The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

This book brings together scholars from a variety of epistemological perspectives to explore the multiple ways in which sexuality does indeed matter in the arena of public education.

In lieu of an abstract, here is a brief excerpt of the content:Buddhist-Christian Studies 21.1 (2001) vi-vii [Access article in PDF] In Memoriam: Winston L. King Winston L. King was ninety-three when he died on February 15, 2000, at his home in Madison, Wisconsin. Diagnosed with cancer over a year ago, he continued many of his usual activities--reading widely, maintaining a voluminous correspondence, visiting with friends, and walking daily. Winston was one of those remarkable scholar-teachers of an older generation who (...) never ceased to develop new intellectual and research interests. With degrees from Asbury College (A.B., 1929), Andover Newton Theological Seminary (1936), and Harvard (S.T.M., 1938; Ph.D., 1940), his career included pastorates in New England (1930-1943, 1945-1949), Dean of the Chapel and professor of Grinnell College (1949-1963), professor of the history of religions atVanderbilt University (1964-1973), and after his retirement fromVanderbilt, an appointment as professor of philosophy at Colorado State University.Winston's two-year appointment with the Ford Foundation as the advisor to the International Institute for Buddhistic Studies in Rangoon (Yangon), Burma (Myanmar), from 1958 to 1960 proved to be a major turning point in his life and established his reputation as a significant interpreter of Theravada Buddhism in Southeast [End Page vi] Asia. Three important monographs resulted from Winston's stay in Burma: Buddhism and Christianity: Some Bridges of Understanding (1963), In the Hope of Nibbana: An Essay on Theravada Buddhist Ethics(1964), andAThousand Lives Away(1964). The last volume was the most widely regarded of the three, but each was at the forefront of later developments in the fields of Buddhist-Christian studies, Buddhist ethics, and modern studies in Southeast Buddhism.Winston was already well grounded in a broad comparative study of religion, as demonstrated by his Introduction to Religion(Harper,1954), before his sojourn in Burma. In the first chapter of that textbook, he set forth an understanding of religion as "unity-in-diversity and diversity-in-unity" that informed his sensibilities as a historian of religions--especially Buddhism--throughout his life. He saw being a person of faith as an advantage rather than a disadvantage in the study of religion, anticipating his subsequent work in Buddhist-Christian studies.Winston believed that the adherent of a particular faith is better able "to penetrate to the centrally important features of another religion" that might be opaque to the "nonreligionist." His analogical observation, "Being in love he will know how to understand something of another's being in the same situation" grew out of the deep mutual devotion between Winston and Jocelyn, his beloved wife of more than sixty-six years.Winston's special interest in Japanese Buddhism began to take shape in the latter part of his career with a Fulbright Lecturership in Kyoto in 1965-1966. Subsequently, he was to return to Japan to continue his study of Buddhism and Japanese language at sixty years of age. Several articles and two major monographs followed: Death Was His Koan: The Samurai-Zen of Suzuki Shosan(1986) and Zen and the Way of the Sword (1993).Throughout his career, Winston maintained a strong interest in the practice of faith, giving both personal and scholarly attention to Buddhist meditation in particular. While he was in Burma, he spent ten days at the International Meditation Center founded by U Ba Khin. An account of his experience appeared in the Journal of Religion (1961). In Buddhism and Christianity, he compared Christian prayer and Buddhist meditation; later he was to compare Theravada and Zen meditational methods and goals (History of Religions, 1970) and explore the yogic methodological background to Buddhist insight meditation (Theravada Meditation: The Buddhist Transformation ofYoga, 1980).Winston's empathetic approach to religious understanding, his scholarly breadth and productivity, and his humane, personal integrity set a standard to be emulated by those who follow him. We celebrate his life and his scholarship.Donald K. Swearer Swarthmore College... (shrink)

In the modal literature various notions of "completeness" have been studied for normal modal logics. Four of these are defined here, viz. completeness, first-order completeness, canonicity and possession of the finite model property -- and their connections are studied. Up to one important exception, all possible inclusion relations are either proved or disproved. Hopefully, this helps to establish some order in the jungle of concepts concerning modal logics. In the course of the exposition, the interesting properties of first-order definability and (...) preservation under ultrafilter extensions are introduced and studied as well. (shrink)

At the beginning of the study of physical phenomena, the idea of "force" was widely used to explain the non-stationarity of observed phenomena, such as the movement of bodies. However, as mechanics and physical theories developed, the force notions gained own formal definitions and names, without the use of the term "force". So, the concept of kinetic energy arose instead of "vis viva", and "current" instead of "current strength" ets. Additionally, a number of new physical theories have been formulated without (...) the use of force concept. As a result, different types of forces have gradually been replaced by other more important concepts, such as energy and action, which are closely linked to fundamental physical principles. It is interesting to note that the general trend in the development of civilizations has been a shift from unrestricted power (expressed in the thesis "might makes right") to its subordination and incorporation into a legal framework. This is similar to the evolution of physics, which has seen the notion of force become eliminated or subordinated to more general principles and laws. (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

Which systems/organisms are conscious? New tests for consciousness (‘C-tests’) are urgently needed. There is persisting uncertainty about when consciousness arises in human development, when it is lost due to neurological disorders and brain injury, and how it is distributed in nonhuman species. This need is amplified by recent and rapid developments in artificial intelligence (AI), neural organoids, and xenobot technology. Although a number of C-tests have been proposed in recent years, most are of limited use, and currently we have no (...) C-tests for many of the populations for which they are most critical. Here, we identify challenges facing any attempt to develop C-tests, propose a multidimensional classification of such tests, and identify strategies that might be used to validate them. (shrink)

★ Publishers Weekly starred review One of the Top 100 Books and One of the 5 Best Books in Religion for 2019, Publishers Weekly Christianity Today 2020 Book Award Winner (Spiritual Formation) Outreach 2020 Resource of the Year (Spiritual Growth) Foreword INDIES 2019 Honorable Mention for Religion This is not a book about Saint Augustine. In a way, it's a book Augustine has written about each of us. Popular speaker and award-winning author James K. A. Smith has spent time on (...) the road with Augustine, and he invites us to take this journey too, for this ancient African thinker knows far more about us than we might expect. Following Smith's successful You Are What You Love, this book shows how Augustine can be a pilgrim guide to a spirituality that meets the complicated world we live in. Augustine, says Smith, is the patron saint of restless hearts--a guide who has been there, asked our questions, and knows our frustrations and failed pursuits. Augustine spent a lifetime searching for his heart's true home and he can help us find our way. "What makes Augustine a guide worth considering," says Smith, "is that he knows where home is, where rest can be found, what peace feels like, even if it is sometimes ephemeral and elusive along the way." Addressing believers and skeptics alike, this book shows how Augustine's timeless wisdom speaks to the worries and struggles of contemporary life, covering topics such as ambition, sex, friendship, freedom, parenthood, and death. As Smith vividly and colorfully brings Augustine to life for 21st-century readers, he also offers a fresh articulation of Christianity that speaks to our deepest hungers, fears, and hopes. (shrink)

In this paper I explore Michael Loux’s important distinction between “tropes” and “tropers”. First, I argue that the distinction throws into relief an ambiguity and discrepancy in the literature, revealing two fundamentally different versions of trope theory. Second, I argue that the distinction brings into focus unique challenges facing each of the resulting trope theories, thus calling into question an alleged advantage of trope theory—that by uniquely occupying the middle ground between its rivals, trope theory is able to recover and (...) preserve the insights of these views. Ultimately, the distinction suggests that trope theory is a divided house. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

Erasmus was one of the most widely read and controversial authors of the early modern period, inspiring a broad range of reader reactions. The present volume addresses various aspects of Erasmus's reception, including how the author's name was sometimes used to bolster decidedly "un-Erasmian" ideals.

A comprehensive review of Marxism and its development by Engels, Lenin, and contemporary Soviet philosophers. Two sections of equal length deal with "Marxism as a Philosophy" and "Marxism as a Theory of History." The results of recent scholarship done in many parts of the world are presented in a systematic account of Marx and his relationship to Engels, Lenin and others. In post-Marxian philosophy, major emphasis is placed on the "classical" dialectical materialism, but other types of Marxism are considered as (...) well. Extensive notes and an excellent annotated bibliography are included. This volume will be of use both as a text book and as a resource to those who are interested in Marx or Marxism-Leninism.—K. A. M. (shrink)

Die Teilhabe an der lateinischen res publica litterarum der frühneuzeitlichen Fakultäten und Universitäten wurde mittels gemeinsamer literarischer Ausdrucksformen reguliert - zuweilen in Gestalt feingeistiger philologischer Kontroverse, zuweilen als wüste Polemik oder tosender Jubel. In Fallstudien zu Humanisten aus drei Jahrhunderten geht der Band der Frage nach, wie kollegiale Beziehungen literarisch inszeniert und innerhalb der Gelehrtengemeinschaft instrumentalisiert wurden. Diskursregeln und Kommunikationsbedingungen kommen dabei ebenso zur Sprache wie die Anwendung literarischer Modelle aus antiker und nachantiker Invektive, Satire und Panegyrik.

Background: In 2014, companies began covering the costs of egg freezing for their employees. The adoption of this benefit was highly contentious. Some argued that it offered women more reproductive...

Objective We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments in order to build ethics capacity and provide a foundation for the development of an ethics education programme. Methods This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Results Of the (...) 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress, conflict management with patients or families and resource issues. Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams was the most desired method. Conclusions Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino and (...) Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

Previous research has found that funding disparities are driven by applications’ final impact scores and that only a portion of the black/white funding gap can be explained by bibliometrics and topic choice. Using National Institutes of Health R01 applications for council years 2014–2016, we examine assigned reviewers’ preliminary overall impact and criterion scores to evaluate whether racial disparities in impact scores can be explained by application and applicant characteristics. We hypothesize that differences in commensuration—the process of combining criterion scores into (...) overall impact scores—disadvantage black applicants. Using multilevel models and matching on key variables including career stage, gender, and area of science, we find little evidence for racial disparities emerging in the process of combining preliminary criterion scores into preliminary overall impact scores. Instead, preliminary criterion scores fully account for racial disparities—yet do not explain all of the variability—in preliminary overall impact scores. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and (...) cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)