When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.

The aim of this study was to assess attitudes of intensive care nurses to selected ethical issues related to end-of-life decisions in paediatric intensive care units. A self-administered questionnaire was distributed in 2005 to intensive care nurses at two different scientific occasions in Turkey. Of the 155 intensive care nurse participants, 98% were women. Fifty-three percent of these had intensive care experience of more than four years. Most of the nurses failed to agree about withholding (65%) or withdrawing (60%) futile (...) treatment. In addition, 68% agreed that intravenous nutrition must continue at all costs. In futile treatment cases, the nurses tended to leave the decision to parents or act maternalistically. The results showed that intensive care nurses could ignore essential ethical duties in end-of-life care. We suggest that it is necessary to educate Turkish intensive care nurses about ethical issues at the end of life. (shrink)

The aim of this study was to assess the opinions and role of intensive care unit (ICU) nurses regarding the distribution of ICU beds. We conducted this research among 30% of the attendees at two ICU congresses in Turkey. A self-administered questionnaire was used, which included 13 cases and allocation criteria. Of the total (136 nurses), 53.7% participated in admission/discharge decisions. The most important criterion was quality of life as viewed by the physician; the least important was the patient’s social (...) status. According to the findings, the nurses thought that medical benefit and avoiding discrimination were important. On the other hand their ignorance of patients’ autonomous preferences arouses suspicions about these nurses’ role in advocating for patients’ rights. For this reason, nurses’ role in allocation decisions should be clearly described and should also be the basis on which intensive care nurses’ duties in allocation decisions should be determined. (shrink)

Background Several ethical issues are associated with providing living organ transplantation services, and there is limited information on these issues faced by the teams providing service to refugees or asylum seekers. Aim To determine the challenges healthcare professionals face in organ transplant centers providing services to Syrians under temporary protection status and discern whether these difficulties align with ethical issues in living organ transplantation. Research design This study employed a qualitative design and conducted individual semi-structured, in-depth interviews with 18 transplant (...) team members in Istanbul between September and November 2022. Data analysis was based on Braun and Clarke’s thematic analysis. Participants and research context The participants comprised 18 healthcare professionals, including 6 physicians and 12 nurses working in organ transplant teams in Istanbul. Ethical considerations The University’s Ethics Committee provided approval. Participants were informed regarding confidentiality and signed an informed consent form. Results Three themes emerged from the data on ethical issues faced by organ transplantation services to Syrians: (a) beneficence or double equipoise, (b) autonomy, and (c) justice. Transplant teams experience problems related to preserving double equipoise in the provision of living donor organ transplantation because of language barriers, poor socioeconomic conditions, and cultural factors, which increases transplant teams’ individual and indirect social burden. Although problems arise from the language barrier when obtaining informed consent in the autonomy theme, institutional and national policies in preventing donor abuse have a comforting effect. Health workers had the least problems with the justice theme, wherein national health policies are determined. Conclusion Fewer issues related to autonomy and justice were reported in providing organ transplantation services to Syrians, with the most intense reported issues being maintaining double equipoise. The results revealed the need to develop institutional, national, and international policies with individual solutions to prevent difficulties healthcare professionals face in this process. (shrink)

The aim of this study is to create a sample curriculum which aims to explain the belief and belief of Allah, which is one of the most basic concepts of religious education, based on the developmental based life centred religion concept as an alternative to the existing religious education practices, based on the order and functioning of the universe and to explain its functionality. For this purpose, 12 children who have been educated in the 3rd grade in the institutional sense (...) have not been educated before. Our study is based on the assumption that religious education and science education are complementary to each other. It is assumed that in such cases where religious education practices and scientific processes are run together, children can better establish both scientific processes based on cause-effect relationship in the universe and their relationship with a Creator. In conclusion, although there are some limitations occurred outside the researcher, it has been seen that scientific processes are applied and these are supported in theological speeches and the related conceptualization is realized. In addition, in the studies to be carried out with the children of this age period, it has been observed that the attitudes of the classroom teacher should be taken into consideration and if possible, the researcher has to do the study only with the students. (shrink)

The purpose of this study was to determine the professional and personal values among midwifery students in Turkey and to identify whether the years of study affected these values. A total of 192 participants were asked to prioritize 16 professional and 36 personal values. The relationship between the year of study and value ranking was analyzed by Kruskal–Wallis test. The first three of the professional values were justice, equality, and human dignity. Equality ranked sixth among the personal terminal values, and (...) it increased with the years of study. Of personal instrumental values, responsibility and cleanliness ranked second and fifth, which are of central importance for the profession of midwifery. However, the other two important values, privacy and preventing unnecessary suffering, ranked lower when the years of study increased, in other words when the students confront clinics. Since these values are important for midwifery, ethics courses should be given throughout the midwifery education to prepare students for the challenges they face in the clinical environment. (shrink)

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus (...) by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. (shrink)

Background Undergraduate medical education is beginning to concern itself with educating students about professional attributes as well as about clinical knowledge and skills. Defining these characteristics, and in particular seeking the help of the students themselves to define them, can be a useful starting point when considering how to incorporate aspects of professional behaviour into the medical curricula. Method This study explores the views of first-year medical students at Kocaeli University Faculty of Medicine in the 2007–8 academic year. The students (...) were asked the open-ended question: ‘What, in your opinion, are the attributes a good physician should have?’ Four topics were defined by researchers based on the undergraduate and graduate education projects. The attributes expressed by the students were evaluated by the researchers according to these topics and compared with the topics covered in the undergraduate and graduate education projects. Results A total of 127 students responded, and between them suggested 756 attributes. The majority of these attributes (54.6%) were concerned with interpersonal relations and communication, whereas the category representing the fewest attributes (12.3%) was that involving scientific knowledge and medical practice. In general, students' perception corresponded to the concept of the ‘competent physician’ as described in the professionalism projects, but attributes reflecting their world-view were also expressed. Conclusion Experience suggests that the active participation of students in determining which attributes are necessary for a good physician is a positive way of ensuring they embrace the importance of such qualities and attributes in themselves. (shrink)

The review of literature on stakeholders reveals that there is need to understand more about firm-stakeholder relationships especially from stakeholders’ point of view. Market integration in the European Union (EU) provides an excellent context for increasing such understanding since it is creating opportunities and threats for firms and their stakeholders. This research aims to make a contribution in this direction by analyzing strategic responses of primary stakeholders to selected threat events in the history of Volkswagen (VW) since 1960.

This article presents empirical data on the limited availability of hospice and palliative care to the 6 million people of the English-speaking Caribbean. Ten of the 13 nations therein responded to a survey and reported employing a total of 6 hospice or palliative specialists, and having a total of 15 related facilities. The evolving socioeconomic and cultural context in these nations bears on the availability of such care, and on the willingness to report, assess, and prioritize pain, and to prescribe (...) opiates for pain. Socioeconomics and culture also impinge on what medications and modalities of care are routinely available for pain or other conditions and can challenge professionalism, empathy, and responsiveness to patients’ unrelieved pain. Although all respondents report having a protocol for pain management, hospice, or end-of-life care, their annual medical use of opiates is well below the global mean. The International Narcotics Control Board , which monitors such use, encourages Caribbean and other low- and middle-income countries to increase their use of opiates to treat pain, and to overcome both unfounded fears of addiction and overly restrictive interpretation of related laws and regulations. Contextual considerations like those described here are important to the success of policies and capacity-building programs aiming to increase access to hospice and palliation, and perhaps to improving other aspects of health and healthcare. Exploring and responding to the realities of socioeconomic and cultural conditions will enhance public and policy dialogue and improve the design of interventions to increase access to palliative and hospice care. Improving access to palliative and hospice care in the Caribbean demonstrates beneficence and helps to fulfill human rights conventions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Ch'an/Zen-Catholic Dialogue Spreads a "Welcome Table" at the 2009 Annual MeetingFrancis V. TisoA retreat program designed by the participants in the ongoing Ch'an/Zen-Catholic Dialogue explored the dialogue of religious experience and the dialogue of life, set amid the redwoods of Guerneville, California. The 28–31 January 2009 meeting was cochaired by the Rev. Heng Sure of the Berkeley Buddhist Monastery and the Institute for World Religions, Berkeley, California, and by (...) Most Rev. John C. Wester, Bishop of Salt Lake City, Utah.Sr. Mary Ann Donovan of the Jesuit School of Theology, Berkeley, led an experience of lectio divina based on John 15:1–17, Jesus's simile of the vine and the branches. Rev. Victoria Austin of the San Francisco Zen Center gave an "encouragement talk," which would typically be delivered to Zen retreatants. She referred to the Gospel passage, noting: "We don't prune the vine because it is dead, but because it has the capacity to be fruitful. We don't purify the mind to get rid of dirt, but to return to the mind's original purity, which is the source of our conscience and is the true life within us." Rev. Jan Chosen Bays of Great Vow Zen Monastery in Oregon observed that "Vows make our life energy more focused, keeping us from losing purpose and meaning. Vows prune away unnecessary things. When we ask for help with the challenge of being faithful to our vows, we call up and encounter unexpected sources of support and 'grace.' "The Ch'an Buddhist presentation focused on meditation experience, which was described as "recovering the natural state of the mind." Prof. Martin Verhoeven of the Pacific School of Religion pointed out that in meditation "we are returning to the origin, not moving forward to 'gain something.'" Linking ethical engagement with contemplation, he said, "When the mind of a meditator is motivated to act out of genuine compassion, its action is accurate and correct. Action is neither driven nor obstructed by ego or sentiment." These comments resonated with Rev. Heng Sure's presentation on the statement on the environment from the recent Gethsemane III conference "Simple and Sufficient," in which Buddhist and Christian monastics embraced an ecologically valid way of life. Urging the group to notice the connections between contemplation and ethical action, Bishop John C. Wester commented: "This [End Page 145] work embodies mercy by lifting people up; it embodies justice as it arises out of our common humanity."Because of the financial challenges that all three sponsoring institutions are facing, it was decided to conclude formal sponsorship of the Ch'an/Zen-Catholic Dialogue with this meeting. However, participants agreed to work together to reconstitute the dialogue regionally. A steering committee was designated to undertake new logistical arrangements and to draft a narrative of the previous seven years of dialogue for posting on our respective websites. Bishop Wester summarized the convictions of participants, both Buddhist and Catholic, by observing: "It is impossible not to be affected by this experience. Dialogue in this atmosphere has had an impact on my own way of ministering to others. I feel that my faith, sensitivity, compassion, and reverence have been enhanced by participating in these meetings."Participants in the 2009 dialogue meeting included Rev. Heng Sure, Berkeley Buddhist Monastery; Bishop John C. Wester, Salt Lake City; Dr. Snjezana Akpinar, Dharma Realm Buddhist University; Rev. Gigen Victoria Austin, San Francisco Zen Center; Rev. Jan Chozen Bays, Great Vow Zen Monastery; Sr. Phyllis D'Anna, SND, Zen Center, Palo Alto; Sr. Mary Ann Donovan, SC, Jesuit School of Theology at Berkeley; Dr. Ron Epstein, Dharma Realm Buddhist Association; Mrs. Lorraine Moriarty, Society of St. Vincent De Paul; Bhikshuni Heng Jiao, City of 10,000 Buddhas; Bhikshuni Heng Liang, City of 10,000 Buddhas; Rev. Canon Francis Tiso, United States Conference of Catholic Bishops; Rev. James Massa, United States Conference of Catholic Bishops; Rev. Thomas W. Devereaux, Diocese of Santa Rosa ecumenical and interreligious officer; Dr. Martin Verhoeven, Pacific School of Religion; and Ron Brown, observer (Cloverdale, California). [End Page 146]Francis V. TisoUnited States Conference of Catholic BishopsCopyright © 2009 University of Hawai'i Press... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Transformation of Hearts and Minds:Chan Zen-Catholic Approaches to PreceptsHarry L. WellsCatholic and Buddhist priests, monastics, teachers, and community leaders participated in the second of an anticipated four annual dialogues. The series is sponsored by the Dharma Realm Buddhist Association, the San Francisco Zen Center, and the United States Conference of Catholic Bishops (USCCB). The conference took place 4–7 March 2004 at Mercy Center in Burlingame, CA, whose own East-West (...) meditation program, led by Fr. Thomas Hand, celebrated its twentieth anniversary that year. A popular retreat center and home to the Sisters of Mercy of Burlingame, the Center offered participants tree-dotted, spacious grounds and strolling paths, as well as a labyrinth for contemplative walking.Each day began with both Catholics and Buddhists in Mercy Center's Rose Room, a Zen-style meditation space, for an hour of silent meditation in the morning. Catholic liturgy was celebrated in the afternoon in the main chapel, with all participants invited to attend and share prayer and blessings. On the two full days, Friday and Saturday, two sessions of presentations were held each morning, with one session following in the afternoon. Each of the six sessions focused on a position paper, with three papers given from a Buddhist and three from a Christian perspective. Each paper was presented by its authors, followed by two formal responses, one by a Buddhist and one by a Catholic participant. This was in turn followed by an open discussion within the whole group. A minute of silent meditation began and ended each session.The presentations focused on various meanings embraced by the term "precepts" in each tradition. One paper introduced perspectives on Buddhist precepts in three different Buddhist lineages. Another presented six guidelines as "Precepts on the [End Page 155] Mind-Ground" that connect ethical commitments with social engagement. A third paper focused on Bodhisattva practice, which embraces and unifies all sentient beings. On the Christian side, presentations discussed the precepts as signposts on the path that leads away from suffering, as motivations that move us, and as the practice of the presence of God, exemplified by the writings of Brother Lawrence.A glossary prepared by Fr. Francis Tiso helped define Catholic Christian terms for the Buddhist participants in the dialogue. Similarly, a book distributed to all participants by the Dharma Realm Buddhist Association provided background on "Buddhism A–Z." Formal discussion sessions in the evenings, as well as informal talks by the participants while walking outside or in the form of impromptu hallway meetings added to the depth and richness of the dialogue. Some recurring themes were the importance and meaning of a personal teacher in both traditions; another was the "embodiment" of the teachings, the value of teaching through presence. Personal stories and practical experiences offered by individual participants were much appreciated and added poetry and emotion to the headiness of theological discussion.Members of both the Buddhist and the Catholic traditions reported that the encounter with the spiritual practices and beliefs of the other faith provides both affirmation of the familiar and welcome discovery of unexpected riches of the spirit. The next meeting will be held 20–23 January 2005 at the San Francisco Zen Center. The theme will be "Practice: Method and Experience Toward Transformation."Participating in the 2004 dialogue were Rev. Heng Sure (Berkeley Buddhist Monastery), Bishop John C. Wester (Auxiliary Bishop, Archdiocese of San Francisco), Rev. Taigen Dan Leighton (Mountain Source Sangha), Fr. Arthur Kennedy (Secretariat for Ecumenical and Interreligious Affairs, USCCB), Bhikshuni Heng Liang (Dharma Realm Buddhist Association), Dr. Martin Verhoeven (Institute for World Religions), Dr. Ron Epstein (Institute for World Religions), Dr. Snjezana Akpinar (Dharma Realm Buddhist University), Rev. Shosan Victoria Austin (San Francisco Zen Center), Rev. Alan Senauke (Berkeley Zen Center), Jan Chozen Bays (Zen Community of Oregon), Sr. Phyllis D'Anna, SND (Center for the Practice of Applied Spirituality), Fr. Thomas W. Devereaux (Diocese of Santa Rosa), Robert Hale, OSB Cam. (Incarnation Monastery, Berkeley, CA), Thomas Hand, S.J. (Mercy Center, Burlingame, CA), Fr. Rafael Luévano (Diocese of Orange), Deacon Thomas McGowan (Diocese of Oakland), Lorraine Moriarity (St. Vincent de Paul Society of San Mateo County), Fr. Gerry O'Rourke (Archdiocese... (shrink)