Background Requirements for organ donation after cardiac or imminent death have been introduced to address the transplantable organs shortage in the United States. Organ procurement organizations (OPOs) increasingly use the Internet for organ donation consent. Methods An analysis of OPO Web sites available to the public for enrollment and consent for organ donation. The Web sites and consent forms were examined for the minimal information recommended by the United States Department of Health and Human Services for informed consent. Content scores (...) were calculated as percentages of data elements in four information categories: donor knowledge, donor consent reinforcement, donation promotion, and informed consent. Results There were 60 Web sites for organ donation enrollment serving the 52 states. The median percent (10 percentile-90 percentile) content scores of the Web sites for donor knowledge, donor consent reinforcement, and donation promotion were 33% (20–47), 79% (57–86), and 75% (50–100), respectively. The informed consent score was 0% (0–33). The content scores for donor knowledge and informed consent were significantly lower than donor consent reinforcement and donation promotion for all Web sites (P < .05). The content scores for the four categories were similar among the 11 regions of the United Network for Organ Sharing. Conclusion The Web sites and consent forms for public enrollment in organ donation do not fulfill the necessary requirements for informed consent. The Web sites predominantly provide positive reinforcement and promotional information rather than the transparent disclosure of organ donation process. Independent regulatory oversight is essential to ensure that Internet enrollment for organ donation complies with legal and ethical standards for informed consent. (shrink)
Islam and End-of-Life Practices in Organ Donation for Transplantation: New Questions and Serious Sociocultural Consequences Content Type Journal Article Pages 175-205 DOI 10.1007/s10730-009-9095-8 Authors Mohamed Y. Rady, Mayo Clinic Hospital in Phoenix 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Joseph L. Verheijde, Mayo Clinic College of Medicine 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Muna S. Ali, Arizona State University Phoenix Arizona USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue (...) Volume 21, Number 2. (shrink)
The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy (...) raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden. (shrink)
Mass media campaigns are widely and successfully used to change health decisions and behaviors for better or for worse in society. In the United States, media campaigns have been launched at local offices of the states’ department of motor vehicles to promote citizens’ willingness to organ donation and donor registration. We analyze interventional studies of multimedia communication campaigns to encourage organ-donor registration at local offices of states’ department of motor vehicles. The media campaigns include the use of multifaceted communication tools (...) and provide training to desk clerks in the use of scripted messages for the purpose of optimizing enrollment in organ-donor registries. Scripted messages are communicated to customers through mass audiovisual entertainment media, print materials and interpersonal interaction at the offices of departments of motor vehicles. These campaigns give rise to three serious concerns: (1) bias in communicating information with scripted messages without verification of the scientific accuracy of information, (2) the provision of misinformation to future donors that may result in them suffering unintended consequences from consenting to medical procedures before death (e.g, organ preservation and suitability for transplantation), and (3) the unmanaged conflict of interests for organizations charged with implementing these campaigns, (i.e, dual advocacy for transplant recipients and donors). We conclude the following: (1) media campaigns about healthcare should communicate accurate information to the general public and disclose factual materials with the least amount of bias; (2) conflicting interests in media campaigns should be managed with full public transparency; (3) media campaigns should disclose the practical implications of procurement as well as acknowledge the medical, legal, and religious controversies of determining death in organ donation; (4) organ-donor registration must satisfy the criteria of informed consent; (5) media campaigns should serve as a means of public education about organ donation and should not be a form of propaganda. (shrink)
The utilitarian construct of two alternative criteria of human death increases the supply of transplantable organs at the end of life. Neither the neurological criterion (heart-beating donation) nor the circulatory criterion (non-heart-beating donation) is grounded in scientific evidence but based on philosophical reasoning. A utilitarian death definition can have unintended consequences for dying Muslim patients: (1) the expedited process of determining death for retrieval of transplantable organs can lead to diagnostic errors, (2) the equivalence of brain death with human death (...) may be incorrect, and (3) end-of-life religious values and traditional rituals may be sacrificed. Therefore, it is imperative to reevaluate the two different types and criteria of death introduced by the Resolution (Fatwa) of the Council of Islamic Jurisprudence on Resuscitation Apparatus in 1986. Although we recognize that this Fatwa was based on best scientific evidence available at that time, more recent evidence shows that it rests on outdated knowledge and understanding of the phenomenon of human death. We recommend redefining death in Islam to reaffirm the singularity of this biological phenomenon as revealed in the Quran 14 centuries ago. (shrink)
There is a divide within political and legal theory concerning the justification of hate-crime legislation in liberal states. Opponents of Hate-Crime Legislation have recently argued that enhanced punishment for hate-motivated crimes cannot be justified within political liberal states. More specifically, Heidi Hurd argues that criminal sanction which target character dispositions unfairly target individuals for characteristics not readily under their control. She further argues that a âcharacterâ based approach in criminal law is necessarily illiberal and violates the stateâs commitment to political (...) neutrality. In the current paper, I attempt to show the difficulties and absurdity that follows from Hurdâs characterization of hate- rimes. I aim to show that punishment for undesirable character traits is consistent with western conceptions of criminal law. Upon doing so, I then go on to construct a positive argument for the justifiability of punishing for character traits as well as for the enhanced punishment associated with hate-motivated crimes. (shrink)
Není tomu tak dávno, co se ti, kdo vzývali termín "analytická filosofie", v naší zemi jevili jako příslušníci nějaké divné sekty, kteří smysl termínu "filosofie" jakýmsi úchylným způsobem překrucují. Není-li však člověk zrovna Valihrachem, nemůže o tom, co slova znamenají, svévolně rozhodovat; a faktem je, analytická filosofie tvoří podstatnou část toho, co se ve světě pod hlavičkou "filosofie" učí a provozuje. (Já bych řekl, že dokonce většinu, ale statistické údaje samozřejmě k dispozici žádné nemám.) Během posledních zhruba deseti let se (...) ovšem situace podstatně změnila a analytický způsob filosofování se u nás začíná široce etablovat. Existují již překlady celé řady klasických děl (Frege, Russell, Wittgenstein, Popper, ...) i těch novějších (Quine, Davidson, ...), a vznikla i celá řade původních prací. Co dosud scházelo bylo nějaké systematické historické pojednání o tom, jak tento filosofický směr vznikl, jak se vyvíjel a jak dospěl k tomu druhu otázek, který si předsevzal řešit. Tuto mezeru se nyní pokouší zaplnit kniha docenta filosofické fakulty olomoucké univerzity Lubomíra Valenty Problémy analytické filosofie. (shrink)
This article examines ḥikma as it was practiced by Ṣadr al-Dīn Shīrāzī, or Mullā Ṣadrā (d. 1640), in explaining the connection between the divine names and the attributes of God. This is done via a translation of the fourth part of his al-Maẓāhir al-ilāhiyya fī asrār al-ʿulūm al-kamāliyya [The loci of divine manifestations in the secrets of the knowledge of perfection]. Ḥikma, philosophy, as it is defined here, is the combination of rational demonstrations and spiritual unveiling. Shīrāzī’s philosophy is a (...) synthesis of Ibn ʿArabī’s school of metaphysical unveiling, the Ishrāqī school led by Suhrawardī, and the rational school of the Peripatetics. The text is translated here for the first time, and includes annotations. (shrink)
This study investigates whether financial performance is affected by corporate violations of laws and regulations. In a sample of 128 publicly traded banks that were subject to enforcement actions by US regulatory authorities over a 20-year period, we observed a significant negative market reaction pursuant to the violations. However, the market reaction did not vary meaningfully in accordance with the severity or repetitiveness of the violation. The results of this study are in conformity with previous research on industries other than (...) banking, notably with regard to negative market reaction. This confirms that shareholders in the banking industry react in a manner considerably similar to their counterparts in other industries. (shrink)
Building on the modified theory of planned behavior (TPB), this study examined the underlying psychological motives for academic dishonesty in a sample of 250 undergraduates drawn from three selected Malaysian public universities. The results yielded additional supports for usefulness of modified TPB model in predicting academic misconduct. All components of the model exerted statistically significant effects on intention towards academic misconduct, and intention itself exerted a statistically significant impact on academic dishonesty. This suggests that students’ academic misconducts could be addressed (...) effectively if proper attention is given to the underpinning factors. Further, the findings revealed that the hypothesized relationships among variables of the modified model were all statistically significant. The uniqueness of this study lies in the large amount of variance (69 % and 75 %) explained by components of the model (in the prediction of intention and academic dishonesty respectively). These variances have rarely been accounted for in the previous studies. Implications of the findings are discussed and suggestions advanced for future studies. (shrink)
In this paper I outline my propensiton version of quantum theory (PQT). PQT is a fully micro-realistic version of quantum theory that provides us with a very natural possible solution to the fundamental wave/particle problem, and is free of the severe defects of orthodox quantum theory (OQT) as a result. PQT makes sense of the quantum world. PQT recovers all the empirical success of OQT and is, furthermore, empirically testable (although not as yet tested). I argue that Einstein almost put (...) forward this version of quantum theory in 1916/17 in his papers on spontaneous and induced radiative transitions, but retreated from doing so because he disliked the probabilistic character of the idea. Subsequently, the idea was overlooked because debates about quantum theory polarised into the Bohr/Heisenberg camp, which argued for the abandonment of realism and determinism, and the Einstein/Schrödinger camp, which argued for the retention of realism and determinism, no one, as a result, pursuing the most obvious option of retaining realism but abandoning determinism. It is this third, overlooked option that leads to PQT. PQT has implications for quantum field theory, the standard model, string theory, and cosmology. The really important point, however, is that it is experimentally testable. I indicate two experiments in principle capable of deciding between PQT and OQT. (shrink)
In Philip K. Dick’s Counter-Clock World the direction of time flips in 1986, putting the Earth into what its inhabitants call the ‘Hogarth Phase’. Named after the scientist who predicted that ‘time’s arrow' would change direction, the Hogarth Phase is a period in which entropy decreases instead of increases. During this time the dead call from their graves to be excavated, people clean their lungs by ‘smoking’ stubs that grow into mature cigarettes, coffee separates from cream, and so on. Although (...) such reversals may be familiar from works of fiction, we are utterly unfamiliar with them in experience. The processes of nature behave in a temporally asymmetric manner. Once the cream mixes with the coffee, it stays that way, never to return to its original separated state. Neither cigarettes nor people ever fully reconstitute themselves. This kind of asymmetric behaviour is ubiquitous in thermodynamic, radiative, and quantum mechanical phenomena. But we also find our common-sense impression ofthe world painted with temporally asymmetric concepts. Time feels like it is ‘f|owing’ forward and causation appears to be an asymmetric relation. These phenomena and impressions stand in sharp contrast with the world as perceived through eyes tutored by modem science. Spacetime, rather than.. (shrink)
In many physical systems, coupling forces provide a way of carrying the energy stored in adjacent harmonic oscillators from place to place, in the form of waves. The wave equations governing such phenomena are time-symmetric: they permit the opposite processes, in which energy arrives at a point in the form of incoming concentric waves, to be lost to some external system. But these processes seem rare in nature. What explains this temporal asymmetry, and how is it related to the thermodynamic (...) asymmetry? This paper attempts to clarify these old issues, in the light of recent contributions. After brief introductory remarks (§1), the paper is in three main parts. §2 examines the so-called ‘Sommerfeld Radiation Condition’, arguing that its link to the observed asymmetry is much less direct than commonly supposed. §3 begins with Zeh's proposal to make the Sommerfeld condition an ingredient in an explanation of the observed asymmetry, and makes explicit a useful distinction between two ways in which the thermodynamic asymmetry might connect to the radiation asymmetry. §4 reviews a proposal I have defended in earlier work about the relation of the radiative asymmetry to that of thermodynamics, and defends it against recent objections by Zeh and Frisch. I also distinguish it from a recent proposal due to North. I agree with North that the observed asymmetry of radiation stems from the low entropy history, but argue that she mis-characterises the asymmetry, and hence misses a crucial element in a proper account of the role of the low entropy past. (shrink)
Existuje překvapivě málo knih, které by se pokoušely o syntetizující pohled na analytickou filosofii. Je ovšem pravda, že ve druhé polovině našeho století se soubor filosofů, kteří se k analytické filosofii hlásí nebo kteří k ní bývají řazeni, stává natolik různorodý, že se jakákoli syntéza stává problematickou; překvapivě málo syntetizujících prací existuje ale i o ‘klasické’ analytické filosofii, to jest o analytické filosofii období zhruba od konce devatenáctého století do poloviny století dvacátého. Dejnožkova kniha je jednou z těch mála, které (...) se o něco takového pokouší, a to je třeba přivítat. Dejnožka se ovšem nesnaží podat všestranný rozbor názorů klasiků analytické filosofie; soustředí se pouze jeden aspekt jejich učení, totiž na jejich ontologii. Hned v úvodu své knihy k tomu vysvětluje, jaké opodstatnění může mít hovořit o ontologii u takového druhu filosofie, která se programově distancuje od metafyziky. Podle něj je tomu tak, že i když se někteří analytičtí filosofové někdy více či méně úspěšně vyhýbali otázkám metafyzickým (to jest otázkám po nejzákladnějších kategoriích bytí), ontologickým otázkám (to jest otázkám po povaze bytí jako takového) se v podstatě vyhnout nelze. A Dejnožka se snaží ukázat, že klasikové analytické filosofie se těmito otázkami zabývali mnohdy velice do hloubky. To je patrné zejména u Frega a Russella, kterým autor věnuje největší pozornost; avšak k těm, kteří podle Dejnožky berou ústřední otázku ontologie za svou, řadí Dejnožka i Wittgensteina i Quina (jimž se však věnuje na pouze velice omezeném prostoru - každému asi na dvanácti stránkách). (shrink)
