Background Nurses are challenged with many situations that require them to solve ethical dilemmas and make moral decisions based on professional values and a sense of accountability and responsibility. To support their decisions, it is important to know how they perceive and relate their ethical ideology, professional values, and clinical accountability in their workplace. Purpose The study’s aim was twofold: to investigate the ethical ideology and perceived importance of professional values and accountability among nurses. Further, explore the relationship between each (...) of ethical ideology and professional values with nurses’ work accountability. Methods A correlational study was conducted in an Egyptian hospital. All nurses were invited to participate = 192, and 150 nurses (78.3%) completed the study questionnaires. The Ethical Position Questionnaire, the Professional Values Scale, and the Clinical Vignettes Assessment for Clinical Accountability were proven to be reliable study measures. Ethical considerations Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants’ right to voluntary participation and withdrawal were maintained. Results Nurses showed good ethical ideology (75 ± 6.2) and are more idealistic while maintaining professional values (108 ± 10.8). Most nurses believed they were accountable for documenting errors, completing incident reports, and calling physicians to discuss or manage the situations. Ethical ideology and the idealism subscale were positively correlated with overall nurses’ professional values (r = 0.321, p < 0.004, r =0.464, p 0.000), respectively. On the other hand, work accountability showed a partial correlation in some areas with ethical ideology and professional values. Discussion Professional values and nurses' accountability appear to be influenced by ethical positions and ideology. Conclusion Healthcare organizations should provide a supportive work environment to help nurses develop self-awareness, and knowledge of their ethical ideologies, which improve professional values and clinical accountability in their practice. Ethical ideology and professional values should be emphasized more in nursing curricula. (shrink)

BackgroundThe nursing profession requires ethical and legal regulations to guide nurses’ performance. Ethical climate plays a part in shaping nurses’ ethical practice. Therefore, ethico-legal aspects and ethical climate contribute to improving nurses’ ethical practice and competencies with reducing medical errors in hospital settings.ObjectiveThis study examined the effect of ethico-legal aspects and ethical climate on managing safe patient care and medical errors among nurses.Materials and methodsA cross-sectional correlational study was carried out on 548 nurses. Data were collected through self-administered questionnaires about (...) nurses’ knowledge in both ethical and legal aspects, ethical practice, competencies, ethical climate and experience with medical error.ResultsThe main sources of nurses’ knowledge of ethical and legal aspects were undergraduate lectures, job experience and colleagues. Nurses’ knowledge in both ethical and legal aspects, nurses’ ethical practice and competencies were insufficient. Nurses fairly perceived their ethical climate. Also, nurses experienced medical errors about 22.6% in their units. Nurses’ knowledge of ethical and legal aspects, as well as the ethical climate were positive predictors of inadequate nurses’ ethical practice and competencies. Additionally, nurses’ knowledge in both ethical and legal aspects, ethical climate and practice had a negative influence on the occurrence of medical errors.ConclusionEnhancing nurses’ knowledge in both ethical and legal aspects as well as ethical climate could significantly influence improving nurses’ ethical practice, competencies and reducing medical errors in the study units. Therefore, planning for enhancing the nurses’ ethico-legal learning and ethical climate seems to be mandatory. (shrink)

Les Enjeux du discours philosophique pour l'Afrique est consacré non pas à l'ethnophilosophie, mais à l'orientation africaine en philosophie ou de la philosophie qui se déploie sous des talents et plumes aussi riches que contradictoires : Placide Tempels, John Mbiti et Alexis Kagame, Nkrumah, Paulin Hountondji, Eboussi Boulaga, Marcien Towa, Niamkey Koffi, Abdou Touré, Yacouba Konaté, Jean-Godefroy Bidima, Augustin Dibi, etc. Ce n'est pas un ouvrage de "philosophie africaine", si l'adjonction de l'épithète africaine devrait trahir la philosophie qui, depuis Platon, (...) est universelle et ses "vérités" indépendantes des limitations géographiques, raciales et nationales. L'Afrique a, certes, ses limites dans tous les sens du substantif, mais la vocation trans-territoriale du discours philosophique demeure. Elle s'incarne dans le pari que prend Les enjeux du discours philosophique pour l'Afrique de redire, dans les termes de la théorie critique, de l'espace africain ce qu'il garderait sous un double voile d'ignorance et d'opulence. Il s'agit des défis rapportés aux langues, aux savoirs et aux orphelins du savoir, aux pouvoirs et aux orphelins du pouvoir, aux sous-développements et aux démocraties du même ordre, aux idéologies, etc. (shrink)

— Y.K. Karaosmanoglu: "General, this party has no doctrine...".— Mustafa Kemal: "Of course it hasn't, my son; if we had a doctrine, we would paralyze the movement”.The many studies, articles, essays, conferences and seminars dedicated to the personality and the work of Mustafa Kemal are still far from having exhausted an area of knowledge with many facets, a historical reality with unending extensions. By studying the apologetic literature about the civilizing hero and a historiography which is limited to the relatively (...) neutral description of the rich career of an individual, it can be noted that there are very few writings inspired by the desire not only to analyze, to explain and to understand but also to think through the Kemalist revolution. (shrink)

We show that the U.S. anti-discriminatory laws prohibiting discrimination in the workplace based on sexual orientation and gender identity identities) spur innovation, which ultimately leads to higher firm performance. We use the Human Rights Campaign’s Corporate Equality Index of 398 U.S. firms between 2011 and 2014, and find a significantly positive relationship between CEI and firm innovation. We also find that an interacting effect of CEI and firm innovation leads to higher firm performance. We use our understanding of Rawls’ Theory (...) of Justice and stakeholder theory to show that firms with workplace diversity policies are likely to be more innovative and perform better than those without such policies. Our results are robust to endogeneity, reverse causality and simultaneity issues. Our results will trigger debate in similar markets around the globe on the economic benefits of LGBT workplace diversity policies for firms. (shrink)

Modern biomedical technologies managed to revolutionise the End-of-Life Care (EoLC) in many aspects. The dying process can now be "engineered" by managing the accompanying physical symptoms or by "prolonging/hastening" death itself. Such interventions questioned and problematised long-established understandings of key moral concepts, such as good life, quality of life, pain, suffering, good death, appropriate death, dying well, etc. This volume examines how multifaceted EoLC moral questions can be addressed from interdisciplinary perspectives within the Islamic tradition. Contributors Amir Abbas Alizamani, Beate (...) Anam, Hamed Arezaei, Asma Asadi, Pieter Coppens, Hans Daiber, Khalid Elzamzamy, Mohammed Ghaly, Hadil Lababidi, Shahaboddin Mahdavi, Aasim Padela, Rafaqat Rashid and Ayman Shabana. (shrink)

In recent years there has been a number of promising technical and institutional developments regarding use of ontologies in industry. At the same time, however, most industrial ontology development work remains within the realm of academic research and is without significant uptake in commercial applications. In biomedicine, by contrast, ontologies have made significant inroads as valuable tools for achieving interoperability between data systems whose contents derive from widely heterogeneous sources. In this position paper, we present a set of principles learned (...) from the successful Open Biomedical Ontologies (OBO) Foundry initiative to guide the design and development of the Industrial Ontologies Foundry (IOF), which is a counterpart to the OBO Foundry initiative for the manufacturing industry. We also illustrate the potential utility of these principles by sketching the conceptual design of a framework for sustainable IOF development. (shrink)

Ces deux ouvrages qui font la matière de ce volume se complètent parfaitement, c'est pourquoi ils paraissent sous le même titre. L'auteur analyse dans Esquisse d'une esthétique l'activité gratuite de l'artiste. Le procès de la conscience dénonce d'un côté la conscience de l'autre, reconnaît que les religions et les philosophies ne sont que des issues qui permettent de combler le vide d'être que la conscience a creusé en nous.

Machine generated contents note: 1. Introduction; 2. International law and postcolonial Africa; 3. Violence and conflicts in Africa; 4. Institutional responses to conflicts; 5. Genesis of the African Union; 6. Structures and philosophy of the African Union; 7. The African Union's peacebuilding travails in Burundi; 8. The African Union and peace initiatives in post-state Somalia; 9. Towards an African Union philosophy on peacebuilding?.

The people's‐led Separatist movement was justified as an effort to bring about self‐determination, freedom, and justice for marginalized planets that did not feel represented by the Republic. The same spirit of resistance of the Separatist movement can also be found in the citizens of the Republic itself. The Clone Wars depicts the dangers and costs of endless militarism and highlights problems with the Jedi. Cornel West discusses the ways democratic traditions and values are under threat in the US, highlighting three (...) dogmas that seriously threaten democratic sensibilities: free‐market fundamentalism, aggressive militarism, and escalating authoritarianism. In the Clone Wars episode “Sabotage,” the end of the war is near, and the Republic's increasing militarization foreshadows its transition to the Empire. With Admiral Tarkin in command, the Republic becomes more ruthless in carrying out the war effort. (shrink)

The purpose of this paper is to investigate the nature of rhetoric and rhetorical strategies that are implicit in the standalone sustainability reporting of the top 24 companies of the Fortune 500 Global. We adopt Bormann’s :396–407, 1972) SCT framework to study the rhetorical situation and how corporate sustainability reporting messages can be communicated to the audience. The SCT concepts in the sustainability reporting’s communication are subject to different types of legitimacy strategies that are used by corporations as a validity (...) and legitimacy claim in the reports. A content analysis has been conducted and structural coding schemes have been developed based on the literature. The schemes are applied to the SCT model which recognizes the symbolic convergent processes of fantasy among communicators in a Society. The study reveals that most of the sample companies communicate fantasy type and rhetorical vision in their corporate sustainability reporting. However, the disclosure or messages are different across locations and other taxonomies of the SCT framework. This study contributes to the current CSR literature about how symbolic or fantasy understandings can be interpreted by the users. It also discusses the persuasion styles that are adopted by the companies for communication purposes. This study is the theoretical extension of the SCT. Researchers may be interested in further investigating other online communication paths, such as human rights reports and director’s reports. (shrink)

A comprehensive introduction to the life and thought one of the Islamic intellectual tradition's most original and profound authors.

Islamic Perspectives on the Principles of Biomedical Ethics presents results from a pioneering seminar in 2013 between Muslim religious scholars, biomedical scientists, and Western bioethicists at the research Center for Islamic Legislation & Ethics, Qatar Faculty of Islamic Studies. By examining principle-based bioethics, the contributors to this volume addressed a number of key issues related to the future of the field. Discussion is based around the role of religion in bioethical reasoning, specifically from an Islamic perspective. Also considered is a (...) presentation of the concept of universal principles for bioethics, with a response looking at the possibility (or not) of involving religion. Finally, there is in-depth analysis of how far specific disciplines within the Islamic tradition -- such as the higher objectives of Sharia (maqāṣid al-Sharī'ah) and legal maxims (qawā'id fiqhīyah) -- can enrich principle-based bioethics. (shrink)

Normativity is assessed as we evaluate and compare the environmental reporting practices of a sample of French and Canadian companies through the lens of institutional legitimacy. More specifically, we examine how French and Canadian firms changed their reporting practices in reaction to the promulgation of laws and regulations in their respective countries, i.e., the NER and Grenelle II Acts in France, and National Instrument 51-102 and CSA Staff Notice NR 51-333, issued by the Canadian Securities Administrators. The firms’ voluntary disclosures (...) according to GRI guidelines are also investigated. Substantive legitimacy theory is used to explore the level of substantive disclosures provided by Canadian and French firms. The findings reveal that the French parliamentary regime is more successful than the Canadian stock exchange regulation in triggering environmental reporting, and that the GRI combined with local regimes prompts environmental disclosures. Notwithstanding the improvements in environmental reporting under all three regimes, a very low level of substantive disclosure is noted in both countries. (shrink)

Guilt and fear today have developed an unexpected quality: they contribute powerfully to the survival of humanity. The feeling of guilt proceeds from an elementary awareness: although the unequaled progress of science and technology in the twentieth century has undoubtedly ameliorated the conditions of human life, it also has given rise to an infernal logic of genocide and crimes against humanity, in which almost all nations, directly or indirectly, have participated and participate still. This awareness is joined to another, which (...) is itself accompanied by a primordial fear: for the first time in history, science and technology have endowed humanity with the power to destroy itself and the planet, without furnishing humans with the means of escaping their destined role as sorcerer's apprentice, for no science can tell us what to do with science. It is this double feeling of guilt and fear that pushes contemporary man to search feverishly for ethical foundations capable of furnishing discreet regulatory principles to underpin decisions and actions. From the point of view of contemporary humanity, ethics must be able to confer meaning and perspective on an existence which apparently has neither: “Now,” writes Hans Jonas, “we shiver in the nakedness of nihilism in which near-omnipotence is paired with near-emptiness, greatest capacity with knowing least for what ends to use it.”. (shrink)

The main purpose of this paper is to better understand how sustainability rating agencies, through discourse, promote an “ideology of numbers” that ultimately aims to establish a regime of normalization governing social and environmental performance. Drawing on Thompson’s (Ideology and modern culture: Critical social theory in the era of mass communication, 1990 ) modes of operation of ideology, we examine the extent to which, and how, the ideology of numbers is reflected on websites and public documents published by a range (...) of sustainability rating agencies. Our analysis indicates that the ideology of numbers promotes a relatively narrow vision of corporate social and environmental responsibility. That is, it establishes some areas of visibility while leaving in the shadow certain aspects of the ways in which companies fulfill, or fail to meet, their social and environmental responsibilities. The ideology of numbers also exerts power by identifying those companies that are deemed to be worthy of inclusion, or not, in a supposedly socially responsible corporate elite. (shrink)

Ten years ago, an issue of the journal L'Homme et la Société was entitled “La Mode des identités.” Most of the articles were about cultural identity, but the basic thrust of the work was “a critique of the ‘fashion’ of identity calling into question the validity of a notion as striking as it is uncertain.” Recently, a special issue of the journal Sciences Humaines, entitled “Identité et identités,” dealt with personal, familial, social, professional identities and only spoke of cultural identity (...) marginally and in a roundabout way. Finally, in a manual of Sociologie politique published by the Presses Universitaires de France, the author takes to task the notion of ethnicity inherent to cultural identity and pushes the critique of the ethnic group to the point of negating its objective existence. Must we think then that the notion of cultural identity is henceforth obsolete, that it has lost all pertinence? (shrink)

The term takyīf fiqhī stands for one crucial concept in Islamic jurisprudence and refers to one of the important steps in the process of formulating fatwā. It basically revolves around the categorization of particular issues under the appropriate rules and precedents established in Islamic juristic thought. The present article attempts to examine the concept of takyīf fiqhī in a comprehensive manner in terms of its meaning, authority, types, importance, and governing criteria as can be gleaned from the works of Sharī‘ah (...) scholars. This is then followed by an exploration of its application to modern contracts, taking as a case study the Central Provident Fund Nomination in Singapore. The article concludes with the view that the Central Provident Fund Nomination, in terms of its essential characteristics and objective, resembles the Islamic will contract as discussed in books of Islamic Jurisprudence. (shrink)

1. Object of Study and Basic Epistemological Questions -- 2. Basic Questions Regarding the Rational Justifiability of the Šarīʻa's Moral Theology -- 3. Maṣlaḥa as the Cornerstone of Ethical Orientation -- 4. Ethical Orientation as Identity Building -- 5. Al-Aḥkām at-taklīfiyya: Basic Questions of Maqāṣid's Morality of Obligations -- 6. Al-Aḥkām al-waḍʻiyya as the Constitutive Rules of Moral Action -- Closing Remarks and Prospects -- Glossary -- Bibliography -- Index.

This paper proposes a conceptual framework for understanding the implementation process of a complex intervention concerned with professional role change. The proposed framework holds that the intervention must address three interacting systems (socio-cultural, educational and disciplinary) through which a health professional role is evolved. Each system is operationalized by four dimensions (values, methods, actors and targets). As for the implementation, the framework posits that it can be analyzed, by depicting the barriers and facilitators located within the dimensions of the three (...) interacting systems and within the intervention involved in the process through using the “menu of constructs” approach suggested by the Consolidated Framework for Implementation Research (CFIR). The implications of this framework, on theoretical research and practical levels, are reviewed. (shrink)

Discusses philosopher Mulla Sadra's commentary on the opening chapter of the Qur'an.

Islamic bioethics is in good health, this article argues. During the twentieth century, academic researchers had to deal with a number of difficulties including the scarcity of available Islamic sources. However, the twenty-first century witnessed significant breakthroughs in the field of Islamic bioethics. A growing number of normative works authored by Muslim religious scholars and studies conducted by academic researchers have been published. This nascent field also proved to be appealing for research-funding institutions in the Muslim world and also in (...) the West, such as the Qatar National Research Fund (QNRF) and the Netherlands Organization for Scientific Research (NWO). On the other hand, the article argues that contemporary Islamic bioethics is in need of addressing news issues and adopting new approaches for the sake of maintaining and improving this good health in the future. (shrink)

This book offers the first comprehensive introduction to one of the most significant Arab thinkers of the late 20th century and the early 21st century: the Moroccan philosopher and social theorist Mohammed Abed al-Jabri. With his intellectual and political engagement, al-Jabri has influenced the development of a modern reading of the Islamic tradition in the broad Arab-Islamic world and has been, in recent years, subject to an increasing interest among Muslims and non-Muslim scholars, social activists and lay men. The contributors (...) to this volume read al-Jabri with reference to prominent past Arab-Muslim scholars, such as Ibn Rushd, al-Ghazali, al-Shatibi, and Ibn Khaldun, as well as contemporary Arab philosophers, like Hassan Hanafi, Abdellah Laroui, George Tarabishi, Taha Abderrahmane; they engage with various aspects of his intellectual project, and trace his influence in non-Arab-Islamic lands, like Indonesia, as well. His analysis of Arab thought since the 1970s as a harbinger analysis of the ongoing “Arab Spring uprising” remains relevant for today's political challenges in the region. (shrink)

Using a sample of 21,030 US firm-year observations that represents more than 3000 individual firms over the 1998–2012 period, we investigate the relationship between Corporate Social Responsibility (CSR) and investment efficiency. We provide strong and robust evidence that high CSR involvement decreases investment inefficiency and consequently increases investment efficiency. This result is consistent with our expectations that high CSR firms enjoy low information asymmetry and high stakeholder solidarity (stakeholder theory). Moreover, our findings suggest that CSR components that are directly related (...) to firms’ primary stakeholders (e.g. employee relations, product characteristics, environment, and diversity) are more relevant in reducing investment inefficiency compared with those related to secondary stakeholders (e.g. human rights and community involvement). Finally, additional results show that the effect of CSR on investment efficiency is more pronounced during the subprime crisis. Taken together, our results highlight the important role that CSR plays in shaping firms’ investment behaviour and efficiency. (shrink)

. In the wake of the February 1997 announcement that Dolly the sheep had been cloned, Muslim religious scholars together with Muslim scientists held two conferences to discuss cloning from an Islamic perspective. They were organized by two influential Islamic international religioscientific institutions: the Islamic Organization of Medical Sciences and the International Islamic Fiqh Academy. Both institutions comprise a large number of prominent religious scholars and well‐known scientists who participated in the discussions at the conferences. This article gives a comprehensive (...) analysis of these conferences, the relation between science and religion as reflected in the discussions there, and the further influence of these discussions on Muslims living in the West. Modern discussions on Islamic bioethics show that formulating an Islamic perspective on these issues is not the exclusive prerogative of religious scholars. Formulating such perspectives has become a collective process in which scientists play an essential role. Such a collective approach strengthens the religious authority of Muslim scholars and makes it more influential rather than undermining it. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

End-of-life organ donation is controversial in Islam. The controversy stems from: scientifically flawed medical criteria of death determination; invasive perimortem procedures for preserving transplantable organs; and incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: reinterpreting religious scriptures, reeducating faith leaders, and utilizing media (...) campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life. (shrink)

Should face transplants be undertaken? This article examines the ethical problems involved from the perspective of the recipient, looking particularly at the question of identity, the donor and the donor’s family, and the disfigured community and society more generally. Concern is expressed that full face transplants are going ahead.

The ethical climate in Turkey is beset by ethical problems. Bribery, environmental pollution, tax frauds, deceptive advertising, production of unsafe products, and the ethical violations that involved politicians and business professionals are just a few examples. The purpose of this study is to compare and contrast the ethical beliefs of American and Turkish consumers using the Ethical Position Questionnaire (EPQ) of Forsyth (1980), the Machiavellianism scale, and the Consumer Ethical Practices of Muncy and Vitell questionnaire (MVQ). A sample of 376 (...) subjects that consists of American consumers (n = 188) and Turkish consumers (n = 199) was used to compare the ethical beliefs and practices of the two samples. The MANOVA results for the two nationality groups found that five out of six criterion variables differed between the two groups. The implications of this study are intended to assist marketers to develop strategies that suit a particular market and lessen their risk of entry. (shrink)

In 2022, the Research Center for Islamic Legislation & Ethics (CILE) and the World Innovation Summit for Health (WISH) submitted a proposal to host the 17th edition of the World Congress of Bioethics. After announcing that the CILE‐WISH proposal was the winning bid, concerns were raised by bioethicists based in Europe and the USA. To address these concerns, the International Association of Bioethics (IAB) developed a dedicated FAQ section, in coordination with the host institutions, for the first time in IAB (...) history. One‐to‐one communication ensued and individual responses were shared with these colleagues. As a continuation of this conversation, we (CILE Acting Director, WISH Research Fellow and Head of Content, and WISH CEO) address the concerns raised in the Letter‐to‐the‐Editor of Bioethics by Graaf et al. As we support the call to revisit some contentious issues within the global community of bioethicists, we maintain that this should be based on meticulously discussed, informed, consistent and equitable criteria. We also argue that mutual learning from diverse cultures and moral traditions is the optimal way for our scholarly community to be truly global and to eschew the flaws ensuing from ethnocentric discourses. (shrink)

Recently, due to the rapid progress of computer technology, researchers develop an effective computer program to enhance the achievement of the student in learning process, which is Intelligent Tutoring System (ITS). Science is important because it influences most aspects of everyday life, including food, energy, medicine, leisure activities and more. So learning science subject at school is very useful, but the students face some problem in learning it. So we designed an ITS system to help them understand this subject easily (...) and smoothly by analyzing it and explaining it in a systematic way. In this paper, we describe the design of an Intelligent Tutoring System for teaching science for grade seven to help students know the 7 characteristics for living things smoothly. The system provides all topics of living things and generates some questions for each topic and the students should answer these questions correctly to move to the next level. In the result of an evaluation of the ITS, students like the system and they said that it is very useful for them and for their studies. (shrink)

This essay is an attempt to assess critically the wax and gold tradition as a philosophical foundation of Ethiopian hermeneutics. In the first part, I shall analyze the wax and gold tradition as a poetic and literary tradition. After exploring how this tradition has shaped social and political interaction in the second part, in the third part I will show the implications of the wax and gold tradition for hermeneutics. I shall then make a critical assessment of the wax and (...) gold tradition as an interpretive philosophy before closing the essay with concluding remarks. (shrink)

The Royal College of Physicians of London published the 2013 national clinical guidelines on prolonged disorders of consciousness in vegetative and minimally conscious states. The guidelines acknowledge the rapidly advancing neuroscientific research and evolving therapeutic modalities in PDOC. However, the guidelines state that end-of-life decisions should be made for patients who do not improve with neurorehabilitation within a finite period, and they recommend withdrawal of clinically assisted nutrition and hydration . This withdrawal is deemed necessary because patients in PDOC can (...) survive for years with continuation of CANH, even when a ceiling on medical care has been imposed, i.e., withholding new treatment such as cardiopulmonary resuscitation for acute life-threatening illness. The end-of-life care pathway is centered on a staged escalation of medications, including sedatives, opioids, barbiturates, and general anesthesia, concurrent with withdrawal of CANH. Agitation and distress may last from several days to weeks because of the slow dying process from starvation and dehydration. The potential problems of this end-of-life care pathway are similar to those of the Liverpool Care Pathway. After an independent review in 2013, the Department of Health discontinued the Liverpool Care pathway in England. The guidelines assert that clinicians, supported by court decisions, have become the final authority in nonconsensual withdrawal of CANH on the basis of “best interests” rationale. We posit that these guidelines lack high-quality evidence supporting: 1) treatment futility of CANH, 2) reliability of distress assessment from starvation and dehydration, 3) efficacy of pharmacologic control of this distress, and 4) proximate causation of death. Finally, we express concerns about the utilitarian-based assessment of what constitutes a person’s best interests. We are disturbed by the level and the role of medical authoritarianism institutionalized by these national guidelines when deciding on the worthiness of life in PDOC. We conclude that these guidelines are not only harmful to patients and families, but they represent the means of nonconsensual euthanasia. The latter would constitute a gross violation of the public’s trust in the integrity of the medical profession. (shrink)

Abstract. In January 1985, about 80 Muslim religious scholars and biomedical scientists gathered in a symposium held in Kuwait to discuss the broad question “When does human life begin?” This article argues that this symposium is one of the milestones in the field of contemporary Islamic bioethics and independent legal reasoning (Ijtihād). The proceedings of the symposium, however, escaped the attention of academic researchers. This article is meant to fill in this research lacuna by analyzing the proceedings of this symposium, (...) the relevant subsequent developments, and finally the interplay of Islam and the West as a significant dimension in these discussions. (shrink)

We respond to Morgan and Feeley’s critique on our article “Mass Media in Organ Donation: Managing Conflicting Messages and Interests.” We noted that Morgan and Feeley agree with the position that the primary aims of media campaigns are: “to educate the general public about organ donation process” and “help individuals make informed decisions” about organ donation. For those reasons, the educational messages in media campaigns should not be restricted to “information from pilot work or focus groups” but should include evidence-based (...) facts resulting from a comprehensive literature research. We consider the controversial aspects about organ donation to be relevant, if not necessary, educational materials that must be disclosed in media campaigns to comply with the legal and moral requirements of informed consent. With that perspective in mind, we address the validity of Morgan and Feeley’s claim that media campaigns have no need for informing the public about the controversial nature of death determination in organ donation. Scientific evidence has proven that the criteria for death determination are inconsistent with the Uniform Determination of Death Act and therefore potentially harmful to donors. The decision by campaign designers to use the statutory definition of death without disclosing the current controversies surrounding that definition does not contribute to improved informed decision making. We argue that if Morgan and Feeley accept the important role of media campaigns to enhance informed decision making, then critical controversies should be disclosed. In support of that premise, we will outline: (1) the wide-spread scientific challenges to brain death as a concept of death; (2) the influence of the donor registry and team-huddling on the medical care of potential donors; (3) the use of authorization rather than informed consent for donor registration; (4) the contemporary religious controversy; and (5) the effects of training desk clerks as organ requestors at the Department of Motor Vehicles offices. We conclude that organ donation is a medical procedure subject to all the ethical obligations that the medical profession must uphold including that of transparency and truthfulness. (shrink)

The study aims to identify the reality of management of electronic documents and electronic archiving retirement in the Palestinian Pension Agency -analytical study, as well as to recognize the reality of the current document management system in the Palestinian Pension Agency. The study found the following results: that the reality of the current system for the management of documents in the agency is weak and suffers from many jams. Employee in the agency understand the importance and benefits of the management (...) of electronic documents system, where the application of electronic document management system provide important features and benefits most of which reduce the loss of documents between departments, illustrates the flow path, the speed, accuracy, transparency, and reduce the proportion of damage and destruction of files. Furthermore, the electronic documents system cost will be less than the cost of the current system and it will reduce the tasks assigned for the staff. The existence of a clear adoption of the agency for the policies and procedures established for the application of electronic documents management system. There are weak plans for training and developing of staff in the agency to raise their efficiency. The study found a set of recommendations, including: increased interest and awareness of the need to implement policies, mechanisms, and procedures to ensure the success of electronic document management system through benefiting from the experiences of other organizations and the private sector. The agency need to increase and develop its services for retirees in order to encourage the private sector, universities, and institutions to join the agency, and open the way for all segments of society in Gaza and West Bank and enhance its competitiveness between international social security institutions. The need to focus its attention on developing and publishing appropriate clear plans and specific goals about management of electronic documents and the agency should be committed to apply them. The need to focus on the establishment of a public management of archiving in the structure dealing with all technical operations and having competent and qualified employees in the field of electronic document management. The need to focus on the Palestinian National Archives and the follow-up with the international standards by the International Council Archives (ICA). (shrink)