Introduction: Decisions to withdraw or withhold curative or life-sustaining treatment can have a huge impact on the symptoms which the palliative-care team has to control. Palliative-care patients and their relatives may also turn to palliative-care physicians and nurses for advice regarding these treatments. We wanted to assess Indian palliative-care nurses and physicians’ attitudes towards withholding and withdrawal of curative or life-sustaining treatment. Method: From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programmes in (...) New Delhi, using a semi-structured questionnaire. For the interviews and analysis of the data we followed Grounded-Theory methodology. Results: Withholding a curative or life-sustaining treatment which may prolong a terminal cancer patient’s life with a few weeks but also has severe side-effects was generally considered acceptable by the interviewees. The majority of the interviewees agreed that life-sustaining treatments can be withdrawn in a patient who is in an irreversible coma. The palliative-care physicians and nurses were of the opinion that a patient has the right to refuse life-saving curative treatment. While reflecting upon the ethical acceptability of withholding or withdrawal of curative or life-sustaining treatment, the physicians and nurses were concerned about the whole patient and other people who may be affected by the decision. They were convinced they can play an important advisory role in the decision-making process. Conclusion: While deciding about the ethical issues, the physicians and nurses do not restrict their considerations to the physical aspects of the disease, but also reflect upon the complex wider consequences of the treatment decisions. (shrink)

The aged in India have conventionally enjoyed privileges within the framework of a social economy where the needs of the old remained a moral responsibility of family, kith and kin. However the present changing times have forced a shift in the approach to old age care. The old person finds him- or herself in a sticky situation, in between an insensitive state and the demands of globalization. The present paper situates this problem within the framework of globalization and systematically measures (...) the strategic response of the state to this daunting challenge, with respect to economic security and health care in particular. In the conclusion, the paper argues for a rejection of the conventional welfare approach and it advocates an integrated approach based on a coherent social development perspective within the valuation framework of social quality. (shrink)

Background: There are intriguing and challenging ethical dilemmas in the practice of palliative care in a traditional developing society.Objective: To review the different ethical issues involved in cancer and palliative care in developing countries, with special reference to India.Methods: Published literature on pain relief and palliative care in the developing countries was reviewed to identify ethical issues and dilemmas related to these, and ways in which ethical principles could be observed in delivery of palliative care in such countries are discussed.Results: (...) The literature review revealed a number of ethical dilemmas and challenges that professionals, cancer patients and their families encountered during palliative care. It was noted that patients’ preferences and decisions are influenced by family members. Dilemmas leave the professionals and families confused about how ethical their actions have been. Specific ethical issues were noted in relation to the availability and use of oral morphine for pain relief, spiritual care, lack of adequate palliative care services, and palliative care education.Conclusions: The four principles of ethics posed difficulties in understanding the complex ethical issues in a developing country with a traditional background. Ethical issues need to be handled delicately and sensitively in palliative care settings, within the framework of the traditions and culture of the society and financial constraints. The possible role of ethics committees in palliative care settings to help decision-making needs to be studied and discussed. (shrink)

ABSTRACTThe concept of poverty is understood differently by people across the globe. Despite this conceptual limitation, higher economic growth in the last few decades in many countries has helped reduce extreme global poverty. The growth process has been supported by globalization. The number of global poor is, however, still quite large and more than the entire population of USA, UK, France and Russia. Their numbers have gone up by 100 million in Sub Sahara region in last three decades. While removal (...) of extreme poverty is clearly vital, it cannot be considered sufficient for a dignified life. The crux of human dignity is development and it must provide every individual access to education, healthcare, nutrition, habitat, and exercising of democratic rights in accordance with the rule of law. While helping reduce poverty, globalization has also led to some morally unsustainable consequences. There is huge and rapidly increasing inequality of wealth and income in most nations. There are now new opportunities for corruption which are being exploited by multinationals. These corrupt practices are resulting in illicit flow of about one trillion Dollars every year. For a more ethical society, effective measures are needed for controlling corruption for improving quality of life. (shrink)

Addressing religion and feminism on a global scale, this unprecedented book contains a nuanced and fine-tuned treatment of seven of the world's religions from a feminist perspective by leading women scholars. The fact that these authors share a dual but undivided commitment both to themselves as women and to their traditions as adherents imparts to their voices a prophetic quality, and if Mahatma Gandhi is to be believed, even scriptural value.

As a forum for philosophical discourse of religious studies as related to the world's women, the "Annual Review of Women in World Religions" fails. The first three issues display an unfortunately limited approach. Certain articles are promising, but editorial intellectual constraints appear to have circumscribed the philosophical latitude provided to contributors. In spite of the potential of the journal's topic area, it is doubtful it will soon succeed in emerging as a publication with adequate inclusionary liberality and ideal discursive freedom.

The anthology Dharma: The Categorial ImperativeThe choice of using ‘the categorial imperative’ over the standard ‘the categorical imperative’ has not been supported with reason in the anthology, notwithstanding its mentioning of Kant. consists of a brief introduction and 18 essays which were presented in an international conference of the same title in 1997, with the purpose to provide an alternative interpretation of the concept ‘dharma’ while taking into view the influence of Western notion of religion and treating it as an (...) epistemological , and not as a moral, concept. Here, dharma has been understood as a category, as an intellectual exercise, for ‘viewing’ Indian reality.The fundamental question is this: what constitutes the concept of dharma in the context of our changing forms of life? I.e., What aspects of dharma upon which Western influence are to be noted? Some aspects of the constitutive elements of dharma, as identified by the contributors of .. (shrink)

Review of Arvind-Pal S. Mandair, Religion and the Specter of the West: Sikhism, India, Postcoloniality, and the Politics of Translation Content Type Journal Article Pages 499-501 DOI 10.1007/s11841-011-0250-8 Authors Brian K. Pennington, Division of Humanities, Maryville College, 502 E. Lamar Alexander Pkwy, Maryville, TN 37804, USA Journal Sophia Online ISSN 1873-930X Print ISSN 0038-1527 Journal Volume Volume 50 Journal Issue Volume 50, Number 3.