(1884). MINUTES OF PROCEEDINGS. Transactions of the South African Philosophical Society: Vol. 4, No. 1, pp. xxi-xxvii.

Objectives: to assess physicians’ and patients’ views in Saudi Arabia towards involving the patient versus the family in the process of diagnosis disclosure and decision-making, and to compare them with views from the USA and Japan.Design: A self-completion questionnaire was translated to Arabic and validated.Participants: Physicians from different specialties and ranks and patients in a hospital or attending outpatient clinics from 6 different regions in KSA.Results: In the case of a patient with incurable cancer, 67% of doctors and 51% of (...) patients indicated that they would inform the patient in preference to the family of the diagnosis . Assuming the family already knew, 56% of doctors and 49% of patients would tell the patient even if family objected . However, in the case of HIV infection, 59% of physicians and 81% of patients would inform the family about HIV status without the patient’s consent . With regards to withholding ventilatory support, about 50% of doctors and over 60% of patients supported the use of mechanical ventilation in a patient with advanced cancer, regardless of the wishes of the patient or the family. Finally, the majority of doctors and patients were against assisted suicide.Conclusions: Although there was more recognition for a patient’s autonomy amongst physicians, most patients preferred a family centred model of care. Views towards information disclosure were midway between those of the USA and Japan. Distinctively, however, decisions regarding life prolonging therapy and assisted suicide were not influenced to a great extent by wishes of the patient or family, but more likely by religious beliefs. (shrink)

Muhammadiyah and NU are two well-known socio-religious organizations in the world over the years. In spite of the fact that both organizations are characterized as religious social movement, each of them has their individual creativity, which is called al-thaqafat in their motions. This study aims to identify the organization of Muhammadiyah-NU as a religious heritage,which affects other religious organizations both in Indonesia and other countries. This research employed a qualitative approach by using historical method to obtain the actual reality. For (...) data collection, literature reviews,documentation and interviews were also conducted to gather empiric facts.The researchers interviewed public figures of the organizations. Al-thaqafat becomes part of elements rather than cultivated culture, which is understood as habitual patterns of human creativity, including a religious organization. Both organizations are the result of an al-thaqafat religious creativity created by each founder and can be pursued into the world monumental heritage. Without denying, the existence of al-thaqafat creativity will continue to enlighten the world civilization. Therefore, Muhammadiyah and NU have been doing and keeping continuing al-thaqafat creativity enlightenment through their charitable organizations and institutions. The result is profoundly proven so that they have been in an existence more than a century. (shrink)

Background: Discussing treatment risks has become increasingly important in medical communication. Still, despite regulations, physicians must decide how much and what kind of information to present. Objective: To investigate patients’ preference for information about a small risk of a complication of colonoscopy, and whether medical and personal factors contribute to such preference. To propose a disclosure policy related to our results. Design: Vignettes study. Setting: Department of Gastroenterology, Academic Medical Centre, the Netherlands. Patients: 810 consecutive colonoscopy patients. Intervention: A home-sent (...) questionnaire containing three vignettes. Vignettes varied in the indication for colonoscopy, complication severity and level of risk. Patients were invited to indicate their wish to be informed and the importance of such information. In addition, sociodemograhic, illness-related and psychological characteristics were assessed. Main outcome measurements: Wish to be informed and importance of information. Results: Of 810 questionnaires, 68% were returned. Patients generally wished to be informed about low-risk complications, regardless of the indication for colonoscopy or the severity of the complication. The level of risk did matter, though (OR = 2.48, SE = 0.28, p = 0.001). The information was considered less important if done for population screening purposes or diagnosis of colon cancer, if the complication was less severe (bleeding) and if the risk was smaller (0.01% and 0.1%). Patients’ information preference was also related to age, mood and coping style. Limitations: Difficulty of vignettes. Conclusions: Patients generally wish to be informed about all possible risks. However, this might become uninformative. A stepwise approach is suggested. (shrink)

Augustine’s metaphysics is a subject little studied, but often much criticized. Among the recent studies of Augustine’s metaphysics, Scott MacDonald’s interpretation of Augustine’s notion of goodness claims that Augustine’s account is incoherent. This suggests a reading of Augustine that is somewhat problematic. This article argues that much of the difficulty that MacDonald claims rests on a misunderstanding of Augustine’s views about the goodness of creation and existence and the corruptibility of created things. Augustine’s position takes for granted an understanding of (...) existence as a good and the participation of all things in the pre–eminent good, that is God. (shrink)

OBJECTIVES: To ascertain which conditions nurses believe should be in a law allowing active voluntary euthanasia (AVE). DESIGN: Survey questionnaire posted to registered nurses (RNs). SETTING: Australian Capital Territory (ACT) at the end of 1996, when active voluntary euthanasia was legal in the Northern Territory. SURVEY SAMPLE: A random sample of 2,000 RNs, representing 54 per cent of the RN population in the ACT. MAIN MEASURES: Two methods were used to look at nurses' opinions. The first involved four vignettes which (...) varied in terms of critical characteristics of each patient who was requesting help to die. The respondents were asked if the law should be changed to allow any of these requests. There was also a checklist of conditions, most of which have commonly been included in Australian proposed laws on AVE. The respondents chose those which they believed should apply in a law on AVE. RESULTS: The response rate was 61%. Support for a change in the law to allow AVE was 38% for a young man with AIDS, 39% for an elderly man with early stage Alzheimer's disease, 44% for a young woman who had become quadriplegic and 71% for a middle-aged woman with metastases from breast cancer. The conditions most strongly supported in any future AVE law were: "second doctor's opinion", "cooling off period", "unbearable protracted suffering", "patient fully informed about illness and treatment" and "terminally ill". There was only minority support for "not suffering from treatable depression", "administer the fatal dose themselves" and "over a certain age". CONCLUSION: Given the lack of support for some conditions included in proposed AVE laws, there needs to be further debate about the conditions required in any future AVE bills. (shrink)

Nicholas Wolterstorff's Divine Discourse attempts to give philosophical warrant to the claim that ‘God speaks’. While Wolterstorff's argument depends largely on his appropriation of J.L. Austin's speech act theory, he also uses two narratives that for him demonstrate how ‘God speaks’. The first is the story of Augustine's conversion in the Confessions and the second is a story that Wolterstorff recounts about a certain ‘Virginia’. This study argues that what Wolterstorff claims to derive from Augustine's narrative for his view of (...) divine discourse is not fully supported by the Confessions, and that Augustine's interpretation of the words ‘tolle lege, tolle lege’, can be construed as a useful interpretation of an ambiguous sign. This is consistent with Augustine's understanding of the interpretation of texts in both the De doctrina christiana and the Confessions. In short, Augustine is far more open to the ambiguity of signs than Wolterstorffs's account suggests. (shrink)

Iris Murdoch’s Metaphysics as a Guide to Morals ranges wide over the field of Western philosophical thought. Throughout the work, Murdoch proposes and enacts a form of philosophical inquiry that she believes supports a moral philosophy based on the idea of the good. One of her attempts, partly inspired by Paul Tillich and J. N. Findlay, centers on her critique and appropriation of the structure of the so-called “ontological argument” in Anselm’s Proslogion. This study assesses Murdoch’s accomplishment and the tenability (...) of the kind of Platonism she proposes against Anselm’s argument about the good in both the Monologion and the Proslogion. My claim is that Anselm’s conception of the good simply does not permit the kind of interpretation that Murdoch puts on the “ontological argument.”. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

Background If trials of therapeutic interventions are to serve society's interests, they must be of high methodological quality and must satisfy moral commitments to human subjects. The authors set out to develop a clinical - trials compendium in which standards for the ethical treatment of human subjects are integrated with standards for research methods. Methods The authors rank-ordered the world's nations and chose the 31 with >700 active trials as of 24 July 2008. Governmental and other authoritative entities of the (...) 31 countries were searched, and 1004 English-language documents containing ethical and/or methodological standards for clinical trials were identified. The authors extracted standards from 144 of those: 50 designated as ‘core’, 39 addressing trials of invasive procedures and a 5% sample of the remainder. As the integrating framework for the standards we developed a coherent taxonomy encompassing all elements of a trial's stages. Findings Review of the 144 documents yielded nearly 15 000 discrete standards. After duplicates were removed, 5903 substantive standards remained, distributed in the taxonomy as follows: initiation, 1401 standards, 8 divisions; design, 1869 standards, 16 divisions; conduct, 1473 standards, 8 divisions; analysing and reporting results, 997 standards, four divisions; and post-trial standards, 168 standards, 5 divisions. Conclusions The overwhelming number of source documents and standards uncovered in this study was not anticipated beforehand and confirms the extraordinary complexity of the clinical trials enterprise. This taxonomy of multinational ethical and methodological standards may help trialists and overseers improve the quality of clinical trials, particularly given the globalisation of clinical research. (shrink)