The aim of this study was to explore the obligations of nurses and physicians in providing end-of-life care. Nineteen nurses and 11 physicians from a single newborn intensive care unit participated. Using content analysis, an overarching obligation of creating the best possible experience for infants and parents was identified, within which two categories of obligations (decision making and the end of life itself) emerged. Obligations in decision making included talking to parents and timing withdrawal. End-of-life obligations included providing options, preparing (...) parents, being with, advocating, creating peace and normalcy, and providing comfort. Nurses and physicians perceived obligations in both categories, although nurse obligations centered on the end of life while physician obligations focused on decision making. The findings demonstrate that, although the ultimate goal is shared by both disciplines, the paths to achieving that goal are often different. This has important implications for collaboration, communication, and improving the end of life. (shrink)

The design of new constitutions is fraught with challenges on both issues of structural design and individual rights. As both a descriptive and normative matter it is exceedingly difficult to believe that one structural solution will fit all cases. The high variation in nation size, economic development, and ethnic division can easily tilt the balance for or against a Presidential or Parliamentary system, and even within these two broad classes the differences in constitutional structure are both large and hard to (...) measure. The only confident claim is that some system of separation of powers coupled with checks and balances is needed. Deciding which system, however, is far harder. In contrast, that same level of doubt does not arise in connection with the correct specification of individual right. Strong systems of negative rights on matters of liberty, property, religion, and speech are preferable across a wide range of social organizations. On the other hand, any effort to create systems of positive entitlements will fail because of the negative effects that they have on wealth creation and the inability to define or limit the scope of the relevant entitlements. (shrink)

This groundbreaking work by one of the world's foremost theoreticians of Russian literature, culture, and thought gives for the first time an extensive and detailed examination of the development of Russian thought during the late Soviet period. Countering the traditional view of an intellectual wilderness under the Soviet regime, Mikhail Epstein offers a systematic account of Russian thought in the second half of the 20th century. In doing so, he provides new insights into previously ignored areas such as Russian (...) liberalism, personalism, structuralism, neo-rationalism, and culturology. Epstein shows how Russian philosophy and culture has long been trapped in an intellectual prison of its own making as it sought to create its own utopia. However, he demonstrates that it is time to reappraise Russian philosophical thought and cultural theory, now freed from the bonds of totalitarianism. We are left with not only a new and exciting interpretation of Russian thought, but also an opportunity to rethink our own intellectual heritage. (shrink)

This groundbreaking work by one of the world's foremost theoreticians of culture and scholars of Russian philosophy gives for the first time a systematic examination of the development of Russian philosophy during the late Soviet period. Countering the traditional view of an intellectual wilderness under the Soviet regime, Mikhail Epstein provides a comprehensive account of Russian thought of the second half of the 20th century that is highly sophisticated without losing clarity. It provides new insights into previously mostly ignored (...) areas such as late Soviet Russian nationalism and Eurasianism, religious thought, cosmism and esoterism, and postmodernism and conceptualism. Epstein shows how Russian philosophy has long been trapped in an intellectual prison of its own making as it sought to create its own utopia. However, he demonstrates that it is time to reappraise Russian thought, now freed from the bonds of Soviet totalitarianism and ideocracy but nevertheless dangerously engaged into new nationalist aspirations and metaphysical radicalism. We are left with not only a new and exciting interpretation of recent Russian intellectual history, but also the opportunity to rethink our philosophical heritage. (shrink)

When We Collide is a landmark reassessment of the significance of sex in contemporary Jewish ethics. Rebecca Epstein-Levi offers a fresh and vital exploration of sexual ethics and virtue ethics in conversation with rabbinic texts and feminist and queer theory. Epstein-Levi explores how sex is not a special or particular form of social interaction but one that is entangled with all other forms of social interaction. The activities of sex-doing it, talking about it, thinking about it, regulating it-are (...) sites of ongoing moral formation on individual, interpersonal, and communal levels. When We Collide explores the development of Jewish sexual ethics, and represents an opportunity to move beyond the usual heteronormative accounts that are presented as though they were neutral representations of what "Judaism teaches about sex.". (shrink)

This book uses the body to peel back the layers of time and taken-for-granted ideas about the two defining political forms of modernity, the state and the subject of rights. It traces, under the lens of the body, how the state and the subject mutually constituted each other since their original crafting in the seventeenth century. Considering multiple sites of theory and practice, Charlotte Epstein analyses the fundamental rights to security, liberty, and property respectively as the initial knots where (...) the state-subject relation was first sealed. (shrink)

A theoretical platform for a much‐needed change in the provision of healthcare based on restoring the autonomy of doctor–patient relationships.

The inner ecology: Buddhist ethics and practice -- A Buddhist perspective on animal rights -- Pollution and the environment: some radically new ancient views -- Animals for dinner: a Karmic tale -- Our relationship with nature: a Buddhist exploration -- Environmental issues: a Buddhist perspective -- Human spiritual potential and the environmental crisi -- The need for ethical guidelines to protect us from the very real dangers of a technological world -- Looking at hi-tech through the lens of the five (...) moral precepts -- Science and Buddhism: a critical comparison -- Genetic engineering: a Buddhist assessment -- Redesigning the world: ethical questions about genetic engineering -- Some ethical challenges posed by the Internet and digital social media: a Buddhist perspective -- Where are we going - digitally? (shrink)

Since the late 1960s, the legal doctrine of consent has occasionally been subject to severe criticism from within the bioethical discourse. The criticism was often based on observations indicating that consents and refusals, which had been considered valid from legal or institutional points of view, had frequently failed to reflect genuinely autonomous decision making, hence genuinely autonomous choices.This has led several critics to conclude that informed consent is a legal fiction. To clarify the concept, a legal fiction is a supposition (...) of fact taken to be true by the courts of law, irrespective of whether it is true or not, and even though it might not be true .1 What these critics probably meant to say was that the law deems any person who has given a legally valid consent to be genuinely task specifically autonomous, regardless of whether this is true or not and even though it might not be true. In other words, informed consent is a legal fiction, since it presupposes—that is, claims to reflect—genuine task specific autonomy, however baselessly.It was precisely this potentially embarrassing conclusion that prompted Faden and Beauchamp to develop a brilliant and remarkably effective argument in defence of the legal doctrine of consent. In their seminal work, AHistory and Theory of Informed Consent, they indeed acknowledged that effective consent often fails to be compatible with autonomous authorisation . Indeed, they recognised that effective consent does not necessarily entail autonomous authorisation. They argued, however, that the former is not a legal fiction, since it does not presuppose the …. (shrink)

In this article we examine the association between national welfare regime and the propensity of middle–aged and older individuals with adult children of their own to provide social support to aged parents. Using data from mature adults (50+) in 26 European countries, we examine whether older and younger generations compete for the time resources of the middle “sandwiched” generation, and whether national policy context shapes this competition. Contrary to expectations, we found that sandwich generation members were less likely to provide (...) support to their parents in Conservative–Mediterranean and East European regimes, but more likely to do so in universalistic Social–Democratic regimes. This evidence supports the hypothesis that well–developed welfare states “crowd–in” family support to older individuals. Middle generation members who provided social support to their adult children tended to provide to their older parents as well. This was particularly true in the two regimes where resources and public benefits tend to be more generous and may be interpreted as state benefits that reduce intergenerational competition. Findings are discussed in terms of the capacity of state policies to shape the allocation of family resources to older adults where extended family lineages have become the norm. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work is in the "public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

The recently published Report of theAHAG on the Operation of NHS Research Ethics Committees advocates major reforms of the NHS research ethics committees system. The main implications of the proposed changes and their probable effects on the major stakeholders are described.The Ad Hoc Advisory Group on the operation of NHS research ethics committees, set up in November 2004 by Lord Warner on behalf of the Department of Health, submitted its report in June 2005.1 The report advocates major reforms of the (...) research ethics committee system. The primary aim of the report is to streamline the processes around the approval of research projects and to pursue conformity of governance across Europe. Implicit in the report is the contention that failure to achieve this objective would be harmful to everyone with vested interests in improving health and social care. Moreover, it is stated that the reforms will enhance the mechanisms that protect the interests of all parties concerned.1Being mindful of two published critiques of the Warner Report, we suggest that its alleged benefits should not be taken at face value.2,3 In fact, the reformed system will give rise to moral failings akin to those of the existing system, but will differ from the existing system in its effect on the stakeholders. Thus, whereas the outgoing system has given each stakeholder a unique mixture of benefit and harm, the incoming system offers benefit only to sponsors and researchers and nothing but detriment to participants in research and consumers of its products.In the light of this conclusion, we finally suggest that the Warner Report be construed not merely as an ill-considered document, but rather as an ideological reflection of a long-established hegemonic contract fine-tuning itself to contemporary global challenges.To avoid …. (shrink)

A theorem on the extendability of certain subsets of a Boolean algebra to ultrafilters which preserve countably many infinite meets (generalizing Rasiowa-Sikorski) is used to pinpoint the mechanism of the Barwise proof in a way which bypasses the set theoretical elaborations.

The present note is a reworking and streamlining of Daigneault and Monk's Representation Theory for Polyadic Algebras. MSC: 03G15.