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)

In this paper, the authors have detected a new effect in the area of geomagnetism, related to the behavior of a magnetic dipole freely floating on water surface. An experiment is described in the present paper in which a magnetic dipole fixed upon a float placed on non- magnetized water surface undergoes displacement along with reorientation caused by fine structure of the earth's magnetic field. This fact can probably be explained by secular decrease of the earth's major dipole moment. Further, (...) a detailed study of the phenomenon may create interesting premises for its practical use, particularly for the analysis of fine structure of geomagnetic field and its time-dependent anomalies. A strange behavior of some sea fish species prior to strong earthquakes may be explained if the fish are assumed as 'live magnetic dipoles'. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

The notion of patients’ duties has received periodic scholarly attention but remains overwhelmed by attention to the duties of healthcare professionals. In a previous paper the author argued that patients in publicly funded healthcare systems have a duty to participate in clinical research, arising from their debt to previous patients. Here the author proposes a greatly extended range of patients’ duties grounding their moral force distinctively in the interests of contemporary and future patients, since medical treatment offered to one patient (...) is always liable to be an opportunity cost in terms of medical treatment needed by other patients. This generates both negative and positive duties. Ten duties—enjoining obligations ranging from participation in healthcare schemes to promoting one’s own earliest recovery from illness—are proposed. The characteristics of these duties, including their basis, moral force, extent and enforceability, are considered. They are tested against a range of objections—principled, societal, epistemological and practical—and found to survive. Finally, the paper suggests that these duties could be thought to reinforce a regrettably adversarial characteristic, shared with rights-based approaches, and that a preferable alternative might be sought through the notion of a “virtuous patient” contributing to a problem-solving partnership with the clinician. However, in defining and giving content to that partnership, there is a clear role for most, if not all, of the proposed duties; their value thus extends beyond the adversarial context in which they might first be thought to arise. (shrink)

The International Classification of Functioning, Disability and Health (ICF), designed by the WHO, attempts to provide a holistic model of functioning and disability by integrating a medical model with a social one. The aim of this article is to analyze the ICF’s claim to holism. The following components of the ICF’s complexity are analyzed: (1) health condition, (2) body functions and structures, (3) activity, (4) participation, (5) environmental factors, (6) personal factors, and (7) health. Although the ICF claims to be (...) holistic, it presupposes a monistic materialistic ontology. We indicate some limitations of this ontology, proposing instead: (a) a pluralistic–holistic ontology (PHO) and (b) a multidimensional view of the human being, with individual and environmental aspects, in relation to three levels of reality implied by the PHO. For the ICF to attain its holistic claim, the interactions between its components should be based on (a) and (b). (shrink)

Patients participating in the shared benefits of publicly funded health care enjoy the benefits of treatments tested on previous patients. Future patients similarly depend on treatments tested on present patients. Since properly designed research assumes that the treatments being studied are—so far as is known at the outset—equivalent in therapeutic value, no one is clinically disadvantaged merely by taking part in research, provided the research involves administering active treatments to all participants. This paper argues that, because no other practical or (...) moral considerations count decisively against so doing, we could and should oblige patients to agree to receive indicated treatment within the terms of any concurrent research protocols. This ensures their treatment will benefit not only themselves but also future patients through contributing to new knowledge. By analogy with the paying of income tax, patients should not be allowed to “veto” their social responsibility to take part in clinical research. (shrink)

The Responsible Self was H. Richard Niebuhr's most important work in Christian ethics. In it he probes the most fundamental character of the moral life and it stands today as a landmark contribution to the field. The Library of Theological Ethics series focuses on what it means to think theologically and ethically. It presents a selection of important and otherwise unavailable texts in easily accessible form. Volumes in this series will enable sustained dialogue with predecessors though reflection on classic works (...) in the field. (shrink)

Required reading for anyone who believes in the equality of the sexes. A long awaited, highly acclaimed new translation of Simone De Beauvoir's landmark work.

Geleitwort von Prof. P. Nicki -- Dr. Hermann Freund im Gespräch mit Prof. Dr. Dr. Hinderk M. Emrich -- Die Angst und der existentielle Sprung -- Die neue Zeit -- Der gedachte Gott -- Wie kommt das Ich zum Du? - Hysterie als Lebensform -- Was heisst, sich entscheiden? - Zur Theologie der Freiheit -- Re-formation der Reformation -- Das metaphysische und zugleich dämonische Wesen des Schlosses in Franz Kafkas Schloss-Roman -- Nachwort von Wolfgang Teichert: Epiphanie oder wo sprechende Philosophie (...) und Theologie aufhören müssen -- Literatur -- Verzeichnis der Mitwirkenden -- Abbildungsverzeichnis. (shrink)

The objective of this paper is to outline challenges associated with the inclusion of welfare issues in breeding goals for farm animals and to review the currently available methodologies and discuss their potential advantages and limitations to address these challenges. The methodology for weighing production traits with respect to cost efficiency and market prices are well developed and implemented in animal breeding goals. However, these methods are inadequate in terms of assessing proper values of traits with social and ethical values (...) such as animal welfare, because such values are unlikely to be readily available from the product prices and costs in the market. Defining breeding goals that take animal welfare and ethical concerns into account, therefore, requires new approaches. In this paper we suggest a framework and an approach for defining breeding goals, including animal welfare. The definition of breeding goals including values related to animal welfare requires a multidisciplinary approach with a combination of different methods such as profit equations, stated preference techniques, and selection index theory. In addition, a participatory approach involving different stakeholders such as breeding organizations, food authorities, farmers, and animal welfare organizations should be applied. We conclude that even though these methods provide the necessary tools for considering welfare issues in the breeding goal, the practical application of these methods is yet to be achieved. (shrink)