Abstractabstract:This article provides an in-depth ethical analysis of living donor uterus transplantation, incorporating clinical, psychological, and qualitative study data into the discussion. Although the concept of living organ donors as patients in their own right has not always been present in the field of transplantation, this conceptualization informs the framework for living donor ethics that we apply to living uterus donation. This framework takes root in the principles of research ethics, which include respect for persons, beneficence, and justice. It incorporates (...) an analysis based on eight potential vulnerabilities of living donors: capacitational, juridic, deferential, social, medical, situational, allocational, and infrastructural. Finally, it recognizes that special relationships—such as that of the living donor advocate with the potential donor—require special responsibilities, including identifying vulnerabilities and engaging donors in a shared decision-making process. Directed and non-directed uterus donors require separate ethical analyses because their different relationships with recipients will influence the types of vulnerabilities, they are subject to as well as the potential benefits they may gain from donation. (shrink)

A woman with congenital absence of a uterus applied for participation in a clinical trial for uterus transplantation. She was married to a woman who had the potential to carry a child without the need for aggressive medical intervention. Thus, the question arose regarding whether the infertile partner should be considered for uterus transplantation. In this article we discuss the ethical issues with uterus transplantation for a member of a same-sex couple, whose partner could carry a pregnancy. We review the (...) medical criteria for uterus transplantation, discuss the additional options for parenthood in same-sex couples, examine how to determine if this meets the criteria of just distribution of uterus grafts, and ultimately argue that the value of gestation is at the level of the individual rather than the couple. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)

This paper proposes a new definition of vocation that honors the concept’s ancient roots, is consistent with how the term is used in modern contexts, and also expands the concept for greater versatility. We discuss the centrality of service in the concept of vocation locating it as part of the bridge between a student’s core values and their embodiment in community life. The commitment to one’s profession begins before independent status as a practitioner of that profession. It begins in training (...) during which service-learning is a laudable and increasingly popular way to connect to the charitable aspects of professionalism. We further discuss how the concept of vocation is especially appropriate in the context of citizenship. Citizenship is a way of belonging to a community. It is a relationship that requires giving and taking. Service-learning is an ideal way to practice good citizenship on a local scale, and prepare future professionals for understanding their communities and commitments morebroadly. We discuss how these concepts are being emphasized in the medical informatics master’s degree program at Saint Louis University through the incorporation of a service-learning module. We describe the module, discussing how it can be applied to curricula at other institutions and modified for inclusion in other types of courses. (shrink)

John Venn is known as one of the clearest expounders of the interpretation of probability as the frequency of a particular outcome in a potentially unlimited series of possible events. This view he held to be incompatible with the alternate interpretation of probability as a measure of the degree of belief that would rationally be held about a certain outcome based upon the reliability of testimony and other prior information. This paper explores the reasons why Venn may have been so (...) opposed to the degree-of-belief interpretation and suggests that it may have been a way for him to resolve a conflict in his own mind between his ideas of proper scientific methods of inference and the religious beliefs that he held as a young man. (shrink)

In their manuscript, Nielsen Busch and Mjaaland (2023) argue that controlled donation after circulatory death (cDCD) is compatible with the dead donor rule (DDR) by describing the DDR and the incor...

Ethical problems are common in clinical medicine, so medical volunteers who practice clinical medicine in developing countries should expect to encounter them just as they would in their practice in the developed world. However, as this article argues, medical volunteers in developing countries should not expect to encounter the same ethical problems as those that dominate Western biomedicine or to address ethical problems in the same way as they do in their practice in developed countries. For example, poor health and (...) advanced disease increase the risks and decrease the potential benefits of some interventions. Consequently, when medical volunteers intervene too readily, without considering the nutritional and general health status of patients, the results can be devastating. Medical volunteers cannot assume that the outcomes of interventions in developing countries will be comparable to the outcomes of the same interventions in developed countries. Rather, they must realistically consider the complex medical conditions of patients when determining whether or not to intervene. Similarly, medical volunteers may face the question of whether to provide a pharmaceutical or perform an intervention that is below the acceptable standard of care versus the alternative of doing nothing. This article critically explores the contextual features of medical volunteer work in developing countries that differentiate it from medical practice in developed countries, arguing that this context contributes to the creation of unique ethical problems and affects the way in which these problems should be analyzed and resolved. (shrink)

In their article, Bruno and Arora (2018) conclude that if deceased donor uterus transplantation has equivalent outcomes and the supply of deceased donors is sufficient, then living uterus donation...

A man of twenty‐two is admitted to an intensive care unit (ICU)after intentionally overdosing on Tylenol. The nurse asks the intensivist on call if someone from the local organ procurement organization should be called in to speak to the family, given a worsening clinical picture and the likelihood that the patient will progress to brain death. The patient's condition is such that multiple organs, including his heart and lungs, could be donated. The intensivist instructs the nurse not to call, as (...) he wishes to have an end‐of‐life discussion with the parents. He believes that the parents should know that death is imminent and that further interventions will not save their son. He argues that introducing the OPO at this point will cause the family more distress. He wants the parents to be able to give their son a peaceful death without additional stressors. What are the broader implications of not calling the OPO at this juncture? Does the nurse involved have an ethical obligation to override the intensivist's instructions by calling the OPO? Should the fact that multiple healthy organs could be harvested from this patient's body have any bearing on the decision to call the OPO? (shrink)

Volume 19, Issue 11, November 2019, Page 25-26.

Surgeons are in a unique position, serving as gatekeepers to the operating room. They determine if operations are possible, are indicated, and have a reasonable risk–to–benefit profile. When an operation is indicated and the patient is amenable to it, the conversation between surgeon and patient is usually straightforward. On the other hand, when a patient’s co–morbidities substantially increase the risk of operative intervention, surgeons often question the utility of offering their services. These situations become immensely more difficult when patients have (...) the expectation of being offered surgical treatment. This case describes the clinical encounter between an endocrine surgeon and an 83–year–old woman who has been incidentally found to have adrenal metastasis from melanoma. The patient wants an operation that the surgeon is reluctant to offer because of her frailty and high operative risk. The case focuses on the ethical dilemma that arises when a patient wants an operation that a surgeon does not want to perform. I was the resident in the endocrine surgery clinic the day that Ms. M came in. Given my background in bioethics, the attending physician told me about the patient’s history beforehand and asked for advice on how to approach the clinical encounter. I then accompanied him into her room to talk with her and her husband. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, were addressed.Results: Non-maleficence was the most (...) frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

In 1866, the young John Venn published The Logic of Chance, motivated largely by the desire to correct what he saw as deep fallacies in the reasoning of historical determinists such as Henry Buckle and in the optimistic heralding of a true social science by Adolphe Quetelet. Venn accepted the inevitable determinism implied by the physical sciences, but denied that the stable social statistics cited by Buckle and Quetelet implied a similar determinism in human actions. Venn maintained that probability statements (...) were intelligible solely as projections of the ultimate frequency of an outcome in an unlimited series of trials and therefore led to no inferences about free will. An issue here was Venn's claim that although the aggregate probability may be stable, the individual events were completely irregular and, in fact, displayed randomness. Venn's concept of randomness was really apparent, or pseudo-, randomness, which could be totally determined. Ironically, Venn's frequentist position was very useful to the growing field of statistics, which could develop correlations and predictive models empirically without having to address implications for personal freedom or fatalism. (shrink)

This book is a collection of secondary essays on America's most important philosophic thinkers—statesmen, judges, writers, educators, and activists—from the colonial period to the present. Each essay is a comprehensive introduction to the thought of a noted American on the fundamental meaning of the American regime.

This issue is a continuation of the theme of Catholic Peacemakers in the Americas with a focus on Latin American peacemakers such as ArchbishopOscar Romero and Ignacio Ellacuria, S.J. The relationship between the Catholic Church and Latin American politics is one in which the "cross and crown" symbolize a relationship that dates back to the sixteenth century and the Spanish conquest of indigenous peoples throughout the Americas.

This paper considers the use of textual analysis of oral histories as a method for historians of nursing. Fifty‐three oral histories of retired nurses in midwestern USA were analyzed for the purpose of historical reconstruction of past education experiences in nursing. Textual analysis was used to determine how nurses made sense of their educational experiences, and it involved gathering data, analyzing the information, and using a different method of interpreting the data. Although the participants responded to specific questions, the oral (...) histories in this study are more than mere answers to the researchers’ queries. The participants’ memories are narratives that are the joint product of both the historian and the participant. As such, the oral history becomes a text to be stored along with other primary sources for future historians’ use. The research also suggests decentering oral histories from an exclusively academic agenda and focusing more on what the participants choose to remember and why they make those choices. (shrink)

In research textbooks, and much of the research practice, they describe, qualitative processes and interpretivist epistemologies tend to dominate visual methodology. This article challenges the assumptions behind this dominance. Using exemplification from three existing visual data sets produced through one large education research project, this article considers the affordances and constraints of the research process focusing particularly on analysis. It examines how and when the visual can be incorporated, gives some critical reflections on the role and use of visual methods (...) to fulfil different research intents, and, in particular, considers combining large, open-ended data sets with acceptable and rigorous analysis techniques. We then explore arguments about the nature of visual data, what is considered epistemologically appropriate and the decision-making which accompanies any appraisal of process in education research. The intention is to challenge ourselves, and fellow visual methods researchers, to develop a more complete understanding of the theory and practice of visual research. (shrink)

In the early eighteenth century Newtonianism became popular in the Netherlands both in academic and non-academic circles. The ‘Book of Nature’ was interpreted with the help of Newton’s natural philosophy and his ideas about a providential deity, thereby greatly enhancing the attractiveness of physico-theology in the eighteenth-century United Provinces. Like other Europeans the Dutch welcomed physico-theology as a strategic means in their battle against irreligion and atheism. Bernard Nieuwentijt, Johan Lulofs, Petrus Camper, and Johannes Florentius Martinet were prominent experts in (...) the field. Combining Newtonian notions with Leibnizian optimism and romanticist trends, physico-theology remained popular in the Netherlands well into the nineteenth century.Author Keywords: Apologetics; Dutch Enlightenment; Physico-theology; Prophetic theology; Argument from design; Empiricism. (shrink)