Cultural values influence how people understand illness and dying, and impact their responses to diagnosis and treatment, yet end-of-life care is rooted in white, middle class values. Faith, hope, and belief in God’s healing power are central to most African Americans, yet life-preserving care is considered “aggressive” by the healthcare system, and families are pressured to cease it.

This paper presents three basic ideas which are interrelated with one another: 1) The assertion that a single subject unites all the discussions in Sefer Yezirah, from beginning to end: namely, the nature of Wisdom, upon which the world stands (or is suspended); 2) A stylistic-linguistic analysis leading to the division of Sefer Yezirah into three “accounts,” around which are crystallized the style and contents of the book as a whole. The Account of the “Sealing of the Ends” is the (...) latest of these accounts, and was written by the editor of the book, who joined his account with the other two to form a single book; 3) The assertion that the worldview reflected in Sefer Yezirah acknowledges the existence of a secondary power alongside God, that assists Him in the Creation and ongoing existence of the universe (as against doctrines claiming the existence of an additional force in conflict with God). The term I use in this context is binitarianism. In the earliest of the three accounts, that of the Covenant, this power assumes the form of an angel, while in the other two it is more abstract. This paper lays the foundations for this claim but, due to the limitations of this paper, I do not enter into discussion of its far-reaching implications. I hope to continue this discussion elsewhere, on another occasion. (shrink)

Compassion is acknowledged as a key motivational source of prosocial opportunity recognition. This study examines the underlying processes of different types of compassion that lead to prosocial OR interventions designed to solve or ameliorate social problems. Self-compassion is associated with intimate personal experiences of suffering and encompasses a desire to alleviate the distress of others based on common humanity, mental distance and mindfulness. Other-regarding compassion is associated with value structures and social awareness and is based on a desire to help (...) the less fortunate. Using a life-story analyses of 27 Israeli social entrepreneurs, we identified two OR process mechanisms, reflexivity and imprinting. The relationship between these two types of compassion are equifinal, that is, both can lead to prosocial OR; however, the mechanisms differ. We contribute to the literature by showing that compassion serves as an internal enabler based on both cognitive and affective motivations for prosocial OR. We introduce a theoretical perspective that establishes a process model for further research on the role of compassion in identifying and leading prosocial action. (shrink)

Background Nurses have an essential role in caring for end-of-life patients. Nevertheless, the nurse’s involvement in the passive euthanasia decision-making process is insufficient and lower than expected. Objectives To explore factors associated with nurses’ intention to be involved in non-treatment decisions (NTD) regarding passive euthanasia decision-making versus their involvement in the palliative care of patients requesting euthanasia, using the Theory of Planned Behavior (TPB) framework. Design A cross-sectional study utilizing a random sample. Participants and research context The study was conducted (...) in one of the largest hospitals in Israel among 125 nurses employed in internal and surgical care wards. Data was collected through face-to-face interviews between March and April 2019. Method A closed structured questionnaire was developed according to TPB instructions. A paired sample t test and two multiple hierarchical regressions were conducted. Variance explained (R2) and the significance of F change were calculated for each regression. The study used the STROBE statement guideline. Ethical considerations The study was approved by the hospital’s Helsinki Committee (#20.11.2017). Findings A paired sample t test revealed that nurses’ involvement in the palliative care of patients requesting passive euthanasia was significantly higher than in NTD regarding euthanasia. Regression analyses revealed that nurses’ position and attitudes explain their intention to be involved in decision-making; attitudes and perceived behavioral control explain nurses’ intention to be involved in the care of patients requesting euthanasia. Conclusions According to the TPB, nurses’ attitudes explained their intention to participate in decision-making regarding passive euthanasia. It is recommended to enhance open discussion of this complex issue to encourage nurses’ willingness to participate in NTD decision-making regarding euthanasia. (shrink)

A child’s death is a profound loss for mothers and affects hundreds of thousands of women. Mothers report inconsolable and progressive grief that is distinct from depression and impacts daily emotions and functions. The brain mechanisms responsible for this relatively common and profound mental health problem are unclear, hampering its clinical recognition and care. In an initial exploration of this condition, we used resting state functional MRI (fMRI) scans to examine functional connectivity in key circuits, and task-based fMRI to examine (...) brain network activity in grieving mothers in response to pictures of their deceased child and as well as recognizable deceased celebrities and unfamiliar individuals. We compared nine mothers who had lost an adult child and aged-matched control mothers with a living child of a similar age. Additionally, we collected diffusion imaging scans to probe structural connectivity and complemented the imaging studies with neuropsychological assessments. Increased functional activation in Ventral Attention/Salience Networks accompanied by a reduced activation in the medial prefrontal cortex in response to the deceased child’s picture robustly distinguished the grieving mothers from controls. Heightened resting-state functional connectivity between the paraventricular thalamic nucleus (PVT) and the amygdala distinguished the grieving mothers from the controls and correlated with subjective grief severity. Structurally, maternal grief and its severity were associated with alterations in corticolimbic white matter tracts. Finally, grieving mothers performed worse than controls on neuropsychological tests of learning, memory, and executive function, linked with grief severity. Reduced activation in cortical regions inhibiting emotions and changes in the PVT circuitry—a region involved in long-term emotional memories and decision making under conflict—distinguish grieving mothers from controls. Notably, the magnitude of neurobiological changes correlates with the subjective severity of grief. Together, these new discoveries delineate a prevalent and under-recognized mental health syndrome and chart a path for its appreciation and care. (shrink)

The success of popular women's fiction requires a mode of analysis that is able to reveal the patterns across this category in order to better understand the appeal of these books. Popular fiction, like chick-lit, can be contradictorily framed as simultaneously constituting one, as well as many genres, if a genre is the codification of discursive properties. It may consist of romances, thrillers, romantic suspense and so forth in terms of its discursive properties, but popular women's fiction will also have (...) a pattern of similarity that cuts across these forms – that similarity, I will suggest, lies in the idea of pleasure as a genre of affect that ties various popular fictions together, thereby acting as a type of imperial genre. Pleasure is so ubiquitous and so diverse across the multiple forms that constitute popular women's fiction that I argue it has become a genre in itself. This is, however, not a genre that limits itself to one particular stylistic form, but rather, as a dynamic social construct, it has become a genre of affect that invokes feelings of pleasure. Nthikeng Mohlele's most recent novel, Pleasure, exemplifies the applicability and plasticity of the concept of pleasure, allowing me to examine this work as a type of fictionalised theory which I then apply to South African chick-lit texts: the Trinity series by Fiona Snyckers and Happiness Is a Four-Letter Word by Cynthia Jele. Mohiele's expansive theorisation of pleasure is inherently local in that it is depicted at the level of experience and imagination; yet it is simultaneously macro and global in the connections made to deeply political circuits of identity-based oppressions and structural inequalities. Mohlele reveals the mobility of pleasure as a genre that offers an opportunity to think through the circuits that connect popular fiction through the lens of African literature. (shrink)

The Inner Kalacakratantra: A Buddhist Tantric View of the Individual. Vesna A. Wallace. Oxford University Press, Oxford 2001. x, 273 pp. £45.00. ISBN 0-19-512211-9.

There is common agreement that preschool-level science education affects children’s curiosity, their positive approach towards science, and their desire to engage with the subject. Children’s natural curiosity drives them to engage enthusiastically in all forms of exploration. Engaging in scientific exploration necessitates self-regulation capabilities and a wide repertoire of cognitive and metacognitive strategies. The purpose of this study was to examine to what extent preschoolers (aged 5‒6 years) implement nascent inquiry skills, metacognitive awareness, and self-regulation capabilities during play-based scientific exploration (...) tasks. An additional purpose was to investigate the relationships between these capabilities, a relationship not yet investigated in the context of play-based, scientific exploration among young children. The study consisted of 215 preschoolers, from 10 preschools. For this study, we developed two scientific exploration tasks—structured and open-ended. Our motivation was to examine whether preschoolers’ capabilities will differ in the context of structured task which is aligned with the view that young children need guidance and explicit instructions compared to the context of open-ended, play-based task–allowing the children to apply and test their intuitive theories and skills. During performance participants were videotaped. Their verbal and non-verbal responses were analyzed by means of a scoring scheme. The results of a micro-analysis of about 100 hours of video showed that given the opportunity, even without setting explicit goals and instructions, children exhibit inquiry capabilities: they ask questions, plan, hypothesize, use tools, draw conclusions. Asking questions and planning were better manifested during the structured task. Children also manifested higher levels of attention, persistence, and autonomy during the structured task. However, significant higher scores of self-regulation indications were revealed in the context of the open-ended, play-based, exploration task. Moreover, results indicate significant correlations between the five measures of preschoolers’ inquiry capabilities and measures of metacognitive strategic awareness and self-regulation. The results of the present study suggest the importance of combining various learning environments and experiences in early science education that encourage children to engage in structured exploration alongside play-based, open-ended, exploration. (shrink)

Western liberal thought, which is rooted in the social contract tradition, views the relationship between rational contractors as fundamental to the authority of law, politics, and morality. Within this liberal discourse, dominant strands of modern moral philosophy claim that morality too is best understood in contractual terms. Accordingly, others are perceived first and foremost as autonomous, free, and equal parties to a reciprocal cooperative scheme, designed for mutual advantage.This Article aims to challenge the contractual model as an appropriate framework for (...) morality. My claim is that the constituting concepts of contractualist thought, especially the idea of reciprocity, while perhaps fitting to law, are misplaced in morality. I argue that importing the concept of reciprocity and its conceptual habitat from law to morality yields ethical contractualism an unconvincing moral theory. (shrink)

We examine how opinion on a controversial real-world issue shifts as a function of reading relevant arguments and engaging in a specific mental simulation about a future, fictional state of affairs involving the target issue. Individuals thought either counterfactually about a future event (“if only X had not happened …”) or semifactually about it (“even if X had not happened …”). In Experiment 1, as expected, individuals became more in favour of a course of action (the electronic tagging of children) (...) after reading relevant supporting arguments. They also became more in favour after they thought counterfactually how a negative future event could have been avoided if only electronic tagging had not been banned some years earlier. The effects of argument relevance and type of mental simulation were additive. Using a similar procedure but a different target issue (whether the UK should join the Economic Monetary Union), Experiment 2 confirmed that the type of mental simulation exerts a substantial effect on the impact of relevant arguments. Much weaker effects arose when the mental simulation was not relevant to the target issue. We set and discuss our results in terms of dual-processing theory. (shrink)

Providing effective feedback to patients in a rehabilitation training program is essential. As technologies are being developed to support patient training, they need to be able to provide the users with feedback on their performance. As there are various aspects on which feedback can be given, it is important to ensure that users are not overwhelmed by too much information given too frequently by the assistive technology. We created a rule-based set of guidelines for the desired hierarchy, timing, and content (...) of feedback to be used when stroke patients train with an upper-limb exercise platform which we developed. The feedback applies to both success on task completion and to the execution of compensatory movements, and is based on input collected from clinicians in a previous study. We recruited 11 stroke patients 1–72 months from injury onset. Ten participants completed the training; each trained with the rehabilitation platform in two configurations: with motor feedback and with no motor feedback. The two conditions were identical, except for the feedback content provided: in both conditions they received feedback on task success; in the MF condition they also received feedback on making undesired compensatory movements during the task. Participants preferred the configuration that provided feedback on both task success and quality of movement. This pilot experiment demonstrates the feasibility of a system providing both task-success and movement-quality feedback to patients based on a decision tree which we developed. (shrink)

This article discusses the Tibetan notion of rlung, usually translated as: ‘wind’, but perhaps better understood as a close equivalent of pneuma in the Greek tradition, or qi in the Chinese tradition. The article focuses on the way rlung provides a useful prism through which concepts of health, illness and disease may be observed in a cross-cultural perspective. An analysis of syndromes linked with rlung in a Tibetan cultural context illuminates some of the ways in which culture determines particular syndromes. (...) The article raises a number of questions which are relevant for a more general multicultural approach to concepts of health, illness and disease.The article argues that notions of rlung/pneuma/wind/ qi constitute a particularly interesting area for an exploration of culture-bound syndromes, as they reside in the meeting point between material and non-material, physical and mental, as well as the psychological, spiritual and religious. They are hence fundamental for a more cross-cultural approach to the mind-body problem.The article also deals with the significance of history of medicine, particularly histories of medicine, which attempt to widen the scope of the traditional Eurocentric narrative of the history of medicine, in dealing with questions such as concepts of health and illness. Allowing alternative narratives—whether narratives of patients, other cultures or historical ones—can enhance our understanding of what health, illness and disease are. Discussing perceptions of the body as culturally defined is not only important from a philosophical or historical point of view, but also has important practical ramifications, which are particularly crucial in our global age. (shrink)

Buddhism and Medicine: An Anthology of Premodern Sources, edited by C. Pierce Salguero. Columbia University Press, 2017. 728 pp.; Hb $150. ISBN-13: 9780231179942.

In August 2001, the Israeli Ministry of Health issued its Limitation of Smoking in Public Places Order, categorically forbidding smoking in hospitals. This forced the mental health system to cope with the issue of smoking inside psychiatric hospitals. The main problem was smoking by compulsorily hospitalized psychiatric patients in closed wards. An attempt by a psychiatric hospital to implement the tobacco smoking restraint instruction by banning the sale of cigarettes inside the hospital led to the development of a black market (...) and cases of patient exploitation in return for cigarettes. This article surveys the literature dealing with smoking among psychiatric patients, the role of smoking in patients and the moral dilemmas of taking steps to prevent smoking in psychiatric hospitals. It addresses the need for public discussion on professional caregivers’ dilemmas between their commitment to uphold the law and their duty to act as advocates for their patients’ rights and welfare. (shrink)

The posthumous retrieval and use of gametes is socially, ethically, and legally controversial. In the countries that do not prohibit the practice, posthumous assisted reproduction is usually permitted only at the request of the surviving spouse and only when the deceased left written consent. This paper presents the recommendations of an ethics committee established by the Israeli Fertility Association. In its discussions, the committee addressed the ethical considerations of posthumous use of sperm—even in the absence of written consent from the (...) deceased—at the request of either the spouse or the deceased’s parents who wish to become the offspring’s parents or grandparents. It is concluded that under certain conditions, a request by the deceased’s parents to posthumously use the deceased’s sperm is justified and should be granted. (shrink)

ReOrienting Histories of Medicine: Encounters Along the Silk Roads, by Ronit Yoeli-Tlalim. Bloomsbury Academic, 2021. xvi+236 pp.; Hb $115.00 USD; Pb $39.95. ISBN-13: 9781472512574.

La precisione di dettagli con cui l’elaborazione delle immagini interviene sempre di più nello sviluppo della ricerca scientifica - si pensi solo all’uso fattone dalle neuroscienze - sollecita il dibattito filosofico a occuparsi di nuovo e da punti di vista diversi dell’antica disputa sul rapporto tra arte e natura. Se oggi si tratta prevalentemente di immagini ottenute al computer, regolamentate fino all’obbligo di dichiarare il programma informatico utilizzato, la questione della Bildlichke...

Ronit Stahl and Ezekiel Emanuel have recently issued a stark challenge to conscience protections in medical law and ethics. Their argument is flawed, however. They misrepresent the nature and relevance of conscientious protection in the military, misinterpret the scope of consent tendered by modern medical professionals, and offer no reason to think either that conscientious objection harms patient well-being or that such harm should solely determine the permissibility of conscientious objection. Moreover, and most fundamentally, Stahl and Emanuel do not (...) recognize that conscience protections promote moral integrity, a basic aspect of human well-being that justifies protective action. (shrink)

Market metaphors have come to dominate discourse on medical practice. In this essay, we revisit Peter Berger and colleagues’ analysis of modernization in their book The Homeless Mind and place that analysis in conversation with Max Weber’s 1917 lecture “Science as a Vocation” to argue that the rise of market metaphors betokens the carry-over to medical practice of various features from the institutions of technological production and bureaucratic administration. We refer to this carry-over as the product presumption. The product presumption (...) foregrounds accidental features of medicine while hiding its essential features. It thereby confounds the public understanding of medicine and impedes the professional achievement of the excellences most central to medical practice. In demonstrating this pattern, we focus on a recent article, “Physicians, Not Conscripts—Conscientious Objection in Health Care,” in which Ronit Stahl and Ezekiel Emanuel decry conscientious refusals by medical practitioners. We demonstrate that Stahl and Emanuel’s argument depends on the product presumption, ignoring and undermining central features of good medicine. We conclude by encouraging conscientious resistance to the product presumption and the language it engenders. (shrink)

Los orígenes de la APS y de la Política de SALUD PARA TODOS se remontan al siglo XVIII y al movimiento de Medicina Social de 1848. Del siglo XX se destacan las experiencias pioneras de los años 30-50s. Entre ellas, Chile, Saskachewa (Canadá), EUA, Suráfrica, con Henry Sigerist, Sidney Kark, Salvador Allende, Gustavo Molina, trabajos pioneros de la medicina y la epidemiologia social vinculados a los del antropólogo Benjamin Paul. Así como personajes menos reconocidos en APS especialmente el italiano (...) Franco Basaglia transformador de la atención psiquiátrica y sanitaria con los principios de libertad terapéutica. A éstas están articuladas numerosas y desconocidas experiencias en América Latina y Colombia con Héctor Abad Gómez, Santiago Rengifo y César Uribe Piedrahita por el proceso de “Renovación de APS” de la OPS. En Latinoamérica, las luchas por la salud estaban articuladas a la luchas por una sociedad justa, con personajes como Ernesto Guevara desde la medicina, Paulo Freire en pedagogía, teología y filosofía de la liberación, y el sociólogo colombiano Camilo Torres, que aportaron metodologías cualitativas en la investigación en salud, los que junto aportes de integración como el Desarrollo a Escala Humana, consideran a los servicios sanitarios como elementos principales en la vida de las personas, y aportan a la construcción transdisciplinar e intersectorial de la salud para nuestro hoy. (shrink)

The areas of interest of the scholar of religious studies, Karl E. Grozinger, are diverse. His research is concentrated on the religious and cultural history of Judaism throughout the ages: Israel in antiquity, the era of rabbinical traditional literature, philosophy of religion during the Middle Ages, the kabbalistic tradition, as well as Jewish thinkers and devout movements in contemporary times. On the occasion of Professor Grozinger's seventieth birthday, numerous scholars present the first fruits of their current research as a first (...) look into the tendencies of future research in Jewish studies. In accordance with this scholar's broad interests, the volume Jewish Lifeworlds and Jewish Thought, edited by Nathanael Riemer, is comprised of contributions to a wide variety of topics of Jewish cultural history.With contributions by Hermann Lichtenberger, Hanna Liss, Ronit Meroz, Yoav Elstein, Susanne Talabardon, Nathanael Riemer, Giuseppe Veltri, Dirk Westerkamp, Thomas Meyer, Daniel Jutte, Frederek Musall, Robert Jutte, J. Friedrich Battenberg, Admiel Kosman, Rella Kushelevsky, Elvira Grozinger, Simon Bronner, Avidov Lipsker, Jascha Nemtsov, Rebekka Denz, Micha Brumlik, Micha? Galas, Manja Herrmann, Hans-Michael Haussig, Anat Feinberg, Adam Lipszyc, Vivian Liska, Julius H. Schoeps, Edward D'browa, Ewa Geller, Manfred Voigts, Mordechai Lewy and Stanislaw Krajewski. (shrink)

This essay challenges the relevance of the primary analogy in Ronit Stahl and Ezekiel Emanuel’s article “Physicians, Not Conscripts: Conscientious Objection in Health Care.” The author then proposes an alternative, classi­cally inspired model of conscience based on the work of E. Christian Brugger, Edmund Pellegrino, and Alasdair MacIntyre. This teleological model enables a more robust analysis of conscience claims than does Stahl and Emanuel’s social-constructivist framework.

Les etudes ici rassemblees interrogent les articulations et desarticulations que Jean-Francois Lyotard place au principe du langage. Le volume dessine ainsi les lignes de force et les deplacements de sa pensee, ses presupposes et ses apories. Il montre les malentendus et les polemiques suscites par sa reecriture radicale de la rationalite. Pas de langage en general, dit Lyotard, mais des langages multiples, des types de discours heterogenes que la politique brasse sans pacifier leurs conflits. La recherche du consensus, dont l' (...) ethique de la discussion a souligne l'importance, tend a occulter les differends qui divisent les fins respectives des genres de discours. On ne peut pas etre pacifiste en matiere de phrases, et pas indifferent. Car tout enchainement discursif signe la victoire d'un genre et porte tort aux autres. Sans compter que la parole, quel qu'en soit le registre, eclipse par principe ce qui echappe aux contraintes linguistiques, ce champ de la sensation et du sentiment que Discours, figure explorait, des 1971, en inventant le figural. Apres 1983, apres l' ontologie des phrases du Differend, Lyotard cherche a cerner ce que les mots laissent en souffrance et dont ils doivent pourtant temoigner. Phrase-affect, infantia, donation sensible, Chose sont quelques-uns des noms sous lesquels il pense alors ce qui resiste au langage, le travaille de l'interieur et signe la difficulte de l'ecriture.Ont participe a ce volume Isabelle Aubert, Geoffrey Bennington, Gaelle Bernard, Corinne Enaudeau, Frederic Fruteau de Laclos, Alberto Gualandi, Laurence Kahn, Charlotte Murgier, Andreas Niederberger, Sophie Nordmann, Michel Olivier, Claire Pages, Ronit Peleg, Gerard Raulet, Jean-Francois Rey, Jean-Michel Salanskis, Francois-David Sebbah, Gerald Sfez, Rieke Trimcev. (shrink)

Austin Harrington’s monumental investigation into the ‘radical centrists’ of the Weimar Republic is discussed in terms of key themes such as universalism, cosmopolitanism, and the critique of Eurocentrism that still resonate with recent debates. Contrasting the voices of lesser known critical intellectuals from this period such as Karl Jaspers and Kark Mannheim with the political writings of Max Weber and Georg Simmel, as well as with the reactionary positions of Carl Schmitt and Martin Heidegger, Harrington’s book affords a useful (...) critical perspective on ‘protesting the West’, yesterday and today. (shrink)