Classical verse work expounding early Vedantic approach in Hindu philosophy.

For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...) Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children’s competence. (shrink)

Social theory has paid little attention to air, despite its centrality to bodily existence and air pollution being named the world’s biggest public health crisis. Where attention to air is found, the body is largely absent. On the other hand, conceptualizing the body without life-sustaining breath fails to highlight breathing as the ongoing metabolic bodily act in which the materiality of human and more-than-human intermingle and transmute one another. Political ecology studies how unequal power structures and knowledge production reproduce human–environment (...) relations, including a nascent focus on the body and air – but as separate issues. This article argues that a political ecology of air would productively fuse with a political ecology of the body to bring the visceral realm into intersectional analysis of air’s contemporary materialities. A feminist political ecology situates explicitly air-and-breathing-bodies, their intimately posthuman, relational, elemental and corpomaterial intra-action, at the heart of such analysis. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

La relación médico-paciente (RMP) es una relación profesional-interpersonal base para la gestión de la salud. Nuestro objetivo fue desarrollar un instrumento que permitiera evaluar la presencia de los principios bioéticos en la atención médica recibida en la consulta externa de una institución hospitalaria. El instrumento quedó constituido por 21 reactivos para evaluar su confiabilidad y consistencia. El coeficiente de correlación intraclase fue de 0,81 (_p_.

In the article, I examine Hélène Cixous's play La Ville parjure ou le Réveil des Erinyes as a political contribution to the debate over memory and justice. The focus is on the question of how the telling of a story of atrocities may be therapeutic to both the victim and to society. I stress Cixous's alternative way of addressing justice: through forgiveness instead of criminal prosecution or other forms of retribution or reconciliation. Referring to Jacques Derrida's work, the main argument (...) revolves around the question of whether forgiveness for unspeakable crimes should be unconditional or conditional. Instead of seeing Cixous's play as an unequivocal stance on restorative justice in general, and on conditional forgiveness in particular, I stress that the main protagonist, the Mother, is not willing to forgive the crime itself because of its unforgivable nature. (shrink)

The aim of this study was to describe how patients’ participation in the care they received was documented in their health care records during the last three months of their lives. Two hundred and twenty-nine deceased adult persons were randomly identified from 12 municipalities in a Swedish county and their records were selected from different health care units. Content analysis was used to analyse the text. Four categories of patient participation were described: refusing offered care and treatments; appealing for relief; (...) desire for everyday life; and making personal decisions. The most common way for these patients to be involved in their care at the end of their life was by refusal of the treatment and care offered. Characteristic of the different ways of participation were the diverse activities represented. The description of patients’ involvement in their life situation at this time indicated their dissociation from the health care offered more than consenting to it. (shrink)

Paul T. Schotsmans; The Ethical Claim of a Dying Brother, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 9, Issue 2-3, 1 January 2003.

In this paper we discuss expected and reported effects on care provider-patient relations of the introduction of electronic patient records (EPRs) in consultation settings by reviewing exemplary studies and literature on the subject from the past decade. We argue that in order for such assessments to be meaningful, talk of effects of “the” EPR needs to be replaced by an “unpacking” of EPR systems into their constituent parts and functionalities, the effects of which need to be assessed individually. Following from (...) this principle, the paper discusses EPR systems ranging from simple data entry and retrieval systems to more sophisticated multi-user and multifunctional on-line systems. On a second level, our analysis of the literature is informed by the question which model of ideal patienthood underlies the assessment of effects of EPRs. To this end, we identify three “models of patienthood” implicit in writing about benefits and drawbacks of EPRs for patients: the autonomy, the consumer, and the holistic models, and argue that assumptions concerning these models need to be reflected upon more critically to improve understanding of what exactly EPR use does to the doctor-patient relationship. (shrink)

The Roman Catholic theological approach to euthanasia is radically prohibitive. The main theological argument for this prohibition is the so-called “stewardship argument”: Christians cannot escape accounting to God for stewardship of the bodies given them on earth. This contribution presents an alternative approach based on European existentialist and philosophical traditions. The suggestion is that exploring the fullness of our relational responsibility is more apt for a pluralist – and even secular – debate on the legitimacy of euthanasia.

Background Studying the contribution of individual countries to leading journals in a specific discipline can highlight which countries have the most impact on that discipline and whether a geographic bias exists. This article aims to examine the international distribution of publications in the field of bioethics. Methods Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics (Bioethics, Cambridge Quarterly of Healthcare Ethics, Hastings Center Report, Journal of Clinical Ethics, Journal of Medical Ethics, Kennedy (...) Institute of Ethics Journal, Nursing Ethics, Christian Bioethics, and Theoretical Medicine and Bioethics). Results In total, 4,029 articles published between 1990 and 2003 were retrieved from the nine bioethical journals under study. The United States (59.3%, n = 2390), the United Kingdom (13.5%, n = 544), Canada (4%, n = 160) and Australia (3.8%, n = 154) had the highest number of publications in terms of absolute number of publications. When normalized to population size, smaller affluent countries, such as New Zealand, Finland and Sweden were more productive than the United States. The number of studies originating from the USA was decreasing in the period between 1990 and 2003. Conclusion While a lot of peer reviewed journals in the field of bioethics profile themselves as international journals, they certainly do not live up to what one would expect from an "international" journal. The fact that English speaking countries, and to a larger extent American authors, dominate the international journals in the field of bioethics is a clear geographic bias towards the bioethical discussions that are going on in these journals. (shrink)

Revisión del libro Violencia, espionaje y represión estatal. Seis estudios de caso sobre el pasado reciente argentino por D. D´Antonio (comp.).

Medical ethics enjoyed a remarkable degree of continuity from the days of Hippocrates until its long-standing traditions began to be supplanted, or at least supplemented, around the middle of the twentieth century. Scientific, technological, and social developments during that time produced rapid changes in the biological sciences and in health care. These developments challenged many prevalent conceptions of the moral obligations of health professionals and society in meeting the needs of the sick and injured .The Anglo-American textbook of Beauchamp and (...) Childress became the referential work for the discipline of `bio-ethics'. The authors are convinced that a long history of ancient, medieval and modern health care reflection remains very disappointing from the perspective of contemporary biomedical ethics: “It shows how inadequately, and with what measure of insularity, problems of truthfulness, privacy, justice, communal responsibility and the like were framed in past centuries ”. They defend the four principles approach to biomedical ethics, an approach which somewhat disparagingly has been called principlism.The influence of their work has been so strong that bio-ethics seemed to become overwhelmed by the importance of their contribution. It even created a large separation between Anglo-American approaches in bio-ethics and the European-Continental approach . In any case, contemporary biomedical ethics incorporates theoretical conflicts of considerable complexity, and the diverse theories make it no easier.The personalist approach to biomedical ethics presents itself as a typical European reaction to the rapid changes in medicine and health care. Some call it, however, a kind of renewal of the old Thomistic approach, whereby the concept of `nature' has been replaced by the more dynamic concept of `person'. In that way personalism has been situated by many observers as a `person' centred natural law tradition which focuses on the rational nature of the human person as the moral norm of nature. This gives the impression that personalism is only a very `static' variant of the natural law approach.I would, however, defend the opinion that personalism offers a very dynamic and creative approach to the complexities of recent developments in biomedicine. In what follows, I will illustrate this by clarifying two basic dimensions of the integration of personalism in biomedical ethics: the personalist approach offers a relational foundation for medicine as a healing profession and it presents an ethical framework for the integration of new developments in medicine. First, however, I would like to situate the importance of this theoretical reflection for medical ethics. (shrink)

The COVID-19 pandemic has impacted medical care in many ways; previously, a patient would enter a hospital and had an approximate idea of what would happen upon his admission, the physician informed them about it, but in the last two years this scenario has changed. Therefore, our aim was to identify if bioethical principles are present in the physician–patient relationship and the effect of these in the health care provided, through an observational and descriptive study where patients answered the validated (...) ReMePaB questionnaire that measures the presence of bioethical principles in the physician–patient relationship, on the seventh day of their hospital stay and 24 h after discharge, during the period from 1 August to 5 November 2020. In autonomy, an improvement in the score was observed in the second application compared to the first measurement; in the principle of non-vulnerability, the same scenario was observed for the first and second measurements, respectively. In the principles of beneficence, dignity, and justice, no statistically significant differences were observed. Considering the presence or absence of bioethical aspects in health care in this pandemic creates an area of opportunity to know the feelings of the patient during the care received and to maintain what is done well and improve those aspects that can be improved. (shrink)

Church-ethical statements in the context of contemporary medicine often give rise to a lot of controversy and commotion. Just think of the debates about medically assisted reproduction, genetics, prenatal diagnosis, stem cell research, organ donation, palliative sedation or euthanasia. Paul Schotsmans notes that many of these statements are inspired by a well-defined ethical model, specifically the act-deontological model. He argues that a more dynamic ethical model (personalism based on Western-European value-systems) creates space for a humane integration of the new medical (...) possibilities. With this book, he seeks to indicate how Christian faith can be an inspiration for an open-minded, humane and dynamic health care. (shrink)

The purpose of this study is to analyse the teachings of religious moderation contained in the Wawacan Babad Walangsungsang script. This research employs a qualitative method with philology as the main analysis of the data, namely manuscript inventory, script description, script transfer, and language translation. The script shows the story of Prince Walangsungsang’s journey in search of spirituality, specifically Islam. Interestingly, he learned his spirituality through many non-Muslim teachers until he finally met Sheik Datuk Kahfi in Bukit Amparan Jati. The (...) result of this study shows that upon his spiritual journey while gaining knowledge he experienced magical scenery. The conclusion is the willingness of prince Walangsungsang to learn knowledge and ajimat from Budhaprawa teachers, the openness and support of Budhaprawa teachers about the Prophet’s shari’a and the explanation of Sheikh Datuk Kahfi (Muslim) for the religious search conducted by Prince Walangsungsang shows the beauty of speech that is rich with nuances of religious moderation. Contribution: This research is important as a basic reference for religious moderation, which is rooted in the local wisdom of the Sundanese culture and tradition and can be adopted to spread those in our interaction with other religions. (shrink)

On September 23, 2002, the Belgian law on euthanasia came into force. This makes Belgium the second country in the world to have an act on euthanasia. Even though there is currently a legal regulation of euthanasia in Belgium, very little is known about how this legal regulation could be translated into care for patients who request euthanasia. Although euthanasia-related mortality rates in Belgium are low, ranging from 0.30% to 1.20%, it can be expected that caregivers will increasingly be confronted (...) with euthanasia requests and will, therefore, be more involved in the care for these patients. (shrink)

The COVID-19 pandemic has posed significant burden across different industrial sectors. Generally, an increase in psychological stress experiences has been reported, while the stress and coping responses of specific, potentially burdened populations have received less attention thus far. Thus, the present study investigated relations between individual and organizational factors, indicators of psychological health, and possible mediating effects of four broad coping dimensions in a specific sample of soldier students who engage in a double-role being military affiliates and students of non-military (...) subjects. To this end, we assessed data of soldier students at two measurement points shortly after the second national lockdown in Germany during the COVID-19 pandemic. Personality traits showed expected associations with indicators of psychological health, i.e., positive relations between neuroticism and social loneliness, between extraversion and COVID-19 stress, and negative relations between neuroticism and life satisfaction. Remarkably, organizational variables showed effects above and beyond personality traits on loneliness and life satisfaction. Neither individual, nor organizational factors could predict change in psychological health over time. We found evidence for mediation effects through active coping, avoidant coping, and the use of social support, but not through positive cognitive restructuring. Findings highlight the relative importance of organizational factors besides personality traits for psychological health in a military student sample, holding important implications for designing efficient support systems in the military. (shrink)

Las feministas han reconocido la importancia de defender la capacidad de pensar de las mujeres y de pensarse a sí mismas; es necesario ir más allá: sólo logramos devolver el respeto a las dominadas duraderas producidas por el machismo patriarcal en el que aún vivimos, al establecer que su facultad de juzgar radica en el uso del diálogo que comparte con los hombres, además de su diferencia de sexo y que sólo podemos disipar todas las presuntas dudas planteadas por violadores (...) e intelectuales que se han mantenido machistas respecto a su facultad femenina de juzgar mostrando su origen en una segunda naturaleza común del lenguaje así como su eficacia. Apoyaremos nuestro análisis con un caso que fue noticia en los medios televisivos de Francia. (shrink)

Diese Situation wird als eine Kumulation aller Ungleichheiten beschrieben, die einen Menschen treffen können: soziale Klassenungleichheit, sexuelle Ungleichheit und Ungleichheit aufgrund der Rasse. Durch die Zuspitzung dieser Ungleichheiten lässt sich die große Zahl afrikanischer Migrantinnen erklären. Die Suche nach sozialer, ziviler und bürgerlicher Gleichheit, die nach dem Modell der von Männern propagierten und zur Schau gestellten Selbstbeherrschung gedacht ist, kann in dem Maße nicht erfolgreich sein, wie sie versucht, sich einem Macho-Modell zu unterwerfen, das der Natur des Menschen widerspricht. Weil (...) die zeitgenössische Anthropologie uns lehrt, dass dieser die Sprache erfinden musste, um sich das Leben zu ermöglichen und es jedes Mal neu zu harmonisieren, wenn er in eine Sackgasse gerät, weil die dialogische Vorstellungskraft, die den Dialog der Seele mit sich selbst antreibt, den Platon entdeckt hatte, durch das Gesetz der Wahrheit geregelt wird, müssen afrikanische Frauen erkennen, dass sie die Objektivität der ihnen auferlegten und der von ihnen selbst erfundenen Lebensbedingungen beurteilen müssen, um ihre Wahrheitsurteile mit ihren männlichen Partnern teilen zu können und um sich von jeglicher Herrschaft zu emanzipieren, unabhängig von ihrer Geschlechtszugehörigkeit. (shrink)

El objetivo del trabajo de investigación fue evaluar la relación entre el uso de una red social y el rendimiento académico en la materia de matemáticas. Para el método de investigación se trabajó con una muestra de 570 alumnos inscritos en la materia de matemáticas, la cual se dividió en estratos. Se llevó a cabo en una universidad pública del norte de México. La investigación fue longitudinal y correlacional. Los principales resultados indican que a mayor interacción académica en una red (...) social, mejor rendimiento académico en matemáticas. Lo cual puede ser aplicable para ciencias exactas en Instituciones de Educación Superior. (shrink)

Christian ideas have continued to inspire European bioethics until now. The central thesis of this essay is that the open-mindedness of Roman Catholic and other Christian denominations in Europe is crucial for understanding why Christian ethics is so well integrated in the European culture. The essay describes first the institutional frameworks in which these Christian mainly Roman Catholic ideas are developed. It analyzes further the difference between the secular Anglo-American and European bioethics as it has been influenced by these Christian (...) ideas. It finally summarizes the challenges to which Europe's Christian bioethical identity is presently exposed to. The essay states that the Christian inspiration of European bioethics is mainly connected with the ideologically moderate, tolerant, and dialogical participation of Christian bioethicists in the bioethical debate in Europe. (shrink)

The author – a European “companion” of H. T. Engelhardt during the two last decades of the 20th century – describes his meetings with and impressions of Tris Engelhardt. He clarifies how open mindedness was the main concern in their common activities.

This commentary on Merks' contribution is essentially written from the impact the question of this symposium 'Where is truth?' can have in medical ethics. This well-organised discipline inside applied ethics reached the last decennia a highly functioning importance in the societal discussion on medical progress. The author of this commentary shares with Merks his critique on procedural ethics, a critique which is crucial for medical ethics. Indeed, ethical decision-making procedures have invaded the most important institutes of medical ethics. Recently, this (...) evolution has been criticised for neglecting to establish a foundational ethical culture for medicine. The author thinks personalist ethics can function as such a culture and as an answer to the need for a more comprehensive ethical approach. This leads him to his main critique on Merks' contribution: indeed, where Merks underlines the importance of 'human rights' concepts as a tool for ethical reflection, the author warns for the abuses of this concept in the Anglo-American approach of medical ethics, where the concept functions as an instrument for individual selfdetermination and doesn't refer to the - more Germanic - interpretation of this concept in the lines of a foundation of human dignity. Foundational moral concepts as fundamental disposition, human values and norms seem more apt to develop the type of ethics which is also supported by Merks. Even more it permits a really dynamic ethics, where the most humanly possible is realised in the light of the promotion of the most humanly desirable. (shrink)

This commentary on Merks' contribution is essentially written from the impact the question of this symposium 'Where is truth?' can have in medical ethics. This well-organised discipline inside applied ethics reached the last decennia a highly functioning importance in the societal discussion on medical progress. The author of this commentary shares with Merks his critique on procedural ethics, a critique which is crucial for medical ethics. Indeed, ethical decision-making procedures have invaded the most important institutes of medical ethics. Recently, this (...) evolution has been criticised for neglecting to establish a foundational ethical culture for medicine. The author thinks personalist ethics can function as such a culture and as an answer to the need for a more comprehensive ethical approach. This leads him to his main critique on Merks' contribution: indeed, where Merks underlines the importance of 'human rights' concepts as a tool for ethical reflection, the author warns for the abuses of this concept in the Anglo-American approach of medical ethics, where the concept functions as an instrument for individual selfdetermination and doesn't refer to the - more Germanic - interpretation of this concept in the lines of a foundation of human dignity. Foundational moral concepts as fundamental disposition, human values and norms seem more apt to develop the type of ethics which is also supported by Merks. Even more it permits a really dynamic ethics, where the most humanly possible is realised in the light of the promotion of the most humanly desirable. (shrink)