Verbal autopsy presents the opportunity to understand the disease burden in many low-income countries where vital registration systems are underdeveloped and most deaths occur in the community. Advances in technology have led to the development of software that can provide probable cause of death information in real time, and research considering the ethical implications of these advances is necessary to inform policy. Our research explores these ethical issues in rural Nepal using a public health ethics framework. We considered the burdens (...) and benefits of VA and giving cause of death information to families of the deceased through qualitative research with VA interviewers, community members, national policy stakeholders and international academics. Burdens can be experienced differently, and it is important to balance the emotional burden of VA with utilization of the data to inform planning and increased access to health services. The training, support and supervision of VA interviewers should be prioritized if VA is taken to scale. Initial and ongoing community engagement is recommended in addition to engaging ethical, legal, health and policy personnel in developing protocols and systems. Integrating rigorous research while cautiously moving forward is recommended to ensure systems and responses to concerns are relevant to contexts. (shrink)

The doctor patient relationship starts with a story. Doctors' notes, a patient's chart, the recommendations of ethics committees and insurance justifications all hinge on written and verbal narrative interaction. The "practice" of narrative profoundly affects decision making, patient health and treatment and the everyday practice of medicine. In this edited collection, the contributors provide conceptual foundations, practical guidelines and theoretical considerations central to the practice of narrative ethics.

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in (...) as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas’s understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas’s theory of modern society and the concept of the system’s colonization of the life world. (shrink)

All activities which are taking place in the Cosmos also exist in a human body in subtle micro-scale. Plexuses centers in a human body are the most mysterious kinds of energies. The six-center plexus system is the path of the Kundalini shakti, the primordial cosmic energy of a person. Each plexus has its own propensities (vibrating words/dimensions/vritti) and an acoustic root. These plexuses control some cluster of words of sounds and corresponding physical organs in human body. The 50 main propensities (...) of the human’s unit mind are expressed through the vibration-expression of these plexuses. These vibrations cause hormones to secrete from the corresponding glands of the human’s body. These plexuses can play very important roles in curing the diseases. According to the Theory of Nikola Tesla’s 369, there are all together 1 to 9 digital root numbers exist. All other higher or lower numbers are the combination of those digital root numbers. This statement seems quite true when we compare it with Theory of Absolutivity. If 3, 6, 9 numbers are arranged together it makes a letter Ohm (AUM) which represents actually a Sagun Bramh/Nikola Tesla’s 369 triangle which is a part of NirgunBramh having higher dimensions. Number zero is the NirgunBramh (having all the qualities but in dormant form) which does not possess any quality in action. Number 3, 6, 9 forming as an equilateral triangle of static, mutative and sentient forces representing the Black-hole which is a part of Sagun Bramh projecting Himself as a Visible World through Big-bang along with forming five basic elements such as Ethereal, Areal, Fire, Liquid and Solid. According to the biological science, life emerged in this planet from matter about four billion years ago in the form of DNA that carried the software for the development of billion of species on the way to its final destination in humans. These facts also fully support the above hypothesis of universe formations. (shrink)

The Cosmos we live in consists of Invisible Prakriti and Visible World. In Visible World, we do live. All the galaxies, Milky Ways, nebulas and planets, stars, and physical bodies belong to this world are governed by the physical and mathematical laws of nature. Prakriti which is invisible spiritually governed and wave-formed existed even before the Big-Bang. Purush holds the Visible World and Prakriti around makes entire Cosmos in existence. Purush which is an absolutely positively charged and quality less with (...) no traces of negative portions always existed, neither being created nor destroyed. A fraction of a Purush known as Omega Point appears into the portion of Prakriti due to some causal effect for further expansion of the Visible World. Purush is situated in the middle of the cylindrical universe surrounded by the Prakriti and Visible World. Theories proposed by different scientists and philosophers to verify the Purush seem to be incomplete trial and error of the zigzag puzzle show. Today, our scientists, cosmologists, and mathematicians are trying to explain the function of the universe through only four physical dimensions of science, which seems to be incomplete without explaining the transcendental factors while dealing with the living bodies. (shrink)

A development project introduces various changes into a community. Some of these changes are positive while others are negative or warrant better planning. Evaluation reports designed strictly for quantitative, targetoriented physical and fiscal achievements often overlook many of these changes. Our personal field observations and experiences with an agricultural development project showed us several examples of impacts brought about in the local farming system in some hill districts of Nepal. These impacts cannot be neglected and project evaluation and progress reports (...) should accommodate such changes. (shrink)

Background The allocation of scarce deceased donor kidneys is a complex process. Transplant providers are increasingly relying on constructs such as frailty and cognitive function to guide kidney transplant (KT) candidate selection. Patient views of the ethical issues surrounding the use of such constructs are unclear. We sought to assess KT candidates’ attitudes and beliefs about the use of frailty and cognitive function to guide waitlist selection.Methods KT candidates were randomly recruited from an ongoing single-center cohort study of frailty and (...) cognitive function. Semi-structured interviews were conducted, and thematic analysis was performed. Inductively derived themes were mapped onto bioethics principles.Results Twenty interviews were conducted (65% contact rate, 100% participation rate) (60% male; 70% White). With respect to the use of frailty and cognitive function in waitlisting decisions, four themes emerged in which participants: (1) valued maximizing a scarce resource (utility); (2) prioritized equal access to all patients (equity); (3) appreciated a proportional approach to the use of equity and utility (precautionary utility); and (4) sought to weigh utility- and equity-based concerns regarding social support. While some participants believed frailty and cognitive function were useful constructs to maximize utility, others believed their use would jeopardize equity. Patients were uncomfortable with using single factors such as frailty or cognitive impairment to deny someone access to transplantation; participants instead encouraged using the constructs to identify opportunities for intervention to improve frailty and cognitive function prior to KT.Conclusions KT candidates’ values mirrored the current allocation strategy, seeking to balance equity and utility in a just manner, albeit with conflicting viewpoints on the appropriate use of frailty and cognitive impairment in waitlisting decisions. (shrink)

In this timely and highly original merging of theory and practice, conflict photographer and critical theorist Rita Leistner applies Marshall McLuhan's semiotic theories of language, media, and technology to iPhone photographs taken during a military embed in Afghanistan. In a series of what Leistner calls iProbes—a portmanteau of iPhone and probe—Leistner reveals the face of war through the extensions of man. As digital photography becomes more ubiquitous, and as the phones we carry with us become more advanced, the process (...) of capturing images becomes more democratic and more spontaneous. Leistner's photos result from both access and impulse. Looking for Marshall McLuhan in Afghanistan will appeal anyone with an interest in the conflicts in the Middle East, the seminal communications theorist, or iPhone apps and photography. (shrink)

'Manning successfully argues that theory and ethics should once again be reunited...thorough and provocative...'—THE MIDWEST BOOK REVIEW.

Across two studies, a wide age range of participants was interviewed about the nature of death. All participants were living in rural Madagascar in a community where ancestral beliefs and practices are widespread. In Study 1, children (8–17 years) and adults (19–71 years) were asked whether bodily and mental processes continue after death. The death in question was presented in the context of a narrative that focused either on the corpse or on the ancestral practices associated with the afterlife. Participants (...) aged 8 years and older claimed that death brings an end to most bodily and mental processes. Nevertheless, particularly in the context of the religious narrative, they claimed that certain mental processes continue even after death. This assertion of an afterlife was more evident among adults than children, especially with respect to cognitive processes, such as knowing and remembering. In Study 2, 5‐ and 7‐year‐olds were asked similar questions in connection with the death of a bird and a person. Seven‐year‐olds consistently claimed that bodily and mental processes cease at death, whereas 5‐year‐olds were unsystematic in their replies. Together, the two studies replicate and extend findings obtained with Western children showing that, in the course of development, different conceptions of death are elaborated—a biological conception in which death terminates living processes and a religious conception in which death marks the beginning of a new form of spiritual existence. (shrink)

In this paper, I consider the claim that a corporation cannot be held to be morally responsible unless it is a person. First, I argue that this claim is ambigious. Person flags three different but related notions: metaphysical person, moral agent, moral person. I argue that, though one can make the claim that corporates are metaphysical persons, this claim is only marginally relevant to the question of corporate moral responsibility. The central question which must be answered in discussions of corporate (...) moral responsibility is whether corporations are moral agents or moral persons. I argue that, though we can make a case for saying corporations are moral agents, they are not moral persons, and hence, we can hold them responsible. In addition, we need not treat them the way we would be obligated to treat a moral person; we needn't have the same scruples about holding a corporation morally responsible as we would a moral person. (shrink)

This essay collects four decades of my own reflections, as an anthropologist and feminist, on gender and coloniality across various contexts in Latin America. It also highlights the decolonial methodology and vocabulary that I have had to develop in my various roles as scholar, public intellectual, and expert witness over the years. Briefly, what I present here is a decolonial feminist perspective that argues for the existence of a patriarchal political order in communal societies before colonization. Yet, in my view, (...) precolonial gender has a dual structure that is plural in essence and differs markedly from the binary gender structure of colonial-modern societies, which works in terms of a One and its marginalized others. As I argue, the capturing and transformation of precolonial dual gender structures by the modern gender system exacerbates inequality, increases violence against women, and disempowers them politically. For that reason, I speak of “low-intensity” and “high-intensity” patriarchal systems. (shrink)

I have become curious about reciprocity within clinical practice. A vast topic that mobilizes considerations of money, knowledge, kinship, power, culture, and uses of the body, reciprocity is a strong means by which to achieve the egality required of just health care. Within health care, reciprocity might enable not only so‐called shared decision‐making and patient autonomy. It might open the door to mutual acknowledgement of the value of each participant's beliefs and habits. It might appear as a humble realization that (...) no one understands what health is and a concurrent welcoming curiosity about one another's conception of how the body and speech and mind work. From the intimate to the international levels of care, such forms of reciprocity may culminate in the radical and powerful state of reciprocal recognition.In this short essay, I will focus on one aspect of reciprocity in health care: the narrative and potentially reciprocal nature of attention in health care. A critical element in the development of therapeutic alliance, clinical accuracy, and effective practice, attention requires a donation of the self as a vessel into which can enter that which is perceived or, from the other side, a penetrating of that which is perceived so that one sees it from within its own vessel. (shrink)

We consider the problem of moral disjunction in professional and business activities from a virtue-ethical perspective. Moral disjunction arises when the behavioral demands of a role conflict with personal morality; it is an important problem because most people in modern societies occupy several complex roles that can cause this clash to occur. We argue that moral disjunction, and the psychological mechanisms that people use to cope with it, are problematic because they make it hard to pursue virtue and to live (...) with integrity. We present role coadunation as a process with epistemic and behavioral aspects that people can use to resolve moral disjunction with integrity. When role coadunation is successful, it enables people to live virtuous lives of appropriate narrative disunity and to honor their identity-conferring commitments. We show how role coadunation can be facilitated by interpretive communities and discuss the emergence and ideal features of those communities. (shrink)

If our sense of the past is inevitably shaped by the explanatory logic of narrative, then the stories that we create in turn reveal the inescapable presence and ...

Proposing that the interaction between reader and literature involves four “modes of textual engagement” — recognition, enchantment, knowledge, and shock — The Uses of Literature bridges the gap between literary theory and common-sense beliefs about why we read literature.