Accountability Without Causality: Tort Litigation Reaches Fairy Tale Levels

This article is adapted from a lecture delivered on September 18, 1991, at the Columbus School of Law, The Catholic University of America, as part of the Brendan Brown Lecture Series. The Lecture Series honors Dr. Brendan Brown, the sixth dean of the Columbus School of Law (1942-54)

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

GILSON AND RÉMI BRAGUE ON MEDIEVAL ARABIC PHILOSOPHY

Given contemporary interest in Islam, compelled by the astounding violence perpetrated in its name, the author considers what two historians of philosophy, Étienne Gilson and Rémi Brague, writing a generation apart, have to say about medieval Arabic philosophy and the relevance of its study to our own day

Maritain as an Interpreter of Aquinas on the Problem of Individuation

Abstract: The medieval problem of individuation is not the contemporary problem of «individuals » or «particulars»" discussed by P F. Strawson, J. W Meiland and othersl. In a certain sense the problem of individuation originates with Parmenides, but it is Plato's philosophy of science which bequeaths the problem to Aristotle and to his medieval commentators. Its solution in Aquinas is not that of Aristotle, nor is it that of Scotus or Suárez. Aquinas will distinguish between the problem of individuation and what we may call the problem of «individuality» or the problem of «subsistence ». The solution to both will draw upon many Aristotelian distinctions but will incorporate key elements of St. Thomas' own metaphysics, including the real distinction between essence and existence and his doctrine of participation. It is Maritain's appropriation of St. Thomas' metaphysics which enables him to produce a realistic philosophy of science, one which he offers as compatible with contemporary scientific enquiry. It also enables him to develop a theory of person and personality. But the story begins with Plato

The Universe We Think In by James V. Schall

This paper is a review of the book: James V. Schall, The Universe We Think In (Washington, D.C.: The Catholic University of America Press, 2019). The author discisses the reasons and consequences of modern philosophy’s propensity to neglect the innate or purposeful direction of human life

WE ARE MODERN AND WANT TO BE MODERN

The author traces the thought of George Santayana, Brad S. Gregory, Pierre Manent, and Rémi Brague, who addressed the transformation of the West into its modern present. They all show that by being cut off from its cultural and political inheritance in modern times, Western Civilization presently finds itself in a burning need of recovering its identity. To save its identity, the West is to challenge the errors of modernity. We used to have the example of Winston Churchill and Charles de Gaulle in the darkest hours of World War II, and the remarkable example of John Paul II who through his leadership of the Solidarity movement inspired hope not only in his own people but also for others in the Soviet bloc at the time. “The cultural task awaiting Europe,” to use a phrase of Rémi Brague, challenging though it may be, may in time find its voice in another Churchill or John Paul II. At present, with no remedy in sight, all we can do is to hope

Maritain as an interpreter of Aquinas on te problem of idividuation

Abstract: The medieval problem of individuation is not the contemporary problem of «individuals » or «particulars»" discussed by P F. Strawson, J. W Meiland and othersl. In a certain sense the problem of individuation originates with Parmenides, but it is Plato's philosophy of science which bequeaths the problem to Aristotle and to his medieval commentators. Its solution in Aquinas is not that of Aristotle, nor is it that of Scotus or Suárez. Aquinas will distinguish between the problem of individuation and what we may call the problem of «individuality» or the problem of «subsistence ». The solution to both will draw upon many Aristotelian distinctions but will incorporate key elements of St. Thomas' own metaphysics, including the real distinction between essence and existence and his doctrine of participation. It is Maritain's appropriation of St. Thomas' metaphysics which enables him to produce a realistic philosophy of science, one which he offers as compatible with contemporary scientific enquiry. It also enables him to develop a theory of person and personality. But the story begins with Plato

Walter Kaufmann: Philosopher, Humanist, Heretic by Stanley Corngold

This paper is a review of the book: Stanley Corngold, Walter Kaufmann: Philosopher, Humanist, Heretic (Princeton: Princeton University Press, 2018). The author concludes that Corngold’s book acquaints the reader not only with the thought of Walter Kaufmann, but also with the thought of a prominent, late twentieth century generation that in effect rejected the source of the very culture that nourished it