In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 11.2 (2001) 165-168 [Access article in PDF] UPMC Presbyterian Policy and Procedure Manual Guidelines for Disclosure and Discussion of Conditions and Events with Patients, Families and Guardians* I. Introduction and Background In the course of hospital care, an extensive amount of clinical information is generated. It includes diagnostic findings, treatment options, responses to interventions, and professional opinions. The information can be positive or negative. (...) Clinical events may or may not be caused by clinicians and consequently may be iatrogenic (caused by medical treatment), nosocomial (occurring in the hospital) or natural events.In accordance with the informed consent policy (#4011), Patients' Bill of Rights (# 0154, Section II H), and the Guidelines on Forgoing Life Sustaining Treatment (#4007), patients have the right to information regarding their condition and care. Physicians and other caregivers are obligated to provide accurate information as expeditiously as possible. While it is usually easy to provide positive information, negative information is more difficult to disclose, especially when the cause is iatrogenic."Therapeutic privilege" has been invoked to explain why certain negative information might be withheld. By invoking therapeutic privilege, the physician refrains from full disclosure to protect the patient from the effects of receiving the information itself. The use of therapeutic privilege is increasingly being called into question because it decreases patient autonomy and reduces trust.The following recommendations are provided to clinicians to help guide delivery of sensitive information, positive and negative. Specific recommendations [End Page 165] are provided for situations where the information is about an unfavorable or adverse event, or where the information might best be characterized as "bad news." II. Definitions Unfavorable event or unfavorable condition. For the purposes of these guidelines, an unfavorable condition is an occurrence or diagnosis that results in or is likely to result in a significant negative outcome, and/or a significant alteration in the care plan.An unfavorable event in this context is not the same as a sentinel event, which in policy #4025 is defined as, "a serious, unexpected, adverse patient event which has resulted in, or if repeated would have a significant probability of resulting in, loss of life or serious physical or psychological injury, that is judged to be a warning of an underlying problem involving hospital facilities, policies, procedures, systems or personnel."Adverse Event. An unfavorable event for the purposes of these guidelines is also distinguished from the FDA definition of the term "adverse event", which is a reportable negative effect of a drug or device potentially resulting in death, hospitalization, or medical or surgical intervention. (See policy #4022 Safe Medical Device Act.)Examples of unfavorable events or conditions for the purpose of these guidelines include a new diagnosis of cancer, a perioperative myocardial infarction, or unintended delivery of an incorrect medication that results in clinical change.Examples of events not covered by these guidelines are intravenous saline infiltration and medication dosing errors that have no clinical impact on care.Iatrogenic. Event caused by the treatment of a healthcare provider. III. Guidelines and Principles It is appropriate that UPMC Presbyterian support basic principles for patient and family notification regarding all clinical events and conditions, including unfavorable ones. Physicians must be honest because that is a cornerstone of the patient-physician relationship, and because it fosters patient autonomy.UPMC Presbyterian supports the following AMA position regarding patient information: [End Page 166] It is a fundamental ethical requirement that a physician should at all times deal honestly and openly with patients. Patients have a right to know their past and present medical status and to be free of any mistaken beliefs concerning their conditions. Situations occasionally occur in which a patient suffers significant medical complications that may have resulted from the physician's mistake or judgement. In these situations, the physician is ethically required to inform the patient of all the facts necessary to ensure understanding of what has occurred. Only through full disclosure is a patient able to make informed decisions regarding future medical care. Ethical responsibility includes informing patients of changes in their diagnoses... (shrink)

This article considers the theological influences on the Balfour Declaration which was made on the 2 November 1917 and for the first time gave British governmental support to the establishment of a Jewish homeland in Palestine. It explores the principal personalities and political workings behind the Declaration before going on to argue the statement cannot be entirely divested from the religious sympathies of those involved, especially Lord Balfour. Thereafter, the paper explores the rise of Christian Restorationism in the context of (...) Scottish Presbyterianism, charting how the influence of Jonathan Edwards shaped the thought of Thomas Chalmers on the role of the Jews in salvation history which in turn influenced the premillennialism of Edward Irving and his Judeo-centric eschatology. The paper then considers the way this eschatology became the basis of John Darby’s premillennial dispensationalism and how in an American context this theology began to shape the thinking of Christian evangelicals and through the work of William Blackstone provide the basis of popular and political support for Zionism. However, it also argues the political expressions of premillennial dispensationalism only occurred in America because the Chicago evangelist Dwight L. Moody was exposed to the evolving thinking of Scottish Presbyterians regarding Jewish restoration. This thinking had emerged from a Church of Scotland ‘Mission of Inquiry’ to Palestine in 1839 and been advanced by Alexander Keith, Horatius Bonar and David Brown. Finally, the paper explores how this Scottish Presbyterian heritage influenced the rise of Zionism and Balfour and his political judgements. (shrink)

According to Paul Russell’s irreligious interpretation of Hume’s Treatise, the aim of the Treatise is to discredit “Christian theology” generically construed. In this paper, I argue that in seeking to discredit Christian theology in the Treatise, Hume uses an early eighteenth-century Anglican version of Christian theology rather than “Christian theology” in a generic sense as his theological paradigm. Taking Hume’s attacks on “hidden powers” and “the liberty of indifference” as test-cases, I show that whereas Hume’s views on these topics are (...) subversive of the Anglican theology of his day, they are not subversive of other major forms of Christian theology that were current at the time, including the Calvinist theology of the Kirk of Scotland. If this is right, then the immediate theological target of Hume’s Treatise should be deemed narrower than Russell’s irreligious interpretation takes it to be. (shrink)

The biblical creation of woman in which she was taken from man’s rib is one of the passages that are misinterpreted to solidify the subjection and oppression of women with the two Cameroonian Churches, Presbyterian and Full Gospel Mission (FGM). This implies that the complementarity that existed in pre-colonial leadership was eroded as a result. This article will use the qualitative approach to unmask and analyse the practices of gender inequality within the Presbyterian and FGM of Cameroon and the challenges (...) that they are facing with gender equality issues between males and females. The sampling of 22 participants was used to formulate how the findings that will target to unveil the coordination, managerial and financial positions within these two churches are elected or chosen. The stereotypes that are involved in the elections of people who must hold these offices will be explained, discussed and analysed and even exposed in order to seek ways to avoid the manipulations of biblical texts in justifying the exclusion of females from leading church leading positions. This article argues that the misuse of misinterpretation or misrepresentation of scriptures cannot be condoned to justify the marginalisation of women from leadership within the Presbyterian Church in Cameroon (PCC) and the FGM. As much as women are working hard for the church, they should also be allowed to continue growing the church even from the managerial or leadership positions. Contribution: To work towards gender imbalances in the African context are not only unmasked and exposed, but some meaningful suggestions are made as to how this inhuman practice can be eliminated or even destroyed completely, with a case example of the two churches mentioned, the PCC and FGM in Cameroon. (shrink)

Für gewöhnlich wird die orthodoxe Kirche nicht mit der amerikanischen Social Gospel Bewegung in Verbindung gebracht. Im Fall Nicholas Bjerrings, der sowohl der sozialen Frage innerhalb der orthodoxen Kirche als auch des Katholizismus und – vermittelt über den Presbyterianismus – des Protestantismus nachging, findet sich genau diese Verbindung: Bjerring war als einzige Person der amerikanischen Religionsgeschichte des 19. Jahrhunderts dem sozialen Dienst aller drei großen christlichen Konfessionen nachgegangen. Aus Dänemark als Katholik eingewandert, wurde er 1870 russisch-orthodoxer Priester, 1883 presbyterianischer Minister (...) und 1899 wieder römisch-katholischer Laie. Ungeachtet der vielfachen Konversion und der damit verbundenen ekklesiologischen Variationen bewahrte Bjerring eine dogmatische Treue an ein solches Verständnis vom Christentum, das ein Engagement im sozialen Dienst als notwendig geboten erscheinen ließ. Daraus folgte zweierlei: Einmal die letztliche Anerkennung päpstlicher Unfehlbarkeit, die Bjerring 1870 noch abgelehnt hatte, und sodann eine solche Aufassung vom Evangelium als “sozialer” Botschaft, die Bjerring seinen Platz in der Social Gospel Bewegung gab. (shrink)

From 1940, ecumenical developments in the Presbyterian/Congregational corpus in Southern Africa became more tortuous and complex, with an expansion of the number of denominations involved in union negotiations to include the Bantu Presbyterian Church of South Africa, the Congregational Union of South Africa, later the United Congregational Church of South Africa, the Presbyterian Church of Southern Africa and the Tsonga Presbyterian Church. The problem statement centres around the complex situation that despite substantial similarities in doctrine, liturgy and polity, as well (...) as involvement in the Church Unity Commission and the South African Council of Churches, the union proved to be elusive. The aim of this article is to investigate the dynamics of the developing relationships and hindrances to closer relationships in the wider South African context. This study is conducted from the perspective of the BPCSA and RPCSA, and the methodology is based predominantly on archival research. (shrink)

Cameroon’s post-independence era has so far been marked by an upsurge in the number of Christian churches. This proliferation of Catholic, Protestant, and Pentecostal churches is probably the product of the heightened desire for spirituality. These churches, according to public opinion, are expected to be epicenters of good moral values and Christian behavior. Unfortunately, this has not always been the case. The present article seeks to point out that the establishment and growth of some indigenous denominations has been impacted by (...) corruption. The Presbyterian Church in Cameroon is a case in point. This article draws extensively from archival and oral sources and seeks to examine the causes and manifestations of corruption in the PCC. It also examines the effects of corruption on the Church and provides some recommendations to address this. The article concludes that Church elections, Church property, Church management, and integrity in leadership are crucial issues within the PCC around which corruption rotates. Hence, it suggests a multidimensional anti-corruption approach as the way out. (shrink)

This research engaged a realist paradigm to triangulate existing literature with data that emerged from a PhD study on ministerial formation within the context of being a missional church in the Uniting Presbyterian Church in Southern Africa (UPCSA). The study identified the need for theological training and ministerial formation to be relevant, contextual and responsive to the realities of the African communities. We concluded that current theological training module is dominated by Eurocentric expressions and narratives, which highlight an urgent need (...) for a theological and ministerial formation model that will equip leaders with relevant and contextual missional strategies necessary for rapidly transforming African communities. There is a need for decolonisation and contextualisation of academic studies in order to align theological training and leadership development with the emerging challenges within the African context. CONTRIBUTION: This article contributes to systematic, contextual and postcolonial reflections on theological education and ministerial formation in Africa. (shrink)

Worship as the work of the people of God does not arise in a vacuum. It is contextual and cultural. In the areas of the world, long designated as the mission field, many developments were transported to countries in the global south and imposed on local peoples. This was true of the arrival of Presbyterians who came to settle in southern Africa. Presbyterians imported two differing traditions of worship, the evangelical and the liturgical, and introduced them to the indigenous peoples (...) they encountered. They were adopted without adaptation and have largely followed their European ancestors and contemporaries. Africans have largely followed their missionary mentors but have found ways of subverting these traditions by forming a new tradition by blending aspects of each and adding their own African brand of Spirit inspired and led. worship while their mentors pay only lip service to their African colleagues. Contribution: This article highlights the historical continuities in the worship of a mainline Church of European Origin (CEO) with their ecclesiastical and ecumenical source(s). This is in discontinuity with the worship traditions of African Christian communities, which are less formal and tend to incline towards the charismatic and Pentecostal traditions with their freedom of expression of faith rather than the more cerebral forms of expression. (shrink)

SummaryThis article examines the disputes amongst Irish Presbyterians about the teaching of moral philosophy by Professor John Ferrie in the college department of the Royal Belfast Academical Institution in the early nineteenth century and the substantive philosophical and theological issues that were raised. These issues have largely been ignored by Irish historians, but a discussion of them is of general relevance to historians of ideas as they illuminate a series of broader questions about the definition and development of Scottish philosophy. (...) These are represented in the move from two philosophers who had strong connections with Irish Presbyterianism—Francis Hutcheson, the early eighteenth-century moral sense philosopher and theological moderate from County Down, and James McCosh, nineteenth-century exponent of modified Common Sense philosophy at Queen's College Belfast and a committed evangelical. In particular, this article addresses three important themes—the definition and character of ‘the Scottish philosophy’, the relationship between evangelicalism and Common Sense philosophy, and the process of development and adaptation that occurred in eighteenth-century Scottish thought during the first half of the nineteenth century. (shrink)

This article examines Presbyterian interpretations in Scotland and Ireland of the Scottish Reformations of 1560 and 1638–43. It begins with a discussion of the work of two important Presbyterian historians of the early nineteenth century, the Scotsman, Thomas McCrie, and the Irishman, James Seaton Reid. In their various publications, both laid the template for the nineteenth-century Presbyterian understanding of the Scottish Reformations by emphasizing the historical links between the Scottish and Irish churches in the early-modern period and their common theology (...) and commitment to civil and religious liberty against the ecclesiastical and political tyranny of the Stuarts. The article also examines the commemorations of the National Covenant in 1838, the Solemn League and Covenant in 1843, and the Scottish Reformation in 1860. By doing so, it uncovers important religious and ideological linkages across the North Channel, including Presbyterian evangelicalism, missionary activity, church–state relationships, religious reform and revival, and anti-Catholicism. (shrink)

This article argues that James Mill's immersion in Presbyterianism inspired an aversion to hierarchical government and a bias in favour of the Church of Scotland. These views are discernible in Bentham's Church-of-Englandism. Bentham argued for disestablishment on principle but, praising the Scottish Church as a , omitted the Kirk from his church reform manifesto. His position on disestablishment, however, and his endorsement of Presbyterianism were aligned with a voluntaryist strain of Presbyterian ecclesiological theory; Presbyterian dissenters and Benthamite Radicals (...) began to protest against the Kirk's established status. Underpinned significantly by Presbyterian tradition and laced with Benthamic influence, a radical voluntary campaign emerged in Scotland which sought to dismantle the old order and usher in a new era of political democracy and religious voluntaryism. Radicalism in Scotland was not solely characterized by the which J. C. D. Clark believes defined Benthamite ideology; Benthamism, it transpires, was not straightforwardly secularist. (shrink)

Following the union of the Presbyterian Church of Southern Africa and Reformed Presbyterian Church in Southern Africa to form the Uniting Presbyterian Church in Southern Africa in 1999, it was necessary to consolidate theological education of a united church. This was a wise and bold decision by UPCSA, as a first attempt to integrate the training of both black and white students, but more importantly to give institutional expression to the advancement of unity. University of Pretoria became a major training (...) centre of the UPCSA. Collaboration in ministerial formation between UPCSA and UP, its partner institution, has been plagued by manifold challenges. The challenges which will come under the spotlight are ecumenism, relationship between the university and the UPCSA, curriculum and spirituality. (shrink)

This article investigated the paradox between church response to apartheid and resulting action at the local level in the South African churches of European origin from the perspective of the Presbyterian Church of South(ern) Africa (PCSA). It indicated that this discrepancy arose between the reflections (cerebral faith) at the highest levels of church councils, which operated in an intermittent manner and at a distance, compared with the responses (praxis as faith in action) of local church members who lived at the (...) coalface of the struggle and sought to witness in a society dominated by racism, where the tension between faith and politics was most evident. The primary focus was on two inter-racial congregations, one of the PCSA, the other a united congregation in which the PCSA participated. This study used primary and secondary sources. The theoretical framework of the article was Thomas Groome’s approach of shared praxis.Contribution: This article contributed to the history of the apartheid era in ecclesiastical contexts. It demonstrated the anomalies that arose within different constituencies within churches of European origin by investigating the situation in one particular denomination. This was a discussion of the relationship of faith and politics in the private and public domains, which takes account of developments within a shared praxis approach. (shrink)

I investigate the African philosophical foundations of a pneumatological controversy inside the Church of Central African Presbyterian in Malawi. While apparently the conflict consists in difficulties in embracing both the New Pentecostal Theology and the Reformed Calvinist Theology within CCAP, it is rooted in the philosophical conflict between communitarianism and individualism. CCAP fully embraced the African communitarian philosophy mixed with Christian communism as its essence, while adherents of NPT followed individualism. Consequently, this affected the interpretation of the fundamental doctrines such (...) as sola scriptura, sola grazia, and other practices. I suggest a philosophical solution constituting in rebuilding African identity and a theological solution in promoting a new pneumatology based on the concept of enculturation. Keywords: Pneumatology, Communitarianism, Individualism, African philosophy, inculturation. (shrink)