Obtaining informed consent is a cornerstone of biomedical research, yet participants comprehension of presented information is often low. The most effective interventions to improve understanding rates have not been identified.

This paper explores the practical consequences that Enlightenment ideals had on morality as it applies to clinical practice, using Alisdair MacIntyre's conceptualization and critique of the Enlightenment as its reference point. Taking the perspective of a practicing clinician, I critically examine the historical origins of ideas that made shared decision making (SDM) a necessary and ideal model of clinician-patient relationship. I then build on MacIntyre's critique of Enlightenment thought and examine its implications for conceptions of shared decision-making that use an (...) Enlightenment justification, as well as examining contemporary threats to SDM that the Enlightenment made possible. I conclude by offering an alternative framing of SDM that fits with the clinician's duty to act on behalf of and along with patients but that avoids the tenuous Enlightenment assumptions that MacIntyre's work so vocally critiques. (shrink)

Many in academic bioethics worry that robust theological traditions, when articulated in the public square, damage the prospect of serious reflection about tough cases. Here we challenge that prevailing exclusion-by-default methodological impulse by correcting prevalent stereotypes about one particular Christian tradition that may offer relevant conceptual resources for bioethics. We briefly examine the man, John Calvin, and the Calvinist/Reformed Protestant tradition to show how it has been misconstrued in academic bioethics but can be reconstrued as a constructive, substantive theological starting (...) point for tough bioethical questions of our age. Core Calvinist doctrines about the nature of an all-sovereign God and human beings’ relation to that God, as well as related prominent themes from elements of the broader Reformed tradition, including the glory/sovereignty/majesty of God; the created goodness of the world; human beings as desiring/worshiping/image-bearing creatures; the pervasive influence of sin; the limitations of humanity for self-improvement; the completely gratuitous nature of redemption; the comprehensiveness of God’s redemptive purposes; and the pending final completion of his redemptive work could and should influence the tone and content of moral deliberation that can be a positive influence on twenty-first-century bioethics. (shrink)

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The (...) primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6–2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. (shrink)

Purpose: to characterize ethics course content, structure, resources, pedagogic methods, and opinions among academic administrators and course directors at U.S. medical schools. Method: An online questionnaire addressed to academic deans and ethics course directors identified by medical school websites was emailed to 157 Association of American Medical Colleges member medical schools in two successive waves in early 2022. Descriptive statistics were utilized to summarize responses. Results: Representatives from 61 (39%) schools responded. Thirty-two (52%) respondents were course directors; 26 (43%) were (...) deans of academic affairs, medical education, or curriculum; and 3 with other roles also completed the survey (5%). All 61 schools reported some form of formal ethics education during the first year of medical school, with most (n = 54, 89%) reporting a formal mandatory introductory course during preclinical education. Schools primarily utilized lecture and small-group teaching methods. Knowledge-based examinations, attendance, and participation were most commonly used for assessment. A large majority regarded ethics as equally or more important than other foundational courses, but fewer (n = 37, 60%) provided faculty training for teaching ethics. Conclusions: Despite a response rate of 39 percent, the authors conclude that medical schools include ethics in their curricula in small-group and lecture formats with heterogeneity regarding content taught. Preclinical curricular redesigns must innovate and implement best practices for ensuring sound delivery of ethics content in future curricula. Additional large-scale research is necessary to determine said best practices. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Deification through the Cross:Reflections from an Implied Ideal WorshiperAndrew J. SummersonKhaled Anatolios's most recent book, Deification through the Cross,1 develops a definition of salvation out of his experience of the Byzantine liturgy. This experience of worship offers an immersion in what he calls "doxological contrition." By this, Anatolios means that Christ saves us by offering us the ability to participate in the mutual glorification of the persons of the (...) Holy Trinity by vicariously repenting for our sins. For Anatolios, this objective content is subjectively appropriated in Byzantine Christian worship. To explore this theme, Anatolios develops a working account of "doxological contrition" through a synthetic discussion of the Lenten Triodion and Pentecostarion, books of liturgical hymnography that govern the Byzantine worship from Lent to Pentecost. Anatolios derives his approach from the adaption of reader response theory, which aims to expose the effect a text should have on the "implied ideal reader." As such, his account speaks from the perspective of the "implied ideal worshiper"—presumably a theologically educated congregant who can seize these themes that evaporate into the ether as quickly as incense swung throughout the church during the services.Let me say from the outset, I heartily recommend Anatolios's book. It is both an ambitious work and a rewarding read. Ambitious because Anatolios's approach makes otherwise fragmented theological disciplines—liturgical [End Page 1089] studies, Scripture, historical theology, and systematics—fruitful dialogue partners in his exposition of a working account of the Christian experience of salvation. Rewarding because the reader can explore in depth the touchstones of the Christian tradition through Anatolios's deep retrieval of a more coherent soteriology. Deification of the Cross demonstrates the perennial value of historical theology to correctly account for the "half-forgotten, half misunderstood" details of the Christian tradition in the face of caricatures that at best misrepresent and at worst present an idolatrous, counterfeit Christianity.Eastern Christian Liturgy and RevelationPerhaps I am not Anatolios's ideal audience; I may be too close to the source material and lack objectivity. That aside, the bulk of my reflections on this book comes from the perspective of an "implied ideal worshiper." I do share some of Anatolios starting points. Like Anatolios, I am a convert, scholar, and Eastern Catholic priest. Furthermore, I also share the discontent with which Anatolios begins his book, though perhaps for different reasons. He bemoans a loss of the experience of salvation. My own vocation as priest and scholar comes out of a frustrated wonder. As a college student, I set out to learn about this Church and its Tradition. I learned about the Sunday experience I was supposed be having. It was in university when I read for the first time John Paul II's 1995 apostolic letter Orientale Lumen, written to acquaint the wider Catholic Church with the riches of the Christian East. John Paul II dedicated much reflection to the "genius of Eastern liturgy," emphasizing its power to envelop all our human senses into the fullness of the mystery of God. It is worth quoting in full:Within this framework, liturgical prayer in the East shows a great aptitude for involving the human person in his or her totality: the mystery is sung in the loftiness of its content, but also in the warmth of the sentiments it awakens in the heart of redeemed humanity. In the sacred act, even bodiliness is summoned to praise, and beauty, which in the East is one of the best loved names expressing the divine harmony and the model of humanity transfigured, appears everywhere: in the shape of the church, in the sounds, in the colors, in the lights, in the scents. The lengthy duration of the celebrations, the repeated invocations, everything expresses gradual identification with the mystery celebrated with one's whole person. Thus the prayer of the Church already becomes participation in the heavenly liturgy, an anticipation of the final beatitude.(§11) [End Page 1090]The experience of this liturgy has been quite potent throughout history. It led to the baptism of the entire kingdom of Rus' in 988 AD. As the story goes, its ruler, Vladimir the Great, sent emissaries to find a... (shrink)

La longue histoire de l’Acropole d’Athènes est une vitrine fascinante de la façon dont un patrimoine ancien peut être transformé, d’un sanctuaire païen à un sanctuaire chrétien, à une forteresse islamique, à l’autel symbolique de la Grèce moderne. De plus, ce site a suscité l’admiration presque religieuse des chercheurs et, comme dans le cas des marbres d’Elgin, a été contesté à de nombreux égards. L’auteur du volume analysé, William St Clair, un spécialiste des marbres d’Elgin et de divers a...

J. M. Shorter; X*—Personal Identity, Personal Relationships, and Criteria, Proceedings of the Aristotelian Society, Volume 71, Issue 1, 1 June 1971, Pages 165–1.

In Revering God, author and scholar Thaddeus Williams bridges the gap between abstract theology and awe-inspired devotion, helping readers better understand God and drawing them into a deeper state of joy and reverence for their Creator.

Your God is too small—way too small! What if God is not a human-like personal being but the God Beyond God of the Christian mystical traditions? What if God is the ultimate reality beyond all beings, including beyond all divine beings, indeed beyond all Being? It’s a mind-bending idea. Speaking of God as a human-like personal being is much easier but people who care about the deepest mystical understandings of God within our traditions need to make the effort to speak (...) about the God Beyond God, despite the difficulties. This book makes the attempt to speak of the God Beyond God in the language of the sermon, using metaphor and potent imagery tuned to the existential intensities of human life. The God Beyond God is closer to us than our jugular veins, vividly present in every moment of our lives. These sermons are practical and moving, and they also resonate with the most rigorous theological understandings of ultimate reality. Their deconstruction of our convenient fantasies about a divine being make these sermons emotionally intense and perhaps not suitable for beginners in the journey of faith. But veteran believers can breathe deeply in the air of these meditations, relaxing into the bliss of engaging ultimate reality without delusions, without deflections, and without controlling the object of our worship. (shrink)

The paper defends the thesis that for S to V intentionally is for S to V as (in the way) S intended to. For the normal agent the relevant sort of intention is an intention that one's intention to V generate an instance of one's V-ing along some (usually dimly-conceived) productive path. Such an account allows us to say some actions are intentional to a greater or lesser extent (a desirable option for certain cases of wayward causal chains), preserves the (...) intuitive link between intention and intentionally, and supports the common sense view that the concept of intending is more basic than those of acting with an intention and of acting intentionally. The remainder of the paper responds to certain apparent counter-examples offered by Audi, Harman, and Bratman. In the course of this, I discuss connections between intending to V and hoping to V, and I argue that one can intend to do what one doesn't expect to do, and that one always intends what one attempts. (shrink)

This article argues that xing 性 in the Zhuangzi 莊子 should not be understood as “human nature” but as “human condition.” It introduces the problem of interpreting xing as “human nature” by surveying relevant English-language literature before detailing the interpretive paradigm of Chinese accounts showing how the latter’s appropriation of the language of substance ontology hinders an accurate portrayal of Daoist xing. It argues that xing should be interpreted in connection to the concept of ming 命understood as contingent, natural, and (...) temporal “external conditions”. It argues that xing are “internal conditions” that function in conjunction with ming as “external conditions” where “habit” (xi 習) mediates their interaction. (shrink)

To explain the meaning of the Prometheus the late Dr. Walter Headlam quoted the famous lines from theAgamemnon:‘ Sing praise; ’Tis he hath guided, say, Man's feet in Wisdom's way, Stablishing fast for learning's rule That Suffering be her school….’ ‘This,’ he said, ‘is the school in which Prometheus himself is being gradually taught the wise humility; at present he is still in the rebellious stage. And it is with this idea that Io is introduced into the Prometheus Bound; she, (...) too, is an example of the seeming cruelty of Zeus; but it is a blessing in disguise, for she is to be the mother of the blessed Epaphus, and it is a son of Zeus by Alcmena, a descendant of her own, that is to set Prometheus free.’. (shrink)

To explain the meaning of the Prometheus the late Dr. Walter Headlam quoted the famous lines from theAgamemnon:‘ Sing praise; ’Tis he hath guided, say, Man's feet in Wisdom's way, Stablishing fast for learning's rule That Suffering be her school….’ ‘This,’ he said, ‘is the school in which Prometheus himself is being gradually taught the wise humility; at present he is still in the rebellious stage. And it is with this idea that Io is introduced into the Prometheus Bound; she, (...) too, is an example of the seeming cruelty of Zeus; but it is a blessing in disguise, for she is to be the mother of the blessed Epaphus, and it is a son of Zeus by Alcmena, a descendant of her own, that is to set Prometheus free.’. (shrink)

Many critics have condemned, some have defended, Euripides for composing a play ‘altogether wanting in the satisfaction which nothing but a unity of ideas could produce.’ It helps us little to marvel, with Paley, at the ‘obtuseness of critics who forsooth prefer “unity of ideas” to profoundly moving incidents, etc.,’ though it may be admitted that Paley has detected part of the truth when he calls attention to the importance of the fact that Athens is, throughout the play, the only (...) possible asylum for the hero. Verrall's analysis has the merit that it attempts to account for the play as a whole, but it is hard to believe that the Athenian audience was composed of subtle critics, endowed with Verrall's ingenuity and acumen. Still, though it is easy to disagree with Verrall, it is less easy to give the reasons for one's disagreement. In detail one can say: ‘The straightforward and obvious sense of the words is adequate; the subtle suggestion is not likely to have occurred to an audience which had never heard of Schlegel or of Swinburne.’ That leaves us with the fact that the impression made on most of us by the whole work is not one of formal perfection. To most readers there seem to be three episodes, each excellent, but not intimately connected with the other two: in the first we are concerned for the fate of the tyrant Lycus, and rejoice at his just destruction; in the second we are moved by the sudden reversal in the fortunes of the beneficent Heracles; and in the third we are impressed by the magnanimity, and, perhaps, delighted with the Athenian connections, of the excellent Theseus. There is a good deal of talk which we ascribe to the tendency of Euripides to make his characters the mouthpieces for current debate. There are choral odes which we think charming, but, on the whole and as a rule, slightly irrelevant to the main ‘incidents.’ My purpose in this paper is to suggest, first, that the audience was occupied with certain quite familiar ideas upon which Euripides has built his play, and was, therefore, not at leisure to catch at subtleties of detail, suggestions, ambiguities, ironies, points of logic and of lack of logic, such as Verrall emphasizes; and, secondly, that if we also remember these ideas, we shall find both unity in the construction and relevance in the choral odes. (shrink)

Game of Thrones is a popular, award-winning television series with an eight-season run on Home Box Office, based on the Song of Fire and Ice series of books by George R.R. Martin. It depicts a morally complex political situation in a fantasy environment that has some similarities to medieval Europe. In the midst of this setting, the series advocates a cynical attitude towards politics, social structures, and religion. Most notably, the series suggests that there is no such thing as political (...) legitimacy. This chapter identifies a pattern of cynicism throughout Game of Thrones but points towards the thoughts of John Locke and Thomas Aquinas as possible alternatives to the story’s cynicism. (shrink)

O livro almeja ser representativo nos principais debates contemporâneos, oferecendo uma visão panorâmica sobre o campo na atualidade e permitindo-se aprofundar em algumas discussões selecionadas.O ambiente não pode ser reduzido ao “meio ambiente”, à natureza não humana. Ele não é meramente algo que “nos envolve”, um envoltório: o ambiente somos também nós, seres humanos, histórica e culturalmente situados. Quanto aos territórios, eles se estabelecem em íntima conexão com os ambientes em suas dimensões paisagística e material, quer sejam os processos geoecológicos, (...) quer sejam as formas e as dinâmicas socialmente produzidas. Analisar os territórios significa examinar como, a cada momento, os ambientes, seus recursos e significados são disputados e viram objeto de conflitos.O público-alvo principal são os estudantes dos últimos anos da graduação, além daqueles em nível de pós-graduação, de todas as áreas que lidam com problemas e conflitos ambientais. Afora os pesquisadores iniciantes e os jovens universitários em geral, porém, podemos presumir que profissionais experientes também poderão tirar proveito do material de diversos capítulos. É razoável, por fim, nutrir a expectativa de que muito do que este livro contém possa (retro)alimentar o ativismo ambiental crítico e a prática de combater as iniquidades e as distorções que se acumulam em nossas sociedades, principalmente as muitas situações de flagrante injustiça ambiental. (shrink)

Through case studies on biodiversity, deforestation, pollution, and war, among others, Stoett analyzes the ability of international policy to provide environmental protection and discusses the ever-present factors of equality, sovereignty, and human rights integral to these issues. While providing a panoramic view of the actors and structures producing these policies. Stoett reminds readers that the topic is personal, that effective governance is not solely the responsibility of governments but of individuals and communities as well. Environmental diplomacy may not always meet (...) its intended goals, but positive steps are being achieved, and change can only happen when angst is replaced with an educated determination to work toward environmental justice. The Second Edition will explore new events, issues, and agreements since 2011; notably the Paris Agreement. The UN's Sustainable Development Goals (SDGs) will be a new theme added throughout and highlighted in each case study. (shrink)

Language for God explores the ways language and images influence who we are and how we live. It declares the necessity of language and images for God that are expansive and inclusive of all genders. Lutheran perspectives are used as a compass to offer scriptural, theological, and historical insights to advance the reformation of Christian language.

Libertarians claim that human behaviour is undetermined and cannot be predicted from knowledge of past history even in principle since it is based on the random movements of quantum mechanics. Determinists on the other hand deny thatmacroscopic phenomena can be activated bysub-microscopic events, and assert that if human action is unpredictable in the way claimed by libertarians, it must be aimless and irrational. This is not true of some types of random behaviour described in this paper. Random behaviour may make (...) one unpredictable to opponents and may therefore be rational. Similarly, playing a game with a mixed strategy may have an unpredictable outcome in every single play, but the strategy is rational, in that it is meant to maximize the expected value of an objective, be it private or social. As to whether the outcome of such behaviour is genuinely unpredictable as in quantum mechanics, or predictable by a hypothetical outside observer knowing all natural laws, it is argued that it makes no difference in practice, as long as it is not humanly predictable. Thus we have a new version of libertarianism which is compatible with determinism. (shrink)