Substance use disorders (SUDs) constitute a growing global health crisis, yet many limitations and challenges exist in SUD treatment research, including the lack of objective brain-based markers for tracking treatment outcomes. Electroencephalography (EEG) is a neurophysiological technique for measuring brain activity, and although much is known about EEG activity in acute and chronic substance use, knowledge regarding EEG in relation to abstinence and treatment outcomes is sparse. We performed a scoping review of longitudinal and pre-post treatment EEG studies that explored (...) putative changes in brain function associated with abstinence and/or treatment in individuals with SUD. Following PRISMA guidelines, we identified studies published between January 2000 and March 2022 from online databases. Search keywords included EEG, addictive substances (e.g., alcohol, cocaine, methamphetamine), and treatment related terms (e.g., abstinence, relapse). Selected studies used EEG at least at one time point as a predictor of abstinence or other treatment-related outcomes; or examined pre- vs. post-SUD intervention (brain stimulation, pharmacological, behavioral) EEG effects. Studies were also rated on the risk of bias and quality using validated instruments. Forty-four studies met the inclusion criteria. More consistent findings included lower oddball P3 and higher resting beta at baseline predicting negative outcomes, and abstinence-mediated longitudinal decrease in cue-elicited P3 amplitude and resting beta power. Other findings included abstinence or treatment-related changes in late positive potential (LPP) and N2 amplitudes, as well as in delta and theta power. Existing studies were heterogeneous and limited in terms of specific substances of interest, brief times for follow-ups, and inconsistent or sparse results. Encouragingly, in this limited but maturing literature, many studies demonstrated partial associations of EEG markers with abstinence, treatment outcomes, or pre-post treatment-effects. Studies were generally of good quality in terms of risk of bias. More EEG studies are warranted to better understand abstinence- or treatment-mediated neural changes or to predict SUD treatment outcomes. Future research can benefit from prospective large-sample cohorts and the use of standardized methods such as task batteries. EEG markers elucidating the temporal dynamics of changes in brain function related to abstinence and/or treatment may enable evidence-based planning for more effective and targeted treatments, potentially pre-empting relapse or minimizing negative lifespan effects of SUD. (shrink)

Scientists cannot devise theories, construct models, propose explanations, make predictions, or even carry out observations, without first classifying their subject matter. The goal of scientific taxonomy is to come up with classification schemes that conform to nature's own. Another way of putting this is that science aims to devise categories that correspond to 'natural kinds.' The interest in ascertaining the real kinds of things in nature is as old as philosophy itself, but it takes on a different guise when one (...) adopts a naturalist stance in philosophy, that is when one looks closely at scientific practice and takes it as a guide for identifying natural kinds and investigating their general features. This Element surveys existing philosophical accounts of natural kinds, defends a naturalist alternative, and applies it to case studies in a diverse set of sciences. This title is also available as Open Access on Cambridge Core. (shrink)

Group dynamics play an important role in the social interactions of both children and adults. A large amount of research has shown that merely being allocated to arbitrarily defined groups can evoke disproportionately positive attitudes toward one’s in-group and negative attitudes toward out-groups, and that these biases emerge in early childhood. This prompts important empirical questions with far-reaching theoretical and applied significance. How robust are these inter-group biases? Can biases be mitigated by behaviors known to bond individuals and groups together? (...) How can bonds be forged across existing group divides? To explore these questions, we examined the bonding effects of interpersonal synchrony on minimally constructed groups in a controlled experiment. In-group and out-group bonding were assessed using questionnaires administered before and after a task in which groups performed movements either synchronously or non-synchronously in a between-participants design. We also developed an implicit behavioral measure, the Island Game, in which physical proximity was used as an indirect measure of interpersonal closeness. Self-report and behavioral measures showed increased bonding between groups after synchronous movement. Bonding with the out-group was significantly higher in the condition in which movements were performed synchronously than when movements were performed non-synchronously between groups. The findings are discussed in terms of their importance for the developmental social psychology of group dynamics as well as their implications for applied intervention programs. (shrink)

The reflections that follow are written by Roisin Winston, Zoe Carletide, Naomi McLeod and Bahar Mustafa. These four young women outline their experience of feminism and in so doing suggest ways in which the Next Generation are thinking about ‘feminism’ and its relevance to their modern day lives. Topics discussed include sexuality, cultural differences, sex education, rape, and how the face of feminism is changing or needs to change. Thoughts range from a belief that the word ‘feminism’ has too (...) many negative connotations and thus it seems the term, and therefore the movement, is restricted by the glass ceiling which it aims to fight. Another view is that ‘Feminism,’ like any movement, will remain as relevant as it always has been until no person of any gender is coerced or compelled to act, think, feel or endure anything which has reductive gender inequality at its core. (shrink)

PurposeCancer can be a burden on the relationship and even lead to relationship dissolution. Previous studies about the impact of cancer on close relationships almost exclusively involve cancer patients. So far, little is known about the views of spouses. Therefore, this study focuses on partners or ex-partners of cancer patients.MethodsIn this cross-sectional study, N = 265 partners or ex-partners of cancer patients are examined regarding a possible separation, the reasons for separation and the influence of the cancer on the relationship. (...) In addition, predictors of separation and the positive or negative perception of the impact of cancer on the relationship were investigated.ResultsThe separation rate was marginally lower than in the general population in Germany. The most frequent reason for separation was the death of the cancer patient, followed by relationship problems, and the cancer disease itself. Among those who were separated, 57.4% reported that cancer contributed to the separation. On average, the influence of cancer on relationship dissolution is indicated with 82.9%. Also, for those who stayed together, 83.7% reported an impact of the cancer on the relationship, of which 55.9% reported a negative impact. Logistic regressions indicated that higher levels of depression were associated with greater odds of a more negative perception of the influence of cancer on the relationship, whereas a more satisfied relationship tended to be associated with a more positive perception. Those who had no psychological treatment in the past, lower anxiety levels and lower relationship satisfaction had an increased risk of separation. Overall, relationship satisfaction was significantly lower than in the general population in Germany.ConclusionIn particular, psychological factors such as depression and anxiety as well as relationship satisfaction appear to be factors influencing separation and the perception of the influence of cancer on the relationship as positive or negative. Therefore, it seems to be reasonable to consider these aspects in the psychosocial support and also to include the partners in order to achieve a stable and satisfied relationship which has a positive effect on health and psychological well-being. (shrink)

This essay examines why the recent recognition of human rights violations against women, as exemplified by Amnesty International's 1995 report on women, remains bound to the limitations of traditional approaches to human rights. The essay argues that despite Amnesty International's commitment to incorporating violations against women into its activities, it nevertheless upholds questionable assumptions about the gendered subject, gender relations within the family, and the relationship between the family and the state.

We begin by distinguishing computationalism from a number of other theses that are sometimes conflated with it. We also distinguish between several important kinds of computation: computation in a generic sense, digital computation, and analog computation. Then, we defend a weak version of computationalism—neural processes are computations in the generic sense. After that, we reject on empirical grounds the common assimilation of neural computation to either analog or digital computation, concluding that neural computation is sui generis. Analog computation requires continuous (...) signals; digital computation requires strings of digits. But current neuroscientific evidence indicates that typical neural signals, such as spike trains, are graded like continuous signals but are constituted by discrete functional elements (spikes); thus, typical neural signals are neither continuous signals nor strings of digits. It follows that neural computation is sui generis. Finally, we highlight three important consequences of a proper understanding of neural computation for the theory of cognition. First, understanding neural computation requires a specially designed mathematical theory (or theories) rather than the mathematical theories of analog or digital computation. Second, several popular views about neural computation turn out to be incorrect. Third, computational theories of cognition that rely on non-neural notions of computation ought to be replaced or reinterpreted in terms of neural computation. (shrink)

Review of Timothy Brennan (2021) Places of Mind: A Life of Edward Said. London: Bloomsbury.

Background:Forgiveness has the potential to resolve painful feelings arising from nurse–patient conflicts. It would be useful to evaluate direct and indirect important factors which are related to forgiveness in order to design interventions that try to facilitate forgiveness.Aim/objective:The purpose of this study was to evaluate the intermediating role of empathy in the cultural competence–forgiveness association among nurses using structural equation modeling.Research design:The research applied a cross-sectional correlational design.Participants and research context:The study included 380 nurses eight hospitals in southern Iran.Ethical considerations:The (...) Ethics and Research Committee of Birjand University of Medical Sciences approved the study protocol. The voluntary nature of participation was explained consent was obtained from participants, and anonymity was guaranteed.Findings:Most of the participants were married and female and fell in the 20- to 30-year-old category. Most of them (89.5%) had a working experience of 1–10 years. The proposed model showed that nurses’ empathy intermediated the association between nurses’ cultural competence and forgiveness which has fitted the data acceptably (root mean square error approximation = 0.070; comparative fit index = 0.993; goodness-of-fit index = 0.983; and χ2/df = 2.85).Conclusion:Empathy skills and cultural competence training were essential for interventions aimed at increasing the tendency to forgive patients. In such interventions, planners should aim at increasing nurses’ cultural competence in order to enhance their empathy toward patients, which can, in turn, lead to a greater wish to forgive patients. (shrink)

To determine the role of physical self in body-involving consumption, we explore how body image influences purchasing intention toward hybrid products with body-involving features. In this study, we establish the dual nature of body image: specifically, body image influences intention to purchase via the perception of utilitarian value and symbolic value. Further, we find a competitive mediation in which positive body image negatively influences purchase intention, while PBI is positively related to purchase intention via utilitarian and symbolic value. This indicates (...) that without the mediation testing of the utilitarian-symbolic framework, the positive influence of body image will be “hidden.” Additionally, the mediated effect of symbolic value is moderated by personal innovativeness toward technology, suggesting that a consumer’s knowledge of wearables enhances the effect of body image. With the introduction of body image, this paper provides a more comprehensive model to analyze purchase intention with regard to digital products with body-involving features. (shrink)

This chapter delves into the museological side of ‘the way forward’ to conservation for planetary health bioethics. Specifically, it highlights the crucial role that museums play – their curatorial or exhibition interventions, conservation operations, development policies, or practices – which present or represent the vital relationship between human and planetary health. While it is not new to stress the significance of museums’ link to the environment and environmental education, it is necessary to re-examine recent cases in light of the rapid (...) changes brought about by climate change and the constant call for sustainability. We thus offer a review of some recent literature that appraises the museum’s role in bioethically considering the health of our living planet. Learning this role taps into relatively new themes such as ecomuseums and architectural heritage, or critical eco-museology. (shrink)

Does phenomenal force, the distinctive phenomenology attributed to perceptual experience, really form an integral part of the latter? If not, what implications does it have for perceptual justification? In this paper, I first argue for a metacognitive account, according to which phenomenal force constitutes a separate, metacognitive state. This account opens up a previously unexplored path for challenging phenomenal conservatism or dogmatism, which has been a prominent theory of perceptual justification over the past two decades. Moreover, I investigate several alternative (...) possibilities in which phenomenal force might still be deemed as significant, but ultimately demonstrate that its epistemic role remains marginal at best. (shrink)

In research on Augustine, Peter Brown’s paradigm of ‘two Augustines’ has been widely used. According to Brown, Augustine experienced a shift from optimism to pessimism. In his earlier works, Augustine held that humans could achieve happiness in this life by reason. In contrast, in his later works, Augustine emphasised grace, original sin and the imperfection of life. Against Brown’s framework, this paper argues that Augustine does not experience a pessimistic turn. Augustine holds that humans can achieve happiness through faith, hope (...) and love.Contribution: This article explores Augustine’s theory of happiness and revises the ‘two Augustines’ paradigm. On the one hand, Augustine does not deny the freedom of will. On the other hand, Augustine is confident in happiness through faith, hope and love. (shrink)

The aim of this study was to investigate the effects of Islam as a religion and culture on Turkish women’s health. The study included 138 household members residing in the territory of three primary health care centers in Turkey: Güzelbahçe, Fahrettin Altay and Esentepe. Data were collected by means of a questionnaire prepared by a multidisciplinary team that included specialists from the departments of public health, psychiatric nursing and sociology. We found that the women’s health behavior changed from traditional to (...) rational as education levels increased, and that religious and traditional attitudes and behaviors were predominant in the countryside, especially practices related to pregnancy, delivery, the postpartum period, induced abortion and family planning. One of the most important prerequisites for the improvement of women’s health is that nurses should know the religious practices and culture of the society for which they provide care, so that their efforts to protect and improve women’s health will be effective. (shrink)

Based on the 2017 China General Social Survey data, with 5,439 observations as research objects, this paper empirically tests the impact of flexible employment on workers’ wellbeing and introduces labor income as mediator and social security as moderator to explore the mechanism of action. The empirical results show that: flexible employment has an inverted U-shaped relationship with workers’ wellbeing, which indicates that increasing employments’ flexibility will first rise and then reduce their perceived subjective wellbeing after reaching the peak; labor income (...) plays a mediating role in the relationship of flexible employment and wellbeing of workers; social security moderates the mediating effect of labor income whereas the moderating role in the relationship between flexible employment and workers’ wellbeing is not observed. Implications and future development of flexible employment are discussed. (shrink)

After the WHS inscription of the Historic Centre of Macau in 2005, the relationship between citizens of Macau and their heritage is not distanced. Most of these monuments remain functional for religious and social purposes and are actively engaged in public commercial activities such as the annual Macau Light Festival. Several historic houses have been transformed into either a permanent library or a museum where people can experience various events. With such frequent interaction, these monuments are more than just heritage (...) to locals; they are the venues where people’s daily lives are attached. However, this familiarity will cause a paradox in preservation since losing the distance might mean being unable to deliver the message of protection. It would be difficult to find a balance between preservation and reuse of heritage. This paper will use the Historic Centre of Macau as a case study to discuss the types of adaptive reuse in Macau and propose potential risks of these approaches. (shrink)

Seeking consensuses from the public is difficult, this also applies to the heritage sector, particularly in heritage preservation. ‘What, why and how to preserve?’ are the core of debates in the field and the differ- ences between points of views are basically due to the difference in valuation. In order to know everyone’s needs, views and expectations better and for sustainability, involving the community for preservation be- comes fundamental. Education, an experience which does not only provide opportunities for enlightenments and (...) widening horizons, but also introduce various concepts in terms of moral, ethical and social through systematic instructions. Having such great impact to community, promoting heritage education can be an effective approach awakening public consciousness on heritage preservation, and thus, enhancing people’s responsibility towards heritage, for both tangible and intangible, and developing a sustainable future for heritage through public engagement. However, it is necessary to understand the structure or the level of engagement prior setting the goal for heritage education. A model for classifying the level of engagement from performance is proposed for clarification and appraisal. This model is part of the research project of Community Engagement with Heritage in Macau which has an intention to examine its level of community engagement and give suggestions. This essay will first discuss community engagement, then classify the levels of engagement with models and lastly argue heritage education can elevate the level of community engagement which ultimately achieves the aim of heritage preservation. (shrink)

Psychological research has discovered that episodic memories are constructive in nature. This paper examines how, despite being constructive, episodic memories can provide us with justification for beliefs about the past. In current literature, two major approaches to memorial justification are internalist foundationalism and reliabilism. I first demonstrate that an influential version of internalist foundationalism, dogmatism, encounters problems when we compare certain types of memory construction with cognitive penetration in perception. On the other hand, various versions of reliabilism all face skeptical (...) challenges. I propose an alternative, two-factor theory that recognizes an epistemic distinction typically overlooked by dogmatism and reliabilism. Although our account leaves certain aspects unspecified, it is an important step forward. (shrink)

In the encounter between the Western and Eastern Cultures in the 20th century, the Chinese Buddhist classic Blue Cliff Record (Biyanlu 《碧巖錄》) was widely translated in Europe, especially in Germany. In the first part, this paper introduces the various German translations as well as their translators’ evaluations and discussions of the book and Chan Buddhism. In the second part, this paper argues that Blue Cliff Record represents a dynamic ontology by interpreting the Highest Meaning. In the third part, this paper (...) will present the self-understanding and freedom addressed in Blue Cliff Record. The paper shows that Chan Buddhism is characterized by its non-duality between convention and holiness and by the self-realization in this world. (shrink)

Plasmids are a major type of mobile genetic elements (MGEs) that mediate horizontal gene transfer. The stable maintenance of plasmids plays a critical role in the functions and survival for microbial populations. However, predicting and controlling plasmid persistence and abundance in complex microbial communities remain challenging. Computationally, this challenge arises from the combinatorial explosion associated with the conventional modeling framework. Recently, a plasmid‐centric framework (PCF) has been developed to overcome this computational bottleneck. This framework enables the derivation of a simple (...) metric, the persistence potential, to predict plasmid persistence and abundance. Here, we discuss how PCF can be extended to account for plasmid interactions. We also discuss how such model‐guided predictions of plasmid fates can benefit from the development of new experimental tools and data‐driven computational methods. (shrink)

The notion of 'natural kinds' has been central to contemporary discussions of metaphysics and philosophy of science. Although explicitly articulated by nineteenth-century philosophers like Mill, Whewell and Venn, it has a much older history dating back to Plato and Aristotle. In recent years, essentialism has been the dominant account of natural kinds among philosophers, but the essentialist view has encountered resistance, especially among naturalist metaphysicians and philosophers of science. Informed by detailed examination of classification in the natural and social sciences, (...) this book argues against essentialism and for a naturalist account of natural kinds. By looking at case studies drawn from diverse scientific disciplines, from fluid mechanics to virology and polymer science to psychiatry, the author argues that natural kinds are nodes in causal networks. On the basis of this account, he maintains that there can be natural kinds in the social sciences as well as the natural sciences. (shrink)

This paper proposes a novel way to understand trust in blockchain technology by analogy with trust placed in institutions. In support of the analysis, a detailed investigation of institutional trust is provided, which is then used as the basis for understanding the nature and ethical limits of blockchain trust. Two interrelated arguments are presented. First, given blockchains’ capacity for being institution-like entities by inviting expectations similar to those invited by traditional institutions, blockchain trust is argued to be best conceptualized as (...) a specialized form of trust in institutions. Keeping only the core functionality and certain normative ideas of institutions, this technology broadens our understanding of trust by removing the need for third parties while retaining the value of trust for the trustor. Second, the paper argues that blockchains’ decentralized nature and the implications and effects of this decentralization on trust issues are double-edged. With the erasure of central points, the systems simultaneously crowd out the pivotal role played by traditional institutions and a cadre of representatives in meeting their assigned obligations and securing the functional systems’ trustworthy performances. As such, blockchain is positioned as a technology containing both disruptive features that can be embedded with meaningful normative values and inherent ethical limits that pose a direct challenge to the actual trustworthiness of blockchain implementations. Such limits are proposed to be ameliorated by facilitating a shift of responsibility to the groups of people directly associated with the engendering of trust in the blockchain context. (shrink)

Coping with uncertainty is a necessary part of ordinary life and is crucial to an understanding of how the mind works. For example, it is a vital element in developing artificial intelligence that will not be undermined by its own rigidities. There have been many approaches to the problem of uncertain inference, ranging from probability to inductive logic to nonmonotonic logic. Thisbook seeks to provide a clear exposition of these approaches within a unified framework. The principal market for the book (...) will be students and professionals in philosophy, computer science, and AI. Among the special features of the book are a chapter on evidential probability, which has not received a basic exposition before; chapters on nonmonotonic reasoning and theory replacement, matters rarely addressed in standard philosophical texts; and chapters on Mill's methods and statistical inference that cover material sorely lacking in the usual treatments of AI and computer science. (shrink)

The anecdote of Zhuangzi and Hui Shi's brief discussion on a bridge above the Hao river gives us a nice piece of reasoning in ancient Chinese texts that may serve as a platform for a productive philosophical exchange between the East and the West. The present study examines Hansen's inferential analysis of Zhuangzi and Hui Shi's discussion in this spirit. It is argued that Hansen's analysis founders. To do justice to both Hui Shi and Zhuangzi, the present study proposes that (...) we apply the logic developed in the later Mohist text, the Lesser Pick, to an analysis of their discussion. The re-analysis shows that the intricate dialectic of the reasoning in which Zhuangzi and Hui Shi engage, neatly accords with the pattern of discourse expounded in the Lesser Pick, and gives us global insight into Zhuangzi's final statement in the anecdote, which is notoriously recondite, or confusing. (shrink)

Muslim communities in the village facing the COVID-19 Pandemic attempts to find refuge from the plague and hope for survival. However, this led to more caution, which may lead to xenophobia. Via ethnography, this study unmasks the xenophobic attitude. This research discusses the root causes of panic in the community so that remedies can be implemented. The research attempts to explain, from a socio-anthropological viewpoint, how people and religious groups in the village perceive the pandemic of COVID-19 based on their (...) belief in their faith and in the science. The research takes place in Cigagak village, an area of approximately 7000 m2 on the outskirts of Bandung of West Java of Indonesia. This study examines the selected respondents from about 190 inhabitants who had close ties to managing places of worship and public places. This study utilises a collaborative self-ethnographic method and qualitative analysis. The influence of COVID-19 has moved to new exclusive and disintegrating practices from the inclusion-cohesive religious tradition. Therefore, this study tries to find out ways on how to reduce exclusive perception and religious practices to a minimum level and how to disappear xenophobia. Amid the COVID-19 Pandemic, inclusive awareness and actions were re-established, and even social cohesiveness was fostered. This study concludes that in its deep conviction nature, theology can change exclusive behaviour to be inclusive if it is based on the religious principles that are raised in response to human events. In this case, the Muslim community in a village can change the fear of COVID-19 pandemic to be a reducer of the panic based on the support of the religious doctrines.Contribution: This article used a collaborative self-ethnography with a religious socio-anthropological viewpoint. This study could help to solve social problems through theological convergence in Islamic milieu, especially that of the government’s formal Islamic organisation and organic Islamic leaders of the society. (shrink)

As an important view in the epistemology of perception, dogmatism proposes that for any experience, if it has a distinctive kind of phenomenal character, then it thereby provides us with immediate justification for beliefs about the external world. This paper rejects dogmatism by looking into the epistemology of imagining. In particular, this paper first appeals to some empirical studies on perceptual experiences and imaginings to show that it is possible for imaginings to have the distinctive phenomenal character dogmatists have in (...) mind. Then this paper argues that some of these imaginings fail to provide us with immediate justification for beliefs about the external world at least partly due to their inappropriate etiology. Such imaginings constitute counterexamples to dogmatism. (shrink)

According to phenomenal conservatism or dogmatism, perceptual experiences can give us immediate justification for beliefs about the external world in virtue of having a distinctive kind of phenomenal character—namely phenomenal force. I present three cases to show that phenomenal force is neither pervasive among nor exclusive to perceptual experiences. The plausibility of such cases calls out for explanation. I argue that contrary to a long-held assumption, phenomenal force is a separate, non-perceptual state generated by some metacognitive mechanisms that monitor one’s (...) first-order mental processes and states. This new account advances our understanding of the nature of phenomenal force. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Helping a Muslim Family to Make a Life–and–Death Decision for Their Beloved Terminally Ill FatherBahar BastaniI live in a city in the Midwest with a population of around two million people. There are an estimated 2,000 Iranians living in this city, the vast majority of which belong to Shia sect of Islam. [End Page 190] However, the vast majority is also not very religious. Over the past two decades (...) that I have been living in this city, professionally in the capacity of a physician and university faculty at a school of medicine, and socially as one of the community leaders with a particular role in religious matters, I have acquired the trust of my community. Following one of my yearly routine travels to my homeland, Iran, I had just returned to work when I received a phone call from one of the Iranian community members. He informed me that his father was very ill and was hospitalized, and that the physicians had introduced the idea of stopping life support. The family was experiencing a significant emotional, moral and religious dilemma as to whether they could consent to this. I was requested by the patient’s children to help them make the right decision.I requested that the oldest son, who had called me, to ask the three other siblings and their mother to be present at the bedside of the patient that night, so that we could discuss the matters face–to–face. That same night, all requisite family members and myself gathered at the bedside of this 88–year–old husband and father, who had developed multi–organ failure, which commenced with an infection following a heart valve replacement, followed by bacteremia and sepsis. Moreover, the patient was hypotensive, had developed respiratory failure requiring intubation and artificial ventilation, and had also developed hematologic coagulation abnormalities secondary to sepsis. Because of the sepsis, hypotension, and multiple drugs, including antibiotics and vasopressors, his kidneys had also failed, and there was a need to start hemodialysis if his life was to be maintained. After speaking with the intensive care physicians who were taking care of this elderly gentleman, it became clear to me that further care was futile, and there was absolutely no hope for him to recover from his multiple organ failure. I presented all the facts that I had acquired to the family members, and expressed my own viewpoint that I agreed with those physicians and that further care of their beloved, terminally ill husband and father was futile and only extended his dying. My assurances made it easier for the family members, particularly for his four sons who were present, to come to the decision to withdraw life support. After I informed the intensive care physicians of the family’s decision, the patient was heavily sedated with morphine, and the intravenous fluids, antibiotics, vasopressors, and the ventilator machine were all stopped. Over the next several minutes, the patient developed agonal breathing, his blood pressure dropped to zero, and his heart stopped. During the last few minutes of his life, I held the hands of the family members, we all prayed Islamic prayers to bless his soul while departing from his body. The next day, I supported the family with funeral services that included the Islamic prayers for the dead, the ceremonial religious washing of the body of the deceased, and the ceremonial religious burial.The dilemma that this family faced was multi-factorial: (1) the children had spent all of their adult life in America, and were unfamiliar with Islamic end of life and funeral traditions; (2) they had been asked by their father’s physicians to make a decision regarding the withdrawal of life support, which posed a moral and ethical dilemma; (3) they did not know whether it was religiously acceptable to withdraw life support; and (4) they did not know what type of funeral service would be acceptable to the religious beliefs of their deceased father.My presence as a trusted community leader, physician and religious leader was reassuring to the family members that the decision to stop life support for their loved one with a terminal illness and multiple organ... (shrink)