En este artículo se analiza el proceso de formación de la nacionalidad latinoamericana, así como las pistas que ayuden a descubrir las características de nuestra identidad, reconociendo el mestizaje como definitorio de nuestro ser y quehacer como latinoamericanos. Se advierten las potencialidades que se desprenden de la riqueza que significa la diversidad étnica y cultural de la región. La integración de América Latina es vista como un reto que nuestros pueblos deben asumir, partiendo de una concepción que supere la visión (...) puramente economicista y se afirme en la dimensión humana y solidaria. Finalmente se examinan las tareas que las universidades deberían asumir para contribuir a hacer realidad ese desafío, tales como auspiciar estudios e investigaciones interdisciplinarias sobre las posibilidades de diseñar un proyecto latinoamericano de Desarrollo Humano, Endógeno y Sostenible, además de contribuir a crear una conciencia integracionista y establecer institutos de estudios latinoamericanos, entre otros aspectos. (shrink)

This article analyses domestic and foreign reactions to a 2008 report in the British Medical Journal on the complementary and, as argued, synergistic relationship between palliative care and euthanasia in Belgium. The earliest initiators of palliative care in Belgium in the late 1970s held the view that access to proper palliative care was a precondition for euthanasia to be acceptable and that euthanasia and palliative care could, and should, develop together. Advocates of euthanasia including author Jan Bernheim, independent from (...) but together with British expatriates, were among the founders of what was probably the first palliative care service in Europe outside of the United Kingdom. In what has become known as the Belgian model of integral end-of-life care, euthanasia is an available option, also at the end of a palliative care pathway. This approach became the majority view among the wider Belgian public, palliative care workers, other health professionals, and legislators. The legal regulation of euthanasia in 2002 was preceded and followed by a considerable expansion of palliative care services. It is argued that this synergistic development was made possible by public confidence in the health care system and widespread progressive social attitudes that gave rise to a high level of community support for both palliative care and euthanasia. The Belgian model of so-called integral end-of-life care is continuing to evolve, with constant scrutiny of practice and improvements to procedures. It still exhibits several imperfections, for which some solutions are being developed. This article analyses this model by way of answers to a series of questions posed by Journal of Bioethical Inquiry consulting editor Michael Ashby to the Belgian authors. (shrink)

In The Community of Advantage, Robert Sugden advocates an opportunity-oriented framework for normative analysis, positions it a substitute for behavioral welfare economics, and criticizes the latte...

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type (...) of ethics education and support they believe may be helpful. (shrink)

Public health ethics is emerging as a new field of inquiry, distinct not only from public health law, but also from traditional medical ethics and research ethics. Public health professional and scholarly attention is focusing on ways that ethical analysis and a new public health code of ethics can be a resource for health professionals working in the field. This article provides a preliminary exploration of the ethical issues faced by public health professionals in day-to-day practice and of the type (...) of ethics education and support they believe may be helpful. (shrink)

Es ist in der Literatur weithin bekannt, dass im Gesundheitswesen auf unterschiedlichen Ebenen Allokationsentscheidungen getroffen werden. Während es auf der Makroebene um gesellschaftlich-politische Strukturfragen geht, stehen die Akteure der Mikroebene vor der Aufgabe, begrenzte Ressourcen in einer Organisation sinnvoll einzusetzen. In den ethischen Analysen der Mikro-Allokationsebene werden zumeist Entscheidungen der Healthcare Professionals thematisiert, weil sie eine unmittelbare Auswirkung auf die konkreten Patienten haben. Weniger in den Blick geraten Allokationen des Managements, welche die Rahmenbedingungen für Ressourcenzuteilungen beim Patienten betreffen. Hierbei geht (...) es nicht bloß um den Einsatz von Sachmitteln (z. B. Medikamenten- oder Gerätebudgets), sondern auch um den Personaleinsatz. Das Personalmanagement ist damit in wichtige Allokationsentscheidungen eingebunden und trägt eine dreifache Verantwortung: für die Gesundheit der Patienten, der Mitarbeiter und der Organisation. Der vorliegende Beitrag geht der Frage nach, welche Aspekte der Allokationsethik aus der Sicht des Personalmanagements in einem Krankenhaus zu bedenken sind, um der dreifachen Verantwortung gerecht zu werden. Dadurch zeigt sich, dass Allokationsethik in einem Krankenhaus nicht adäquat erfasst werden kann, ohne sich mit dem Personalmanagement zu beschäftigen, da das Personal die wertvollste Ressource ist, die es in einem Krankenhaus zu allozieren gilt. (shrink)

Charles Bernheimer described decadence as a "stimulant that bends thought out of shape, deforming traditional conceptual molds." In this posthumously published work, Bernheimer succeeds in making a critical concept out of this perennially fashionable, rarely understood term. Decadent Subjects is a coherent and moving picture of fin de siècle decadence. Mature, ironic, iconoclastic, and thoughtful, this remarkable collection of essays shows the contradictions of the phenomenon, which is both a condition and a state of mind. In seeking to show why (...) people have failed to give a satisfactory account of the term decadence, Bernheimer argues that we often mistakenly take decadence to represent something concrete, that we see as some sort of agent. His salutary response is to return to those authors and artists whose work constitutes the topos of decadence, rereading key late nineteenth-century authors such as Nietzsche, Zola, Hardy, Wilde, Moreau, and Freud to rediscover the very dynamics of the decadent. Through careful analysis of the literature, art, and music of the fin de siècle including a riveting discussion of the many faces of Salome, Bernheimer leaves us with a fascinating and multidimensional look at decadence, all the more important as we emerge from our own fin de siècle. (shrink)

Erich Bernheimer verfolgt mit dem hier vorliegenden Werk - anknüpfend an die Ästhetik des Naturphilosophen Gustav Fechner - "die analytische Durchforschung der Faktoren des ästhetischen Genusses, die Fechner in seiner `Vorschule der Ästhetik' begonnen hatte... fortzusetzen und die Faktoren brauchbar zu kategorisieren" (Vorwort) anhand der beiden Teile "die Kunstbetrachtung" und "Das Kunstschaffen", untersucht dabei z. B. die Arten der Kunstbetrachtung, Normen und Werte für den Betrachtenden, die Dynamik des Kunstschaffens, Werte und Normen des Schaffens und noch weitere Gesichtspunkte. Nachdruck der (...) Originalausgabe aus dem Jahr 1913. (shrink)

Various domains of life widely recognise the concept of human rights. Regardless of one's spiritual beliefs or background, individuals possess an inherent understanding of their fundamental rights. This knowledge of human rights originates from Allah, who has communicated it through various messengers, including the esteemed Prophet Muhammad ﷺ. This study focuses on examining the religious perspective on basic human rights in order to establish a comprehensive understanding of these rights. There are two revelations: This study employs a linguistic descriptive analysis (...) approach to evaluate the Holy Quran and the guidance of the Prophet. The study primarily focuses on conducting a content analysis and descriptive analysis of case studies and literary insights found in the Holy Quran and the Prophet's ﷺ guidance. The goal is to extract as much content as possible about human rights. The study has identified four major themes defined by the Holy Quran and the Prophet's ﷺ guidance. The study has improved our understanding of key human rights concepts and suggests that future scholars concentrate on assessing other fundamental rights that the two revelations under investigation have illuminated. (shrink)

From one of our most outspoken feminist critics, this collection explores various ways in which the body can be rethought of as a site of knowledge rather than as a medium to move beyond or dominate.

In his article “Storied Bodies, or Nana at Last Unveil’d” , Peter Brooks makes the claim that, for a certain dominant mode of nineteenth-century narrative, the female sexual organ is the occult source of the narrative dynamic. On a superficial reading, Brooks’s piece might appear to empower women by putting their sexuality at the generative origin of the story. But the opposite is the case: his argument reflects rather than critiques the misogynist strategies of the texts he discusses. I will (...) begin my analysis of his article with a brief return to the story by Barbey d’Aurevilly whose climactic scene Brooks offers as “a kind of allegory of the cultural story [he has] been delineating” . Charles Bernheimer is professor of romance languages and chair of the program in comparative literature and literary theory at the University of Pennsylvania. The author of Flaubert and Kafka and Figures of Ill Repute , he is currently working on a study of fin-de-siècle literature and art, The Decadent Subject. (shrink)

BackgroundFear of abandonment and aloneness play a key role in the clinical understanding interpersonal and attachment-specific problems in patients with borderline personality disorder and has been investigated in previous functional Magnet Resonance Imaging studies. The aim of the present study was to examine how different aspects of attachment representations are processed in BPD, by using for the first time an fMRI attachment paradigm including personalized core sentences from the participants’ own attachment stories. We hypothesized that BPD patients would show increased (...) functional involvement of limbic brain regions associated with fear and pain when presented personalized attachment relevant stimuli representing loneliness compared to healthy controls.MethodsWe examined the attachment classifications of 26 female BPD patients and 26 female HC using the Adult Attachment Projective Picture System. We used an fMRI-adapted attachment paradigm to investigate the neural correlates of attachment. All participants were presented three personalized sentences extracted from their AAP attachment narrative, combined with standardized AAP pictures representing being alone or in interactive attachment situations.ResultsAs expected, the classification of unresolved attachment was significantly greater in BPD compared to HC. BPD patients showed increased fMRI-activation in brain areas associated with fear, pain, and hyperarousal than HC when presented with personalized attachment-relevant alone stimuli. In particular, pictures with monadic attachment situations induced greater anterior medial cingulate cortex, anterior insula, amygdala, thalamus and superior temporal gyrus activation in the patient group.ConclusionThe results point to increased fMRI-activation in areas processing emotional distress and painful experiences in BPD patients. In particular, the emotional cascade reflecting attachment distress was evoked by combining monadic pictures, representing abandonment and aloneness, with the patients’ personalized narrative material. Our results confirmed and replicated previous results that illustrate once again the high relevance of aloneness and feelings of abandonment for BPD in the context of attachment trauma. Moreover, our results support the hypothesis of hypermentalization in response to attachment distress as a core feature of social-cognitive impairment in BPD associated with common treatment implications across different therapeutic orientations. (shrink)

The Rebellion of Muḥammad al-Nafs al-Zakiyya in 145/762: Ṭālibīs and Early ʿAbbāsīs in Conflict. By Amikam Elad. Islamic History and Civilization, vol. 118. Leiden: Brill, 2016. Pp. xi + 527. $245, €176.

This paper explores the use of an ethics framework based on the Public Health Code of Ethics to guide rationing decisions during a pandemic flu crisis involving a shortage of ventilators. While the law provides public health officials with authority to act, public health officials, as community leaders and health department managers, must address complex questions about how they should use their legal authority, how they can ethically justify a particular action, how they should engage community stakeholders in decision making, (...) and how the process of public justification should take place. Recognising the need for a tool that could help public health officials manage ethical tensions in practice, such as allocation of scarce resources, the Public Health Leadership Society led efforts to develop a Public Health Code of Ethics. The 12 Principles in the Code were written to express the general norms implicit in the practice of public health professionals. The Code offers no hierarchical weighting of the different principles and anticipates that weights and specification of the principles would take place in the context of each community through a process of engagement between public health officials and community stakeholders about specific cases. We describe how public health officials can use the Code to guide deliberation in helping communities prepare to address the tragic choices when allocating scarce ventilators in an influenza pandemic. (shrink)

Introduction : a framework for public health ethics -- Moral considerations : bases and limits for public health -- The political and legal context of public health ethics -- Public health perspectives -- Surveillance and public health data : the foundation and eyes of public health -- Case finding : screening, testing, and tracing -- Immunization : protection through vaccination -- Containing communicable diseases : personal control measures -- Health communication -- Public health and the environment.

Amyotrophic lateral sclerosis (ALS; also called motor neuron disease) is a devastating medical condition that progressively robs patients of their ability to move, speak and eventually breathe. At present, many physicians are hesitant to propose tracheostomy and respiratory support in the terminal phase of ALS. In accordance with the principle of patient autonomy, physicians should respect the right of the ALS patient to accept or refuse any treatment, including mechanical ventilation. Also, in environments where euthanasia or physician-assisted death is legal, (...) such requests can be acceptable. At least two conditions are necessary for full autonomy. To have a claim on full autonomy, people need to have intact cognitive abilities, and to exercise this right they must be able to communicate. In the past, the first condition was in doubt (indeed, overlap with other neurodegenerative diseases is sometimes suspected and some patients with ALS are thought to have associated frontotemporal dementia) and the second was severely compromised in patients with devastating motor impairment (communication being limited to the twitch of a finger or the blink of an eye). In this issue of J Neurol Neurosurg Psychiatry, Lakerveld and colleagues1 investigated cognition in 11 patients with late stage ALS (see page 25). They showed preserved cognitive functioning (ie, language, executive function, intelligence, learning and long term memory) compared with healthy controls. Assessments were exclusively based on a ‘‘yes–no’’ response mode. Because of the absence of verbal and motor communication, the neuropsychological assessment of these patients is complicated, and adapted testing is needed. By using a ‘‘yes–no’’ response mode based on the remaining motor abilities of the patient, this study proves the possibility of assessing patients with minimal motor capacities. (shrink)

The use of quality of life (QOL) outcomes in clinical trials is increasing as a number of practical, ethical, methodological, and regulatory reasons for their use have become apparent. It is important, then, that QOL measurements and differences between QOL scores be readily interpretable. We study interpretation in two contexts: when determining QOL and when basing decisions on QOL differences. We consider both clinical situations involving individual patients and research contexts, e.g., randomized clinical trials, involving groups of patients. We note (...) the ethical importance of such understanding: proper interpretation and communication facilitate health care decision making. Communication that facilitates interpretation is of moral significance since better communication can attenuate ethical problems and inform choices. Much of what is communication worthy about QOL assessments is determined by the particular QOL instrument used in the assessment and how it is administered. In practice, these choices will be driven by the purpose of the assessment, but, it is argued, to maximize understanding, we should combine the information garnered from traditional standardized QOL instruments, from individualized QOL assessments, and from a recently proposed dialogic paradigm, where QOL is determined by shared conversation regarding the interpretation of texts. And, while some studies can surely succeed using abbreviated methods of administration (e.g., postal surveys may suffice for certain purposes), we will focus on methods of administration involving interviewer–respondent interaction. We suggest that during the QOL elicitation process, interviewer and respondent should engage in a two-way conversation in order to achieve a shared understanding of the “answers” to QOL “questions” and, finally, to reach a shared interpretation of the individual’s QOL. (shrink)

Historically, scientists in training have learned the rules of ethical conduct by the example of their advisors and other senior scientists and by practice. This paper is intended to serve as a guide for the beginning scientist to some fundamental principles of scientific research ethics. The paper focuses less on issues of outright dishonesty or fraud, and more on the positive aspects of ethical scientific behavior; in other words, what a scientist should do to maintain a high level of ethical (...) conduct in research.There are a number of fairly specific rules, guidelines, or commonly accepted operating principles that have evolved for the ethical conduct of science. In order to discuss this code of ethics, this paper is divided into sections dealing with specific areas of scientific ethics. These areas are: data collection and storage, ownership of data, confidentiality, communication, authorship, collaboration, the peer review system, and rules of dealing with ethical complaints. Illustrative case histories are presented to provide examples of the type of ethical dispute or problem being discussed. If scientific trainees learn the accepted rules of behavior that govern the conduct of science, ethical problems that arise out of ignorance, misunderstanding, or poor communication can be avoided. (shrink)

Ein Leitmotiv der medizinethischen Auseinandersetzung mit der tiefen Hirnstimulation (THS) ist die Beschäftigung mit Fragen personaler Identität. Da es sich bei personaler Identität auch um ein Problem der theoretischen Philosophie handelt, wird in diesem Aufsatz nicht nur die praktische Frage nach der ethischen Legitimation der THS durch informierte Einwilligung gestellt und ein modifiziertes Legitimationskriterium für wesensändernde THS erarbeitet. Vielmehr wird zunächst versucht, das Problem, um das es in der Debatte um THS und personaler Identität geht, besser zu verstehen.

The WHO Commission on the Social Determinants of Health revealed that there is a 28-year disparity between the life expectancy in the poorest postcode and the richest postcode of Glasgow (CSDH, 2008). There are two sets of questions that it is important to ask about health inequalities like these: first, epidemiological questions about the mechanisms that cause inequalities in health and the measures that are effective in reducing them. Second, normative questions about which inequalities in health are wrong and why (...) they are wrong. The papers in this symposium result from the inaugural conference of UCL's Centre for Philosophy, Justice and Health (CPJH) and focus on the relationship between these epidemiological and normative questions. (shrink)

Die jüngste höchstrichterliche Rechtsprechung zur Selbstbestimmung der Patienten und zur Normierung medizinischer Handlungen am Lebensende hat eine intensive Debatte ausgelöst. Das Urteil und die akademisch vorgetragene Kritik werden einer grundlegenden medizinethischen Analyse unterworfen. Sie betrifft die objektive Eingrenzung der Zulässigkeit einer Behandlungsbegrenzung und die Subsumtion des Wachkomas als irreversibel tödliches Grundleiden, das ärztliche Ermessen bei der Indikationsstellung, die normative Einordnung einer Ernährungstherapie am Lebensende und die Verbindlichkeit von Patientenverfügungen. Die medizinethische Kritik offenbart eine unzureichende Wahrnehmung medizinischer und medizinethischer professioneller Dokumente (...) und den Rückgriff auf medizinethisch veraltete Konzeptionen der Sterbehilfe durch das Gericht. Die Folge ist eine fehlerhafte Subsumtion der Wachkomapatienten in die Kategorie irreversibel tödlicher Erkrankungen und eine inhaltliche Schwächung der Verbindlichkeit von Patientenverfügungen. Beides bedarf dringend der Korrektur. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NEWMAN'S PSYCHOLOGICAL DISCOVERY: THE ILLATIVE SENSE (V. Continued) 15. The Universals. A long and vehement dispute once raged about the reality of universals. Are they only mental creations, forged by the human brain, without any reality outside them, or have they some independent existence apart from their mental reality? Anyhow, there was an apparent contradiction between die universal character of our ideas and the individual character of concrete things. (...) The Scholastics solved this problem by drawing clear distinctions. An idea is an abstraction; as soon as it becomes applicable to a number of objects or things in the same sense, it is a universal idea. The "direct universal" (universale directum seu metaphysicum) as such has no existence apart from our minds, because an existing thing is always bound up with concrete, determining, individualizing notes, and it is these very circumstances or accidents which are ignored by the mind as it strips the thing of its individual characteristics. When the mind reflects on this "direct universal," i.e., on the abstract essence of the thing, it sees that this is to be found in many more things and that it is identical in all those things, and in this way the "reflex or logical universal" is formed (universale reflexum seu logicum). This same essence or quiddity is not really different from the thing itself, but the mind makes abstraction of all accidents, and this foundation makes it possible to apply this idea in die same sense to all other beings of the same kind, whether they are actually existing or not. In other words the universal as a universal has only reality in the mind but it has a foundation or a ground in the thing itself. Newman was not so well acquainted with Scholasticism that he knew and mastered the solution of the problem. As a matter of fact he approached it from quite another angle. Hence when scholastically trained minds read some of his statements on universals, they may feel shocked. They sound very curious, they seem incon418 DR. ZENO, O.F.M. CAP.419 sistent with each other, they apparenüy imply a negation of the objective reality of universals. This makes it necessary to compare the texts and to explain his meaning. a. Newman Inconsistent. We should never lose sight of the fact that Newman had no intention at all to enter the province of philosophy in the restricted sense of the word. "I am only contemplating the mind as it moves in fact, by whatever hidden mechanism,"1 that is what could be put as a heading to every page of the Grammar of Assent. And when he virtually deals with metaphysics, he wants us to consider his statements as hypotheses, or as propositions stated only by the way, and in this department he always wishes "to speak under correction." This explains how he could refer to the universale metaphy sicum and the universale directum in a very correct way without realizing he was teaching Scholastic doctrine. As far as I know, it is Professor Walgrave who has first drawn attention to this fact,2 when he dealt with Newman's alleged conceptualism. Newman states that "even one act of cruelty, ingratitude, generosity or justice reveals to us at once intensive the immutable distinction between those qualities and their contraries; that is, in that particular instance and pro bac vice."3 The same holds for the opposites: right and wrong, true and false, just and unjust, beautiful and deformed.4 In one experience, therefore, he sees a thing as an immutable, absolute quiddity, which objectively and in the same sense belongs to all possible things of the same kind, although the mind does not yet explicidy confirm this universal applicability. The contemplated quality remains limited to the particular case; but in its absoluteness it is stripped of all individual, changeable and concrete characteristics. This is the metaphysical universal of the Scholastics. But Newman also mentions the logical universal when he says: "As we form our notion of whiteness from the actual sight of snow, a lily or a cloud, so, after experiencing the sentiment of approbation which arises in us on the sight of certain... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:NEWMAN'S PSYCHOLOGICAL DISCOVERY: THE ILLATIVE SENSE (Continued) VI THE FACULTIES OF COGNITION AND APPETITION Since the Grammar of Assent gives us a phenorhenological analysis of the art of thinking and often refers to the influence of other faculties in our reasoning processes, it will be very instructive to examine what the author holds about our faculties of cognition and appetition. This will make us better acquainted with the nature (...) of the illative sense. I. THE SENSES 1. The External Senses and their Objects. We had already arrived at the conclusion that Newman rejects the mere subjectivity of our knowledge. When he writes about this matter he explicitly deals with sensation or sensuous cognition. Although he takes exception to the word "immediate perception," 1 we may nevertheless call him an adherent of direct or immediate realism according to Scholastic terminology, because he emphatically excludes the intervention of a reasoning process from sense perception and uses the term "mediate perception" only to express the instrumentality of experience. In this meaning our perception of external objects is mediate or indirect indeed.2 The fact is that as early as 1839 he wrote in his University Sermons: "Of the material we have direct knowledge through the senses"3 and in 1843: "The senses are direct, immediate, and ordinary informants, and act spontaneously without any will or effort on our part."4 On the importance of sense perception for our mental activities he writes in a series of hitherto unpublished notes, entitled Elements of Thought:6 "I grant or I assume that the soul would not think without some external stimulus; that if it were cut off from all communication from the external world, it would pass this life in a sort of torpor... But then, as soon as it is roused, it reflects upon itself, and thereby gains a number of ideas..." 1. See supra V, 14.2. Supra V, 14.3. P. 205. 4.P. 303 ; cf. Gramm., p. 260. 5.See the unpublished Philosophical Papers, note Fcbr. 24, 1859. 40 DR. ZENO, OJM. CAP.41 Apart from the passages already referred to, Newman nowhere enlarges on the doctrine about the senses. He does not speak about the distinctions between sensible objects; he does not explain the difference between sensation and perception, and uses those terms promiscuously.6 There are no statements on the subject which contradict current Scholastic notions, although sometimes his vague terminology may be an occasion for misunderstandings. For instance, some passages in connection with "images" and "impressions," when read apart from the context, would appear to imply that he identifies them with the Scholastic species a sensibili accepta. However, we shall show further on that. Newman means something quite different. He deals with these species and the so-called sensibilia per acci· dens by the way when describing our knowledge of God7 and teaching that we have evidence of the presence of individuals or substances in the phenomena which occur to our senses. We picture those things to ourselves in those phenomena. They are like pictures, he says, but at the same time "they give us no exact measure or character of the unknown things beyond them." "Therefore when we speak of our having a picture of the things which are perceived through the senses, we mean a certain representation, true as far as it goes, but not adequate." 2. The Internal Senses and their Objects. Newman nowhere gives a distinction between external and internal senses, but nevertheless he speaks about those faculties of the mind which by the Scholastics are called the internal senses. These philosophers distinguish a common sense or rather a central sense (sensus communis), which unites the impressions of the external senses into one whole, makes us conscious of the conditions of our body and notifies to us the sensations of our external as well as internal senses; — the imagination or the faculty which preserves and reproduces things perceived; — the sensuous memory, i. e., the power to retain and to reproduce sense images; — and the vis aestimativa or the instinctive faculty, which discovers without any intellectual means, what is good and what is bad for our welfare. 6.It would seem that he generally... (shrink)