Research involving recently deceased humans that are physiologically maintained following declaration of death by neurologic criteria—or ‘research involving the recently deceased’—can fill a translational research gap while reducing harm to animals and living human subjects. It also creates new challenges for honouring the donor’s legacy, respecting the rights of donor loved ones, resource allocation and public health. As this research model gains traction, new empirical ethics questions must be answered to preserve public trust in all forms of tissue donation and (...) in the practice of medicine while respecting the legacy of the deceased and the rights of donor loved ones. This article suggests several topics for immediate investigation to understand the attitudes and experiences of researchers, clinical collaborators, donor loved ones and the public to ensure research involving the recently deceased advances ethically. (shrink)

About 6,000 individuals participate in the U.S. transplant system as a living organ donor each year. Organ donation by living individuals is a unique procedure, where healthy patients undergo a major surgical operation without any direct functional benefit to themselves. In this article, the authors explore how the ideal of informed consent guides education and evaluation for living organ donation. The authors posit that informed consent for living organ donation is a process. Though the steps in this process are partially (...) standardized through national health policy, they can be improved through institutional structures at the local, transplant center-level. Effective structures and practices aimed at supporting and promoting comprehensive informed consent provide more opportunities for candidates to ask questions about the risks and benefits of living donation and to opt out voluntarily Additionally, these practices could enable new ways of measuring knowledge and improving the consent process. (shrink)

The training relationship between sport psychology professionals (SPPs) and their students is a critical aspect of graduate training. Maintaining ethical, appropriate boundaries within training relationships is imperative, as boundary crossings can have deleterious effects on students. SPPs (N = 152) and Sport Psychology graduate students (N = 165) completed The Survey of Applied Sport Psychologists to explore their experiences and perceptions of sexual attractions and boundary crossings within training relationships. Nearly 30% of SPPs acknowledged sexual attractions toward their students, yet (...) few students (8.5%) perceived such attractions. Compared to the SPPs, the students reported higher levels of anxiety regarding the SPP’s attraction toward them; both groups reported infrequent use of supervision for this attraction. Nine students and 13 SPPs reported engaging in sexual behaviors (e.g., kissing, dating, intercourse) with the other. Within the larger sample, the three most common nonsexual boundary crossings were becoming social friends, attending social gatherings, and the SPP initiating nonsexual touching. Both groups are advised to engage in ongoing monitor their behaviors, receive training specific to ethics within training relationships, and seek consultation/supervision to ensure appropriate boundaries remain intact. (shrink)

Volume 19, Issue 11, November 2019, Page 42-44.

Abstract:This symposium includes thirteen personal narratives from people who have received at least one organ transplant from a living or deceased donor. These narratives foster better understanding of the experiences of life-saving organ recipients and their families, including post-transplant difficulties experienced—sometimes requiring multiple transplants. This issue also includes three commentaries by Macey L. Levan, Heather Lannon, and Vidya Fleetwood, Roslyn B. Mannon & Krista L. Lentine. Dr. Levan is a living kidney donor and associate professor of surgery (...) and population health. She writes and teaches on organ transplant and has expertise and experience in governance at the federal level as a member of the board of directors for the U.S. Organ Procurement and Transplantation Network. Dr. Lannon is a social worker and transplant advocate. Her work and interest in the topic were inspired by her husband who needed a heart transplant. Dr. Fleetwood is a surgeon specializing in liver transplantation, pancreas transplantation, kidney transplantation, as well as living donor nephrectomy. Dr. Mannon is a nephrologist and professor of medicine, pathology and microbiology. Her work focuses on understanding and improving long-term kidney transplant outcomes for patients, donors, and caregivers. Dr. Lentine is a nephrologist specializing in treatment of adult patients with kidney disease. She is a researcher and co-chaired the international work group that developed guidelines for living donor kidney transplantation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Editors’ NoteJames M. DuBois, Ana S. Iltis, and Heidi A. WalshFrom childhood, David Slakter had undergone tests and invasive procedures to monitor his nephritis. It was not a surprise when in 2015, doctors told him he needed a kidney transplant. The wife of a childhood friend was a close match and gave him one of her kidneys. Before his transplant, aerobic exercise was difficult; a few months after transplant, (...) Slakter could ride his bike, hike, and work out with a personal trainer. He no longer had to weigh food or gauge his potassium consumption, a concern for people with kidney failure. For Slakter, “life post-transplant has been a significant improvement.”Individuals or family members of those who have received an organ transplant from a living or deceased donor share their stories in this issue of Narrative Inquiry in Bioethics. The symposium is titled “Receiving the Gift of Life: Stories from Organ Transplant Recipients.” Organ transplantation can extend an individual’s life by decades. It can also greatly improve an individual’s quality of life, as was Slakter’s experience. At the same time, organ transplantation is expensive and stressful. Recipients can experience complications, including organ rejection, and there are few appealing alternatives.After her heart transplant, author Leilani R. Graham required four open-heart surgeries, ECMO, and an intra-aortic balloon pump. She experienced delirium, necrotizing pneumonia, and severe muscular atrophy that required her to re-learn how to walk. She struggled with weight gain, explosive mood swings, hair loss, and was terrified that her body would reject the new heart. For Graham, “[Transplant] was not the miracle [she] was hoping for.” Graham says she felt unprepared for and inadequately informed about what to expect after her transplant, which left her “battered, beaten, and bruised” with a 12-inch line from neck to navel and “bullet holes” up and down her torso from the chest tubes. When reflecting on her experience post-transplant, Graham says, “It wasn’t the physical trauma that hurt the most. It was that no one seemed surprised [by the aftereffects of transplant].” Seemingly no one, that is except Graham, who calls on transplant providers to “prioritize empathy.”The symposium editors are Jason T. Eberl and Tristan McIntosh. Three commentary articles, written by Macey Leigh Levan, Heather Lannon, and Vidya A. Fleetwood, Roslyn B. Mannon & Krista L. Lentine, offer important insights into the authors’ stories. The editors thank Mid-America Transplant, the UCSF Lung Transplant Program, Donor Connect, William L. Freeman, MD, MPH, MJIL, CIP, Janet Monk, and the individuals who gave anonymous donations to support the publication of this issue, an open-access VOICES edition of the symposium, and accompanying teaching guides.The research article in this issue, “‘A Shell of My Former Self’: Using Figurative Language to Promote Communication about Patient Suffering,” was written by Tyler Tate, Elizabeth Stein, and Robert A. Pearlman. The relief of suffering is a primary goal of medicine. However, the authors note that clinicians often miss or ignore suffering because they focus on the causes rather than the experience of suffering, or the subjective nature of suffering makes it difficult to discuss. The authors believe that “the key to communicating about suffering lies in finding [End Page vii] the right kind of words to describe the experience” and say that figurative language offers a promising approach. In their research, the authors performed qualitative analysis on 52 works of literature and identified 254 excerpts of figurative language with themes of non-physical or psychological suffering. The authors found 13 salient themes: brokenness, diminishment, disorientation, drowning, emptiness, imprisonment, battle, darkness, isolation, invisibility, lifelessness, punishment, and torture. The authors reiterate that developing a shared language of suffering could foster a therapeutic patient-clinician relationship and improve clinicians’ ability to recognize and address a patient’s experience of suffering.María Susana Ciruzzi wrote the first of two case studies included in this issue. “The Sword of King Solomon” addresses a tragic and difficult subject—how to navigate the situation posed by conjoined twins when “any decision will produce damage and suffering.” The case involves two infant male patients born at 37 weeks gestation as omphalo-ischiopagus conjoined twins... (shrink)

In his article, “The Unified Brain-Based Determination of Death Conceptually Justifies Death Determination in DCDD and NRP Protocols,” James Bernat argues that Thoracoabdominal Normothermic Regiona...

BackgroundPeople with upper extremity amputations report receiving insufficient information about treatment options. Furthermore, patients commonly report not knowing what questions to ask providers. A question prompt sheet, or list of questions, can support patient-centered care by empowering patients to ask questions important to them, promoting patient-provider communication, and increasing patient knowledge. This study assessed information needs among people with UE amputations about UE vascularized composite allotransplantation and developed a UE VCA-QPS.MethodsThis multi-site, cross-sectional, mixed-methods study involved in-depth and semi-structured interviews with (...) people with UE amputations to assess information needs and develop a UE VCA-QPS. Qualitative data were analyzed by thematic analysis; quantitative data were analyzed by descriptive statistics. The initial UE VCA-QPS included 130 items across 18 topics.ResultsEighty-nine people with UE amputations participated. Most were male, had a mean age of 46 years, and had a unilateral and below-elbow amputation. Participants desired information about UE VCA eligibility, evaluation process, surgery, risks, rehabilitation, and functional outcomes. After refinement, the final UE VCA-QPS included 35 items, across 9 topics. All items were written at a ≤ 6th grade reading level. Most semi-structured interview participants reported being ‘completely’ or ‘very’ likely to use a UE VCA-QPS.ConclusionPeople with UE amputations have extensive information needs about UE VCA. The UE VCA-QPS aims to address patients’ information needs and foster patient-centered care. Future research should assess whether the UE VCA-QPS facilitates patient-provider discussion and informed decision-making for UE VCA. (shrink)

In this letter to the editor, the author responds to articles by G. Testa and colleagues, "Living Donation and Cosmetic Surgery: A Double Standard in Medical Ethics?" and by L. Friedman Ross and colleagues, "Different Standards Are Not Double Standards: All Elective Surgery Patients Are Not Alike," which were published in the Summer 2012 issue of The Journal of Clinical Ethics.

Les professeurs Macey et Miller analysent la relation entre l’assurance des dépôts et l’ inadé quation dans la structure des échéances des actifs et passifs des banques commerciales. Après avoir critiqué l’hypothèse traditionnelle concernant la réglementation, d’après laquelle les banques sont incitées à financer les actifs à long terme par des passifs à court terme parce que l’assurance des dépôts garantie par l’Etat stimule le crédit des banques et subventionne les passifs à court terme, ils utilisent l’analyse économique des (...) décisions publiques pour soutenir qu’une version modifiée de l’hypothèse de la réglementation est la meilleure explication de la déstructuration des échéances des actifs et passifs bancaires.Finalement, ils considèrent que soutenir l’hypothèse de la réglementation n’entraîne pas l’ acceptation du modèle d’assurance des dépôts garantie par l’Etat tel qu’il existe aux Etats-Unis aujourd’hui.Professors Macey and Miller explore the relationship between deposit insurance and the mismatch in the term structure of commercial banks’ assets and liabilities. After criticizing the traditional regulatory hypothesis, which posits that banks have incentives to fund long-term assets with short-term liabilities because government-sponsored deposit insurance enhances bank credit and subsidizes short-term liabilities, they use public choice theory to argue that a modified version of the regulatory hypothesis is the best explanation for the mismatch in the term structure of banks’ assets and liabilities. Finally, they argue that embracing the regulatory hypothesis does not imply acceptance of the government-sponsored deposit insurance scheme as it exists in the U.S. today. (shrink)

When making decisions, humans can observe many kinds of information about others' activities, but their effects on performance are not well understood. We investigated social learning strategies using a simple problem-solving task in which participants search a complex space, and each can view and imitate others' solutions. Results showed that participants combined multiple sources of information to guide learning, including payoffs of peers' solutions, popularity of solution elements among peers, similarity of peers' solutions to their own, and relative payoffs from (...) individual exploration. Furthermore, performance was positively associated with imitation rates at both the individual and group levels. When peers' payoffs were hidden, popularity and similarity biases reversed, participants searched more broadly and randomly, and both quality and equity of exploration suffered. We conclude that when peers' solutions can be effectively compared, imitation does not simply permit scrounging, but it can also facilitate propagation of good solutions for further cumulative exploration. (shrink)

Lars Løvlie, Paul Standish; Introduction: Bildung and the idea of a liberal education, Journal of Philosophy of Education, Volume 36, Issue 3, 16 December 2002.

Transcript of speeches by a Hindu philosopher, chiefly on Hindu philosophy and Hinduism.

This provocative study revives a classical idea about rationality by developing analogies between the structure of personality and the structure of society in the context of contemporary work in the philosophy of mind, ehtics, decision theory, and social choice theory.

This book presents three of the works of Abdu'l-Bahá, son of the founder of the Bahá'i Faith, dealing with social and political issues.00In 'The Secret of Divine Civilization' (1875) Abdu'l-Bahá supports the administrative and broader social reforms of Mirzá Hosayn Khán, but looks mainly for organic reform through the efforts of Iranian intellectuals to waken and educate the masses. In this work, Abdu'l-Bahá gives virtuous and progressive Islamic clerics a leading role among these intellectuals, indeed most of his appeals are (...) directed specifically to them. 'A Traveller's Narrative' (1889/90) is an authoritative statement of the broad lines of Bahá'i social and political thinking. 'The Art of Governance' (1892/93) was written as Iran entered a pre-revolutionary phase, and ideas that we recognise today as the precursors of political Islam were spreading. It sets out the principles underlying the ideal relationship between religion and politics and between the government and the people.00In addition to presenting the first parallel text translations of these works, the Persian texts incorporate notes on variants in the early published sources. An introduction outlines the intellectual and political landscape from which Abdu'l-Bahá wrote, and in which his expected readers lived. (shrink)

Sur la toile de fond de la theologie negative, tissee par la discussion des apories que soulevent les notions de l'ineffable et de l'un, Damascius, le dernier diadoque de l'Ecole d'Athenes, elaboreson systeme metaphysique, sans se departir de la rigueur de sa methode aporetique, qui est une critique radicale du langage a l'interieur des coordonnees fixees par le Parmenide de Platon et par les Oracles Chaldaiques. Damascius, dans une enquete unique par son ampleur et son originalite questionne tour a tour (...) Porphyre, Jamblique, Syrianus et Proclus sur les principes; il examine les problemes que pose, en derivation de l'un, la formation de la trinite; de l'un-tout (la limite), du tout-un (l'infini) et de l'unifie (le mixte ou l'etre). Lien a priori entre l'un-tout et le tout-un, l'unifie est le principe de constitution de tout ordre et de toute realite. Damascius etudie sa nature de mixte originaire et autoconstituant, d'etre exemplaire et de premier intelligible. Cette notion lui permet de pas au crible, pour la mieux fonder, la problematique neoplatonicienne de la manence, de la procession et de la conversion. Les divers niveaux d'unification de la pluralite intelligible l'amenent a construire une theorie generale des elements, des parties et des formes Au passage, de nombreux textes, capitaux du point de vue de l'ontologie et de la doctrine de la connaissance, font regretter qu'ils aient ete inconnus du Moyen Age et qu'ils le demeurent pour beaucoup de nos contemporains. (shrink)

This article explores Gerardus van der Leeuw’s view of phenomenology of religion. The phenomenological method he defended is basically a hermeneutical approach in which an observer relates personally and even existentially to the “phenomena” (s)he studies in order to determine their essence (Wesensschau). In his anthropology (that reflects on the basic structure of human beings) a similar way of relating to the world is discussed: the “primitive mentality” that is characterized by the “need to participate” (besoin de participation). Both phenomenology (...) and mentalité primitive imply a critique of modern scholarship. This fundamental criticism of the prevailing (historical) approach in the humanities including religious studies explains the growing distance between van der Leeuw and the majority of scholars of religion in the decades after his death in 1950. (shrink)

This article explores Gerardus van der Leeuw’s view of phenomenology of religion. The phenomenological method he defended is basically a hermeneutical approach in which an observer relates personally and even existentially to the “phenomena” (s)he studies in order to determine their essence (Wesensschau). In his anthropology (that reflects on the basic structure of human beings) a similar way of relating to the world is discussed: the “primitive mentality” that is characterized by the “need to participate” (besoin de participation). Both phenomenology (...) and mentalité primitive imply a critique of modern scholarship. This fundamental criticism of the prevailing (historical) approach in the humanities including religious studies explains the growing distance between van der Leeuw and the majority of scholars of religion in the decades after his death in 1950. (shrink)

The publication of the article “Recent Models of the African Iron Age and the Cattle-Related Evidence” by Hromnik in a journal sponsored by Unesco raises a number of serious issues which we, as members of the International Scientific Committee charged with the responsibility of preparing an up-to-date and scientific history of Africa purged of its mists of racist propaganda, unfounded assertions and misleading and dangerous misinterpretations, cannot ignore. These issues include the scientific accuracy or authenticity of the article.

Pucelle tries to show how the idea of personal liberty is central to Green's ethics. Green's criticisms of other philosophers and the historical context of his philosophy are especially well handled. --W. L. M.

Three of the four commentators endorse our concerns about intervention by the Roman Catholic church as anamicus curiaein civil litigation, with few reservations. One commentary rejects our arguments in toto. We deal first with the three commentaries that support our arguments; secondly, with the reservations and qualifications in those commentaries, and thirdly, with the commentary that totally rejects our arguments.

The purpose of the article is distinguishing between "internal" and "external" public human through comprehending the phenomenon of Self in its virtual-digital essence as a popular demonstrative-project space "BETWEEN" aggression and harmony. Theoretical basis of the work is based on the study of the phenomenon of modern human aggression in the virtual-digital space and the "project space" of the living environment through understanding the nature of the human "I". The penetration limits of the Self of the public human into the (...) "project space" are comprehended and the nature of the self-realization and self-search models of human through the "transcendent ego" is revealed. Originality is demonstrated through comprehending the Self phenomenon of the public human, which forms new anthropological research direction and represents a conceptual paradigm of relationship of "human I – publicity – human We – the living space of the Other". Conclusions. The Self of the public human as the space "BETWEEN" does not completely "dissolve" in a separate ontological basis, but is the basis for the formation of his/her "I", while only participation in the existence of others reveals the meaning of his/her own existence. Such interaction requires significant human efforts – skills and competencies of public communication, which are able to create a successful self-identification of a public human without aggression and conflict. (shrink)

Our purpose in this article is to identify and suggest resolution for two core problematics of grounded theory. First, while grounded theory provides transparency to one part of the conceptualization process, where codes emerge directly from the data, it provides no such systematic or transparent way for gaining insight into the conceptual relationships between discovered codes. Producing a grounded theory depends not only on the definition of conceptual pieces, but the delineation of a relationship between at least two of those (...) pieces. Second, the conceptualization process of grounded theory is done in hierarchical fashion, where individual codes emerge from the data but then are used to generate insight into more general concepts and thematic statements. But various works on grounded theory have failed to provide any systematic way of using data specific levels of scale (the codes) to gain insight into more macro levels of scale (concepts and themes). We offer fractal concept analysis as a means of resolving both of these issues. By using a logic structure generator, fractal concept analysis delineates self-similar conceptual frameworks at various levels of abstraction, yielding a method for linking concepts together within and between levels of scale encountered in the grounded theory coding and categorization process. We conclude that this fractal analytic technique can bolster the aims of grounded theory as a formalized and systematic process for generating theory from empirical data. (shrink)

The introduction of novel diagnostic techniques in clinical domains such as genomics and radiology has led to a rich ethical debate on how to handle unsolicited findings that result from these innovations. Yet while unsolicited findings arise in both genomics and radiology, most of the relevant literature to date has tended to focus on only one of these domains. In this article, we synthesize and critically assess similarities and differences between “scanning the body” and “sequencing the genome” from an ethical (...) perspective. After briefly describing the novel diagnostic contexts leading to unsolicited findings, we synthesize and reflect on six core ethical issues that relate to both specialties: terminology; benefits and risks; autonomy; disclosure of unsolicited findings to children; uncertainty; and filters and routine screening. We identify ethical rationales that pertain to both fields and may contribute to more ethically sound policies. Considerations of preserving public trust and ensuring that people perceive healthcare policies as fair also support the need for a combined debate. (shrink)