in the role of ethics consultant, facilitating a conflict between family members played by paid professional actors. This article concludes with survey data responses from Program alumni gathered as part of a quality study.

After the political fragmentation of the “Five Dynasties and Ten Kingdoms” period, the Northern Song consolidated much of the lands under these regional states into a larger polity in a process often described as “reunification.” But this “reunification,” judged against the domain of the Tang dynasty, was incomplete. The “Sixteen Prefectures” to the northeast were ceded to the Liao, and this became a vexing issue for Song emperors and officials. But the northeast was not the only region once under Tang rule that did not enter the Song domain. In this article, I discuss the area to the northwest of the Song, much of which was eventually governed by the Tangut Xia state. This area, roughly the modern provinces of Ningxia and Gansu, featured prominently in Northern Song political discussions, national geographical treatises, and national and regional maps. By analyzing the treatment of the northwest in these diverse genres of representation, I demonstrate a spectrum in the perceptions of the northwest. It was sometimes seen as little different from areas under Song rule; in other cases, it was treated as “beyond the sphere of civilization” (huawai). Such ambiguity is visualized in many Song cartographers who placed this area between two segments of the Great Wall. For Song emperors and officials, the northwest sat uncomfortably in their imaginations of the world, not easily dismissed and forgotten, yet irrecoverable.

Modal panentheism claims that God encompasses all possible worlds and that a substantial number of possible worlds exist. This article defends a version of modal panentheism that is grounded in perfect-being theology, which maintains that God holds all great-making properties to the highest possible degree. In addition to goodness, modal panentheists consider encompassment to be a great-making property, and therefore, God (a maximally encompassing being) is said to encompass all possible worlds.

Nagasawa argues that modal panentheism faces a significant problem: the modal problem of evil. The argument states that if modal realism is true, then there exists a substantial number of possible evils that contradict God’s perfect goodness. Nagasawa proceeds to claim that modal evil poses a greater threat to modal panentheism than actual evil does to traditional theism.

This article develops two responses to the modal problem of evil. The first response (maximal-panentheism) argues that God need not be all-good or all-encompassing. The second response (no evil worlds) argues that worlds contradicting God’s perfect goodness are not possible worlds. In the light of these responses, I claim the modal problem of evil for modal panentheism is no more intractable than the problem of evil for traditional theism.

Biber, Szmrecsanyi, Reppen & Larsson (2023) argue for a more liberal inclusion of genitive variants, evoking Labov's principle of accountability (Labov 1969: 737–8, fn. 20, 1972), which calls for the inclusion of all variants that are functionally equivalent and allow variation. They suggest that the term ‘genitive’ should be defined grammatically, as a restrictive modifier to the head noun, rather than semantically in terms of a possessive relation, thus redefining the linguistic variable for English genitive variation. In particular, they include noun modifiers as a third genitive variant (with s-genitives and of-genitives). In this reply I argue that the authors proceed from a notion of ‘genitive’ that is too broad, including variants that are not functionally equivalent and contexts that are not variable, thus actually violating the principle of accountability.

Although ethics is increasingly integrated in the curriculum of U.S. medical schools, it remains not well integrated with system issues, and social and structural contexts of illness. Moreover, ethical analysis is not often taught as a clinical skill. To address these issues, an outcomes driven course in Social Sciences, Humanities, Ethics and Professionalism (SHEP) was created. Within the course, a web-based concept mapping device, SHEP Case Analysis Tool (SCAT), was created which schematizes the structure and flow of clinical cases from diagnosis to treatment options, to shared decision making to outcome, and includes key stakeholders, influences, and structural features of the health system. In the course, each student analyzes a case in which they were directly involved using SCAT and presents their analysis to faculty and peers. This exercise 1) reinforces knowledge-based portions of the course pedagogy, 2) supports meta-cognition and critical thinking through concept mapping, 3) applies multidimensional analysis to identify ethical, social, and system issues that impact patient-care. 4) develops problem solving skills, 5) counters the hidden curriculum/support professional identity formation, and 6) develops skills in reflective discourse. This paper outlines the development and use of this concept mapping case analysis tool in an undergraduate medical education curriculum.

This paper explores the intense bond formed between two Qing women, Li Ti and Huang Xunying, as well as their double suicide. The sheer survival of the rich personal and family narratives (in both poetry and prose) surrounding their relationship and suicides represents a startling discovery. By actively resisting the restrictions imposed by the patriarchal family and social order and explicitly defining an unbreakable union marked by moral commitment to and spiritual connection with each other, Li Ti and Huang embody the concept of queerness in today’s usage. The two women’s double suicide, furthermore, posed an extreme form of social protest and an individual quest for freedom. Despite being historically conditioned and ideologically mediated, the excavated primary sources, such as Li Ti’s own poems, challenge not only the norms of their time and place, but also our scholarly consensus about women’s lives in China’s past.

Classic serotonergic psychedelics are experiencing a clinical revival, which has also revived ethical debates about psychedelic-assisted therapy. A particular issue here is how to prepare and protect patients from the vulnerability that the psychedelic state creates. This article first examines how this vulnerability manifests itself, revealing that it results from an impairment of autonomy: psychedelics diminish decision-making capacity, reduce controllability, and limit resistance to external influences. It then analyzes the strengths and weaknesses of five safety measures proposed in the literature, what aspect of the patient’s vulnerability they seek to reduce, and how they can be optimized. The analysis shows that while preparatory sessions, advance directives, and specific training and oversight are useful, starting with a lower dosage and no therapy is less so. Finally, the article presents a safety measure that has been overlooked in the literature but could be highly effective and feasible: bringing a close person to the psychedelic session.

We study original position arguments in the context of social choice under ignorance. First, we present a general formal framework for such arguments. Next, we provide an axiomatic characterization of social choice rules that can be supported by original position arguments. We illustrate this characterization in terms of various well-known social choice rules, some of which do and some of which do not satisfy the axioms in question. Depending on the perspective one takes, our results can be used to argue against certain rules, against Rawlsian theories of procedural fairness, or in support of richer, multidimensional models of individual choice.

In Brazil, numerous participatory institutions have been suspended over the past decades, including many participatory budgeting (PB) programs at the municipal level. Since the introduction of PB in Porto Alegre in 1989, extensive literature has discussed its effects on the way urban social movements make demands. However, the suspension of many PBs across Brazil raises a new question: how do these movements adapt following the loss of an arena that had become central to their efforts? Looking at the pioneering experience of Porto Alegre’s PB, whose progressive erosion started in 2002, I argue that urban movements have since shifted away from institutionalized participation routines, and adopted new routines that combine bureaucratic activism with proximity politics. Focusing on these movements’ repertoires of interactions I argue that the erosion of PB led to the deinstitutionalization of urban social movements.