Death and Dying

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

Anyone who thinks contemporary American society is hopelessly contentious and lacking in shared values has probably not been paying attention to the way the popular media portray the hospice movement. Over and over, we are told such things as that “Humane care costs less than high-tech care and is what patients want and need,” that hospices are “the most effective and least expensive route to a dignified death,” that hospice personnel are “heroic,” that their “compassion and dedication seem inexhaustible,” and (...) that “few could argue with the powerful message that it is better [for dying patients] to leave wrapped in the love of family and care givers than locked in the cold, metallic embrace of a machine.“. (shrink)

Book Information The Ethics of Killing: Problems at the Margins of Life. By Jeff McMahan. Oxford University Press. New York. 2002. Pp. xiii + 540. Aus$110.

Estimates of child mortality are mainly based on reports by mothers on the survival status of their children. Infant mortality estimates from such data do not seem to have declined in recent years. The Bangladesh Bureau of Statistics sample registration infant mortality estimates appear to be suspiciously low.

This paper is a reflection on the puzzle of life after death. It explores the meaning, types and causes of death so as to contemplate the purpose of life. Thus, the paper takes into consideration metaphysical, moral and epistemic issues in the belief in life after death (or life after life). This exploration is done considering the Yoruba philosophy of death (iku), life (iye) and life after death (aye atun wa). We note that, for the Yoruba, life as seen in (...) the body is ephemeral, whereas death (that is, the separation of the soul from the body—iku ara) is a transitory process of life to a renewed life. The paper shows that the Yoruba’s idea of death is not an end to life but a change in its form. It is argued, then, that the Yoruba ontology has the implications that: (a) life is a continuum and, (b) man is not his body, (c) hence, a theory of immortality of the soul is implied. The paper observes that, though certain contradictions exist in the Yoruba worldview, the ethos of the belief seems significant. The paper examines the notions of imo (knowledge) and igbabo (belief) in Yoruba epistemology and thus advances the thesis that their belief in life after death cannot be corroborated, though not unreasonable. (shrink)

This article examines the account of the relationship between sin and suffering provided by J. L. A. Garcia in “Sin and Suffering in a Catholic Understanding of Medical Ethics,” in this issue. Garcia draws on the (Roman) Catholic tradition and particularly on the thought of Thomas Aquinas, who remains an important resource for Catholic theology. Nevertheless, his interpretation of Thomas is open to criticism, both in terms of omissions and in terms of positive claims. Garcia includes those elements of Thomas (...) that are purely philosophical, such as natural law and acquired virtue, but neglects the theological and infused virtues, the gifts and fruits of the Holy Spirit, and the beatitudes. These omissions distort his account of the Christian life so that he underplays both the radical problem posed by sin (and suffering), and the radical character of the ultimate solution: redemption in Christ through the grace of the Holy Spirit. (shrink)

Some weeks ago, we learned that the matriarch of a family, my good friend Anna, is dying. She is 75 and has inoperable esophageal cancer, and the doctors say it will only take a few more weeks or months. Anna is dying the way I want to die–at home, surrounded and lovingly tended by her family: her devoted husband of 54 years, her three daughters, her three worshipful sons-in-law, her adoring granddaughters. All of them see her every day. All of (...) them are a part of a mutual struggle to give Anna a “good death” Anna, too, is a part of it. And, in a very small way, I am part of it, because I have been invited to be. Every few days, I walk next door and spend a few minutes talking to Anna. (shrink)

Samuel Scheffler defends “The Afterlife Conjecture”: the view that the continued existence of humanity after our deaths—“the afterlife”—lies in the background of our valuing; were we to lose confidence in it, many of the projects we engage in would lose their meaning. The Afterlife Conjecture, in his view, also brings out the limits of our egoism, showing that we care more about yet unborn strangers than about personal survival. But why does the afterlife itself matter to us? Examination of Scheffler’s (...) second argument helps answer this question, thereby undermining his argument. Our concern for the afterlife involves bootstrapping: we care more about the afterlife than about personal survival precisely because the latter has such salient limits that our lives are structured by adaptation to mortality, and it is only because the afterlife does provide a measure of personal survival that it can give meaning to our projects. (shrink)

"Suicide" is defined as an act of self-killing which is intentional and not coerced. To say that a suicide is a self-killing is to attribute causal responsibility to an agent for her own death. Suicides must be intentional self-killings, because if intention to die is lacking, then the agent cannot be said to be responsible for her death. Therefore, death by accident or disease is excluded from the class of suicides. Finally, since suicides are intentional self-killings for which the agent (...) is responsible, coerced self-killings are not suicides. ;Political oppression restricts the liberty of members of oppressed classes. Some of this restriction is coercive in nature. Therefore, questions of moral responsibility may have to be answered differently depending upon whether an action is performed under conditions of political equality or conditions of political oppression. For this reason, a self-killing which would be regarded as a suicide if performed under conditions of political equality might be a coerced self-killing and so not a suicide if performed by a member of an oppressed group. This is true only if the suicide is performed because of the political oppression under which the agent lives. ;Even in cases where the self-killing of an oppressed person is considered a suicide, the agent's oppressors may bear some responsibility for her decision to kill herself. Again, this is true only if she killed herself because of the condition of political oppression under which she lives. ;This conclusion about a shift in moral responsibility for suicide performed because of political oppression under which the person who kills herself lives has wider implications for moral theory. If this shift in moral responsibility occurs in the case of suicide, we can suppose that the same is true of other actions performed under conditions of political oppression. (shrink)

This article will explore different images of nature and their implications for the meaning of life in the face of death. First we will elaborate on life as creation, as expressed by Francis of Assisi in his Canticle of the Sun, and see how the imaginative power of this story gives meaning to life and death. Then we will go into the evolutionary approach of life by Richard Dawkins. In his work a totally different significance of finitude becomes visible: death (...) as a necessary segment in the development of life. The philosopher Leo Apostel states that an intellectual/scientific understanding of death is not enough; we need to explore our emotional response to the universe in order to be able to create meaning and value. The work of the biologist Ursula Goodenough and the philosopher Ton Lemaire are discussed as examples of such an affective admiration of life and death based on scientific knowledge. In the end I will conclude that scientific insights give us a lot of information about human beings as concerns their nature and the inevitability of death. But how we can affectively value and give meaning to life in the face of death is still an open question which cannot be answered by science alone. (shrink)