This collection brings together fourteen contributions by authors from around the globe. Each of the contributions engages with questions about how local and global bioethical issues are made to be comparable, in the hope of redressing basic needs and demands for justice. These works demonstrate the significant conceptual contributions that can be made through feminists' attention to debates in a range of interrelated fields, especially as they formulate appropriate responses to developments in medical technology, global economics, population shifts, and poverty.

The United States recognized intellectual property rights from its earliest days and included, in its constitution, a clause which expresses this, "To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries." These few words found in Article 1, Section 8, Clause 8 have grown into a massive body of laws that govern works that were unimaginable to Thomas Jefferson and his contemporaries. Our question (...) today is very simple: is the latest metamorphosis of copyright law, the Digital Millennial Copyright Act of 1998, prudent policy? Specifically, we are concerned with three issues which critics have raised regarding this act: chilling effects on fair use, suppression of innovation, and overreach. We will also touch on the criticism which stresses that the DMCA further expands a system which increasingly and unfairly favors the content industries. This will be limited to illustrating extant tensions between copyright owners and society and also the difficulties law faces in keeping pace with the current, rapid and overwhelming technological and cultural change. We rely primarily on leading cases to establish the impact on fair use and innovation or to demonstrate over reach. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The 2008 Meeting of the Society for Buddhist-Christian StudiesPeter A. HuffThe Society for Buddhist-Christian Studies (SBCS) sponsored two sessions in conjunction with the 2008 annual meeting of the American Academy of Religion (AAR). The first session addressed the topic "Cognitive Science, Religious Practices, and Human Development: Buddhist and Christian Perspectives." The second session focused on the life and legacy of Trappist monk, spiritual writer, and interfaith pioneer Thomas Merton (...) (1915–1968).The first session, moderated by Sandra Costen Kunz (Phillips Theological Seminary), featured five papers probing the relationship between research in the natural and social sciences and lessons from the experience of Buddhist and Christian practice: "The Body and the Mind: Buddhist Bowing and Neuroscience," presented by Paula K. Arai (Louisiana State University) and coauthored with Sascha du Lac (Salk Institute for Biological Sciences); "Who Hears? A Zen Buddhist Perspective" by Robert Aitken Roshi, founder and retired Zen master of the Diamond Sangha in Honolulu (read by Ruben Habito, Southern Methodist University); "'Your Cell Will Teach You Everything': Old Wisdom, Modern Science, and the Art of Attention" by Noreen Herzfeld (St. John's University); "Verbal Imagining: Scientific Reflection on Visual Cognition in Light of Traditional Tibetan and Christian Theologies of the Image" by Thomas Cattoi (Jesuit School of Theology, Berkeley); and "Cognitive Error and Contemplative Practices: The Cultivation of Discernment in Mind and Heart" by Wesley J. Wildman (Boston University). Revised versions of three of these papers with an introductory essay by Prof. Costen Kunz are included in this issue of Buddhist-Christian Studies.The theme for the society's second session, chaired by Alice Keefe (University of Wisconsin), was "Thomas Merton Forty Years after His Death: Buddhist and Christian Perspectives." Four presenters examined and evaluated Merton's distinctive contributions to Buddhist-Christian relations, theological reflection, and interreligious dialogue. In her paper "Self-Surrender in Merton's Writings and Contemplative Psychology," Daijaku Judith Kinst (California Institute of Integral Studies) concentrated on the place of subjective transformation in Merton's thought, describing his [End Page 143] "great gift" to the literature on the contemplative life as the "fearless" rejection of self-centeredness in the practice of prayer and spiritual formation. "Thomas Merton Meets Tibetan Buddhism" by Judith Simmer-Brown (Naropa University) shed new light on the impact of the dzogchen ("great completion") tradition on Merton's evolving spirituality, particularly as expressed in the letters, speeches, and private documents included in the posthumously published Asian Journal of Thomas Merton (1973). In "Non-Dual Wisdom as Feminine: Sophia and Prajnaparamita in Merton's Poem 'Hagia Sophia,'" Paula Hirschboeck (Edgewood College) explored suggestive parallels between Christian mystical experience and Buddhist madhyamika teaching in Merton's long, dreamlike Marian hymn from the early 1960s. Kristin Johnston Largen (Lutheran Theological Seminary, Gettysburg) concluded the session with an analysis of the role of Buddhism-inspired insights in Merton's approach to soteriological questions, especially as seen in his changing attitudes toward traditional Christian doctrines of hell, purgatory, eschatology, and the human person.Between sessions, members and friends of the society participated in the annual SBCS/AAR field trip to a local site significant for its relevance to interdisciplinary Buddhist-Christian studies. This year members visited the Chicago Cultural Center of Soka Gakkai International-USA (SGI-USA), the Buddhist association for peace, culture, and education based on the teachings of thirteenth-century Japanese monk and reformer Nichiren Daishonin. Located at 1455 South Wabash Avenue in downtown Chicago, the cultural center serves as the primary facility for SGI-USA activities in the Midwest. Mr. Guy McCloskey, senior vice president, publisher, and member of the board of directors for SGI-USA, organized the event. The evening's program included a tour of the center's award-winning architecture, an informal overview of the aims and initiatives of SGI-USA, and a delicious dinner served by members of the organization. [End Page 144]Peter A. HuffCentenary College of LouisianaCopyright © 2009 University of Hawai'i Press... (shrink)

This paper examines the perceived ethical values of Malaysian managers. It is based on the opinions of 15 hypothetical ethical/unethical business situations from the 81 managers who agreed to participate in the survey. The findings of this study showed that these Malaysian managers have high ethical values. However 53% of the respondents believed that the ethical standards of today are lower than that of 15 years ago. Apparently, this is related to the existence of many unethical business practices prevalent in (...) the modern business world. The behavior of one's immediate superior is the most important factor in influencing managers to commit unethical practices. The results also indicate only a slight variation among the managers in terms of perceived ethical values by virtue of job position, job specialization, type of business activity or the size of the business organization. (shrink)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

At the beginning of the study of physical phenomena, the idea of "force" was widely used to explain the non-stationarity of observed phenomena, such as the movement of bodies. However, as mechanics and physical theories developed, the force notions gained own formal definitions and names, without the use of the term "force". So, the concept of kinetic energy arose instead of "vis viva", and "current" instead of "current strength" ets. Additionally, a number of new physical theories have been formulated without (...) the use of force concept. As a result, different types of forces have gradually been replaced by other more important concepts, such as energy and action, which are closely linked to fundamental physical principles. It is interesting to note that the general trend in the development of civilizations has been a shift from unrestricted power (expressed in the thesis "might makes right") to its subordination and incorporation into a legal framework. This is similar to the evolution of physics, which has seen the notion of force become eliminated or subordinated to more general principles and laws. (shrink)

The idea of moral reform requires that morality be more than a description of what people do value, for there has to be some measure against which to assess progress. Otherwise, any change is not reform, but simply difference. Therefore, I discuss moral reform in relation to two prescriptive approaches to common morality, which I distinguish as the foundational and the pragmatic. A foundational approach to common morality (e.g., Bernard Gert’s) suggests that there is no reform of morality , but (...) of beliefs, values, customs, and practices so as to conform with an unchanging, foundational morality. If, however, there were revision in its foundation (e.g., in rationality), then reform in morality itself would be possible. On a pragmatic view, on the other hand, common morality is relative to human flourishing, and its justification consists in its effectiveness in promoting flourishing. Morality is dependent on what in fact does promote human flourishing and therefore, could be reformed. However, a pragmatic approach, which appears more open to the possibility of moral reform, would need a more robust account of norms by which reform is measured. (shrink)

The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced (...) staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied. (shrink)

The article is devoted to almost unknown monastery of the Russian Orthodox Church, a Holy Trinity Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia that was one of the important pilgrimage places of the royal family in the 17th century. Despite the fact that the monastery was founded in the reign of Tsar Alexei Mikhailovich, it is an important link in the historical and cultural development of our Fatherland, primarily because the extant architectural monuments of outstanding artistic qualities. That is why the architectural ensemble (...) of the monastery occupies a prominent place in the history of Russian culture. In addition, Novo-Solovetskaya poustinia is an important historical object providing data on the development of Russian spiritual and artistic culture of the late seventeenth century. The question of cultural-historical and social roles that Orthodox monasteries played in the history of Russia is still not sufficiently studied is. The modern development of the Russian state cannot be complete without the restoration of the positive legacy that has been lost in our culture and morality. In this regard, the study of development and formation of the Orthodox monastic culture may fill this gap. Historical development of the Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia, its architecture can contribute to the restoration of our historical memory, which is an important factor in the revival of our national identity. The author of the article also tells about the history of monastery in tough years of godless power and about the people, who died for their faith and who are called now the new martyrs. (shrink)

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)

BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

Objectives To conduct an independent evaluation of the first phase of the Health Foundation’s Safer Patients Initiative (SPI), and to identify the net additional effect of SPI and any differences in changes in participating and non-participating NHS hospitals. Design Mixed method evaluation involving five substudies, before and after design. Setting NHS hospitals in the United Kingdom. Participants Four hospitals (one in each country in the UK) participating in the first phase of the SPI (SPI1); 18 control hospitals. Intervention The SPI1 (...) was a compound (multi-component) organisational intervention delivered over 18 months that focused on improving the reliability of specific frontline care processes in designated clinical specialties and promoting organisational and cultural change. Results Senior staff members were knowledgeable and enthusiastic about SPI1. There was a small (0.08 points on a 5 point scale) but significant (P<0.01) effect in favour of the SPI1 hospitals in one of 11 dimensions of the staff questionnaire (organisational climate). Qualitative evidence showed only modest penetration of SPI1 at medical ward level. Although SPI1 was designed to engage staff from the bottom up, it did not usually feel like this to those working on the wards, and questions about legitimacy of some aspects of SPI1 were raised. Of the five components to identify patients at risk of deterioration—monitoring of vital signs (14 items); routine tests (three items); evidence based standards specific to certain diseases (three items); prescribing errors (multiple items from the British National Formulary); and medical history taking (11 items)—there was little net difference between control and SPI1 hospitals, except in relation to quality of monitoring of acute medical patients, which improved on average over time across all hospitals. Recording of respiratory rate increased to a greater degree in SPI1 than in control hospitals; in the second six hours after admission recording increased from 40% (93) to 69% (165) in control hospitals and from 37% (141) to 78% (296) in SPI1 hospitals (odds ratio for “difference in difference” 2.1, 99% confidence interval 1.0 to 4.3; P=0.008). Use of a formal scoring system for patients with pneumonia also increased over time (from 2% (102) to 23% (111) in control hospitals and from 2% (170) to 9% (189) in SPI1 hospitals), which favoured controls and was not significant (0.3, 0.02 to 3.4; P=0.173). There were no improvements in the proportion of prescription errors and no effects that could be attributed to SPI1 in non-targeted generic areas (such as enhanced safety culture). On some measures, the lack of effect could be because compliance was already high at baseline (such as use of steroids in over 85% of cases where indicated), but even when there was more room for improvement (such as in quality of medical history taking), there was no significant additional net effect of SPI1. There were no changes over time or between control and SPI1 hospitals in errors or rates of adverse events in patients in medical wards. Mortality increased from 11% (27) to 16% (39) among controls and decreased from 17% (63) to 13% (49) among SPI1 hospitals, but the risk adjusted difference was not significant (0.5, 0.2 to 1.4; P=0.085). Poor care was a contributing factor in four of the 178 deaths identified by review of case notes. The survey of patients showed no significant differences apart from an increase in perception of cleanliness in favour of SPI1 hospitals. Conclusions The introduction of SPI1 was associated with improvements in one of the types of clinical process studied (monitoring of vital signs) and one measure of staff perceptions of organisational climate. There was no additional effect of SPI1 on other targeted issues nor on other measures of generic organisational strengthening. (shrink)

В монографии представлены взгляды авторов на возникновение и развитие либеральной и консервативной идеологий в политической истории российского государства.

Objective: To provide an ethical analysis of whether the Ethiopian and Tanzanian national HIV/AIDS treatment guidelines can be considered legitimate and fair rationing tools.Method: Qualitative study and ethical analysis involving guideline documents and interviews with nine key members involved in the development of the guidelines. The analysis followed an editing organising style. The theoretical framework was a guideline-specific framework based on theories of just resource allocation in healthcare and conditions that ensure fair processes in guideline development. According to this framework, (...) legitimate rationing requires reasons for patient selection to be explicit, public and relevant, and decisions must be open to question and revision.Results: The only explicit rationing criteria that both guidelines recommended were clinical antiretroviral treatment indications. Explicit non-clinical rationing criteria were expressed in a separate Ethiopian implementation guideline. Neither of the guideline development processes fully satisfies minimal requirements of procedural fairness. There is a lack of transparency. The reasons for decisions are rarely given and are not publicly available. This reduces the opportunity for public questioning, debate and revisions. The guidelines were based on expert opinion and consensus. Recommendations from the WHO were copied without much discussion, disagreement or adjustment.Conclusions: The two national HIV treatment guidelines discussed are de facto mechanisms for rationing but were developed using methods that do not fully satisfy the requirements of fair processes. (shrink)

This paper argues that there is a general absence of democratic theory in African political scholarship in terms of providing the underlying principles, meaning, canons and criteria of democracy in African culture. The paper exposes the conceptual errors implicit in the conflation of democracy as a concept and as practiced in different political systems. Consequently, it contends that an eclectic appraisal of our indigenous democratic values and practices as well as democratic ideas from other cultural traditions can provide a resonant (...) African theory of democracy. The paperconcludes that eclecticism is consociational in principle, and can help solve many of the contemporary socio-political problems besetting current democratic experiences in Africa. (shrink)

Objective We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments in order to build ethics capacity and provide a foundation for the development of an ethics education programme. Methods This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Results Of the (...) 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress, conflict management with patients or families and resource issues. Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams was the most desired method. Conclusions Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. (shrink)

This collection by a distinguished group of philosophers, psychologists, and physiologists reflects an interdisciplinary approach to the central question of cognitive science: how do we model the mind? Among the topics explored are the relationships (theoretical, reductive, and explanatory) between philosophy, psychology, computer science, and physiology; what should be asked of models in science generally, and in cognitive science in particular; whether theoretical models must make essential reference to objects in the environment; whether there are human competences that are resistant, (...) in principle, to modelling; whether simulated thinking and intentionality are really thinking and intentionality; how semantics can be generated from syntactics; the meaning of the terms "representations" and "modelling;" whether the nature of the "hardware" matters; and whether computer models of humans are "dehumanizing." Contributors include Donald Davidson, Daniel C. Dennett, Margaret A. Boden, Adam Morton, Dennis Noble, T. Poggio, Colin Blakemore, K.V. Wilkes, P.N. Johnson-Laird, and Jonathan St. B.T. Evans. (shrink)

It has gradually become accepted among historians of ancient culture that the Greeks and Romans always, or nearly always, read aloud. They did not read to themselves, silently, save in rare and special cases. Either they were not able to read silently, or they felt no need to do so, or they did not enjoy doing it even when they were alone.