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Objects are inert, passive, devoid of will, and as such bear no intrinsic value or moral worth. This claim is supported by the argument that to be considered a moral agent one must have a conscious will and be sufficiently free to act in accordance with that will. Since material objects, it is assumed, have no active will nor freedom, they should not be considered moral agents nor bearers of intrinsic ethical vale. Thus, the apparent “moral neutrality” of objects rests upon a kind of subject/object or mind/body dualism. The aim of this paper is to explore two paths by which western thought can escape this dualism, re-valuate the alleged “moral neutrality” of material objects, and initiate a sort of “object oriented ethics,” albeit with surprising results. To do so, this paper explores the work of Arthur Schopenhauer and Baruch Spinoza to interrogate both the claim that material objects have no will and that freedom is the necessary condition for ethical responsibility. This paper concludes by arguing that not only should objects been seen as bearers of their own ethical value, a determinate judgement can be made regarding that value through a basic understanding of the laws of physics.

Introduction: Patients within the US Veterans Health Administration (VA) system have higher rates of comorbidities and chronic pain, increasing risks of complications/poor outcomes following spine surgery. Although the use of bone morphogenetic protein 2 (BMP-2) is established for anterior lumbar interbody fusion, its indications for off-label use in posterolateral fusion are unclear. The objective of this study was to evaluate safety and utility of BMP-2 in posterolateral fusion through a 15-year experience at the VA., Methods: Patients underwent posterolateral lumbosacral fusions with BMP-2 by a single VA surgeon from January 1, 2005, to January 1, 2020. The primary outcome was fusion assessed through postoperative radiographs. Secondary outcomes included adjacent segment disease (ASD) and postoperative pain clinic utilization., Results: Sixty-eight patients underwent lumbosacral posterolateral fusion with BMP-2; 77.9% were discharged home and had no postoperative complications. All patients achieved bony fusion at a mean of 113.3 ± 59.9 days postoperatively. Five patients were diagnosed with cancer postoperatively, and eight patients required revision for ASD. No notable predictors of ASD exist. Preoperative opioid use predicted postoperative pain clinic utilization., Discussion: Posterolateral lumbar fusion with BMP-2 in veterans yields high fusion rates and favorable complication profiles and should be considered in multimorbid hosts., Study Design: Retrospective review of prospectively collected data., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)

Hemophilia A and B are chronic inherited bleeding disorders that together rank as one of the most expensive chronic diseases in the United States. Factor replacement products, which are the mainstay of treatment, are among the most expensive therapies, with a total annual cost of more than $250,000 per adult patient in the United States. Indirect costs also contribute to the economic burden and include lost productivity, caregivers' unpaid costs, and hemophiliarelated disability. Advances in hemophilia care have resulted in longer survival and a growing patient population, greater complexity in management of the disorder, and rising treatment costs. The establishment of federally recognized Hemophilia Treatment Centers has decreased costs and improved patient outcomes and quality of life by promoting outpatient, preventive, and homebased care. Successful collaboration among providers and managed care programs can improve outcomes and decrease costs for the delivery of hemophilia services.