Human-centered explainable AI (HCXAI) advocates for the integration of social aspects into AI explanations. Central to the HCXAI discourse is the Social Transparency (ST) framework, which aims to make the socio-organizational context of AI systems accessible to their users. In this work, we suggest extending the ST framework to address the risks of social misattributions in Large Language Models (LLMs), particularly in sensitive areas like mental health. In fact LLMs, which are remarkably capable of simulating roles and (...) personas, may lead to mismatches between designers' intentions and users' perceptions of social attributes, risking to promote emotional manipulation and dangerous behaviors, cases of epistemic injustice, and unwarranted trust. To address these issues, we propose enhancing the ST framework with a fifth 'W-question' to clarify the specific social attributions assigned to LLMs by its designers and users. This addition aims to bridge the gap between LLM capabilities and user perceptions, promoting the ethically responsible development and use of LLM-based technology. (shrink)

Palliative care is a recent branch of health care. The doctors, nurses, and other professionals involved in it took their inspiration from the medieval idea of the hospice, but have now extended their expertise to every area of health care: surgeries, nursing homes, acute wards, and the community. This has happened during a period when patients wish to take more control over their own lives and deaths, resources have become scarce, and technology has created controversial life-prolonging treatments. (...) Palliative care is therefore faced with more ethical problems that other areas of health care. This book, by a clinician, teacher, and writer on health care ethics, has been written to provide all those who care for the terminally ill--doctors, nurses, social workers, clergymen, physiotherapists--with the concepts and principles which will assist them with difficult decisions. It challenges many received doctrines of palliative care, but its well-illustrated central theme is that technical expertise must be controlled by humane, non-technical judgments. (shrink)

As palliative care develops across many of the countries of Europe, we find that it continues to raise important ethical challenges. Palliative care practice requires ethical sensitivity and understanding. At the same time the very existence of palliative care calls for ethical explanation. Ethics and palliative care meet over some vital issues: 'the good death', sedation at the end of life, requests for euthanasia, futile treatment, and the role of research. Yet palliative care appears uncertain (...) about its goals and there is evidence that its ethical underpinnings are changing. Likewise, the moral problems of palliative care are only partly served by the four 'principles' of modern bioethics. This innovative book, with contributions by clinicians, ethicists, philosophers and social scientists, provides the first ever picture of palliative care ethics in the European context. It will be of interest to those involved in the delivery and management of palliative care services, as well as to students and researchers. (shrink)

End-of-life debates in medical ethics often centre around several interrelated issues: improving care, avoiding coercion, and recognising the dignity and rights of the terminally ill. Care ethics advocates relational autonomy and non-abandonment. These commitments, however, face system pressures—economic, social and legal—that can be coercive. This article takes up two related aspects in this domain of ethics. Firstly, that competence and communication are core clinical ethics principles that can sidestep the overplayed dichotomies in end-of-life care. And secondly, (...) it questions the assumption that advance directives are universally benevolent—comparing the provisions of the Council of Europe’s 1999 recommendations on protection of human rights and dignity of the dying within the framework of the Irish context. The article also registers the unintended impacts of changing legal frameworks in relation to euthanasia and assisted suicide in Europe, including recent proposals in the Netherlands. A focus on human dignity can provide a theologically and philosophically shared normative orientation that argues for present directives rather than only advance directives, and a presumption in favour of ‘living up to death’. Dignity approaches not only grant rights but secure them by supporting ongoing initiatives that honour, rather than erode, the ‘longevity dividend’. (shrink)

En la actualidad Cuba desarrolla un Programa de Atención Integral al Paciente con Úlcera de Pie Diabético mediante el uso del Heberprot-P, esencial para disminuir la amputación y la discapacidad. El trabajo tiene el objetivo de realizar un diagnóstico sobre la aplicación del Heberprot-P en el Servicio de Angiología del Hospital Provincial Universitario Manuel Ascunce Domenech de Camagüey. Se realizaron encuestas a pacientes para identificar necesidades sentidas relacionadas con el tratamiento y para las actitudes manifiestas, y se hicieron entrevistas al (...) personal médico y de enfermería. El diagnóstico permitió corroborar la necesaria investigación con enfoque social del servicio de salud escogido a nivel territorial. Destaca elevar el trabajo de captación de pacientes desde el nivel primario de salud para garantizar un mayor alcance del programa, así como la trascendencia del apoyo familiar y la relación profesional de la salud- paciente a fin de lograr la calidad requerida. At present Cuba is developing a program concerning the care of patient with ulcer of the diabetes foot by means of Heberprot-P essential to reduce the amputation and disability. The aim of this paper is to carry out a diagnosis about social aspects of the application of the Heberprot-P in the Angiology service at Manuel Ascunce Domenech Hospital in Camaguey. Some surveys were carry out to identify certain needs related with the treatment and the attitude shown and on the other hand some interview were made to the medical and nursing staff. The diagnosis allowed to verify the need of the research with social approach. The paper highlight how to incorporate patients from the primary health level, in order this program has a higher scope and the importance of the family support and the professional relationship to accomplish the quality required. (shrink)

This article deals with making decisions about starting terminal care. The results are part of a larger survey on nurses’ conceptions of terminal care in community health centres in Finland. The importance, frequency and timing of decision making as well as communication and the number of investigations and procedures carried out are examined. The relationship between decision making and the size of a health centre’s catchment population is also discussed. The results make it possible to compare (...) the current situation in Finland with the national law on patients’ rights. The sample consisted of 328 nurses who worked on the wards of 32 community health centres. The data were collected by means of a structured questionnaire and processed with the Statistical Package for Social Sciences software. The nurses agreed that explicit decision making and documentation about starting terminal care were necessary, but it was highlighted that the practice had many shortcomings. Decisions were often made too late and the patients were not always aware of their situation; family members and the nursing staff were mostly better informed. It was noted that many investigations and other procedures were carried out on terminally ill patients, often at the request of family members. Decision making was found to have some relationship to the size of a health centre’s catchment area. (shrink)

An important examination of the theological, spiritual, and ethical issues surrounding death. At the end of a life of faithfulness comes our dying. To approach it as faithfully as we have our living calls for some serious forethought. Because one of the simplest facts of life—that we all die—seems like the most complicated thing we do. Not only have advances in medical technology saved lives, but they also have prolonged death, and raise a number ethical, moral, social, and theological (...) issues. How far should we go to sustain life? Is it right to withdraw artificial feeding from the dying? Is it wrong to end the lives of those in pain? No matter who we are, dealing with these sorts of choices near the end of life is difficult to do on our own.Faithful Living, Faithful Dying: Anglican Reflections on End of Life Care brings together the wisdom of a task force created by the 72nd General Convention of the Episcopal Church to study what faithful living and faithful dying mean today. The task force’s reflections, published for the first time in this book, assist individuals, congregations, and the Church as a whole to disentangle the thicket of ethical, theological, pastoral, and policy concerns. (shrink)

Educating young people about how to interact with patients at the end of their lives is challenging. A qualitative study based on Husserl’s phenomenological approach was performed to describe the learning experience of secondary education students after watching, analysing, and reflecting on two videoclips featuring Cameron Duncan, a young man suffering from terminal cancer. Students from three vocational centres providing training in ancillary nursing, pharmacy, and dependent care in the Community of Madrid visited the Palliative Care Hospital. (...) A total of 110 students, with a median age of nineteen years, participated in the study. The students’ learning experience through the videoclips reveals the essential aspects required in palliative care, since the character suffers in every dimension of his being: physically as well as psychologically, socially, and spiritually. Therefore, this requires healthcare professionals to understand their experience, putting themselves in their place, to provide affectionate care and to display communication skills leading to a quality helping relationship. Four comprehensive educational categories were identified in the study. The students learned the importance of: 1) providing comprehensive and affectionate care to patients, 2) the need for communication skills in caring for patients, 3) being aware of the end of life and time left, 4) valuing life and fighting for what one wishes to attain. A visit to a PC hospital and the viewing of videoclips and reflection upon these, represents a useful strategy for secondary education healthcare students. The study indicates that videoclips are an innovative method for becoming aware of the various issues pertaining to palliative care. (shrink)

The Health (Regulation of Termination of Pregnancy) Act 2018 was commenced on 01/01/2019 in Ireland. The Act provides for legal termination of pregnancy under defined circumstances including for any reason at < 12 weeks gestation; and where two doctors agree there is ‘a condition affecting the foetus that is likely to lead to the death of the foetus either before, or within 28 days of, birth’. As such, abortion for congenital anomaly (CA) can occur at a number of time points, (...) depending on the adjudged severity. Infants born with CAs frequently require significant medical intervention and account for a high proportion of admissions to paediatric intensive care units (PICUs). The purpose of this paper was to evaluate the number of infants with CAs admitted to an Irish PICU in the period before and after the implementation of the Act. All PICU admissions < 1 month of age to a single Irish paediatric hospital between 2012 and 2021 were analysed. CAs were recorded, and the periods before and after the commencement of the Act compared. We found a difference in admissions involving CAs, particularly those related to congenital heart disease involving single ventricle anatomy. It is plausible that this difference was as a result of improved access to abortion services following the implementation of the Act. This article explores the legal conditions related to the abortion of a foetus with a CA in Ireland, and the possible impact of the Independent Review of the Operation of the Health ( Regulation of Termination of Pregnancy) Act 2018. (shrink)

Symptom Checker Applications (SCA) are mobile applications often designed for the end-user to assist with symptom assessment and self-triage. SCA are meant to provide the user with easily accessible information about their own health conditions. However, SCA raise questions regarding ethical, legal, and social aspects (ELSA), for example, regarding fair access to this new technology. The aim of this scoping review is to identify the ELSA of SCA in the scientific literature. A scoping review was conducted to identify the (...) ELSA of SCA. Ten databases (e.g., Web of Science and PubMed) were used. Studies on SCA that address ELSA, written in English or German, were included in the review. The ELSA of SCA were extracted and synthesized using qualitative content analysis. A total of 25,061 references were identified, of which 39 were included in the analysis. The identified aspects were allotted to three main categories: (1) Technology; (2) Individual Level; and (3) Healthcare system. The results show that there are controversial debates in the literature on the ethical and social challenges of SCA usage. Furthermore, the debates are characterised by a lack of a specific legal perspective and empirical data. The review provides an overview on the spectrum of ELSA regarding SCA. It offers guidance to stakeholders in the healthcare system, for example, patients, healthcare professionals, and insurance providers and could be used in future empirical research to investigate the perspectives of those affected, such as users. (shrink)

Among the important functions of the healthcare provider in providing quality care is the monitoring of the social environment of the patient. Although it is increasingly recognized that caring activity must include the whole patient and not merely the technical and pharmacological aspects of the patient's needs, the impact of the social environment upon the total health state has not been explored and debated to the extent that It might be.

"Ce livre propose une enquête philosophique explorant le rapport à la mort dans nos sociétés. C’est une invitation à penser les liens humains à la fin de la vie. On évoque les liens intimes, mais également les liens sociaux encadrés par la loi. Dans un tel contexte, comment discerner les raisons anciennes et nouvelles convenant au bien de la cité? L’ouvrage s’adresse aux accompagnants en soins palliatifs. Il concerne également toute personne soucieuse pour elle-même et ses proches de réfléchir à (...) son voyage au bout de la vie. Nous sommes mortels, nous le savons et le fil de nos existences provoque des occasions de nous le rappeler. Dans la solitude de mourir s’inscrit l’appel à la compassion. Ainsi, pour les Grecs de l’Antiquité, l’image de la cigogne symbolisait la prise en charge des vieux par les jeunes, un signe de l’amitié politique. L’émergence de la culture palliative est intimement liée aux changements qui ont affecté l’évolution récente de la vie démocratique. Cette culture est née et s’est développée dans des circonstances politiques particulières. À l’observer, on peut déchiffrer certains codes de notre vie civique, ses aspirations, mais aussi ses ambiguïtés. Louis-André Richard propose d’examiner les questions actuelles en compagnie de Platon, d’Aristote, d’Augustin ou de Tocqueville. Grâce à eux, la philosophie, symbolisée par la sagesse de Minerve, est mise à contribution pour explorer la genèse et les métamorphoses de concepts comme la dignité et l’autonomie. Comment se déploie la dynamique de la raison et de la liberté à l’heure de notre mort? Tel est l’enjeu pour les roseaux pensants que nous sommes. Si notre frêle espèce appelle à la sollicitude de la cigogne, elle ne saurait négliger de convoquer aussi la sagesse de Minerve."--Résumé de l'éditeur. (shrink)

Rare diseases are a heterogenic group of disorders with a little in common except of their rarity affecting by less than 5 : 10.000 people. In the world is registered about 6000-8000 rare diseases with 6-8% suffering population only in the European Union. In spite of rarity, they represent an important medical and social problem due to their incidence. For many rare diseases have no treatment, but if it exists and if started on time as being available to patients, (...) there is a good prognosis for them to be able for normal life. The problems of patients affected by rare diseases are related to the lack of diagnosis and timely undergoing as well as their treatment or prevention. Orphan drugs are products intended for treatment, diagnosis or prevention of rare diseases, but for their development and marketing the industry has not been interested in yet because of their marketing reasons. Patients suffering from a rare disease although belonging to the vulnerable group for their specific health needs, is becoming invisible in the health care system due to their additional needs un properly recognized. Ethical problems faced by patients, but also health care professionals are related to the allocation of medical diagnostics, unequal approach to health care, inappropriately specialized social services as well as therapy and rare orphan drugs unavailability. Ethical questions related to clinical trails on orphan drugs, population screening and epidemiology testing on rare diseases will also be discussed in this paper. [Projekat Ministarstva nauke Republike Srbije, br. 41004: Rare diseases: Molecular pathophysiology, the diagnostic and therapeutical modalities, social, ethical and legal aspects] Retke bolesti su veoma heterogena grupa poremecaja i imaju malo toga zajednickog osim retkosti, posto pogadjaju manje od pet osoba na 10.000 ljudi. U svetu je evidentirano izmedju 6.000 i 8.000 retkih bolesti koje pogadjaju sest do osam procenata stanovnistva samo u Evropskoj uniji. Dakle, iako retke, one predstavljaju vazan medicinski i socijalni problem s obzirom na broj obolelih. Za mnoge retke bolesti nema terapije, a ukoliko ona postoji i ako se na vreme zapocne i bude dostupna pacijentima, postoje dobri izgledi da ce oboleli moci da zive normalnim zivotom. Problemi s kojima se susrecu pacijenti sa retkim bolestima vezani su za dijagnostikovanje u smislu nemogucnosti ili nepravovremenog postavljanja dijagnoze, kao i same terapije ili prevencije pojave bolesti. Orphan lekovi su proizvodi koji su namenjeni za lecenje, dijagnozu ili prevenciju retkih bolesti, za ciji razvoj i marketing industrija nije zainteresovana iz trzisnih razloga. Pacijenti s retkim bolestima, iako pripadaju osetljivoj grupi, jer imaju specificne zdravstvene potrebe, ostaju nevidljivi u zdravstvenom sistemu, jer se njihove dodatne specificne potrebe ne prepoznaju. Eticki problemi s kojima se susrecu pacijenti, ali i zdravstveni radnici, ticu se alokacije zdravstvene dijagnostike, nejednakog pristupa zdravstvenoj zastiti i nezi, nedostatka specijalizovanih socijalnih usluga, kao i nepostojanja i nedostupnosti terapije orphan lekovima. Eticka pitanja retkih klinickih ispitivanja orphan lekova i populacionih i skrining ispitivanja u vezi sa retkim bolestima takodje su razmatrani u ovom radu. PR Projekat Ministarstva nauke Republike Srbije, br. 41004: Rare diseases: Molecular pathophysiology, the diagnostic and therapeutical modalities, social, ethical and legal aspects. (shrink)

Recenzowana monografia naukowa dotyczy wybranych, niezwykle ważnych kwestii społecznych i etycznych, związanych z poszczególnymi etapami życia ludzkiego: jego początkiem, trwaniem i śmiercią. Składa się z dziewięciu artykułów, które łącznie tworzą szeroką panoramę współczesnych problemów bioetycznych. […] Jest przykładem ich dobrego diagnozowania, aktualizowania refleksji nad nimi i proponowania konkretnych rozwiązań, które odwołują się – co bardzo cenne – do rodzimych przykładów. […] Adresatami publikacji mogą być zarówno osoby profesjonalnie związane z szeroko rozumianą służbą zdrowia, studenci kierunków medycznych, jak i pacjenci oraz (...) ich rodziny, a także osoby zawodowo organizujące wsparcie w trudnych sytuacjach. Publikacja zainteresuje także osoby, które poszukują refleksji nad społecznie ważnymi kwestiami bioetycznymi, ukazanymi w perspektywie personalistycznej. Z recenzji ks. dr. hab. Zbigniewa Wanata, prof. UMK Monografia zawiera szereg interesujących tekstów analizujących dylematy moralne związane z początkiem i końcem ludzkiego życia. Poruszane zagadnienia są ważne i aktualne. W części pierwszej znajdują się opracowania dotyczące kwestii prenatalnych i okołoporodowych, w części drugiej – kwestii terminalnych, a na końcu tekst zwieńczający, dotyczący pojęcia sumienia […] Szczególnie cenne wydają się teksty prezentujące obszerne wyniki badań własnych (np. opieki nad dziećmi z zespołem Downa) i funkcjonowanie niedawno powstałych instytucji (jak hospicja perinatalne) albo opisujące proponowane procedury postępowania w praktyce (np. w stosunku do osób umierających). Inne teksty, nawet jeśli dotyczą zagadnień znanych (np. diagnostyki prenatalnej lub opieki nad ciężarnymi niepełnosprawnymi), omawiają je w sposób porządkujący dotychczasową wiedzę. Powyższe sprawia, że monografię można uznać za dzieło oryginalne. […] Wśród Autorów poszczególnych rozdziałów znajdują się osoby rozpoznawalne w środowisku medycznym i bioetycznym, co sprawia, że publikacja powinna cieszyć się zainteresowaniem w tych kręgach, a sformułowane w niej postulaty mogą mieć wartość aplikacyjną. Z recenzji dr. hab. med. Jakuba Pawlikowskiego, prof. UKSW. (shrink)

Essays examine various sides of medical ethics issues such as euthanasia, organ transplants, and living wills.

There is a growing tendency for medicine to be used not to prevent or heal illnesses, but to fulfil individual personal wishes such as wishes for enhanced work performance, better social skills, children with specific characteristics, stress relief, a certain appearance or a better sex life. While recognizing that the subject of wish-fulfilling medicine may vary greatly and that it may employ very different techniques, this article argues that wish-fulfilling medicine can be described as a cohesive phenomenon with distinctive (...) features. Following a few examples of well established wish-fulfilling medical practices and a brief definition of the phenomenon, both theoretical aspects and ethical implications of such practices are discussed and the question is raised how wish-fulfilling medicine should be evaluated from an ethical point of view. It is concluded that modern medicine is currently ill equipped to provide reasons why wish-fulfilling medicine should be banned or discouraged. The phenomenon of wish-fulfilling medicine serves as a prime example of the vagueness of the descriptive and the lack of decisive orientation of the normative categories employed in modern medicine. (shrink)

Not everyone finds a in suffering. Indeed, even those who do subscribe to this interpretation recognize the responsibility of each individual to show not only sensitivity and compassion but render assistance to those in distress. Pharmacologic hypnosis, morphine intoxication, and terminal sedation provide their own type of medical to the terminally ill patient suffering unremitting pain. More and more states are enacting legislation that recognizes this need of the dying to receive relief through regulated administration of controlled substances. Wider (...) legislative recognition of this need would go far toward allowing physicians, in the exercise of their reasonable medical judgment, to administer a range of narcotics and barbiturates to the terminally ill without fear of legal sanctions. Sadly, social attitudes and governmental concerns about the spread of drug addiction provide an undeniable policy nexus that impedes unduly a rational approach or exception for the treatment of pain experienced by the dying. (shrink)

Effective palliative care that rests on a sound ethical foundation requires ongoing discussions about patient and family values and preferences. This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death. The eighth volume in the HPNA Palliative Nursing Manuals series, Legal and Ethical Aspects of Palliative Care, provides an overview of critical communication skills and formal organizational mechanisms, (...) such as ethics committees and interdisciplinary rounds, required for decisions in ethical dilemmas which respect diversity in the views of colleagues, as well as patients. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. (shrink)

This article develops an approach to ethical globalization based on a feminist, political ethic of care; this is achieved, in part, through a comparison with, and critique of, Thomas Pogge's World Poverty and Human Rights. In his book, Pogge makes the valid and important argument that the global economic order is currently organized such that developed countries have a huge advantage in terms of power and expertise, and that decisions are reached purely and exclusively through self-interest. Pogge uses an (...) institutional rights framework to argue that direct responsibility for global poverty and inequality lies with the citizens of developed countries, since suffering and death are caused by global economic arrangements designed and imposed by our governments. While this argument is certainly compelling, I have argued that it tells us little about the actual effects of globalization on the real people of the South - including women, children and the elderly. As a result, it can offer little in the way of real alternatives or policy prescriptions. As a moral orientation, a care ethic relies on a relational moral ontology, and leads us to consider different values in terms of human flourishing. Moreover, it pushes us to consider the normative implications of aspects of the global political economy which are usually not 'seen' at all, including the global distribution of care work and the corresponding patterns of gender and racial inequality, the underprovision of care and resources for caring work in both the developed and developing world, and the ways in which unpaid or low-paid caring work helps to sustain a cycle of exploitation and inequality on a global scale. (shrink)

The essence of caring for those in need of help consists in a certain relationality, in giving and receiving a certain relationship. The relationship as such is the protagonist of the care. Material help is always necessary, at least for the time it has to be dedicated. However, the material aspect takes on meaning from the relationship between the one who helps (caregiver) and the one who receives the help (care receiver). It is a lifeworld relationship. What is (...) lacking in today’s society is not so much material and technological resources, but rather the relational skills of welcoming, supporting and socially integrating people in difficulty. The care of the Other is increasingly entrusted to new technologies and impersonal welfare mechanisms, while interpersonal social relationships become increasingly weak, liquid and unavailable. The consequences are evident in the loss of social solidarity and in the degradation of the human condition. Situations of need due to fragility, hardship, marginalization are spreading. We need a social change, first of all cultural, which brings out, rather than concealing, the relational character of human needs and, correlatively, of the necessary response. (shrink)

First published in 1980, Caring and Curing is for all those involved in the 'caring professions' - medicine, social work, and the other health and welfare occupations. It is both an introduction to philosophy for the caring professions and a philosophy of those professions. The authors believe that the best way to introduce philosophy is to engage in it, to philosophize, and that the most exciting way to philosophize is to offer a reasoned but controversial point of view on (...) matters to which people are professionally committed. They argue, first, that there is an essential unity of the caring professions in that the concepts of health and welfare are different aspects of a single value judgement as to what sort of life a person should be enabled to live in his society. Secondly, they show the limits of scientific expertise in relation to human behaviour and argue that the education of medical and social workers should include broader humane disciplines to assist them in coping with the problems of ethics and values of all kinds in present-day society. Thus, the discussion introduces the main branches of philosophy and deals with many of the current moral dilemmas in medicine and social work. (shrink)

The health care systems in Austria, Germany and Switzerland owe their institutional structure to different historical developments. While Austria and Germany voted for the Bismarck-Model of social health insurance,Switzerland adopted a voluntary system of health insurance. In all three countries, until very recently, the different challenges which the healthcare sector faced were met by piecemeal approaches and by stop and go policies, which, in the long run were not very successful either in containing costs or in improving efficacy (...) and efficiency. During the 1990 more fundamental reforms in the health care systems of all three countries took place. Germany and Switzerland chose the path of deregulation of the health insurance system, which consequently strengthened the competition between the insurance companies, and, to some extent between the suppliers of medical services. While this can be seen as an essential part of the reform process for these two countries, Austria favors a state-oriented and interventionist approach in order to meet the challenges. (shrink)

Lower limb major amputations are both life-saving procedures and life-changing events. Individual responses to limb loss are varied and complex, some individuals experience functional, psychological and social dysfunction, many others adjust and function well. Some patients refuse amputation for religious and/or cultural reasons. One of the greatest difficulties for a person undergoing amputation surgery is overcoming the psychological stigma that society associates with the loss of a limb. Persons who have undergone amputations are often viewed as incomplete individuals. The (...) medical and physical consequences of amputation serve as the centerpiece in acute care and are commonly at the forefront of prosthetic rehabilitation. Prosthetic prescription aims to compensate for functional and/or cosmetic losses where possible. The aims of rehabilitation following amputation are to restore acceptable levels of functioning that allow individuals to achieve their goals, to facilitate personal health, and to improve participation in society and quality of life either with or without prosthesis. Our article aims at underscoring some medical, social and religious aspects that can contribute to the wellbeing of patients who suffer a life changing event such as lower limb amputation. (shrink)

This interdisciplinary collection presents valuable discourse and reflection on the nature of a good death. Bringing together a leading judge and other legal scholars, philosophers, social scientists, practitioners and parents who present varying accounts of a good death, the chapters draw from personal experience as well as policy, practice and academic analysis.Covering themes such as patients' rights to determine their own good death, considering their best interests when communication becomes difficult and the role and responsibilities of health professionals, the (...) book outlines how ethical healthcare might be achieved when dealing with assisted suicide by organizations and how end of life services in general might be improved. It will be of interest to students and academics working the area of medical law and ethics as well as health professionals and policy-makers. (shrink)

In the debate concerning the education of nurses that is currently taking place in Denmark, two widely differing views are apparent regarding the best way of training nurses such that the ethical aspect of their work is adequately considered. The first of these is based on the premise that practical care is fundamental to and justified by theories on nursing, care and ethics, which is why the theoretical part of nurse education deserves a higher priority. The second view (...) is based on the premise that social care cannot be taught by means of theories, but can be learnt only through practice. The master-apprentice principle of ancient Greece is stressed in connection with this as being a viable alternative to the theoretical model of education. These two very different views can be traced back to Plato’s and Aristotle’s ideas on ethics and teaching respectively; indeed, those engaged in the debate make specific reference to these philosophers. In Denmark, a third fundamental viewpoint exists, known as ‘ontological ethics’. Phenomenologist KE Løgstrup is one of the best-known representatives of this view. Basing the line of argument on Løgstrup’s ethics and the view of education associated with this, this article questions the relevance of ancient Greek thought to today’s world by illustrating a number of problems that are connected with the theoretical model of nurse education and with the master-apprentice principle. Løgstrup associates ethics with the aesthetic principle that ‘the useless is the most useful’ in human life and with the view we also see in Kierkegaard’s and NFS Grundtvig’s writings that ethics can be imparted only by indirect means. Løgstrup bases his understanding of ethics on the Judaeo-Christian concept of Genesis and the view that human beings were created with an ethical potential that is best nourished by aesthetic impressions. (shrink)

ABSTRACT People who are paid to provide basic care for others are frequently undervalued, exploited and expected to reach often unrealistic standards of care. I argue that appropriate social recognition, support and fair pay for people who provide care for those who are disabled, frail and aged, or suffering ill health that impedes their capacity to negotiate daily activities without support, depends on a reconsideration of the paradigm of the citizen or and moral agent. I argue (...) that by drawing on the ideas of human vulnerability and dependency as central to our personhood, a more realistic conception of selves, citizens and persons can be developed that better recognises the inevitability of human dependency and the social value of care work. I also indicate the significance of this vulnerability‐focussed view for ethical evaluation of the emotional aspects of care relationships. (shrink)

The paper deals predominantly with the theory of moral reconstruction in George H. Mead’s thinking. It also points out certain underdeveloped aspects of Mead’s social-psychological theory of the self and his moral philosophy, and attempts to develop them. Since Mead’s ideas concerning ethics and moral philosophy are anchored in his social psychology, the paper begins with a description of his theory and underlines some problematic areas and tries to solve them. The most important of these, as the author (...) argues, is the hypothesis that social conflicts should be seen as the root of reflective, discursive thinking. Unlike some of his contemporaries (such as Vygotsky), Mead failed to appreciate this aspect of the genesis of the dynamics of the self. (shrink)

The topic of abortion was in the limelight again in Dobbs v Jackson, where the US Supreme Court overturned the decision of Roe v Wade, ‘which guaranteed women and pregnant people a constitutional right to abortion’. While not bound by the judgment, this gives us an opportunity to reflect on the current law in South Africa which regulates the termination of pregnancy. The primary piece of legislation which governs abortion is the Choice on Termination of Pregnancy Act. Section 2 of (...) the Act lists the grounds under which one may lawfully terminate a pregnancy. One of those grounds relates to the period of the 13th up until the 20th week of the gestation period, and states that if a medical practitioner, after consultation with the pregnant woman, is of the opinion that the continued pregnancy would significantly affect the social or economic circumstances of the woman, then the pregnancy may be lawfully terminated. The question is: What exactly is meant by ‘social grounds’? This article considers this aspect from a legal perspective and attempts to provide clarity on the issue, in the hope that this will be of assistance to medical practitioners who are concerned about the outcome of their actions, when assisting persons in this position. (shrink)

Although there has been a proliferation of interest in sustainable business practice, recent research has identified concerns with the relative neglect of the social versus environmental aspects of sustainability. It is argued here that due to its reliance on internally held, concrete and intrinsically motivated forms of responsiveness, as well as its ability to be authentically social versus parochial in nature, that the ethical construct of “embodied care” (Hamington, Embodied Care: Jane Addams, Maurice Merleau-Ponty, and Feminist (...) Ethics, 2004 ) has particular relevance as one path through which responsiveness to the human aspects of sustainable business practice might occur. Consideration is given to care as both an individual and organizational level construct. Business case examples are offered and directions for future research described. (shrink)

This study examined the ethical issues experienced by nurses working in a small group of elderly persons’ care settings in the UK, using a survey questionnaire previously used in other countries for examining the cultural aspects of ethical issues. However ‘culture’ relates not only to ethnicity but also the organizational culture in which care is delivered. Nurses working in elderly persons’ care settings described a range of issues faced when caring for elderly terminally ill people, which illustrated (...) the different needs of patients, relatives, professionals and society. These issues related to the unique needs of elderly people (such as dementia sufferers) and could have an impact on patients’ quality of death. (shrink)

One of the common domains in health care in which the concept of vulnerability is used is end-of-life care, including euthanasia and assisted suicide (EAS). Since different uses and implications of the notion have been recognised in the literature on EAS, this paper aims to analyse them and reflect on who is the most vulnerable in the context of EAS. A prior exploratory review of the literature has served as a starting point for the discussion. We concluded that (...) vulnerability is a complex, multi-perspective and multi-layered concept, which implies the vulnerability of different stakeholders involved in EAS practices and vulnerability in different aspects of being human (i.e., physical, mental, moral, social and spiritual). A comprehensive understanding of the notion of vulnerability, which balances as well as complements the concept of autonomy, seems to be an indispensable element of the discourse on EAS. (shrink)

The first edition of this book was published in 1977. At that time the field of thanatology, the study of death and dying, was still reasonably new and was dominated by research done by psychiatrists and social scientists. The most notable person in the field at the time was Elisabeth Kubler-Ross, who was widely credited with having brought thanatology into public view with the 1969 publication of her book On Death and Dying. Two research centers on death and dying (...) were gaining national reputations: The Foundation of Thanatology in New York (Austin Kutscher, director), and the Center for Death Education and Research (Robert Fulton, director) at the University of Minnesota. (shrink)

The article is devoted to a comprehensive analysis of the transformation of the reflection of computer technologies and network resources in the Terminator cinematic and literary universe created by the American director J. Cameron in the mid 1980s and early 2020s. In this study the authors substantiate the relevance and scientific component of the problem under study. The paper considers the degree of importance of high technologies and social networks in modern public life. The article provides a justification for (...) the fallacy of the judgment, according to which works of fiction of a fantastic orientation perform purely entertaining function and do not carry a significant semantic load. This article also provides an argument for choosing the Terminator fantastic universe as an example for research, wit an analysis of the reasons for its great popularity and high degree of significance for contemporary art. The authors of the work subject the key components of the topic under consideration to reflection, taking into account the changes that have taken place in the public consciousness over three and a half decades, takin inti account the differences in historical and political realities – from the last quarter of the 20-th century to the present, until the beginning of the third decade of the XXI century. This article provides a comparative analysis of the reasons for significant differences in the display of high technology and online resources in cinema and fiction. The work draws parallels and analogies with historical events, analyzes the use of the religious meanings used in the Terminator universe. The authors of the article analyze the moral issues that are raised by the creators of the fantastic universe of Terminator in the context of the positive and negative consequences of the intense growth of the role of high technologies and communicative Internet sites in the life of human society. (shrink)

This study investigates the social and environmental disclosure practices of socially responsible Chinese listed firms as displayed in their annual reports and corporate social responsibility reports from the perspective of stakeholders. A stakeholder-driven, three-dimensional social and environmental disclosure index that integrates the quantity and two aspects of the quality of disclosure perceived by stakeholders is constructed to assess the social and environmental disclosures in firm annual reports and CSR reports. The study results indicate that stakeholders perceive (...) different disclosure types and disclosure items as important to differing degrees. CSR reports provide more stakeholder-relevant social and environmental disclosure than annual reports. (shrink)

Caring for Liberalism brings together chapters that explore how liberal political theory, in its many guises, might be modified or transformed to take the fact of dependency on board. In addressing the place of care in liberalism, this collection advances the idea that care ethics can help respond to legitimate criticisms from feminists who argue that liberalism ignores issues of race, class, and ethnicity. The chapters do not simply add care to existing liberal political frameworks; rather, they (...) explore how integrating dependency might leave core components of the traditional liberal philosophical apparatus intact, while transforming other aspects of it. Additionally, the contributors address the design of social and political institutions through which care is given and received, with special attention paid to non-Western care practices. This book will appeal to scholars working on liberalism in philosophy, political science, law, and public policy, and it is a must-read for feminist political philosophers. (shrink)

Contemporary Christian ethics encounters the challenge to communicate genuinely Christian normative orientations within the scientific debate in such a way as to render these orientations comprehensible, and to maintain or enhance their plausibility even for non-Christians. This essay, therefore, proceeds from a biblical motif, takes up certain themes from the Christian tradition (in particular the idea of social justice), and connects both with a compelling contemporary approach to ethics by secular moral philosophy, i.e. with Axel Honneth's reception of Hegel, (...) as based on Hegel's theory of recognition. As a first step, elements of an ethics of recognition are developed on the basis of an anthropological recourse to the conditions of intersubjective encounters. These conditions are then brought to bear on the idea of social justice, as developed in the social-Catholic tradition, and as systematically explored in the Pastoral Letter of the United States Conference of Catholic Bishops, Economic Justice For All (1986). Proceeding from this basis, aspects of a Christian ethics of community service with regard to long-term care can be defined. (shrink)

At its beginning, the European Union’s Common Agricultural Policy (CAP) did not include measures to guide farmers in preserving ecosystems. At the same time, the social context on the 1960s and 1970s did not encourage environmental care to become a priority. Since the 1980s, new social concern expressed alarm over ecology, recognizing that agriculture can pollute. These social changes moved the CAP to add measures that linked agriculture and environment. In order to study if the EU (...) decision-makers have designed a CAP which responds to a new ethic that incorporates environmental care and social demands, two questions rise: whether the social image of agriculture as a polluting activity has changed; and whether farming performs the environmental functions demanded by society. To answer the previous questions, we have reviewed the environmental aspects added to the CAP, then a poll has been conducted and cluster method and classification tree models have been used to group respondents according to their opinions. The results show that the society ascribes great relevance to the environment for the future sustainability of the region, but they are not satisfied with the role of agriculture in producing environmental outputs. (shrink)

The implicit social contract between large companies and their employees has been recently revised to emphasize workforce flexibility and the financial responsibility of individual employees for their own employment and benefits-related decisions. The most recent aspect of this social contract to be significantly changed is health care benefits. On the basis of in-depth case studies of health benefits purchasing at 15 large United States employers, the authors found that the reported use of a purchasing technique called managed (...) competitionhas enabled firms to bring health benefits purchasing in line with other elements of the revised social contract. An important minority of companies in our study appear to have retained a different, “employer responsibility” approach toward employee health benefits, leading them to move more gradually to managed competition purchasing and refrain from instituting heavy premium cost sharing or cutting coverage for their employees. These findings are preliminary and deserve further study as to their generalizability and persistence. (shrink)

Modern biomedical technologies managed to revolutionise the End-of-Life Care (EoLC) in many aspects. The dying process can now be "engineered" by managing the accompanying physical symptoms or by "prolonging/hastening" death itself. Such interventions questioned and problematised long-established understandings of key moral concepts, such as good life, quality of life, pain, suffering, good death, appropriate death, dying well, etc. This volume examines how multifaceted EoLC moral questions can be addressed from interdisciplinary perspectives within the Islamic tradition. Contributors Amir Abbas Alizamani, (...) Beate Anam, Hamed Arezaei, Asma Asadi, Pieter Coppens, Hans Daiber, Khalid Elzamzamy, Mohammed Ghaly, Hadil Lababidi, Shahaboddin Mahdavi, Aasim Padela, Rafaqat Rashid and Ayman Shabana. (shrink)

In times like these, a new ethico-political ideal is required to contest the adequacy of dominant understandings of social interaction as matters of choice and rational decision-making and in contesting these understandings encourage us to imagine social alternatives. We wish to make a contribution to this project of expanding the universe of political discourse as a means to invigorating ethico-political debate. A range of existing vocabularies — the languages of trust (and relatedly respect), care and associated concepts, (...) including corporeal generosity — are currently put forward as the means to contest the dominance of neo-liberal premises about `atomistic individualism'. While many of these accounts focus on nation-states, others attend to an emerging global community. Nevertheless, we have some reservations about these languages and their premises. In our view they tend frequently to locate the `problem' in the character of citizens. We also make the case that such languages and their associated political agendas reinstate aspects of social hierarchy that mimic neo-liberal conceptions of autonomous individualism. Central to our critique is the claim that the problematic aspects of these existing languages of (inter)connection are due to an attenuated understanding of embodiment and an inadequate dialogue between the socio-political and embodiment. It is this inadequate dialogue we wish to redress. In this paper we offer a new ethical ideal called `social flesh' to ground an alternative politics for reconfiguring exploitative social relations. As an ethico-political starting point, `social flesh' highlights human embodied interdependence and in the process configures a new, more transformative political vision. It draws attention to shared embodied reliance, mutual reliance, of people across the globe on social space, infrastructure and resources. Insistence upon this shared reliance underpins a profoundly levelling perspective, a radical politics. (shrink)

Inside this complete guide you will find: A guide to facilitate conversation with your family; How to create peace when war has been declared on your body; How to alleviate pain and suffering; How to choose your own end; How to use the dying process as a mechanism for personal and family growth. Filled with inspirational and helpful stories, Mortal Dilemmas... is a book that not only will prepare you for the inevitable, but will also give you a sense of (...) satisfaction and control."--P. [4] of cover. (shrink)