Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for the review; (3) (...) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

According to a widely accepted belief, we cannot know our own death—death means ‘nothing’ to us. At first sight, the meaning of ‘nothing’ just implies the negation or absence of ‘something’. Death then simply refers to the negation or absence of life. As a consequence, however, death has no meaning of itself. This leads to an ontological paradox in which death is both acknowledged and denied: death is … nothing. In this article, I investigate whether insight into the ontological paradox (...) of the nothingness of death can contribute to a good end-of-life. By analysing Aquinas’, Heidegger’s and Derrida’s understanding of death as nothingness, I explore how giving meaning to death on different ontological levels connects to, and at the same time provides resistance against, the harsh reality of death. By doing so, I intend to demonstrate that insight into the nothingness of death can count as a framework for a meaningful dealing with death. (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

" Dr. Cassell discusses the world of the sick, the healing connection and healer's battle, the role of omnipotence in the healer's art, illness and disease, and ...

The theory and practice of history and its relevance to the modern world, by Britains greatest radical historian.

Extracorporeal membrane oxygenation (ECMO) is currently reserved predominantly for bridging patients to a different destination therapy, but the use of ECMO as a destination therapy itself (ECMO-DT...

Medicine and ethics alike must learn properly to attend to suffering. We can never truly experience another's distress. We can, however, learn to recognize the particular purposes, values, and aesthetic responses that shape the sense of self whose integrity is threatened by pain, disease, and the mischances of life.

Like the broom in “The Sorcerer's Apprentice,” technologies take on a life of their own. To bring them under control, doctors must learn to tolerate ambiguity, resist the lure of the immediate, cease fearing uncertainty, and rechannel their response to wonder.

Sound is key to our lives, and is the most accessible portal to the vibratory universe. This book takes you there.

Peter Blickle, the great scholar of the German Peasants' War of 1525, has asserted that “in the late Middle Ages Europe saw itself confronted with a phenomenon which had been unknown in the previous history of the west—the peasant rebellion.” Is it indeed true that there are no reports of peasant revolts before the fourteenth century and in the early Middle Ages in particular? If one were to answer this question based on the Western scholarship of popular uprisings that has (...) flourished over the last few decades, one might concur with Blickle, since this research has focused almost exclusively on the fourteenth through sixteenth centuries. Yet there are a few recorded examples of peasant rebellions from the early Middle Ages, although dramatically fewer than in the late Middle Ages and the early modern period. The early-medieval revolt about which we have the most information is the Saxon Stellinga uprising of 841–42. Gerward, the author of the Annals of Xanten, described this revolt with the following words: “That same year throughout all of Saxony the power of the slaves rose up violently against their lords. They usurped for themselves the name Stellinga [apparently Old Saxon for ‘companions’ or ‘comrades’], and they perpetrated much madness. And the nobles of that land were violently persecuted and humiliated by the slaves.” As the only recorded European popular revolt between the sixth and tenth century, the rebellion of the Saxon Stellinga demands an explanation. (shrink)

Let X be an infinite set and let and denote the propositions “every filter on X can be extended to an ultrafilter” and “X has a free ultrafilter”, respectively. We denote by the Stone space of the Boolean algebra of all subsets of X. We show: For every well‐ordered cardinal number ℵ, (ℵ) iff (2ℵ). iff “ is a continuous image of ” iff “ has a free open ultrafilter ” iff “every countably infinite subset of has a limit point”. (...) implies “every open filter on extends to an open ultrafilter” implies “has an open ultrafilter” implies It is relatively consistent with that (ω) holds, whereas (ω) fails. In particular, none of the statements given in (2) implies (ω). (shrink)

My conclusions are threefold: The subject of cosmic evolution is my religion. The process of change itself (especially developmental change) is my God. And global ethics and a planetary culture, which cosmic evolution mandates, are the key to the survival of technologically competent life forms, both here on Earth and perhaps elsewhere in the Universe.

The Prudence of Love focuses upon the intersection of philosophical, theological, and psychological issues related to love. Eric Silverman defends an account of love derived from the views of Thomas Aquinas and argues that love provides numerous psychological and relational benefits that increase the lover's happiness. Furthermore, he argues that love is beneficial according to all major contemporary accounts of happiness.

The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...) respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson. (shrink)

The goals of medicine -- A story about a patient with aortic stenosis -- What are facts in medicine? -- Clarify the chain of events that led to the present state : the case as a narrative -- The case of Myra Manner -- Examine your presuppositions and preconceptions -- Separate and examine the values at issue -- A question of judgment -- The patient, the doctor, and the relationship -- Observation, prognosis, and prognosticating -- Thinking in medicine -- Accepting (...) the challenge. (shrink)

Although written primarily for medical research, the Belmont principles have permeated clinical medicine as well. In fact, they are part of a broad cultural shift that has dramatically reworked the relationship between doctor and patient. In the early 1950s, medicine was about making the patient better and maintaining optimism when the patient could not get better. By the 1990s, medicine was about the treatment of specific physiological systems, as directed by the patient, but as limited by the society's concern for (...) justice. (shrink)

Bioethics, Volume 36, Issue 1, Page 63-70, January 2022.

The cell division and differentiation events that occur during the development of the nematode Caenorhabditis elegans are nearly identical between different individuals, a feature that distinguishes this organism from larger and more complex metazoans, such as humans and Drosophila. In view of this discrepancy, it might be expected that the regulation of cell growth, division and differentiation in C. elegans would involve mechanisms separate from those utilized in larger animals. However, the results of recent genetic, molecular and cellular studies indicate (...) that C. elegans employs an arsenal of developmental regulatory mechanisms quite similar to those wielded by its arthropod and vertebrate relatives. Thus, the nematode system is providing both novel and complementary insights into the general problem of how growth and patterning events are integrated in development. This review offers a general perspective on the regulation of cell division and growth in C. elegans, emphasizing recent studies of these crucial aspects of development. BioEssays 24:38–53, 2002. © 2002 John Wiley & Sons, Inc. (shrink)

Debates concerning the relationship between Tridentine Catholicism and Catholicism after Vatican II dominate theological conversation today, particularly with regard to understandings of the Church and its engagement with the world. Current historical narratives paint ecclesiology after the Council of Trent as dominated by juridical concerns, uniformity, and institutionalism. Purportedly neglected are the spiritual, diverse, and missional aspects of the Church. This book challenges such narratives by investigating the Spanish Jesuit Francisco Suárez's theology of ecclesial unity and catholicity. Analyzing standard as (...) well as overlooked sources of Suárez's ecclesiology, the author shows how Suárez wrestles with the new demands of his time and anticipates later ecumenical developments in twentieth-century Catholic ecclesiology. Early modern expansion prompted theologians after Trent to reckon with the ecclesial status of baptized Protestants, the Greek Orthodox, and non-believers in the New World. It further prompted reflection on the universality, or catholicity, of the Church, and how the Church's mission to the nations serves her greater unity in Christ. Throughout this exposition, the author reveals Suárez's vision of the Church to be deeply spiritual, diverse, and missional-not at the expense of the institutional, but as it's necessary and life-giving source. The Church, for Suárez, is primarily a way of life. This book explores not only Suárez's speculative ecclesiology, but how the unity and catholicity of the body of Christ is lived out in practice, that is, in the worship and works of the faithful, and, most notably, in the charism of his own religious order, the Society of Jesus. Suárez thus shows his readers what the spiritual dynamic between Christic unity and missional catholicity should look like in the Church. (shrink)

Alexander George has put forward a novel interpretation of the Quine-Carnap debate over analyticity. George argues that Carnap's claim that there exists an analytic-synthetic distinction was held by Carnap to be empty of empirical consequences. As a result, Carnap understood his position to be empirically indistinguishable from Quine's. Although George defends his interpretation only briefly, I show that it withstands further examination and ought to be accepted. The consequences of accepting it undermine a common understanding of Quine's criticism of Carnap, (...) and I argue that it is difficult to find a perspective from which Quine can criticize Carnap in a non-question-begging way. (shrink)

Book reviewed in this article: Thinking Clearly About Death. By Jay F. Rosenberg.

Originalism as Faith presents a comprehensive history of the originalism debates. It shows how the doctrine is rarely used by the Supreme Court, but is employed by academics, pundits and judges to maintain the mistaken faith that the Court decides cases under the law instead of the Justices' personal values. Tracing the development of the doctrine from the founding to present day, Eric J. Segall shows how originalism is used by judges as a pretext for reaching politically desirable results. (...) The book also presents an accurate description and evaluation of the late Justice Scalia's jurisprudence and shows how he failed to practice the originalism method that he preached. This illuminating work will be of interest to lawyers, law students, undergraduates studying the Court, law professors and anyone else interested in an honest discussion and evaluation of originalism as a theory of constitutional interpretation, a political weapon, and an article of faith. (shrink)

Phagocytosis is the process of recognition and engulfment of microorganisms or tissue debris that accumulate during infection, inflammation or wound repair. This ingestion, which is performed most efficiently by migrating, bone marrow‐derived cells called ‘professional phagocytes’, is essential for successful host defense. Ingestion results when an invading microorganism is recognized by specific receptors on the phagocyte surface and requires multiple, successive interactions between the phagocyte and the target. Each of these interactions results in a signal transduction event, which is confined (...) to the membrane and cytoskeleton around the ligated receptor and which is required for successful phagocytosis. Many molecules found at sites of inflammation or infection stimulate phagocytosis, so that efficient ingestion is confined to the site of infection or inflammation, which in turn limits the proinflammatory and tissue‐destructive processes that accompany phagocytosis. This review summarizes current understanding of this critical component of host defense and of its regulation. (shrink)

Aristotle's theory of moral character focuses on developing virtues, the deep internal dispositional traits from which external actions naturally flow. Aristotle describes moral virtue as a human excellence that can be developed through practice. The morally worst person is the vicious person who does the wrong thing, desires the wrong thing, and doesn't even know the right thing to do—perhaps even mistaking the wrong thing to do for the right thing. This was the sort of person Eleanor was when she (...) entered The Good Place. One objection to the possibility of moral development is called situationism: the claim that people don't really live according to moral character but are overwhelmingly shaped by the situations around them. As Eleanor learns in The Good Place, the road to being a better person starts with caring about those close to us. (shrink)