These two lectures by Jacques Derrida, 'Foreigner Question: Come from Abroad' and 'Step of Hospitality/No Hospitality', derive from a series of seminars on 'hospitality' conducted by Derrida in Paris, January 1996. The book consists of two texts on facing pages. 'Invitation' by Anne Dufourmantelle appears on the left clarifying and inflecting Derrida's 'response' on the right. The interaction between them not only enacts the 'hospitality' under discussion, but preserves something of the rhythms of teaching. The book also characteristically combines careful (...) readings of canonical texts and philosophical topics with attention to the most salient events in the contemporary world, using 'hospitality' as a means of rethinking a range of political and ethical situations. For example, Antigone is revisited in light of the question of impossible mourning; the trial of Socrates is brought into conjunction with the televised funeral of François Mitterrand. (shrink)

ArgumentIn this article we examine how a leading Israeli hospital gradually became a large biomedical research facility, resembling a huge laboratory. For Chaim Sheba (1908-1971), the founder and first director of Tel-Hashomer Hospital, the massive immigration to Israel in the 1950s was a unique opportunity for research of diverse human populations, especially Jews who had arrived to Israel from Asia and Africa. The paper focuses on the way research and medical practices were integrated and their boundaries blurred, and studies the (...) conditions under which an entire hospital became a research field. Using the case of one of Israel’s prominent medical institutes, we explore and expand upon the idea of “the hospital as a laboratory,” arguing that, for Sheba, it was not only the hospital but the entire country that functioned as a great research site—a vast laboratory that “had no walls.”. (shrink)

BackgroundAn ethics reflection group is one of a number of ethics support services developed to better handle ethical challenges in healthcare. The aim of this article is to evaluate the significance of ERGs in psychiatric and general hospital departments in Denmark.MethodsThis is a qualitative action research study, including systematic text condensation of 28 individual interviews and 4 focus groups with clinicians, ethics facilitators and ward managers. Short written descriptions of the ethical challenges presented in the ERGs also informed the analysis (...) of significance.ResultsA recurring ethical challenge for clinicians, in a total of 63 cases described and assessed in 3 ethical reflection groups, is to strike a balance between respect for patient autonomy, paternalistic responsibility, professional responsibilities and institutional values. Both in psychiatric and general hospital departments, the study participants report a positive impact of ERG, which can be divided into three categories: 1) Significance for patients, 2) Significance for clinicians, and 3) Significance for ward managers. In wards characterized by short-time patient admissions, the cases assessed were retrospective and the beneficiaries of improved dialogue mainly future patients rather than the patients discussed in the specific ethical challenge presented. In wards with longer admissions, the patients concerned also benefitted from the dialogue in the ERG.ConclusionThis study indicates a positive significance and impact of ERGs; constituting an interdisciplinary learning resource for clinicians, creating significance for themselves, the ward managers and the organization. By introducing specific examples, this study indicates that ERGs have significance for the patients discussed in the specific ethical challenge, but mostly indirectly through learning among clinicians and development of clinical practice. More research is needed to further investigate the impact of ERGs seen from the perspectives of patients and relatives. (shrink)

The question "Where do we come from?" has fascinated philosophers, scientists, and artists for generations. This book reorients the question of the matrix as a place where everything comes from (_chora_, womb, incubator) by recasting it in terms of acts of "matrixial/maternal hospitality" producing space and matter of and for the other. Irina Aristarkhova theorizes such hospitality with the potential to go beyond tolerance in understanding self/other relations. Building on and critically evaluating a wide range of historical and contemporary scholarship, (...) she applies this theoretical framework to the science, technology, and art of ectogenesis (artificial womb, neonatal incubators, and other types of generation outside of the maternal body) and proves the question "Can the machine nurse?" is critical when approaching and understanding the functional capacities and failures of incubating technologies, such as artificial placenta. Aristarkhova concludes with the science and art of male pregnancy, positioning the condition as a question of the hospitable man and newly defined fatherhood and its challenge to the conception of masculinity as unable to welcome the other. (shrink)

The image of the hospital is presented to the public as a place of healing. Though the oft‐criticized total institutions of the past have been notably dismantled, the totalizing practices therein are now operationalized in the health care system. Through the lens of Erving Goffman, this article offers ways in which health care institutions operationalize totalizing practices, contributing to the mortification of patients and nurses alike in service to the bureaucratic machine. This article examines the ways in which totalizing practices (...) may disrupt the agency of both patients and nurses alike. (shrink)

Derrida's work on hospitality presents particular local conventions of hospitality as in a necessary but impossible relationship with an absolute hospitality, the obligation to welcome the other without conditions. Although this absolute hospitality is commonly read as the aspiration to which all of our practices of hospitality should tend, Derrida proposes a series of examples that show the dangers implicit in an automatic or limitless welcoming. The most famous of these is that of the Old Testament patriarch, Lot. The aim (...) of this paper is to show, however, that the Genesis story is not primarily a parable about correct and incorrect practices of hospitality. In fact, what is at stake in the visit of the angels to Lot is the covenant between Abraham's line and the divine and the coming into the world of God's absolute sovereign violence. Derrida's account of hospitality is thus part of his discussion of sovereignty, its limitlessness, force and danger. (shrink)

Background: High ethical sensitivity positively affects the quality of nursing care; nevertheless, Chinese nurses’ ethical sensitivity and the factors influencing it have not been described. Research objectives: The purpose of this study was to describe ethical sensitivity and to explore factors influencing it among Chinese-registered nurses, to help nursing administrators improve nurses’ ethical sensitivity, build harmony between nurses and patients, and promote the patients’ health. Research design: This was a descriptive, cross-sectional study. Participants and research context: We recruited 500 nurses (...) from several departments in three tertiary hospitals. The Chinese Moral Sensitivity Questionnaire–Revised version and the Jefferson Scale of Empathy-Health Professionals were used to assess the nurses’ ethical sensitivity and empathy ability, respectively. Fifteen sociodemographic variables were included in the questionnaires. Ethical considerations: Informed consent was obtained from the participants regarding participation and data storage and handling. This program has been examined and supported by the research center of medical ethics and professional ethics of Guilin Medical University. The Approval No. was 2016RWYB04. The whole research process is conducted strictly according to ethical requirements. Results: The valid response rate was 84.40%. The total score of Chinese Moral Sensitivity Questionnaire–Revised was 35.82 ± 8.17. The subscale scores of moral responsibility and strength and sense of moral burden were 21.50 ± 4.91 and 14.33 ± 3.98, respectively. Significant differences were found among age groups, gender, years of working, category of profession, and quality of family communication regarding nurses’ ethical sensitivity. Regression analysis showed that the main factors influencing nurses’ ethical sensitivity were gender, years of working, quality of family communication, career satisfaction, and empathic ability. Discussion: Our findings suggest that Chinese nurses’ ethical sensitivity in tertiary hospitals in Guilin is at a medium level. Conclusion: The director of nursing schools and hospitals in China should pay attention to nurses’ ethical sensitivity and should intensify education and training to improve nurses’ ethical sensitivity. Further studies should focus on interventions aimed at improving Chinese nurses’ ethical sensitivity. (shrink)

We almost can’t find among the countries of the East one not to praise or to display as own virtues – particular or specific – hospitality and tolerance. In fact, to project such qualities in a privileged register of categories is a part of a quasi-generalized imagologic strategy meant to valorize the positive character of some traits – ethnic, national or belonging to a group. Each country needs a favorable mythology, luxuriant in fairytales, heroes, acts of bravery, one in which (...) to be able to project its obsessions and nostalgias, composing a self image as good as possible. Is the fervor of idealization a sin? Certainly not, if the purposes are reasonable, and not subjected to some insidious ideological or propagandistic finalities. (shrink)

The considerable attention to financial interests in clinical research has focused mostly on academic medical centers, even though the majority of clinical research is conducted in community practice settings. To fill this gap, this article maps the practices and policies in 73 community hospitals and several hundred specialized facilities around the country for reviewing clinical investigators’ financial relationships with research sponsors. Community hospitals face a substantially different mix of issues than academic medical centers do because their physician researchers are usually (...) not employees, and more of their studies are later-phase, multicenter trials. Accordingly, community physicians stand to benefit personally from per capita payments, but they tend to have less direct influence over research findings when compared with their academic peers. These and other contrasts require separate guidance for community-based organizations that takes into account their particular needs, circumstances, and institutional capacities. (shrink)

According to UNESCO guidelines, one of the four forms of bioethics committees in medicine are the Hospital Ethics Committees. The purpose of this study was to evaluate how the above guidelines are implemented in real practice. There were 111 hospitals selected out of 176 Polish clinical hospitals and hospitals accredited by Center of Monitoring Quality in Health System. The study was conducted by the survey method. There were 56 hospitals that responded to the survey. The number of HECs members fluctuated (...) between 3 and 16 members, where usually 5 members were part of the board committee. The composition of the HECs for professions other than physicians was diverse and non-standardized. Only 55 % of HECs had a professional set of standards. 98 % of HECs had specific tasks. 62 % of HECs were asked for their expertise, and 55 % prepared <6.88 % of the opinions were related to interpersonal relations between hospital personnel, patients and their families with emphasis on the interactions between superiors and their inferiors or hospital staff and patients and their families. Only 12 % of the opinions were reported by the respondents as related to ethical dilemmas. In conclusion, few Polish hospitals have HECs, and the structure, services and workload are not always adequate. To ensure a reliable operation of HECs requires the development of relevant legislation, standard operating procedures and well trained members. (shrink)

In Hospitality, Volume I, Jacques Derrida continues a seminar series he inaugurated in 1991 under the general title of "Questions of Responsibility." Delivered at the École des Hautes Études en Sciences Sociales (EHESS) in Paris from November 1995 through June 1996, the seminar is guided by questions that focus on responsibility and "the foreigner": How is the foreigner welcomed and/or repressed? What does the notion of the foreigner reveal about kinship, ethnicity, the city, the state, and the nation? What are (...) the stakes of the opposition between friend and enemy? How should we think of this in relation to borders, citizenship, displaced populations, immigration, exile, asylum, integration, assimilation, xenophobia, and racism? Derrida approaches these questions through readings of several classical texts as well as more modern texts from Heidegger, Arendt, and Camus, among others. Central to his project is a rigorous distinction between conventional hospitality (always finite and conditional) and the idea of a hospitality open unconditionally to the newcomer. (shrink)

These two lectures by Jacques Derrida, "Foreigner Question" and "Step of Hospitality/No Hospitality," derive from a series of seminars on "hospitality" conducted by Derrida in Paris, January 1996. His seminars, in France and in America, have become something of an institution over the years, the place where he presents the ongoing evolution of his thought in a remarkable combination of thoroughly mapped-out positions, sketches of new material, and exchanges with students and interlocutors. As has become a pattern in Derrida's recent (...) work, the form of this presentation is a self-conscious enactment of its content. The book consists of two texts on facing pages. "Invitation" by Anne Dufourmantelle appears on the left, clarifying and inflecting Derrida's "response" on the right. The interaction between them not only enacts the "hospitality" under discussion, but preserves something of the rhythms of teaching. The volume also characteristically combines careful readings of canonical texts and philosophical topics with attention to the most salient events in the contemporary world, using "hospitality" as a means of rethinking a range of political and ethical situations. "Hospitality" is viewed as a question of what arrives at the borders, in the initial surprise of contact with an other, a stranger, a foreigner. For example, Antigone is revisited in light of the question of impossible mourning; _Oedipus at Colonus_ is read via concerns that also apply to teletechnology; the trial of Socrates is brought into conjunction with the televised funeral of François Mitterrand. (shrink)

RATIONALE, AIM AND OBJECTIVE: Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in (...) prescribing drugs, using a qualitative approach. (shrink)

Kant’s theory of international politics and his right of hospitality are commonly associated with expansive projects of securing human rights or cosmopolitan governance beyond state borders. This article shows how this view misunderstands Kant’s criticism of the law of nations tradition as handed down into the eighteenth century as well as the logic of his radical alternative, which was designed to explain the conditions of possibility of global peace as a solution to the Hobbesian problem of a war of all (...) against all in the state of nature. I resolve longstanding confusion over the meaning and justification of Kant’s right of “hospitality” by showing how it functions not as a freestanding positive claim demanding enforcement but as a way of ruling out specious justifications for war against those the traditional law of nations permitted one to label “enemies.” This poses important questions for contemporary theories of global justice. (shrink)

This paper presents part of a larger study of contemporary nursing practice and the rationalisation of hospital length of stay. Informed by Michel Foucault's work on governmentality, length of hospital stay and the re-engineering of surgical services are examined, not in terms of numerical representations of hospital use, but as part of social and political processes through which certain concepts are made susceptible to measurement and practices are organised. Using data generated through fieldwork in a hospital surgical division this analysis (...) offers understandings of how social practices around length of hospital stay are translated and how they pattern contemporary hospital nursing practice. Nursing practice is explored through the reconstitution of hospital beds and the demands of local administration of hospital length of stay. (shrink)

This paper engages with the topic of hospitality in its reading of Kant as a thinker of ‘globality’; that is, as one who is keenly attuned to the various and complex ways humans strive to ‘hospitalize’ this planet in their attempts to transform it into a working and living environment. Despite having no illusions about actual international traders’ practices, who all too often perpetuate injustices and commit crimes, he sets out a project for a different conception of commercium as a (...) cultural practice which should remind us of the finite nature of our planet and its resources, and of our own vulnerable dependence on it. This account of a more enlightened ‘spirit of trade’, which is sensitive to cultural difference and environmental issues, is the product of a mobile way of thinking which would favour a more fluid communication with people on the move. (shrink)

Durante su desarrollo el niño se enfrenta a eventos que plantean demandas difíciles de satisfacer como la enfermedad y la hospitalización. La Organización Mundial de Salud define la salud como un estado de completo bienestar físico, mental y social, pero no existe consenso en la literatura sobre el término bienestar. El objetivo del artículo es realizar una revisión bibliográfica acerca del concepto bienestar en niños, asociado al proceso salud - enfermedad y a la hospitalización. Los niños experimentan bienestar cuando predominan (...) sus emociones positivas, estas favorecen la salud, las negativas, pueden provocar estados patológicos y son frecuentes en la hospitalización. Esa realidad amerita ser transformada. El bienestar en niños hospitalizados constituye un reto para las ciencias médicas para penetrar las bases del nivel secundario de atención. Throughout their development, children face events that pose hard-to-satisfy demands for them such as illness and hospitalization. The World Health Organization defines health as a state of complete physical, mental, or social well-being; however, there is no consensus in literature about the term "well-being". The objective of the article is to do a bibliographic review on the concept of children well-being associated to the health-illness process and to hospitalization. Children experience the state of well-being when positive emotions, which favor health, prevail. Negative feelings, on the other hand, can cause pathological states and they are common in hospitalization. That reality merits transformation. Hospitalized children's well-being presents a challenge for medical sciences in order to get inside the basis of secondary health care attention. (shrink)

The notion of hospital chaplaincy raises significant concerns, because it provides for the possibility that the chaplain becomes a generic chaplain rather than a member of a particular faith. Despite these reservations, however, I think that Mennonites should serve as hospital chaplains. Instead of seeing themselves as chaplains to all, though, Mennonites ought to see the service they provide as analogous to relief and development work. This would make Mennonite chaplaincy a form of what Mennonite scholar C. Norman Krause calls (...) “agapeic intervention,” which would allow for the ministry to the sick without requiring genericism. (shrink)

In contemporary discourses on cosmo-political hospitality, contributions of Derrida, and especially of Levinas, have special significance on account of the vision, scale and relevance of their discussions on the theme, in the context of an increasingly globalizing international scene, and the consequent global encounter with diversity. The article strives to read the Indian hospitality tradition and ethos, articulated in several of India's culturally significant texts, and available in some way as a cultural practice even to this day (propped up by (...) a heritage of tolerance and acceptance of difference, which, however, has not necessarily translated into egalitarian social structures), through the lenses of cosmo-political hospitality, found in the writings of Levinas and Derrida, as openness to the other, irrespective of social labels imposed on her/him. Although homely, ritualistic and hierarchical, Indian hospitality was always universalistic in intent. The article argues that an attempt to recapture the core of the Indian ethos of hospitality, should take into account this universalistic intent, revisited as genuine openness to the other person, in the light of contemporary concerns raised by Levinas and Derrida, and fully awake to India's and the world's transformed context. (shrink)

While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing that the reasonable disagreement itself can (...) serve as a compelling basis for Catholic leadership at hospitals that prohibit emergency contraception for rape victims to accommodate physicians who wish to provide levonorgestrel as a matter of conscience (part two). We end by anticipating and responding to some objections. (shrink)

In face of unprecedented awareness of religious diversity, as well as the dangers of conflict, interreligious dialogue has become vital. Yet, these authors maintain, it is the commitment to think together about religious faith and our inherited traditions that genuinely moves mutual understanding to new levels. Here is such a religious experiment, an interreligious theological quest, framed in the interests of peacemaking." -- Publisher.

Hospital ethics committees were created in the United States of America in the 1970s. Their aims were the education of the hospital personnel in the field of ethics, the development of policies and the publication of guidelines concerning ethical issues, as well as consultations and case reviews of hospitalized patients when an ethical concern was present. During the last thirty years, these committees disseminated, particularly in Western Europe. In this manuscript, we describe the benefit, but also some difficulties with these (...) committees, and we propose some solutions. The characteristics of these committees are discussed (i.e. typology of members, functioning and legitimacy). Finally, we carefully describe our local hospital clinical ethics committee in Geneva (Switzerland), which was founded in 1994 and it still very active. After fifteen years of experience, we remain strongly in favour of the implementation of such committees in any modern hospital. (shrink)

Unlike research ethics committees, which were created in 1988, the number of functioning hospital based ethical organisations in France, such as clinical ethics committees, is unknown. The objectives of such structures are diverse. A recent law created regional ethical forums, the objectives of which are education, debate, and research in relation to healthcare ethics. This paper discusses the current situation in France and the possible evolution and conflicts induced by this law. The creation of official healthcare ethics structures raises several (...) issues. (shrink)

Devoy, Frank Review(s) of: The hospitality of ministry: Exercising Christian ministry with a trinitarian heart, by David Ranson, (Strathfield, NSW: St Pauls Publications, 2012), pp. 79, $17.95.

Recent media reports have drawn widespread attention to the experiences of patients who are denied reproductive services at Catholic hospitals. For some patients, such as those experiencing miscarriage, denial of appropriate treatment can lead to serious health consequences. However, many patients are unaware of the limitations on services available at religiously affiliated health care institutions. As a result, patients’ ability to make informed and autonomous decisions about where to seek treatment is hindered. There are currently no federal or state laws (...) requiring health care institutions to inform patients directly of the full scope of medical services they are unable to provide on the basis of religion or conscience. Given religious hospitals’ significant role in the provision of health care in the United States, it is essential that patients be clearly informed about institutional limitations on care. This goal would be best served by adopting a federal disclosure law similar to the Patient Self-Determination Act. (shrink)

As hospital ethics committees become more common in American hospitals, their degree of success should be measured. Just as new technological procedures are evaluated, institutional innovations should also be evaluated. Currently, little is known about the success of HECs, and some authors have wondered whether these committees serve any useful purpose at all. This article reviews the descriptive results of a 1990 study on HEC success as they pertain to the question of how to measure committee success.

Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.

Volume 19, Issue 10, October 2019, Page 90-92.

How do we respond to the patient who no longer needs inpatient care but refuses to leave the hospital? Complex hospital discharges commonly involve consideration of legal, financial, clinical, and practical issues. Yet, the ethical and contextual issues embedded in complex inpatient discharges are of concern and have not received adequate attention by medical ethicists. The aim of this work is to encourage clinicians and administrators to incorporate a justice rubric when approaching inpatient discharge dilemmas. This paper presents justice as (...) the ethical principle most neglected in situations involving complex discharges and suggests that a justice focused lens allows clinicians and administrators to move beyond notions of patient autonomy in crafting morally responsible hospital discharge decisions that reflect efficient stewardship of an appropriate share of medically indicated services. This issue deserves additional attention from medical ethicists in the future. (shrink)

ABSTRACT Refugees, as forced migrants, have suffered displacement under conditions not of their own choosing. In 2000 there were thought to be 22 million refugees of whom 6 million were HIV positive. While the New Zealand government has accepted a number of HIV positive refugees from sub‐Saharan Africa, this hospitality is under threat due to negative public and political opinion. Epidemic conditions raise the social stakes attached to sexual exchanges, contagion becomes a major figure in social relationships and social production, (...) and the fears of the contagious nature of those ‘just off the plane’ connect refugees to an equally deep‐seated fear of racial miscegenation. Jacques Derrida’s notion of unconditional hospitality is a dream of a democracy which would have a cosmopolitan form. This means that one cannot decide in advance which refugees one might choose to resettle. This paper will use Derrida’s notion of unconditional hospitality to emphasise the fragility of HIV positive refugees’ position, caught between becoming newly made New Zealand subjects while at the same time having that subjecthood threatened. For Derrida, both ethics and politics demand both an action and a need for a thoughtful response (a questioning without limit). (shrink)

This paper deepens the knowledge of the hospital and brotherhood of the Resurrection, founded by the moriscos of the Albaicín. Using unreleased documentation from the Historical Archive of Protocols of Granada, the General Archive of Simancas and the Archive of the Alhambra, among others, it traces the history of this institution, so unique, yet relatively unknown, despite its influence in the realm of Granada and its supposed participation in the 1568 rebellion. Special attention is paid to the social profile of (...) the brotherhood members, also mostly members of the group known as “the rich men of the Albaicín”. (shrink)

The role of Hospital Ethics Committees is to support patients and their relatives as well as medical staff in solving ethical issues that arise in relation to the implementation of medical care. In Poland there are no clearly formulated legal regulations concerning the establishment and functioning of hospital ethics committees. Hospitals applying for accreditation are obliged to present solutions defining the way of solving ethical issues in a given institution, some of them appoint HECs for this purpose. The aim of (...) this study was to analyze information concerning the functioning of hospital ethics committees in Poland on the basis of publicly available data published on the websites of accredited hospitals. Very few accredited hospitals make public information about functioning in their ethics consulting facilities through hospital ethics committees. In most cases, the information provided on the functioning of HECs is general, both in terms of the committees’ functioning, type of cases under consideration and the composition of personnel. (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

Hospitals long ago shed their role as alms houses for the poor. What vestiges remain of the early American hospital are the tax-exempt, nonprofit hospital form and a general perception that hospitals, as charitable institutions, owe a duty to their communities. The appropriateness of the nonprofit hospital tax exemption has long been debated, and many theories have been advanced to justify the tax exemption of nonprofit hospitals. In a growing number of jurisdictions, however, state and local authorities have gone beyond (...) the theoretical debate and are challenging the tax exemption of their nonprofit hospitals. For various reasons, efforts are afoot to capture greater community benefit from nonprofit hospitals.At the heart of such challenges is the debate over the nature and extent of the duty charitable institutions owe to their communities. A demand is growing for nonprofit hospitals to earn their tax exemptions by benefiting their communities in concrete ways. Some have been stripped of their tax-exempt status by local authorities or pressured to make payments in lieu of taxes. A number of states have recently implemented initiatives in an attempt to make hospitals more accountable for their community benefits. Many hospitals are responding to this heightened scrutiny in a proactive way, by voluntarily documenting community benefits. A number of nonprofit hospitals and hospital associations are cooperating with—or even sponsoring—state legislation in this area. (shrink)

Hospital ethics, familiar enough in practice but surprisingly neglected in the literature, deals with the ethical problems that arise distinctively or typically in hospitals. More precisely, it consists of the ethical principles that shouldgovern 1) the conduct of healthcare professionals and other staff in their capacities as members of the hospital as an institution, and 2) the conduct of the hospital itself as an institution. It is a species of institutional ethics, which focuses on the ethical problems created or significantly (...) shaped by the institutional setting in which they occur. (shrink)

This paper comprises a case study illustrating ethical and practical challenges for a Ugandan hospital-based social worker early in the COVID-19 pandemic, followed by a commentary. The hospital was under-resourced, with staff and patients experiencing lack of information and panic. The social worker, Denis Adia, recounts his responses to new and ethically challenging situations, including persuading Muslim patients to stop fasting for the good of their health; deciding to keep a baby in hospital with parents although this was against the (...) rules; and supporting a stigmatised former patient in the face of intimidation by colleagues. He reflects on the importance of recognising each person’s unique needs and circumstances, seeing this as a vital role for social workers. The case is followed by a commentary from a UK academic (Sarah Banks), who notes the cognitive and emotional effort (‘ethics work’) undertaken by the social worker to: see the ethical aspects of particular situations; take account of patients’ specific needs; ensure they are treated with respect; promote their well-being; and perform as a good social worker. Banks draws attention to the key role of the virtue of courage in pandemic conditions, which involves working with new risks and facing fears with confidence. (shrink)

Background and aimsFew Polish hospitals have Hospital Ethics Committee (HECs) and the services are not always adequate. In this situation, the role of HECs, in providing, among others, ethical advice on the discontinuation of persistent therapies, may be taken over by other entities. The aim of our research was to investigate, how often and on what issues hospital chaplains are asked for ethical advice in reaching difficult medical decisions.MethodsA survey of 100 Roman Catholic chaplains was conducted, that is, at least (...) 10% of all chaplains currently working in Polish hospitals.ResultsOf the participants, 29% confirmed receiving requests for advice in making a morally difficult medical decision. Receiving this type of request was not conditional on the place of their service, duration of their pastoral mission or HEC membership. The largest group of chaplains (21%) encounter questions concerning the ethical dilemmas associated with discontinuing persistent therapy. Patients and their families most often raise issues related to the methods of birth control, and the medical staff raise the issue of termination of pregnancy—as reported by 9% and 15% of chaplains, respectively. Most of the chaplains asked for help (79%) experience a deficit of specialist knowledge in the area of medicine or ethics.ConclusionsIn order to improve the quality of ethical consultations in Polish hospitals, in addition to further development of HECs, it is postulated to develop a system for bioethical education of chaplains. (shrink)

This short paper responds to the essays by Shilpi Sinha, Shaireen Rasheed, and Lyudmila Bryzzheva. It considers how racial inequality between teachers and students affects the possibilities of educational hospitality, both in cases of white teachers teaching racialized students and in cases of racialized teachers teaching white students. The response takes a phenomenological turn, considering the relative vulnerability of bodies that encounter each other in educational spaces which, themselves, are not neutral.

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)

PROLOGUE: HOSPITALITY TO THE STRANGER AS METAPHOR FOR THE MORAL LIFE You shall not oppress a stranger; you know the heart of a stranger, ...