Resenha de: Blumenbach, J. F. Sobre o impulso de formação e a geração. Tradução, introdução e notas de Isabel Coelho Fragelli. Revisão técnica de Luciana Valéria Nogueira. Santo André: Editora UFABC, 2019.

In Pakistan, as in many non‐Western cultures, decisions about a patient's health care are often made by the family or the doctor. For doctors educated in the West, the Pakistani approach requires striking a balance between preserving indigenous values and carving out room for patients to participate in their medical decisions.

In theory, a commercial market for kidneys could increase the scarce supply of transplantable organs and give impoverished people a new way to lift themselves out of poverty. In‐depth sociological work on those who opt to sell their kidneys reveals a different set of realities. Around the town of Sarghoda, Pakistan, the negative social and psychological ramifications of selling a kidney affect not only the vendors themselves, but also their families, communities, and even the country as a whole.

ABSTRACT Although a preference for sons is reportedly a universal phenomenon, in some Asian societies daughters are considered financial and cultural liabilities. Increasing availability of ultrasonography and amniocentesis has led to widespread gender screening and selective abortion of normal female foetuses in many countries, including India. Feminists have taken widely divergent positions on the morality of this practice. Feminists from India have strongly opposed it, considering it as a further disenfranchisement of females in their patriarchal society, and have agitated successfully (...) for legislative prohibitions. Libertarian feminists on the other hand, primarily from the United States, have argued that any prohibition of the use of this technology is a curtailment of a woman's reproductive choices and a violation of her right to make autonomous decisions regarding procreation. Using India as an illustrative case, this paper argues that in the context of what prevails in some societies, an ethical argument that hinges on the principle of autonomy as understood in the West can be problematic. Furthermore, a liberal theoretical assumption that it is always better to have more rather than fewer choices may not hold up well against the realities of life for such women. Although feminists have little disagreement concerning substantive matters, it is in the area of strategy that differences of opinion have arisen, their moral reasoning and responses shaped by the culture, ethnicity, class and race to which they belong. A view that a single ‘orthodox’ feminism of any variety can embody the aspiration of all women reverts to the problematic issues in the evolution of the rationalistic, individualistic, ‘male’ ethics against which women have consistently raised objections. (shrink)

Despite the majority opinion of Muslim jurists that organ donation is permitted in Sharia, surveys indicate continuing resistance by lay Muslims, especially to donating organs following death. Pakistan, a country with 165 million Muslims, currently reliant on live donors, is considering steps to establish deceased donor programs which will require public acceptance and support. This article analyzes the results of in-depth interviews with 105 members of the public focusing on opinions and knowledge about juristic rulings regarding kidney donations, donor-family dynamics (...) in deceased donation decisions, and attitudes towards buying kidneys. The objective was to determine the influence if any of cultural and religious values, and norms of traditional family structures and kinships, on decisions to donate. Study participants view donation of kidneys, particularly from the deceased, through a different lens from that used by jurists and physicians, one that also does not conform to familiar paradigms defining ethical organ donation. A socially modulated understanding of Islam passed down the generations, and longstanding family-centric norms, shape the moral worldview of many rather than academic juristic rulings or non-contextual concepts of autonomy and rights. The results of this study also highlight that medical science may be universal but its application occurs within particularities of cultural and religious values, social constructs of the self and its relationship with others, and different ways in which humans comprehend illness, suffering, and death. These findings are of relevance both to transplant related professionals and bioethicists involved with this field. (shrink)

Despite the majority opinion of Muslim jurists that organ donation is permitted in Sharia, surveys indicate continuing resistance by lay Muslims, especially to donating organs following death. Pakistan, a country with 165 million Muslims, currently reliant on live donors, is considering steps to establish deceased donor programs which will require public acceptance and support. This article analyzes the results of in‐depth interviews with 105 members of the public focusing on opinions and knowledge about juristic rulings regarding kidney donations, donor‐family dynamics (...) in deceased donation decisions, and attitudes towards buying kidneys. The objective was to determine the influence if any of cultural and religious values, and norms of traditional family structures and kinships, on decisions to donate. Study participants view donation of kidneys, particularly from the deceased, through a different lens from that used by jurists and physicians, one that also does not conform to familiar paradigms defining ethical organ donation. A socially modulated understanding of Islam passed down the generations, and longstanding family‐centric norms, shape the moral worldview of many rather than academic juristic rulings or non‐contextual concepts of autonomy and rights. The results of this study also highlight that medical science may be universal but its application occurs within particularities of cultural and religious values, social constructs of the self and its relationship with others, and different ways in which humans comprehend illness, suffering, and death. These findings are of relevance both to transplant related professionals and bioethicists involved with this field. (shrink)

This paper clarifies the notion of "contact with reality" by investigating one way in which lack of such contact can be expressed: the interrogative attitude. The case of a socially withdrawn, seventeen-year-old schoolboy is examined. Paul C. had long been overly logical and precise in his style of thinking. An acute disturbance began with mental fatigue along with apparent obsessive symptoms (e.g., extreme monitoring of his own actions) to the point that simple, everyday actions became very time-consuming; he also developed (...) a tendency to ask endless questions even about trivial phenomena. However, unlike those of the true obsessive, Paul's monitoring, doubting, and querying seemed to lack any emotional or personal element; he was not anxious but, rather, apathetic. Also, Paul lacked real curiosity: To him, everything had the same level of importance, and his attention was not directed by any precise or personal goal. This paper argues that Paul's interrogative attitude was actually a form of autistic-schizophrenic thinking characterized by "pragmatic weakening" and a loss of vital contact with reality, which are consequences of a weakening of the "élan vital" with its "vital propulsion toward the future." Such patients retain their intellectual powers but do not use these powers in accord with the requirements of reality. The interrogative attitude can be seen as a compensation mechanism—a way to maintain some minimal contact with the world. The paper ends with psychotherapeutic recommendations. (Abstract written by special issue editor: L.A.S.). (shrink)

The Islamic Republic of Pakistan has a population of more than 145 million people, about 95% of whom are Muslims . Although it has a few large cities such as Karachi, almost 65% of the country is still rural, with a per capita income of $408 per year. The overall literacy rate is estimated to be 41.5% but is much lower for women in many of the provinces. Pakistan has a complex culture with many ethnic groups and socioeconomic strata, but (...) overall the society is characterized by hierarchical systems in both private and public domains. The population is religious and family centered with the “family” understood as extending beyond the nuclear; it is not uncommon to have three generations residing under one roof or within close proximity to each other and pooling their resources. (shrink)

This essay provides a brief overview of the rise of organ trade in Pakistan towards the end of the last century and the concerted, collective struggle—of physicians and medical associations aided by the media, journalists, members of civil society, and senior judiciary—in pressuring the government to bring about and implement a national law criminalizing such practices opposed by an influential pro-organ trade lobby. It argues that among the most effective measures to prevent re-emergence of organ trafficking in the country is (...) increasing ethical live donations and above all, establishing sustainable, public supported deceased donor programs. To do this, the transplant community must recognize that organ transplantation is not merely a donor-recipient-physician transaction but a complex issue in which decisions to donate an organ are influenced by indigenous values and belief systems about human illness, life and death. (shrink)

Gabriel Rezende est à Jacques Derrida ce que Reiner Schürmann est à Martin Heidegger. Comme l’essai fondateur de Schürmann, Le principe d’anarchie. Heidegger et la question de l’agir, posait « la question du rapport entre théorie et pratique telle qu’elle résulte de la “déconstruction” » heideggérienne, celui de Rezende, Droit et normativité chez Jacques Derrida, pose celle des rapports entre éthique et morale telle qu’elle résulte de la déconstruction derridienne, c’est-à-dire d’une pensée «...

Contemporary bioethics has evolved over the past 40 years predominantly as a “Western” construct drawing fundamental inspiration for its conceptual and methodological frameworks from secular, Anglo-American philosophical traditions. American bioethicists can be credited with playing a defining role in the globalization of this new discipline to the developing countries of the world, but in this process, in the words of LaFleur, “Bioethics has become international without becoming internationalized.” Among the criticisms leveled against the dominant American model of bioethics is that (...) in its focus on universalism it ignores local cultural and religious influences that are vital to the comprehension of the moral life in many societies. Medical sociologist Renée C. Fox and historian Judith P. Swazey have termed this as a form of “cultural myopia.”. (shrink)

It has been a little over three months since I returned. My day begins with an altercation with a new security guard who stops me as I drive up to the gate of the brand-new university hospital. He tells me that I am to use the other entrance, as only the chairman’s car is allowed through this gate. I inform him that I am the chairman. He peers at me suspiciously. The chairman sahib is a man not a woman, he (...) says. I put on a stern face and tell him that I am the chairman and he will get into trouble for not letting me through. He looks uncertain but eventually lets me drive in through the gate. I pick up my white coat and stethoscope from my... (shrink)

The arrival of the Covid‐19 pandemic in Pakistan necessitated that the Centre of Biomedical Ethics and Culture in Karachi realign its activities to changing realities in the country. As Pakistan's only bioethics center, and with no guidelines available for allocation of scarce medical resources, CBEC developed “Guidelines for Ethical Healthcare Decision‐Making in Pakistan” with input from medical and civil society stakeholders. The CBEC blog connected to the center's bioethics programs for students from Pakistan and Kenya shifted to Covid‐related issues specific (...) to the context of existing social and political realities within these countries. As part of its outreach activities, CBEC initiated a popular Facebook series, #HumansofCovid, as an experience‐sharing platform for health care professionals and members of the public. Narratives received vary from those by frustrated physicians under quarantine to those concerning street vendors left jobless and a transsexual person in whose opinion “social distancing” is not a new phenomenon for their communities. (shrink)

Recent studies indicate that mammalian chromosomes contain discretecis‐acting loci that control replication timing, mitotic condensation, and stability of entire chromosomes. Disruption of the large non‐coding RNA gene ASAR6 results in late replication, an under‐condensed appearance during mitosis, and structural instability of human chromosome 6. Similarly, disruption of the mouse Xist gene in adult somatic cells results in a late replication and instability phenotype on the X chromosome. ASAR6 shares many characteristics with Xist, including random mono‐allelic expression and asynchronous replication timing. (...) Additional “chromosome engineering” studies indicate that certain chromosome rearrangements affecting many different chromosomes display this abnormal replication and instability phenotype. These observations suggest that all mammalian chromosomes contain “inactivation/stability centers” that control proper replication, condensation, and stability of individual chromosomes. Therefore, mammalian chromosomes contain four types ofcis‐acting elements, origins, telomeres, centromeres, and “inactivation/stability centers”, all functioning to ensure proper replication, condensation, segregation, and stability of individual chromosomes. (shrink)

A intenção deste texto é articular dois temas pouco trabalhados juntos nas interpretações de Kant, embora sejam, segundo nosso entendimento, de fundamental importância para uma plena compreensão da filosofia kantiana e do conhecimento filosófico em geral: a disciplina da razão pura e a filosofia teórica. Pretendemos nos utilizar de algumas outras noções, no entanto, para responder a seguinte pergunta: é possível a formação sem a disciplina filosófica? Isto é, seria possível uma formação teórica sem uma disciplina ou uma “contribuição negativa” (...) proveniente da filosofia? O conceito de formação está, segundo gostaríamos de defender, de um ponto de vista teórico, associado intrinsecamente à disciplina da razão. Assim, indicando como esta é, em geral, relacionada, nas interpretações de Kant, apenas com a pedagogia e com a filosofia prática, gostaríamos de, indo no sentido contrário, tratar do lugar da disciplina da razão em relação ao conceito de formação em seu sentido teórico, isto é, de fundamentação do conhecimento. A disciplina da razão pura revela-se, portanto, uma condição necessária para o filosofar e para a formação do conhecimento em geral. (shrink)

In this article, I will try to explain the meaning of the word zihâr, translated as oath of the back, trying only to situate it in its context and to bring an elucidation of the subject`s origin. The zihâr is a type of repudiation used by a husband against his wife in the times of gâhiliyya (the ante-Islamic period), by using a solemn divorce formula which consists in saying: "let (her) be from now on as the back of my mother". (...) Therefore, backing up on this formula, I want to try to clarify this concept. (shrink)

In this article, I will try to explain the meaning of the word zihâr, translated as oath of the back, trying only to situate it in its context and to bring an elucidation of the subject`s origin. The zihâr is a type of repudiation used by a husband against his wife in the times of gâhiliyya (the ante-Islamic period), by using a solemn divorce formula which consists in saying: "let (her) be from now on as the back of my mother". (...) Therefore, backing up on this formula, I want to try to clarify this concept. (shrink)

SummaryThis paper examines the official abortion statistics for South Australia since the legalization of abortion in January 1970. The incidence of abortion is shown to be increasing steadily—in 1976 more than half of the extramarital pregnancies were terminated and the overall ratio of abortions to live births was nearly 1:6. Most abortion patients were single, young women. Comparison of fertility levels in South Australia with the rest of Australia shows that the fertility decline has been much more rapid in South (...) Australia, suggesting that unless the South Australian women are more efficient users of contraception than other Australian women, a significant proportion of the fertility decline in South Australia has to be attributed to legalized abortion. (shrink)

Official statistics on abortion in South Australia for the period 1971–86 are analysed in terms of incidence, age of patients and nuptiality, reasons for abortion, method of termination, period of gestation, previous abortions and concurrent sterilisation. Demographic implications are discussed and recommendations are made for more education and counselling, especially for younger and unmarried women for whom the incidence of abortion seems to be rising.

During the COVID‐19 pandemic, healthcare professionals around the world were driven by universal values of solidarity and duty to provide care. However, local societal norms and existing healthcare systems influenced interactions among physicians, and with patients and their families. An exploratory qualitative study design using in‐depth interviews was undertaken with physicians working at two public sector hospitals in Karachi, Pakistan. Using the constant comparison method of data analysis, several key themes were identified highlighting norms of kinship and interdependencies characteristic of (...) collectivistic societies that influenced professional interactions. The role of seniors in the hierarchical society of Pakistan played a major role in provision of care. Physicians reported numerous challenges in dealing with patients and their families amidst public denial fueled due to ill‐formed government policies. This included interruption of funeral rites which undermined public trust. The study provides insights into the local moral world of two healthcare institutions in Pakistan. (shrink)

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.