A story for all ages about interconnection and learning to live in harmony amid differences, from a leading light of contemporary Zen-based on a parable from Kosho Uchiyama's classic bestseller Opening the Hand of Thought. Features a contextualizing afterword by Shohaku Okumura. [Amplify what kids will benefit from reading this book] "It's true that we are all different squashes... some are bigger and some are smaller... some are rounder and some are longer. But even if we are different, we are (...) all connected. We are all growing together. We don't have to be such squabbling squashes.". (shrink)

In this article, we use the principlist approach to identify, analyse and attempt to solve the ethical problem raised by a pregnant woman's request for cesarean delivery in absence of medical indications.We use two different types of premises: factual (facts about cesarean delivery and specifically attitudes of obstetricians as derived from the EUROBS European study) and value premises (principles of beneficence and non-maleficence, respect for autonomy and justice).Beneficence/non-maleficence entails physicians' responsibility to minimise harms and maximise benefits. Avoiding its inherent risks (...) makes a prima facie case against cesarean section without medical indication. However, as vaginal delivery can have unintended consequences, there is a need to balance the somewhat dissimilar risks and benefits. The principle of autonomy poses a challenge in case of disagreement between the pregnant woman and the physician. Improved communication aimed to enable better informed choice may overcome some instances of disagreement. The principle of justice prohibits unfair discrimination, and broadly favours optimising resource utilisation.Available evidence supports vaginal birth in uncomplicated term pregnancies as the standard of care. The principlist approach offered a useful framework for ethical analysis of cesarean delivery on maternal request, identified the rights and duties of those involved, and helped reach a conclusion, although conflict at the individual level may remain challenging. (shrink)