Background: There are intriguing and challenging ethical dilemmas in the practice of palliative care in a traditional developing society.Objective: To review the different ethical issues involved in cancer and palliative care in developing countries, with special reference to India.Methods: Published literature on pain relief and palliative care in the developing countries was reviewed to identify ethical issues and dilemmas related to these, and ways in which ethical principles could be observed in delivery of palliative care in such countries are discussed.Results: (...) The literature review revealed a number of ethical dilemmas and challenges that professionals, cancer patients and their families encountered during palliative care. It was noted that patients’ preferences and decisions are influenced by family members. Dilemmas leave the professionals and families confused about how ethical their actions have been. Specific ethical issues were noted in relation to the availability and use of oral morphine for pain relief, spiritual care, lack of adequate palliative care services, and palliative care education.Conclusions: The four principles of ethics posed difficulties in understanding the complex ethical issues in a developing country with a traditional background. Ethical issues need to be handled delicately and sensitively in palliative care settings, within the framework of the traditions and culture of the society and financial constraints. The possible role of ethics committees in palliative care settings to help decision-making needs to be studied and discussed. (shrink)

ABSTRACTThe concept of poverty is understood differently by people across the globe. Despite this conceptual limitation, higher economic growth in the last few decades in many countries has helped reduce extreme global poverty. The growth process has been supported by globalization. The number of global poor is, however, still quite large and more than the entire population of USA, UK, France and Russia. Their numbers have gone up by 100 million in Sub Sahara region in last three decades. While removal (...) of extreme poverty is clearly vital, it cannot be considered sufficient for a dignified life. The crux of human dignity is development and it must provide every individual access to education, healthcare, nutrition, habitat, and exercising of democratic rights in accordance with the rule of law. While helping reduce poverty, globalization has also led to some morally unsustainable consequences. There is huge and rapidly increasing inequality of wealth and income in most nations. There are now new opportunities for corruption which are being exploited by multinationals. These corrupt practices are resulting in illicit flow of about one trillion Dollars every year. For a more ethical society, effective measures are needed for controlling corruption for improving quality of life. (shrink)

Introduction: Decisions to withdraw or withhold curative or life-sustaining treatment can have a huge impact on the symptoms which the palliative-care team has to control. Palliative-care patients and their relatives may also turn to palliative-care physicians and nurses for advice regarding these treatments. We wanted to assess Indian palliative-care nurses and physicians’ attitudes towards withholding and withdrawal of curative or life-sustaining treatment. Method: From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programmes in (...) New Delhi, using a semi-structured questionnaire. For the interviews and analysis of the data we followed Grounded-Theory methodology. Results: Withholding a curative or life-sustaining treatment which may prolong a terminal cancer patient’s life with a few weeks but also has severe side-effects was generally considered acceptable by the interviewees. The majority of the interviewees agreed that life-sustaining treatments can be withdrawn in a patient who is in an irreversible coma. The palliative-care physicians and nurses were of the opinion that a patient has the right to refuse life-saving curative treatment. While reflecting upon the ethical acceptability of withholding or withdrawal of curative or life-sustaining treatment, the physicians and nurses were concerned about the whole patient and other people who may be affected by the decision. They were convinced they can play an important advisory role in the decision-making process. Conclusion: While deciding about the ethical issues, the physicians and nurses do not restrict their considerations to the physical aspects of the disease, but also reflect upon the complex wider consequences of the treatment decisions. (shrink)

Rita Bottino,1 Santosh Nagaraju,2 Vikas Satyananda,2 Hidetaka Hara,2 Martin Wijkstrom,2 Massimo Trucco,1 David KC Cooper2 1Institute of Cellular Therapeutics, Allegheny Health Network, 2Thomas E Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA: Diabetes mellitus is increasing worldwide. Type 1 diabetes can be treated successfully by islet allotransplantation, the results of which are steadily improving. However, the number of islets that can be obtained from deceased human donors will never be sufficient to cure more than a (...) very small percentage of patients who might benefit from transplantation. Although there are some differences in glucose metabolism between pigs and humans, the use of pigs could provide an unlimited supply of islets, and the insulin produced would undoubtedly control glucose levels. Transplantation of islets into the portal vein results in islets residing in the liver; however, an early inflammatory response and rejection remain problematic, even when the recipient is receiving immunosuppressive therapy. In the long term, immunosuppressive drugs may exhibit toxicities to patients and specifically harm the islet cells. In contrast, encapsulation techniques provide islets with a physical barrier that prevents antibodies binding to the islet graft while still allowing insulin to be released into the recipient's circulation; in theory, patients receiving encapsulated grafts might not require exogenous immunosuppressive therapy. Nonhuman primates with encapsulated pig islet transplants have remained insulin-independent for several weeks, but long-term efficacy remains uncertain. Furthermore, techniques are now available to knock out genes from the pig and/or insert human genes, thus rendering the antigenic structure of pigs closer to that of humans, and providing protection from the human immune response. Islet transplantation from genetically engineered pigs has been followed by insulin independence in a small number of nonhuman primates for greater than 1 year. Neonatal islets have some advantages over adult islets in that they are easier to isolate and culture, and have the ability to proliferate during the first few months after transplantation. In 2009, the International Xenotransplantation Association set up a group to encourage and advise on clinical trials of pig islet xenotransplantation; this group's guidelines are discussed. Clinical trials of encapsulated pig islets are already under way. Keywords: diabetes, islets, pancreatic, pig, xenotransplantation. (shrink)

Epistemic Evaluation aims to explore and apply a particular methodology in epistemology. The methodology is to consider the point or purpose of our epistemic evaluations, and to pursue epistemological theory in light of such matters. Call this purposeful epistemology. The idea is that considerations about the point and purpose of epistemic evaluation might fruitfully constrain epistemological theory and yield insights for epistemological reflection. Several contributions to this volume explicitly address this general methodology, or some version of it. Others focus on (...) advancing some application of the methodology rather than on theorizing about it. The papers go on to explore the idea that purposes allow one to understand the conceptual demands on knowing, examine how purposeful epistemology might shed light on the debate between internalist and externalist epistemologies, and further develop the idea of purposeful epistemology. (shrink)

Julie K. Ward examines Aristotle's thought regarding how language informs our views of what is real. First she places Aristotle's theory in its historical and philosophical contexts in relation to Plato and Speusippus. Ward then explores Aristotle's theory of language as it is deployed in several works, including Ethics, Topics, Physics, and Metaphysics, so as to consider its relation to dialectical practice and scientific explanation as Aristotle conceived it.

ABSTRACTWhen faced with hardship, how do we emotionally appraise the situation? Although many factors contribute to our reasoning about hardships, in this article we focus on the role of linguistic metaphor in shaping how we cope. In five experiments, we find that framing a person’s cancer situation as a “battle” encourages people to believe that that person is more likely to feel guilty if they do not recover than framing the same situation as a “journey” does. Conversely, the “journey” frame (...) is more likely to encourage the inference that the person can make peace with their situation than the “battle” frame. We rule out lexical priming as an explanation for this effect and examine the generalizability of these findings to individual differences across participants and to a different type of hardship—namely, an experience with depression. Finally, we examine the language participants produced after encountering one of these metaphors, and we find tendencies to repeat and extend the metaphors encountered.... (shrink)

What is the role of language in constructing knowledge? In this article, we ask whether learning new relational language can create new ways of thinking. In Experiment 1, we taught English speakers to talk about time using new vertical linguistic metaphors, saying things like “breakfast is above dinner” or “breakfast is below dinner”. In Experiment 2, rather than teaching people new metaphors, we relied on the left–right representations of time that our American college student participants have already internalized through a (...) lifetime of visuospatial experience reading and writing text from left to right. In both experiments, we asked whether the representations are susceptible to verbal interference. We found that learning new metaphors created new space–time associations that could be detected in a nonlinguistic implicit association task; these newly learned representations were not susceptible to verbal interference; and with respect to both verbal and visual interference, representations newly learned from linguistic metaphor behaved just like those on the left–right axis that our participants had acquired through years of visuospatial experience. Taken together, these results suggest that learning new relational language can be a powerful tool in constructing new representations and expanding our cognitive repertoire. (shrink)

Many accounts of the morality of abortion assume that early fetuses must all have or lack moral status in virtue of developmental features that they share. Our actual attitudes toward early fetuses don’t reflect this all-or-nothing assumption: early fetuses can elicit feelings of joy, love, indifference, or distress. If we start with the assumption that our attitudes toward fetuses reflect a real difference in their moral status, then we need an account of fetal moral status that can explain that difference. (...) I argue that we can have or lack relational obligations to early fetuses in light of our own activities or choices, independent of the fetus’s own features or properties. Those relational obligations make the early fetus morally considerable to the persons who stand in a moral relation to it. Pregnant persons (and other participants in the procreative process) can come to have relational obligations to an early fetus just in virtue of their own decision to create a person, either by intentionally getting pregnant or by deciding to continue a pregnancy. That decision not only makes it appropriate for them to care about the fetus, but it also generates obligations to the fetus that they didn’t have before that decision. (shrink)

Languages around the world use a recurring strategy to discuss abstract concepts: describe them metaphorically, borrowing language from more concrete domains. We “plan ahead” to the future, “count up” to higher numbers, and “warm” to new friends. Past work has found that these ways of talking have implications for how we think, so that shared systems of linguistic metaphors can produce shared conceptualizations. On the other hand, these systematic linguistic metaphors might not just be the cause but also the effect (...) of shared, non‐linguistic ways of thinking. Here, we present a case study of a variety of American English in which a shared, non‐linguistic conceptualization of time has become crystallized as a new system of linguistic metaphors. Speakers of various languages, including English, conceptualize time as a lateral timeline, with the past leftward and the future rightward. Until now, this conceptualization has not been documented in the speech of any language. In two studies, we document how members of the U.S. military, but not U.S. civilians, talk about time using conventionalized lateral metaphors (e.g., “move the meeting right” to mean “move the meeting later”). We argue that, under the right cultural circumstances, implicit mental representations become conventionalized metaphors in language. (shrink)

Die Beiträge dieses Buches untersuchen die Vielfalt der Herangehensweisen an die diversen Erscheinungsformen von Sprache, an das Wort und die Wortsemantik sowie an den Gebrauch von Sprache. Der Band enthält Arbeiten, die linguistische Fragestellungen zu sprachsystematischen Aspekten der Wort-, Satz-, Text- und Diskursebene behandeln sowie Perspektiven eröffnen, um diverse Aspekte von Sprache in einem über diese Domänen hinausgehenden Rahmen zu betrachten. Die Beiträger diskutieren Fragen der lexikalischen Semantik, Pragmalinguistik, Morphologie und der Lexikographie. Das Buch setzt seine Schwerpunkte neben der Wortsemantik (...) auf die Eingebundenheit lexikalischer Bedeutungen in registerspezifische Diskursmuster, öffentliche, interpersonelle und geschäftlich-beruflich orientierte Diskurse. (shrink)

This book is the only contemporary, systematic study of the relationship of time and conscious experience. Peter K. Mclnerney examines three tightly interconnected issues: how we are able to be conscious of time and temporal entities, whether time exists independently of conscious experience, and whether the conscious experiencer exists in time in the same way that ordinary natural objects are thought to exist in time. Insight is drawn from the views of major phenomenological and existential thinkers on these issues. Building (...) on a detailed explication and critique of the views of Kant, Husserl, Heidegger, and Sartre, Mclnerney develops and defends his own positions. He argues that a revised version of Husserl’s three-feature theory of time-consciousness provides the best explanation of our awareness of temporal features, but that an independently real time is necessary to explain our experience of temporal passage. He also shows that human existence has some special temporal features in addition to those it shares with other entities. Time-consciousness, the conscious exercise of powers, and personal identity through time require that any temporal part of human existence be defined by and "reach across" to earlier and later parts. (shrink)

Rosenberg argues that intentional generalizations in the human sciences cannot be law-like because they are not amenable to significant empirical refinement. This irrefinability is said to result from the principle that supposedly controls in intentional explanation also serving as the standard for successful interpretation. The only credible evidence bearing on such a principle would then need conform to it. I argue that psychological generalizations are refinable and can be nomic. I show how empirical refinement of psychological generalizations is possible by (...) considering concrete cases. A sufficiently detailed view of the role of psychological generalizations in interpretation allows us to find in psychological investigations instances of bootstrap testing. (shrink)

ÖZ “Tanzanya’da Leibzig Misyoner Cemiyeti Misyonerliği, Karşılaşılan Zorluklar ve Kullanılan Yöntemler” isimli makale “Tanzanya’da Misyonerlik Faaliyetler Lutheran Kilise Örneği” isimli yüksek lisans tezine dayanmaktadır. Makale, Lutheran misyonerliğinin Tanzanya’da faaliyetlerine nasıl başladıkları, ilerleme yöntemleri ve karşılaşılan güçlükleri anlama noktasında önem arz etmektedir. Makalede ana konuya odaklanmadan önce, Tanzanya hakkında genel bir bilgilendirme yapılmış, ardından Leibzig Misyon Cemiyeti’nin (LMS) faaliyetlerine nasıl başladığı, kronolojik bir şekilde açmış olduğu istasyonlar, bu istasyonlarda karşılaşmış olduğu zorluklar ve kullanılan yöntemler hakkında bilgi verilmiştir. Ayrıca, Tanzanya’da Lutheran misyoner (...) cemiyetlerinin, Tanzanya Evanjelik Lutheran Kilisesi (Tanzania Evangelical Lutheran Church in Tanzania) ELCT ile tek bir kilise çatı altında toplanması ele alınmıştır. Son olarak, ELCT’nin kabul etmiş olduğu ilkeler ve Martin Luther’in öğretilerinin Afrika’daki yansımaları üzerinde durulmuştur. Makale, sadece misyonerleri ve misyonerlik faaliyetlerini değil, ayrıca muhatap olunan ve yüzyıllardır sömürgeleştirilen Afrika halkını anlamamıza da yardımcı olmaktadır. Araştırma, Lutheran misyonerliğinin Tanzanya’da başlamış olduğu 19. yüzyıl sonu ve yoğunlaştığı 20. yüzyıl ile sınırlandırılmıştır. Otto von Bismarck’ın (1815-1898) katkılarıyla gerçekleşen Berlin Konferansı sayesinde, batılı ülkelerin bayrakları ile haçları da sömürge topraklarına girmiştir. Tanzanya'da Lutheran Misyon, Johann Ludwig Krapf (1810-1881) ve Johannes Rebmann'ın (1820-1876) CMS tarafından görevlendirilmeleri sonucu başlamıştır. LMS, CMS'den 1892 tarihinde görevi devralmıştır ve Machame, Mamba, Old Moshi, Pare, Meru'da faaliyet göstermiştir. Misyon faaliyetleri süresince, savaşlar, kıtlık ve salgın, çok eşlilik, sünnet uygulaması, tanrı anlayışı gibi birçok zorlukla karşılaşılmıştır. Zorluklar, onları ortadan kaldırmaya yardımcı olacak; eğitim, sağlık, bütüncül hizmet, ortak dil (lingua franca), Kutsal Kitap çevirileri, ev ziyaretleri, yerli yardımcılar ve yerlileştirme gibi yöntemleri de beraberinde getirmiştir. Tanzanya’da LMS dışında; Katolik Kutsal Ruh Babaları (Holy Ghost Father/ Spiritanlar), Katolik Beyaz Babalar (Peres Blancs), Katolik Benediktinler, Anglikan Kilise Misyon Topluluğu (Chuch Missionary Society) CMS, Anglikan Üniversitelerin Orta Afrika Misyonu (The Universities’ Mission to Central Africa) UMCA gibi misyon grupları mevcuttur. Tanzanya'da bulunan Lutheran Misyon toplulukları, Evanjelik Lüteriyen Kilisesi (ELCT) adı altında 1963 yılında tek bir çatı altında toplanmıştır. ELCT bugün 5,2 milyon üyesi ile Tanzanya nüfusu içinde hatırı sayılır bir yere sahiptir. Bu çalışmada, deskriptif yöntem kullanılmıştır. Ulaşılabilen tüm ilk kaynaklara inilerek Lutheran misyonerler ve Tanzanya hakkında bilgi verilmiştir. Çalışmada Türkçe kaynaklara yer verilmekle birlikte yabancı kaynak kullanımına ve misyon topluluklarının bilinen kısaltmalarının kullanılmasına önem gösterilmiştir. Anahtar Kelimeler; Tanzanya, Hıristiyanlık, Misyonerlik, Lutheranizm, Leipzig Misyon Cemiyeti. (shrink)

Both philosophers and scientists have long assumed that the impetus to develop and hold afterlife beliefs was primarily provided by one’s fear of one’s own death (an egocentric view). Recent empirical studies, however, present compelling evidence against this assumption: it has been observed that participants intuitively believe that others survive death (an allocentric view). Despite this, most theories offered to explain this finding rely on egocentric mechanisms and claim that the deceased are represented as disembodied minds. Here, the author offers (...) an allocentric explanation for intuitive afterlife beliefs based on the intentional stance and offline social reasoning which suggests that the deceased should be represented as socially embodied. The author then argues that this socially embodied representation is more in line with both the findings and folk descriptions of those in the afterlife. Finally, the author discusses the impact on both the scientific and philosophical investigations into afterlife beliefs. (shrink)

A population policy, that assures the negative freedom of the individuals who are not forced to proceed on abortion, their well-being and their positive freedom of escaping from preventable mortality, of avoiding mortality during infancy and childhood, of being free from hunger and undernutrition, is possible in developing countries, if the developed states should realize that they overconsume and that they use nature as their own resource, at the expense of the rest of the world.By avoiding rich nations' overconsumption and (...) injustice towards the poor ones we are moving towards a restraint on resource depletion, environmental degradation, poverty and population explosion, on the destruction of a sustainable life in general. (shrink)

We consider the implications of trends in the number of U.S. farmers and food imports on the question of what role U.S. farmers have in an increasingly global agrifood system. Our discussion stems from the argument some scholars have made that American consumers can import their food more cheaply from other countries than it can produce it. We consider the distinction between U.S. farmers and agriculture and the effect of the U.S. food footprint on developing nations to argue there might (...) be an important role for U.S. farmers, even if it appears Americans don’t need them. For instance, we may need to protect U.S. farmland and, by implication, U.S. farmers, for future food security needs both domestic and international. We also explore the role of U.S. farmers by considering the question of whether food is a privilege or a right. Although Americans seem to accept that food is a privilege, many scholars and commentators argue that, at least on a global scale, food is a right, particularly for the world’s poor and hungry. If this is the case, then U.S. farmers might have a role in meeting the associated obligation to ensure that the poor of the world have enough food to eat. We look at the consequences of determining that food is a right versus a privilege and the implications of that decision for agricultural subsidies as well as U.S. agriculture and nutrition policies. (shrink)