As Medicine shifts from a paternalistic practice to a patient-centered approach, the concept of medical informed consent (IC) has evolved to safeguard patient autonomy. However, its current implementation still presents many challenges in clinical practice. We assessed the knowledge and attitudes of the general Lebanese population regarding the IC process as well as their sociodemographic and medical correlates. An anonymous online survey was distributed to the Lebanese population using social media channels. A sample of 500 adults with an average age (...) of 36.2 ± 13.5 years, including 319 females and 181 males, was recruited. Most of the respondents had a university degree (85.8%), reported previous hospital admissions (75.9%) and had signed an IC for surgical procedures (40.7%). Few participants were knowledgeable about IC Lebanese law. Variability in knowledge level was significantly related to gender and a previous hospitalization history. Positive attitudes toward patient autonomy (53.1%) and shared decision-making (57.5%) correlated with older age, female gender, graduate education, and a previous history of signing an IC document. Males were more likely to believe that IC has positive effects on health than females. This is the first study that provides novel findings regarding Lebanese peoples’ awareness of the ethico-legal components of medical IC. (shrink)

The study aimed to identify Design Thinking and its use in NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in the Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. The overall inventory of the possible study community (...) was based mainly on the use of the SPSS in processing and analyzing the data obtained through the survey tool. Smart-PLS was also used to construct the structural equation model (SEM) Analyzing the relationship between study variables. The study found that Design Thinking mediates the relationship between the management of process design and decision making with a holistic effect. The study showed the interest of local NGOs in creating a good mental image in the local community. And the ownership of local NGOs to the expertise and technical skills required to implement the projects, and showed the adoption of local NGOs in their activities to meet the needs of the beneficiaries and their wishes, and local NGOs analyze the problem, and causes, through data relevant to the decision, based on reference data for decision-making. The main recommendations of the study are: The need for senior management in the local NGOs in Gaza Strip to adopt the methodology of design thinking because of its impact on the sustainability of the projects, design the technical feasibility study and meet the wishes of the beneficiaries. (shrink)

The study aimed to identify the reality of decision-making in the local NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. A Census Method of the possible study community (...) was adopted, and the use of the Statistical Package for Social Sciences (SPSS) was mainly based on the analysis and analysis of the data obtained through the survey tool. The study reached a set of results, the most important of which are: NGOs follow a decision-making mechanism. NGOs examine the problems and causes of the organization. Organizations are less concerned with stakeholder participation. Make decision. The main recommendations of the study are: To promote systematic methods of decision-making in NGOs in Gaza Strip: Local NGOs in Gaza Strip should continue to develop their competencies in order to make sound and correct decisions and encourage them to follow the scientific methodologies in the mechanism of taking Decisions. (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)

Parochial altruism is manifested in the most violent of conflicts. Although it makes evolutionary sense for kin, many non-kin groups also behave parochially altruistically in response to threat from out-groups. It is possible that such non-kin groups share a sense of “fictive” kinship which encourages them to behave parochially altruistically for each other’s benefit. Our findings show that individuals not directly involved in a conflict approved of parochial altruism enacted by an in-group against an out-group more when the out-group posed (...) a threat to the in-group; however, this effect wasgreaterwhen the in-group members expressed fictive kinship by addressing each other using kinship metaphors such as “brothers.” Furthermore, although males approved of parochial altruism more than females, as the male warrior hypothesis would suggest, the effects of threat and kinship metaphor on approval of parochial altruism applied to both genders. These findings were replicated in an honour and non-honour culture. (shrink)

Ethics issues in the areas of science, technology and medicine have emerged during the last few decades. Many countries have responded by establishing ethics committees at the national level. Identification of National Ethics Committees (NECs) in the Eastern Mediterranean (EM) region and the extent of their functions and capacity would be helpful in developing capacity building programs that address the needs of these committees. Accordingly, we conducted a survey to determine the characteristics of existing NECs in the EM region.

The aim of this article is (1) to investigate the ‘neurosciences’ as an object of study for historical and genealogical approaches and (2) to characterize what we identify as a particular ‘style of thought’ that consolidated with the birth of this new thought community and that we term the ‘neuromolecular gaze’. This article argues that while there is a long history of research on the brain, the neurosciences formed in the 1960s, in a socio-historical context characterized by political change, faith (...) in scientific and technological progress, and the rise of a molecular gaze in the life sciences. They flourished in part because these epistemological and technological developments were accompanied by multiple projects of institution-building. An array of stakeholders was mobilized around the belief that breakthroughs in understanding the brain were not only crucial, they were possible by means of collaborative efforts, cross-disciplinary approaches and the use of a predominantly reductionist neuromolecular method. The first part of the article considers some of the different approaches that have been adopted to writing the history of the brain sciences. After a brief outline of our own approach, the second part of the article uses this in a preliminary exploration of the birth of the neurosciences in three contexts. We conclude by arguing that the 1960s constitute an important ‘break’ in the long path of the history of the brain sciences that needs further analysis. We believe this epistemological shift we term the ‘neuromolecular gaze’ will shape the future intellectual development and social role of the neurosciences. (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)

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)

(2013). MUSHROOMING: resistance and creativity in sigmund freud and emily dickinson. Angelaki: Vol. 18, No. 2, pp. 29-44.

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?.

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)

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)

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.

This essay explores seventeenth- and early eighteenth-century programs of natural inquiry where conjecture—an uncertain category of knowledge—played a vital role in the advancement of the sciences. It shows how early modern investigators used conjectures as a bridge between knowledge and ignorance and the process of conjecturing as a way to expand the mental state of inquiry. In publishing their conjectures, they were heeding Francis Bacon’s call to inspire hope and urge fellow experimenters to continue researching complex natural phenomena. Fellow investigators (...) could help to test, verify, revise, invalidate, or propose new inferences in a dialectical, collaborative process. The author argues that, by the eighteenth century, public conjecturing marked a particular kind of broad-minded experimental philosopher. This essay situates conjectures within agnotology—the study of culturally produced ignorance—and Baconian communication of knowledge and ignorance. It explores the philosophical and moral tensions investigators navigated when specifying nature’s unknowns. (shrink)

L’ascension et la chute récentes de la loi islamiste en Égypte appellent une réflexion, non seulement sur le rôle social des idées féministes islamiques, mais aussi sur les raisons des changements politiques, ainsi que sur les questions d’opposition éthique et de principe. Mon approche de ce sujet ne reprend pas l’opposition habituelle entre laïc et islamique, ni la critique du libéralisme laïc, mais propose une critique de tout mouvement féministe, qu’il soit laïc ou islamique, qui s’autorise de lui-même à coopérer (...) ou à être réduit au silence par des régimes politiques corrompus. La première partie de l’article traite de la question des relations fragiles entre les féministes et l’État plus particulièrement dans le contexte égyptien contemporain. La deuxième partie examine les ambiguïtés morales des positions du féminisme islamique. (shrink)

There is a trend of recruiting faith leaders at mosques to overcome religious barriers to organ donation, and to increase donor registration among Muslims. Commentators have suggested that Muslims are not given enough information about organ donation in religious sermons or lectures delivered at mosques. Corrective actions have been recommended, such as funding campaigns to promote organ donation, and increasing the availability of organ donation information at mosques. These actions are recommended despite published literature expressing safety concerns (i.e., do no (...) harm) in living and end-of-life organ donation. Living donors require life-long medical follow-up and treatment for complications that can appear years later. Scientific and medical controversies persist regarding the international guidelines for death determination in end-of-life donation. The medical criteria of death lack validation and can harm donors if surgical procurement is performed without general anesthesia and before biological death. In the moral code of Islam, the prevention of harm holds precedence over beneficence. Moral precepts described in the Quran encourage Muslims to be beneficent, but also to seek knowledge prior to making practical decisions. However, the Quran also contains passages that demand honesty and truthfulness when providing information to those who are seeking knowledge. Currently, information is limited to that which encourages donor registration. Campaigning for organ donation to congregations in mosques should adhere to the moral code of complete, rather than selective, disclosure of information. We recommend as a minimal standard the disclosure of risks, uncertainties, and controversies associated with the organ donation process. (shrink)

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. (...) We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. (shrink)

Belonging to Hebrew Wisdom literature, the Song of Songs offers a fresh look at love and relationships through its main female character, the Shulamite, which profoundly differs from traditional, religious approaches to love and sexuality. Drawing from exegetical as well as philosophical resources, Abi Doukhan follows the Shulamite's journey away from patriarchy to her own self-individuation as she discovers a wisdom that is deeply personal and feminine.

The world’s first COVID-19 human challenge trial using the D614G strain of SARS-CoV-2 is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta variant (B.1.351) for a follow-up human challenge trial, and researchers at Imperial College London are considering conducting that trial. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. While vaccine resistance as such does not increase risks for volunteers in (...) COVID-19 challenge trials, we explore two specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical. (shrink)

The study aimed at identifying the personal variables and their effect in promoting job creation in Gaza Strip through business incubators. The researchers used the descriptive analytical approach to achieve the study objectives. The study population consisted of 92 of the pilot projects benefiting from the three business incubators in Gaza Strip (Palestinian Information Technology Incubator, UCAS Technology Incubator and Business and Technology Incubator). The study reached a number of results, the most important of which are the existence of statistically (...) significant differences on entrepreneurship attributed to each age as most of them are between the ages of 22-30, Gender for males, business incubator, scientific qualification for the specialties of information technology and engineering, and years of experience. Based on the findings, the researchers recommend focusing on university students in guiding them towards entrepreneurship and helping new graduates to start entrepreneurship. And to guide students to scientific disciplines that help them in entrepreneurship after graduation, whether starting a small business or self-employment, support females to entrepreneurship as most of the entrepreneurs are male, in addition to stimulating males as well. (shrink)

In addition to opening a fertile field for inquiry in analytical social epistemology, Miranda Fricker’s work has provided powerful conceptual tools that merge descriptive capacity and political potency. For this reason, over the last fifteen years, the conceptual repertoire introduced by the author has been well received in both academic and political arenas. At times, the concepts of both testimonial and hermeneutical injustice acquire excessive dimensions in the literature, and this undermines, on the one hand, their analytical precision and, on (...) the other, their usefulness. In this paper I argue against Fricker’s structural parallelism thesis and defend an independent treatment of each of these concepts. On this basis, to counteract the hyperinflation of the concept of hermeneutic injustice, I proceed with an exercise of conceptual precision. To this end, I identify the conditions that make hermeneutic injustice both unjust and hermeneutic. Finally, I present theoretical and practical reasons to encourage the rigorous use of these concepts. (shrink)

Background:Healthcare organizations are now challenged to retain nurses’ generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses’ dedication, commitment, satisfaction, and loyalty to their organization.Purpose:This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses’ organizational commitment, job satisfaction, and turnover (...) intention.Methods:A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables.Ethical considerations:Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection.Findings:The result revealed positive significant correlations between nurses’ perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses’ turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention.Recommendation:Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses’ commitment and satisfaction and decreasing their turnover intention. (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)

Advance health care directives and informed consent remain the cornerstones of patients' right to self-determination regarding medical care and preferences at the end-of-life. However, the effectiveness and clinical applicability of advance health care directives to decision-making on the use of life support systems at the end-of-life is questionable. The Uniform Anatomical Gift Act (UAGA) has been revised in 2006 to permit the use of life support systems at or near death for the purpose of maximizing procurement opportunities of organs medically (...) suitable for transplantation. Some states have enacted the Revised UAGA (2006) and a few of those have included amendments while attempting to preserve the uniformity of the revised Act. Other states have introduced the Revised UAGA (2006) for legislation and remaining states are likely to follow soon. (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)

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 determination of death by neurological criteria remains controversial scientifically, culturally, and legally, worldwide. In the United Kingdom, although the determination of death by neurological criteria is not legally codified, the Code of Practice of the Academy of Medical Royal Colleges is customarily used for neurological death determination and treatment withdrawal. Unlike some states in the US, however, there are no provisions under the law requiring accommodation of and respect for residents' religious rights and commitments when secular conceptions of death (...) based on medical codes and practices conflict with a traditional concept well-grounded in religious and cultural values and practices. In this article, we analyse the medical, ethical, and legal issues that were generated by the recent judgement of the High Court of England and Wales in Re: A [2015] EWHC 443. Mechanical ventilation was withdrawn in this case despite parental religious objection to a determination of death based on the code of practice. We outline contemporary evidence that has refuted the reliability of tests of brainstem function to ascertain the two conjunctive clinical criteria for the determination of death that are stipulated in the code of practice: irreversible loss of capacity for consciousness and somatic integration of bodily biological functions. We argue that: the tests of brainstem function were not properly undertaken in this case; the two conjunctive clinical criteria set forth in the code of practice cannot be reliably confirmed by these tests in any event; and absent authentication of the clinical criteria of death, the code of practice wrongly invokes a secular definition of death based on the loss of personhood. Consequently, the moral obligation of a pluralistic society to honor and respect diverse religious convictions to the greatest extent possible is being violated. Re A is contrasted with the US case of Jahi McMath in which the court accommodated parental religious objection to the determination of neurological death codified in the Uniform Determination of Death Act. We conclude that the legal system in the United Kingdom should not favour a secular definition of death over a definition of death that is respectful of religious values about the inviolability and sanctity of life. We recommend the legal recognition of religious accommodation in death determination to facilitate cultural sensitivity and compassionate care to patients and families in a pluralistic society. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 60-62, June 2011.

Are critique and the “art of governing” antithetical? The aim of this article is to examine this tension that was laid bare by the Covid-19 pandemic by introducing “critical friendship” as a conceptual framework for a constructive interdisciplinary engagement with science in a post-pandemic era. It does so by drawing on several works and insights: (i) Michel Foucault’s notion of “critical attitude” as well as his assessment of philosophy as providing a “diagnosis of the present;” (ii) Bruno Latour and colleagues’ (...) idea of a “critical zone” or what I call a horizontal epistemology of critique; (iii) Aristotle’s notion of friendship as being necessary for the “common good;” and finally (iv) Jacques Derrida’s interpretation of the messianic character of friendship in the constitution of progressive democracies. Whereas critical theory has been described as either “explanatory-diagnostic” or “emancipatory-utopian,” a critical friendship approach aims to be both diagnostic and emancipatory in an age of uncertainty and democratic backsliding. (shrink)

We analyzed the patients’ perception of prenatal diagnosis of fetal cardiac pathology, and the reasons for choosing to continue with pregnancy despite being eligible to receive a medical termination of pregnancy. We also identified the challenges, the motives interfering in decision-making, and the consequences of the decisions on pregnancy, child and mother. This descriptive, prospective and longitudinal study was conducted in France, amongst pregnant women who wished to continue their pregnancy despite an unfavorable medical advice. Socio-demographic data were collected through (...) a questionnaire. Such questionnaire covered information assessing the parents/mother’s perception of prenatal diagnosis, and medical termination of pregnancy, their interpretation of the established diagnosis and their motives for not considering pregnancy termination. 72 eligible patients were analyzed over one year: mean age 33 ± 6.89 years, 47 patients had already given birth to ≥1 healthy child. Mean gestational age at the detection of fetal cardiac pathologies was 30 ± 4.37 weeks of amenorrhea. Patients decided to keep the child after 3 ± 1.25 consultations. 56 patients made their decision with their husbands and 16 made their decision alone. Reasons for declining the medical termination were culpability and responsibility, ideologies and convictions, mistrust and hope. Newborns of 67 patients died with a mean survival duration of 38 days. Patient informed consent should be sought before any decision in neonatology, even if conflicting with the medical team’s knowledge and the pregnant mother’s benefits. Decisions to accept or decline pregnancy termination depend on the patients’ psychological character, ideologies, convictions, and mistrust in the diagnosis/prognosis, or hope in the fetus survival. (shrink)