Background There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. (...) The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds. Discussion The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill. Summary Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge. (shrink)

Nursing as a profession has a social mandate to contribute to the good of society through knowledge-based practice. Knowledge is built upon theories, and theories, together with their philosophical bases and disciplinary goals, are the guiding frameworks for practice. This article explores a philosophical perspective of nursing's social mandate, the disciplinary goals for the good of the individual and society, and one approach for translating knowledge into practice through the use of a middle-range theory. It is anticipated that the integration (...) of the philosophical perspective and model into nursing practice will strengthen the philosophy, disciplinary goal, theory, and practice links and expand knowledge within the discipline. With the focus on humanization, we propose that nursing knowledge for social good will embrace a synthesis of the individual and the common good. This approach converges vital and agency needs described by Hamilton and the primacy of maintaining the heritage of the good within the human species as outlined by Maritain. Further, by embedding knowledge development in a changing social and health care context, nursing focuses on the goals of clinical reasoning and action. McCubbin and Patterson's Double ABCX Model of Family Adaptation was used as an example of a theory that can guide practice at the community and global level. Using the theory-practice link as a foundation, the Double ABCX model provides practising nurses with one approach to meet the needs of individuals and society. The integration of theory into nursing practice provides a guide to achieve nursing's disciplinary goals of promoting health and preventing illness across the globe. When nursing goals are directed at the synthesis of the good of the individual and society, nursing's social and moral mandate may be achieved. (shrink)

The American Journal of Bioethics, Volume 11, Issue 7, Page 1-2, July 2011.

"Examines ethical, religious, and aesthetic dimensions of the environment from several different disciplines related to the humanities including anthropology, literature, philosophy, religious studies, and history, with examples drawn from Confucianism, aboriginal Australia, Moby-Dick, liberal democracies, Ken Wilber, Joanna Macy, and Gary Snyder"--Provided by publisher.

Building on a philosophy that a future world will depend on recognition of the interdependence of all life forms and lifestyles of moderation, a volume of essays collected by a prominent Buddhist scholar outlines solutions to contemporary challenges in areas ranging from economic inequality and global health to religion and environmental stability. Original.

In our globalized world, differing conceptions of human nature and human values raise questions as to whether universal and partisan claims and perspectives can be reconciled, whether interreligious and intercultural conversations can help build human community, and whether a pluralistic ethos can transcend uncompromising notions as to what is true, good, and just. In this volume, world-class scholars from religious studies, the humanities, and the social sciences explore what it means to be human through a multiplicity of lives in time (...) and place as different as fourth-century BCE China and the world of an Alzheimer patient today. Refusing the binary, these essays go beyond description to theories of aging and acceptance, ethics in caregiving, and the role of ritual in healing the inevitable divide between the human and the ideal. (shrink)

Pre- and postmeasures of course knowledge correlated more strongly and consistently with course performance variables (essay quizzes, course project, multiple-choice exams, and total course credit)than did pre- and postmeasures of generic critical thinking. In addition, the total sample (N =126) improved significantly on course knowledge from the pre- to the postassessment but changed minimally on critical thinking. The extent and pattern of change in critical thinking differed somewhat for students making high and low grades in the course. High-grade students achieved (...) significantly more favorable changes on both critical thinking and course knowledge than did the low-grade students. (shrink)

This study examined within-person co-occurrence of self-focus, negative affect, and stress in a community sample of adolescents with or without emotional disorders. As part of a larger study, 278 adolescents were interviewed about emotional disorders. Later, they completed diary measures over three days, six times a day, reporting their current thoughts, affect, and levels of stress. Negative affect was independently related to both concurrent stress and self-focus. Importantly, the association between negative affect and self-focus was stronger among participants with a (...) recent unipolar mood disorder, compared to those with an anxiety disorder, comorbid anxiety and depression, or those without an emotional disorder. The implications of these findings to theories of self-focus and its role in emotional disorders are discussed. (shrink)

This paper reports the results of a survey study examining the knowledge, motivations and concerns of egg-share donors and recipients, and assesses the clinical and policy implications of these findings. The survey, combining quantitative and qualitative items, was completed by 48 donors and 38 recipients who took part in an egg-sharing scheme at the London Women's Clinic between 2007 and 2009. Although the most important motivation for all egg-sharers was to have a baby, both donors and recipients displayed multiple motivations, (...) including elements of self-interest and altruism. Many viewed egg-sharing as a reciprocal process in which two women with different needs help one another. The results are reassuring from an ethical and policy perspective: they suggest that if information about egg-sharing was more widely available (especially through general practitioners), more women may consider becoming egg-share donors, gaining swift access to their own treatment and reducing the UK's egg donor shortage. (shrink)

The concept of "fitness" is a notion of central importance to evolutionary theory. Yet the interpretation of this concept and its role in explanations of evolutionary phenomena have remained obscure. We provide a propensity interpretation of fitness, which we argue captures the intended reference of this term as it is used by evolutionary theorists. Using the propensity interpretation of fitness, we provide a Hempelian reconstruction of explanations of evolutionary phenomena, and we show why charges of circularity which have been levelled (...) against explanations in evolutionary theory are mistaken. Finally, we provide a definition of natural selection which follows from the propensity interpretation of fitness, and which handles all the types of selection discussed by biologists, thus improving on extant definitions. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

Unpublished counts of larceny arrests and census data for five of the largest cities in the United States are used to examine the contribution of white and nonwhite men and women in specific age groups to increases in larceny arrests from 1960 to 1980. The results suggest that nonwhite women and white men now have similar larceny arrest rates and that 77 percent of the total increase in the arrest of women for larceny from 1960 to 1980 was the result (...) of increased arrests of nonwhite women. Although 18 percent of this increase can be explained by increased numbers of nonwhite women in specific age groups in the population, the worsening economic situation of young black women in older U.S. central cities is suggested as the most plausible explanation for these trends. Implications of the findings for other theories of women's criminality are examined. (shrink)

Dandruff is a common scalp condition, which frequently causes psychological distress in those affected. Dandruff is considered to be caused by an interplay of several factors. However, the pathogenesis of dandruff remains under‐investigated, especially with respect to the contribution of the hair follicle. As the hair follicle exhibits unique immune‐modulatory properties, including the creation of an immunoinhibitory, immune‐privileged milieu, we propose a novel hypothesis taking into account the role of the hair follicle. We hypothesize that the changes and imbalance of (...) yeast and bacterial species, along with increasing proinflammatory sebum by‐products, leads to the activation of immune response and inflammation. Hair follicle keratinocytes may then detect these changes in scalp microbiota resulting in the recruitment of leukocytes to the inflammation site. These changes in the scalp skin immune‐microenvironment may impact hair follicle immune privilege status, which opens new avenues into exploring the role of the hair follicle in dandruff pathogenesis. Also see the video abstract here: https://youtu.be/mEZEznCYtNs. (shrink)

This article seeks to overcome some of the greatest difficulties in generating a feminist-friendly approach to sacraments by proposing a new paradigm: sacraments as forms of energy. Several factors have hindered feminist theologians in revisioning sacramentality. For the most part sacraments were ‘done to’ women, never ‘done by’ women. A too-literal reading of the Christian scriptures blurs the fact that early Christians developed ritual patterns for Baptism and Eucharist first, and only later wrote them down. To speak of sacraments as (...) mediations may re-inscribe dualism. The static model of reality which explained sacraments in Aristotelian categories of matter and form has given way to dynamic models of matter and energy. A sacramentality of energy can be articulated from three different angles: first, in terms of the action of the Holy Spirit; second, from scientific advances in quantum thinking, and the third from new spirituality. This paradigm applies to both Baptism and Eucharist. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:BOOK REVIEWS 165 arguments. He meets them head on, on their ground; whether or not he is deemed successful, he presents a challenge not only to the philosophers he adduces but also to anyone in the Thomistic tradition who has judged confrontation with contemporary critics to he fruitless. JANICE L. SCHULTZ Canisius College Buffalo, New York Authority and Leadership in the Church: Past Directions and Future Possibilities. By THOMAS (...) P. RAUSCH, S.J. Wilmington, Del.: Michael Glazier, 1989. Pp. 158. $15.95. Rather than offering a sustained study of the question of authority and leadership in the Church, Rausch presents a collection of essays related to the topic. The format reflects the book's genesis: much of the material was developed for the 23rd Faith and Order Conference of the Texas Conference of Churches on the subject "Authority in the Body of Christ." Although the title does not reflect the hook's ecumenical focus, readers who want a general introduction to the present status of agreement in ecumenical discussion of authority and ministry may find Rausch's hook helpful. In " Authority in the Ecumenical Dialogue " Rausch reviews and summarizes the ARCIC Final Report, the Lutheran-Roman Catholic Dialogue, the WCC Baptism, Eucharist and Ministry text, and the Consultation on Church Union. The emerging consensus on the value of ordained ministry in these documents indicates that this ministry is permanent, although the threefold ministry of bishop, presbyter, and deacon stands in need of reform. Rausch notes that the documents do not limit " valid " ministry to ordained ministry in communion with the historic episcopate. As for the shape of ministry in the church of tomorrow, not surprisingly, he identifies shared responsibility and collegiality as the marks of the future exercise of authority. Among the important issues still unresolved by the churches are Petrine ministry and primacy and the problem of the " reception " of ecumenical documents. The chapter on authority and reception, originally published in Theological Studies, may well be the most original contribution of the book. It broadens the discussion of reception from its historical " classical " understanding as " the acceptance by local churches of particular ecclesiastical or conciliar decisions " to an ecumenical understanding of the concept as " the acceptance by one church of a theo- 166 BOOK REVIEWS logical consensus arrived at with another church, and ultimately, the recognition of the other church's faith and ecclesial life as authentically Christian (p. 103)." He concludes that (1) reception is more properly understood as a process rather than as a juridical determination, (2) it also involves formal decisions on the part of church authorities, (3) it cannot be reduced to the acceptance of doctrinal formulations, and (4) the norm for recognizing a common faith is not agreement with a particular ecclesial position but agreement with the apostolic tradition. Ultimately, reception involves the whole church and is not the sole product of theologians or church authorities. Ecumenical dialogues will only be effective when they enter into the practical life of the churches. In "Imaging Tomorrow's Church: Models of Christian Unity" Rausch summarizes four models of church unity: organic union, conciliar fellowship, reconciled diversity, and communion of Churches. He opts for the fourth model. The chapter does not offer any new information to someone familiar with ecumenical discussions, but it does serve as an introduction for the neophyte. Rausch's image of authority in the future lies somewhere between a strictly hierarchical or institutional model and a more egalitarian model. His final chapter, " Authority in Tomorrow's Church," predicts that the church of the future will be " ordered " in the sense that it will combine an authoritative ordained ministry (based on the church's apostolic office) with a recognition of multiple and diverse charismatic gifts. He retrieves Karl Rahner's suggestion that recognition of charism for leadership in an individual may result in that person's " relative" ordination for a particular local community. Authority of the future will be collegial with a more participatory style of decision-making. The renewed papacy will encourage not only a more participatory style of decision-making but also a broader participation in the formulation of church teaching. He suggests that representatives of particular churches could elect the Bishop... (shrink)

The only study of de Lubac that interprets his theology through the categories of medieval exegesis, this volume shows that the principles of spiritual exegesis provided de Lubac with the intellectual tools for thinking about a theology of history, a theology of symbol and sacrament, and a theology of the church's relationship to Christ and the Eucharist.