BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were exposed (...) to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)
Background As a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many (...) were exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk. Discussion In the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics. Summary An honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)
Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, (...) within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. (shrink)
Médecins Sans Frontières is not morally required to continue providing the same therapeutic and preventative interventions for lead poisoning in Nigeria in the face of conditions that negatively impact on the achievement of their objectives. Nevertheless, Médecins Sans Frontières may have reasons to revise their objectives and adopt different interventions or methods.
In this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing (...) and evaluating public health responses to contagion. (shrink)
ABSTRACT This article focuses on the interactions between British Owenites and continental refugees and groups of democrats in London. The article argues that despite serious disagreements between Owenites and Chartists, their interactions were important. The article focuses on refugee groups London, in the 1830s and 1840s, and examines their links with both the democrats’ and Owenites’ networks. The article focuses first on Etienne Cabet and the French republican exiles in 1830s London, before moving on to two democratic societies of exiles (...) of the 1840s, the Société démocratique française and the Deutscher Bildungsverein für Arbeiter. The article concludes with an examination of the place of Owenites and Chartists in a major early experiment in radical internationalism, the Fraternal Democrats. (shrink)
We live in an era where our health is linked to that of others across the globe, and nothing brings this home better than the specter of a pandemic. This paper explores the findings of town hall meetings associated with the Canadian Program of Research on Ethics in a Pandemic , in which focus groups met to discuss issues related to the global governance of an influenza pandemic. Two competing discourses were found to be at work: the first was based (...) upon an economic rationality and the second upon a humanitarian rationality. The implications for public support and the long-term sustainability of new global norms, networks, and regulations in global public health are discussed. (shrink)
In this paper, we propose a new model for development, one that transcends the North–South dichotomy and goes beyond a narrow conception of development as an economic process. This model requires a paradigm shift toward a new metaphor that develops sustainability, rather than sustains development. We conclude by defending a ‘report card on development’ as a means for evaluating how countries perform within this new paradigm.
As everyone knows, since the end of the Second World War there has been a sensational revival of interest in the non-Christian religions particularly in the United States and in this country. The revival has taken two forms, the one popular, the other academic. The first of these has turned almost exclusively to Hindu and Buddhist mysticism and can be seen as an energetic reaction against the dogmatic and until very recently rigid structure of institutionalised Christianity and a search for (...) a lived experience of the freedom of the spirit which is held to be the true content of mysticism, obscured in Christianity by the basic dogma of a transcendent God, the ‘wholly Other’ of Rudolf Otto and his numerous followers, but wholly untrammelled by any such concept in the higher reaches of Vedanta and Buddhism, particularly in its Zen manifestation. On the academic side the picture is less clear. There is, of course, the claim that the study of religion, like any other academic study, must be subjected to and controlled by the same principles of ‘scientific’ objectivity to which the other ‘arts’ subjects have been subjected, to their own undoing. But even here there would seem to be a bias in favour of the religions of India and the Far East as against Islam, largely, one supposes, in response to popular demand. (shrink)
‘Mysticism means to isolate the eternal from the originated.’ This is not my definition of the word ‘mysticism’ but that of the founder of the ‘orthodox’ school of Muslim mysticism, Al-Junayd of Baghdad who flourished in the ninth century a.d . In actual fact it is not a definition of mysticism at all but of the Arabic word tawḥīd which means primarily ‘the affirmation of unity’; and that surely is an essential ingredient of any form of mysticism: it is the (...) affirmation through personal experience of unity either absolutely or in some qualified sense. (shrink)
Christology seems to fall fairly clearly into two divisions. The first is concerned with the truth of the two propositions: ‘Christ is God’ and ‘Christ is a man’. The second is concerned with the mutual compatibility of these propositions. The first part of Christology tends to confine itself to what is sometimes called ‘positive theology’: that is to say, it is largely given over to examining the Jons revelationis —let us not prejudge currently burning issues by asking what this is—to (...) see what evidence can be found for the truth of these propositions. Clearly, the methods used will be above all those of New Testament exegesis. The second part of Christology will necessarily consist entirely of that speculative theology which is contrasted with positive theology. Even if the earliest speculation on this topic is to be found in the New Testament itself and thus becomes fair game for the exegetes, any attempt to relate the primary truths, ‘Christ is God’ and ‘Christ is a man’, to eachother is a work of reflection, and in the terminology I am using speculative. (shrink)
There is a strong tendency in the scholarly and sub-scholarly literature on terrorism to treat it as something like an ideology. There is an equally strong tendency to treat it as always immoral. Both tendencies go hand in hand with a considerable degree of unclarity about the meaning of the term ‘terrorism’. I shall try to dispel this unclarity and I shall argue that the first tendency is the product of confusion and that once this is understood, we can see, (...) in the light of a more definite analysis of terrorism, that the second tendency raises issues of inconsistency, and even hypocrisy. Finally, I shall make some tentative suggestions about what categories of target may be morally legitimate objects of revolutionary violence, and I shall discuss some lines of objection to my overall approach. (shrink)
