A series of papers in Philosophy, Ethics and Humanities in Medicine (PEHM) have recently disputed whether non-heart beating organ donors are alive and whether non-heart beating organ donation (NHBD) contravenes the dead donor rule. Several authors who argue that NHBD involves harvesting organs from live patients appeal to.

The Association of American Medical Colleges (AAMC) is urging academic medical centers to ban pharmaceutical detailing. This policy followed from a consideration of behavioral and neuroeconomics research. I argue that this research did not warrant the conclusions drawn from it. Pharmaceutical detailing carries risks of cognitive error for physicians, as do other forms of information exchange. Physicians may overcome such risks; those determined to do so may ethically engage in pharmaceutical detailing. Whether or not they should do so is a (...) prudential judgment about which reasonable people may disagree. The AAMC's ethical condemnation of detailing is unwarranted and will subvert efforts to maintain a realm of physician discretion in clinical work that is increasingly threatened in our present practice environment. (shrink)

Medical academics are increasingly bringing critical race theory (CRT) or its corollaries to their discourse, to their curricula, and to their analyses of health and medical treatment disparities. The author argues that this is an error. The author considers the history of CRT, its claims, and its current presence in the medical literature. He contends that CRT is inimical to usual academic modes of inquiry and has obscured rather than aided the analysis of social and medical treatment disparities. Remedies for (...) racism suggested by CRT advocates will not work and some of them will make things worse. Academic medicine should avoid the embrace of CRT and should maintain an allegiance to rigorous empirical inquiry and to treating patients not as essentialized ethnic group members but as individual human beings in need of care. (shrink)

Contemporary accounts of medical ethics and professionalism emphasize the importance of social justice as an ideal for physicians. This ideal is often specified as a commitment to attaining the universal availability of some level of health care, if not of other elements of a “decent minimum” standard of living. I observe that physicians, in general, have not accepted the importance of social justice for professional ethics, and I further argue that social justice does not belong among professional norms. Social justice (...) is a norm of civic rather than professional life; professional groups may demand that their members conform to the requirements of citizenship but ought not to require civic virtues such as social justice. Nor should any such requirements foreclose reasonable disagreement as to the content of civic norms, as requiring adherence to common specifications of social justice would do. Demands for any given form of social justice among physicians are unlikely to bear fruit as medical education is powerless to produce this virtue. (shrink)

Opponents of physician-assisted suicide (PAS) maintain that physician withdrawal-of-life-sustaining-treatment cannot be morally equated to voluntary active euthanasia. PAS opponents generally distinguish these two kinds of act by positing a possible moral distinction between killing and allowing-to-die, ceteris paribus. While that distinction continues to be widely accepted in the public discourse, it has been more controversial among philosophers. Some ethicist PAS advocates are so certain that the distinction is invalid that they describe PAS opponents who hold to the distinction as in (...) the grip of ‘moral fictions’. The author contends that such a diagnosis is too hasty. The possibility of a moral distinction between active euthanasia and allowing-to-die has not been closed off by the argumentative strategies employed by these PAS advocates, including the contrasting cases strategy and the assimilation of doing and allowing to a common sense notion of causation. The philosophical debate over the doing/allowing distinction remains inconclusive, but physicians and others who rely upon that distinction in thinking about the ethics of end-of-life care need not give up on it in response to these arguments. (shrink)

In spite of ethical analyses assimilating the palliative deactivation of pacemakers to commonly accepted withdrawings of life-sustaining therapy, many clinicians remain ethically uncomfortable with pacemaker deactivation at the end of life. Various reasons have been posited for this discomfort. Some cardiologists have suggested that reluctance to deactivate pacemakers may stem from a sense that the pacemaker has become part of the patient’s “self.” The authors suggest that Daniel Sulmasy is correct to contend that any such identification of the pacemaker is (...) misguided. The authors argue that clinicians uncomfortable with pacemaker deactivation are nevertheless correct to see it as incompatible with the traditional medical ethics of withdrawal of support. Traditional medical ethics is presently taken by many to sanction pacemaker deactivation when such deactivation honors the patient’s right to refuse treatment. The authors suggest that the right to refuse treatment applies to treatments involving ongoing physician agency. This right cannot underwrite patient demands that physicians reverse the effects of treatments previously administered, in which ongoing physician agency is no longer implicated. The permanently indwelling pacemaker is best seen as such a treatment. As such, its deactivation in the pacemaker-dependent patient is best seen not as withdrawal of support but as active ending of life. That being the case, clinicians adhering to the usual ethical analysis of withdrawal of support are correct to be uncomfortable with pacemaker deactivation at the end of life. (shrink)

Suggestions that academic medicine is systemically racist are increasingly common in the medical literature. Such suggestions often rely upon expansive notions of systemic racism that are deeply controversial. The author argues for an empirical concept of systemic racism and offers a counter argument to a recent suggestion that academic medicine is systemically racist in its treatment of medical trainees: Anderson et al.’s (Academic Medicine, 98(8S), S28–S36, 2023) “The Long Shadow: a Historical Perspective on Racism in Medical Education.” Contra the authors (...) of “The Long Shadow,” the author argues that racial performance disparities in medical education cannot be validly attributed to racism without careful empirical confirmation; he further argues that standards of assessment in medical education cannot be properly deemed racist merely because minority trainees are disproportionately disadvantaged by them. Furthermore, the history of medicine and society in the Anglo-European West is not, as argued by the authors of “The Long Shadow,” best viewed as one long tale of racial oppression culminating in the present day pervasive racism of academic medicine in the United States. Racism is a deplorable stain on our history and our present but it is not the historical essence of Christianity, European civilization, Western medicine, or contemporary academic medical institutions. (shrink)

The dispute over professional conscientious objection presumes a picture of medicine as a practice governed by rules. This rule-based conception of medical practice is identifiable with John Rawls’s conception of social practices. This conception does not capture the character of medical practice as experienced by practitioners, for whom it is a sensibility or “form of life” rather than rules. Moreover, the sensibility of medical practice as experienced by physicians is at best neutral, and at worst hostile, to the demands of (...) those who would override physician conscientious objection to the provision of currently contested services. That being so, calls for overriding physician conscientious objection are much more demanding of the medical profession than they appear in light of Rawls’s view. As such overriding may entail the forcible transformation of medicine’s form of life, the author contends that it would be more prudent to provide contested services by circumventing the medical profession than by compelling it. (shrink)

Since patient autonomy became a prominent theme in medical ethics in the 1970s and 1980s, it has had a troubled reputation among many physicians, to whom claims for its importance in medical decision making seem unrealistic and even undesirable. Of course the discussion has moved on since the early days in which informative or interpretive models of medical decision-making—in which physicians provided information and helped patients clarify and express preferences that then determined decisions—were contrasted with usual medical practice characterized as (...) paternalism: physicians telling patients what to do and patients acquiescing in physician direction. The... (shrink)

Medical work is increasingly being subjected to objective assessment as those who pay for it seek to grasp the quality of that work and how best to improve it. While objective measures have a role in the assessment of health care, I argue that this role is currently overestimated and that no human practice such as medicine can be fully comprehended by objective assessment. I suggest that the character of practices, in which formalizations are combined with judgment, requires that valid (...) assessment involve the perspective of the skilled practitioner. Relying exclusively on objective measures in assessing health care will not only distort our assessments of it but lead to damage as the incentives of health care workers are directed away from the important aspects of their work that are not captured by objective measures. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 15-17, March 2012.

(2010). Response to Open Peer Commentaries on “The Pitfalls of Deducing Ethics from Economics: Why the Association of American Medical Colleges is Wrong About Pharmaceutical Detailing”. The American Journal of Bioethics: Vol. 10, No. 1, pp. W1-W3.

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

It was a dark and stormy night, in the otherwise unnoteworthy year 711 E.C. , and the great-aunt sat crouched at her typewriter, holding his hands out to it from time to time as if for warmth and swinging on a swing. He was a handsome boy of about eighteen, one of those men who suddenly excite your desire when you meet them in the street, and who leave you with a vague feeling of uneasiness and excited senses. On the (...) plate beside the typewriter lay a slice of tomato. It was a flawless slice. It was a perfect slice of a perfect tomato. It is perfectly boring. I hold out my hands to the typewriter again, while swinging and showing my delicate limbs, and observe that the rows of keys are marked with all the letters of the English alphabet, and all the letters of the French alphabet minus accent marks, and all the letters of the Polish alphabet except the dark L. By striking these keys with the ends of my fingers or, conceivably, a small blunt object, the aging woman can create a flaw in the tomato. She did so at once. It was then a seriously, indeed a disgustingly flawed tomato, but it continued to be perfectly boring until eaten. She expired instantly in awful agony, of snakebite, flinging the window wide to get air. It is a dark and stormy night and the rain falling in in the typewriter keys writes a story in German about a great-aunt who went to a symposium on narrative and got eaten in the forest by a metabear. She writes the story while reading it with close attention, not sure what to expect, but collaborating hard, as if that was anything new; and this is the story I wrote . . . Ursula K. Le Guin, distinguished novelist, poet, and essayist, is the author of The Left Hand of Darkness, Malafrena, and The Dispossessed, for which she won both the Hugo and the Nebula Award. Her novel The Lathe of Heaven was made into a film by the Public Broadcasting System. (shrink)

Huddle (2010) claims that the Association of American Medical Colleges (AAMC), in advocating the exclusion of pharmaceutical detail representatives from academic medical centers, erred in placing t...

Why, then, do we huddle in the dark around the campfires of our flickering narratives? There are obviously many different reasons for doing so. Yet, having heard various récits—whether "stories" or "accounts"—during the narrative conference, I am more inclined than ever to see self-assertive entertainment and self-transcending commitment as two kinds of ultimate motivation for our countless narratives. Stories and histories and other narrative or descriptive accounts help us to escape boredom and indifference—ours as well as that of other people. (...) Those nearly vacant states of mind at the zero degree of entertainment and commitment bring us frightfully close to the experience of nonexistence. Hence our desire to replace boredom by thrilling or gratifying entertainment and to replace indifference by the social or cosmic commitment either to change the world or to change ourselves. In a world of unmixed colors and pure literary genres, tragedy, comedy, satire, and romance might answer distinct needs for thrill, gratification, indignation, and admiration. But, as Roy Schafer and Victor Turner have reminded us, the private and social dramas underlying psychoanalytical and anthropological accounts are even less pure than most works of literature. Couldn't we conclude that life's internal and external dramas stem from a compound desire for self-assertion and self-transcendence—a desire which, in the realm of literary entertainment and commitment, motivates the emergence and appreciation of tragicomedy? Paul Hernadi teaches English and comparative literature at the University of Iowa. He is the author of Beyond Genre: New Directions in Literary Classification and the editor of What is Literature? and What is Criticism? His previous contribution to Critical Inquiry, "Literary Theory: A Compass for Critics," appeared in the Winter 1976 issue. (shrink)

Moral distress (MD) has received considerable attention in the nursing literature over the past few decades. It has been found that high levels of MD can negatively impact nurses, patients, and their family and reduce the quality of patient care. This study aimed to investigate the potentially effective interventions to alleviate MD in critical care nurses. In this systematic review, a broad search of the literature was conducted in the international databases including PubMed/MEDLINE, Web of Science, and Scopus, as well (...) as Google Scholar search engine using keywords such as moral distress, intensive care unit, ICU, nurses, and critical care nurses from 1984, when the concept of MD was first introduced in the nursing literature, up to 29 October 2020. Studies focusing on the interventions for managing MD in critical care nurse were evaluated. The quality of eligible papers was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. A total of 8 studies fulfilled the eligibility criteria. Three studies had RCT design and five studies had quasi-experimental design. All studies were conducted in the United States or Iran. Educational workshop, moral empowerment program, social work intervention, nursing ethics huddles, and multifaceted resiliency bundle intervention were effective interventions for managing of MD among critical care nurses. There is limited but promising research evidence evaluating the efficacy of educational interventions for managing of MD among critical care nurses. Although some positive results have been reported, there is limited generalizable evidence due to the variability of interventions. These findings highlight the need for further studies to validate the efficacy of these interventions or develop more potent and efficient interventions for reducing MD in critical care nurses. (shrink)

Marie was 15 when her abdominal pain began. After two years of negative work-ups, countless visits to gastroenterologists, and over 70 days of high school missed, she found herself readmitted to the hospital. “Refractory abdominal pain” was her ostensible diagnosis; “troubled teen” who was “going to be difficult” was embedded in the emergency department’s sign-out. When the medical team arrived to meet Marie, she was huddled in the corner of her hospital bed, silent and withdrawn. Her intern noted the numerous (...) scars cutting across her forearms as she felt for her radial pulses. Marie squirmed in pain when the intern palpated her abdomen.The ED’s work-up had been negative for abdominal pathology. When the... (shrink)

Martin Hollis, in the introduction to the collection of Rationality and Relativism he edited recently with Steven Lukes, describes himself as the most arch of arch rationalists, “by which we mean, merely, that [we] reject the forthright relativization of truth and reason.” You might suppose that his self-description would place him unambiguously in the army of traditionalists arrayed against what Richard Rorty fondly calls the New Fuzzies. You might suppose, then, that Hollis would indulge in furious letter writing to, say, (...) Harper's, telling us that “we need to stand shoulder to shoulder against the growing army of enemies of rationality. By that I mean the followers of the fashionable cult of absolute relativism, emerging from philosophy, linguistics, semiotics, and deconstructionism.” You might suppose that he would go on in this way equivocating between “rationality” and “rationalism,” identifying the people he dislikes with the enemies of civilization: fascists, Stalinists, bikers, bomb throwing nihilists — Richard Rorty and Wayne Booth and Stephen Toulmin riding into town on their Harley- Davidsons, spurning warrants for belief and good reasons, reading pornographic comic books, and snarling at the townsfolk huddled behind the local syllogism. (shrink)

We respond to Morgan and Feeley’s critique on our article “Mass Media in Organ Donation: Managing Conflicting Messages and Interests.” We noted that Morgan and Feeley agree with the position that the primary aims of media campaigns are: “to educate the general public about organ donation process” and “help individuals make informed decisions” about organ donation. For those reasons, the educational messages in media campaigns should not be restricted to “information from pilot work or focus groups” but should include evidence-based (...) facts resulting from a comprehensive literature research. We consider the controversial aspects about organ donation to be relevant, if not necessary, educational materials that must be disclosed in media campaigns to comply with the legal and moral requirements of informed consent. With that perspective in mind, we address the validity of Morgan and Feeley’s claim that media campaigns have no need for informing the public about the controversial nature of death determination in organ donation. Scientific evidence has proven that the criteria for death determination are inconsistent with the Uniform Determination of Death Act and therefore potentially harmful to donors. The decision by campaign designers to use the statutory definition of death without disclosing the current controversies surrounding that definition does not contribute to improved informed decision making. We argue that if Morgan and Feeley accept the important role of media campaigns to enhance informed decision making, then critical controversies should be disclosed. In support of that premise, we will outline: (1) the wide-spread scientific challenges to brain death as a concept of death; (2) the influence of the donor registry and team-huddling on the medical care of potential donors; (3) the use of authorization rather than informed consent for donor registration; (4) the contemporary religious controversy; and (5) the effects of training desk clerks as organ requestors at the Department of Motor Vehicles offices. We conclude that organ donation is a medical procedure subject to all the ethical obligations that the medical profession must uphold including that of transparency and truthfulness. (shrink)

There have been significant changes in the ways in which humans experience music from the time of the publication of Gadamer’s Truth and Method in 1960 until today. While music was formally listened to in “earthier” formats, whether that be through live concerts or huddled around vinyl record players, we now live in a digital age in which music is largely experienced through what we can refer to as more “liquidated” formats, such as music streaming services or smart speakers and (...) similar modalities in which the music is plugged into an easily accessible system whose very accessibility makes the music easily disposable. Using concepts from Gadamer’s hermeneutics, I think through what it means for music to be in these various formats. While certain modes of musical experience allow for the possibility of auditory Ereignis, that is, a musical event so full of meaning that it is capable of transforming one’s world, others more easily relegate the experience of music to episodic insignificance, that is, as lacking inner coherence. Ultimately, I argue that it matters how we experience music and in which contexts, since those very choices can render the musical elements of our lives as meaningful or meaningless. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Invisible ChildrenMaureen KelleyИсчезаю в весне,в толпе,в лужах,в синеве.И не ищите.Мне так хорошо...I fade into spring,or into a crowd,or into a puddle,sometimes into the blue.There's no sense in looking for me.I feel fine...—¾"Absentee" by Arvo Mets"You have to go through Lesha to get to Danil," Alexandra told me. Lesha was a small but unmoving dog with matted hair and a fierce growl. The dog was pressed against the little (...) boy, who looked no more than three or four years old. Alexandra later told me he was eight. Danil was wearing a Spider Man shirt that was four sizes too big and came down to his feet and mismatched sandals. He was huddled against his dog not only for security but warmth. His tiny arm circled Lesha's neck and he looked at me with a mix of curiosity and caution. I knelt and put my hand out for Lesha to smell me. Apparently I didn't pass the smell test. The dog didn't budge from his post. We stood like that for a long time, at the base of the steps to the shelter. I tried the few Russian words I had learned while visiting as a volunteer. The dog didn't understand my broken Russian, or pretended not to, but I managed to get a shy smile from Danil.Alexandra, a nurse volunteer at the shelter, eventually mediated the standoff by giving Lesha, the dog, a cookie. I introduced myself to the little boy. And just like that, he leaned up against me and put both arms around my legs. It didn't matter that I was a stranger, and a stranger who spoke terrible Russian. "Spidey" was an affectionate little guy. He gripped my hand while Alexandra led us up the steps and Lesha followed close behind. Inside was a small room, warm and full of color. One wall was covered in kids' drawings. Another had public health posters in Russian, some with instructions for condom use, others on literacy. There were about fifteen kids in the shelter that afternoon. The young ones were drawing pictures at a low table. Two teenage boys were hunched over a small TV playing a video game. There was only one teenage girl, Irina. She was cooing at the little kid's drawings, showing one girl how to draw a princess. Alexandra said quietly to me, "Most of the teenage girls are only here in the morning. The rest are back at work right now." I found out later "back at work" meant on the streets as sex workers. This city was frequented by businessmen and itinerant workers heading to the factories or lumber mills in the North. The best money for homeless girls was in prostitution. Danil unwrapped himself from me and ran over to the two older boys playing video games. One put his controller down long enough to pull Danil into his lap. The three boys stared intently as Super Mario hopped from mushroom to magic cloud, golden coins spinning above his cartoon head.To the right of the main room was a closet-sized office for the shelter director, Anya, a pediatrician who donated her time to running the shelter for homeless and orphaned youth living on the streets. Alexandra and I stood in the doorway waiting for Anya to finish a phone conversation. Her desk was covered in papers. Behind her were photos of the kids who had "graduated" from the streets. There were cards and letters pinned to a cork board. When [End Page E4] she finished, Anya greeted us with bear hugs and showed us to the clinic area. Next to her office was a small bathroom with a shower and tub. She explained that bath days were on Wednesdays. Around back, with a separate entrance was the small clinic space. The outside metal door had a sliding window that you see at some nightclubs. They ran a needle exchange program out of that door. It was funded for street youth, but from time to time they would get adult addicts. Anya was adamant that this side of the clinic remain separate from the central space for the children. In reality the distance... (shrink)

The genesis for this volume was in the bombing of Japan during World War II, where the author, as a young boy, watched the bombers overhead, speculating about the lives of the pilots and their relationship with those huddled on the ground._ From this disturbing diorama, Professor Hiroshi Kojima, the translator of Martin Buber into Japanese, unfolds a new approach to Buber's “I-Thou” relation, drawing upon insights from Husserl, Heidegger, and others in the tradition of continental philosophy to extend and (...) deepen Buber's thought. In chapters that reflect upon a wide range of phenomena—from religion, science, and technology, to imagination, embodiment, and power—Professor Kojima articulates a conception of what it means to be a human being that stands as an alternative to atomism and alienation of the modern world. Analyses of haiku and other aspects of Japanese culture demonstrate how Kojima's theory can illuminate the spiritual traditions of both East and West. Original in its thought and revealing in its insight into Japanese thought and culture, _Monad and Thou__ represents the life's work of one of Japan's great thinkers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Borrowed Gods and Foreign Bodies: Christian Missionaries Imagine Chinese ReligionWhalen LaiBorrowed Gods and Foreign Bodies: Christian Missionaries Imagine Chinese Religion. By Eric Reinders. Berkeley: University of California Press, 2004. 266 + xvi pp.For a long time, Sinology was dominated by scholars with direct or indirect missionary backgrounds, going all the way back to the founding of the discipline by James Legge. Legge occupied the first university chair in (...) the China field in Britain. Legge's vision of China has recently been placed into historical context by Norman Girardot (The Victorian Translation of China [2002]). There were other early figures whose records of Chinese beliefs and folk customs we still use. Beginning with Timothy Richard, more came around to seeing how China needed more than soul saving for the hereafter. China needed urgent sociopolitical reforms in the here and now. In time, the YMCA and the missionary schools would help chaperone in a whole generation of "modern Chinese"; some of them, though exposed to the Gospel, would, in the May Fourth Movement, pit science and democracy against any and all religions. For all that, scholars still do count on the missionary records for understanding the "old China." By exploring what the majority of these men of God saw in China—or thought they saw, since their perception could well be colored by cultural biases—this book by Eric Reinders proves quite refreshing. Instead of holding up those records as a mirror on a Chinese reality, Reinders (to wit) "reversed the light so that it would reflect upon" the Protestant missionaries themselves. For one thing, these Protestant evangelicals reported on China using rhetoric borrowed from their long-standing complaints against the Catholics. For another, they painted the Chinese "body language" in light of their own proud Victorian manners. These missionaries were no James Legge, who was tutored into classical Chinese by erudite Confucians and who then presented the Confucian Classics with appreciative classical (Latin and Greek) references. They were no Arthur Waley either, Waley being one who could "without leaving the door [as to live in China], know all the affairs of the (Chinese) world." By steeping himself in Chinese language and its written culture, Waley could render the Confucian "chun-tzu" into the familiar English "gentleman," and doing so with due sympathy for two land-owning gentry cultures. There is no such sympathy from the Protestant missionaries who lived among the common people. They purported to know the "real" (rural) China that was opened to the inland mission. The China they reported on was not found in library books, the Confucian classics, or some Mandarin's manicured garden. Theirs is not the Good Earth depicted later by Pearl Buck, either.These nineteenth-century Protestant missionaries, flourishing in the heydays of the British Empire, held few illusions about the once fabled Cathay. Their reports sent home served, in the end, both God and country. As means for raising funds for their missionary efforts, the reports probably had to fan high hopes for the Gospel in relation to a very deprecating assessment of the pagan, heathen culture they encountered. The reports also reflected the hard times these zealous missionaries did have [End Page 226] to face. They were living in the backwater, among often illiterate peasants and in isolated enclaves surrounded by what they saw as a huddling mass of faceless humanity. Their frustration at learning the vernacular tongue well enough to communicate with the people led to the still popular joke about the inscrutable Chinese. But the conclusion the missionaries drew, about how the Chinese language is inherently "godless," is more theological than philological. That the many Chinese tongues (local dialects?) were deemed a living Babel assumes somehow that the Queen's English is divinely inspired. This book does not tell us often what China was really like, for so much of that reality is woefully "lost in translation."Above all, "Borrowed Gods and Foreign Bodies" is about how the Protestants transposed their endless bouts with Rome into seeing the errors of the Chinese way as copies of the Catholic way. The Chinese were mindless in their idolatry; they kept up blindly this ritualistic gesture with little or... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Mechanisms of Violent Retribution in Chinese Hell Narratives Charles D. Orzech University ofNorth Carolina Greensboro Ai! The criminals in this hell have all had their eyes dug out and the fresh blood flows [from them], and each of them cries out, their two hands pressing their bloody eye-sockets—truly pitiful! To the left a middle-aged person is just having an eye pulled out by one of the shades; he struggles (...) unceasingly, screaming; his left eye has already been extracted... (56b) Ai-yah!... Each of the criminals is bound to a an iron pillar and the ox-headed demons are in the process of administering punishment—using iron or copper blades they peel the skin of the person's face, just as a butcher kills a pig and then flays it. Each of the criminal ghosts screams in pain... (59b) The criminal ghost's hands are bound about an iron pillar which is entirely red [with heat] and the criminal ghost's two hands are entirely cooked and it is unbearable... (126a) Record ofA Journey to Hell These passages are found, not in some medieval description of hell, nor in a work for sadists, but in a modern and quite popular Chinese "good book" (shan-shu) titled Record ofA Journey to Hell (Ti-yu yu-chi). Record ofA Journey to Hell is the most recent work of a genre which emerged in tenthcentury China and which may be found throughout Asia from Vietnam to Japan. This persistent fascination with gruesome scenes of torture stands in striking contrast to Michel Foucault's observations that by the first quarter of the nineteenth century "punishment had gradually ceased to be a spectacle" in Europe (9). In Record ofA Journey to Hell we are not faced with a seachange in the discourse and practice of a society. Rather, we must come to 112Charles D. Orzech grips with and seek to understand the persistence of images oftorture as well as actual torture and public execution in some modern Chinese societies. The Chinese hells—more properly purgatories, as punishment there is not eternal—are a product of cultural adaptation and interaction. Before the first century of our era we have evidence of only the most attenuated notions of the underworld, a "yellow springs" (huang-yiian) where "all, good and bad, huddled together in darkness being guarded jealously by the god of the Soil who ended by devouring them" (Thompson 29). The ruling elite avoided this fate through elaborate ancestral ritual indexed by the possession of a surname. Social status was, from the earliest times, "inscribed" on tablets which gave visible form to both social and cosmological hierarchies (Li 247-54). However, the rise of the Taoist Celestial Masters movement (T'ien-shih tao, second century) with its heavenly and infernal bureaucracies soon coupled with newly imported Indian Buddhist descriptions of the workings of karma and the hells. The result of this amalgam is the popular Chinese vision of the underworld as a vast bureaucracy centered on ten "courts," and headed by Yama, the South Asian lord of the dead (Seidel). At death the soul is summoned before the lords of hell who administer punishments appropriate to the misdeeds of the soul. After almost interminable periods of suffering, often in all of the hells in succession, the soul is reborn as a human, an animal, or even an insect, to start the whole process again. By the tenth century this distinctly Chinese version ofthe underworld had found wide dissemination and was the framework for worship and ritual directed to the recently dead.18 Unlike the South Asian prototypes, Chinese hells appear to be modeled on the imperial bureaucracy and administered by a hellish staff. The "court" layout often major and numerous subsidiary hells mimics Chinese palace and temple architecture and is quite distinct from the mandala-like layout found in "orthodox" Buddhist prototypes. Taoist priests, Buddhist monks and nuns, and a variety of folk practitioners and mediums act as intermediaries between this world and the other. They grease the wheels of the bureaucracy with their ritual knowledge and with community offerings to obtain release for imprisoned souls. Knowledge of the workings of the underworld is, according... (shrink)

The article reviews the article "The Pitfalls of Deducing Ethics From Behavioral Economics: Why the Association of American Medical Colleges Is Wrong About Pharmaceutical Detailing," by T. S. Huddle in the January 1, 2010 issue of "American Journal of Bioethics.".

From the time of the Eastern Han dynasty [A.D. 23-220] onward, Buddhism gradually became a very important ideological tool for the feudal landlord class in China in their establishing their rule over the country. Although Buddhism had its roots in India and was transmitted to China in the form of seeds of ideas, it found even more fertile soil in China and grew into a tall and leafy tree with a stout trunk, casting its protective shadow over the entire Chinese (...) system of feudalism. In the age of feudalism in China, the political power of Buddhism was constantly in competition with that of the Daoist religion in areas populated by the Han people, and there was quite an ebb and flow. However, it is fair to say that in terms of ideological and cultural influence Buddhism enjoyed a great advantage. Naturally, the other imported religions and/or regional religions, which were by and large even weaker than the Daoist religion, were even less of a match for Buddhism. Nevertheless, in terms of China's historical conditions, owing to intermittent class conflict — primarily the revolutionary peasant wars, to a powerful despotic system of concentration of political power and to the conflict of practical interests between secular landlords and monastic landlords — monastic orders who controlled land on the basis of the monastery economy, and also owing to the traditionally powerful influence of Confucianist orthodoxy — all these factors combined to wage war against religion and theology. As a result, the development of Buddhism was greatly hindered, and, unlike the religions of Europe and other Asian countries, it was unable to place religious authority over and above secular political authority or to achieve an absolute monopoly over the realm of ideology and culture. In China, no matter how brightly the star of Buddhism shone and how great and compelling its power and prestige came to be, it still nonetheless always huddled up at the feet of the feudalistic monarchy and was never able to take the place of the orthodoxy of Confucianism. Still, it was indispensable as a supplementary tool of government. (shrink)

One August evening in a sweated Virginia field that led to a pond I frequented just to hear frogs burble up and see the west sky turn an erotic, apricot orange, I was surrounded by seven four month-old Angus calves who formed a sort of fairy ring around me. They’d grown used to me there at dusk, when I often watched them group, huddle, and hunch, like quarterbacks. Then explode unpredictably in pursuit of the first calf to break rank and (...) flee. Or they might side-butt, or utter-butt, or butt-butt a cow, who would swing her rear end, swart her deft tail, until her tormentors finally galloped off, graceful as fat butterflies. Most usually they’d lock imaginary horns in scattered pairs or in threesomes and go at it.. (shrink)

“Let's get one thing straight: there is no such thing as a show code,” my attending asserted, pausing for effect. “You either try to resuscitate, or you don't. None of this halfway junk.” He spoke so loudly that the two off-service consultants huddled at computers at the end of the unit looked up… We did four rounds of compressions and pushed epinephrine twice. It was not a long code. We did good, strong compressions and coded this man in earnest until (...) the end. Toward the final round, though, as I stepped up to do compressions, my attending looked at me in a deep way. It was a look in between willing me as some object under his command and revealing to me everything that lay within his brash, confident surface but could not be spoken. (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in _Ethics at the End of Life: New Issues and Arguments_, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters—written (...) by a team of experts—survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The 14 chapters in Ethics at the End of Life: New Issues and Arguments, all published here for the first time, focus on recent thinking in this important area, helping initiate issues and lines of argument that have not been explored previously. At the same time, a reader can use this volume to become oriented to the established questions and positions in end of life ethics, both because new questions are set in their context, and because most of the chapters--written (...) by a team of experts--survey the field as well as add to it. Each chapter includes initial summaries, final conclusions, and a Related Topics section. TABLE OF CONTENTS John K. Davis, "Introduction" Geoffrey Scarre, "Is it possible to be better off dead?" Taylor W. Cyr, "How Does Death Harm the Deceased?" Benjamin Mitchell-Yellin, "The Significance of an Afterlife" Jens Johansson, "The Severity of Death" John K. Davis, "Defining Death" James Stacey Taylor, "Autonomy, Competence, and End of Life" Eric Vogelstein, "Deciding for the Incompetent" Paul T. Menzel, "Change of Mind: An Issue for Advance Directives" Nancy S. Jecker, "Medical Futility and Respect for Patient Autonomy" Paul T. Menzel, "Refusing Lifesaving Medical Treatment and Food and Water by Mouth" Thomas S. Huddle, "Suicide, Physician-Assisted Suicide, the Doing-Allowing Distinction and Double Effect" Michael Cholbi, "Grief and End of Life Surrogate Decision-making" Bruce Jennings, "Solidarity near the End of Life: The Promise of Relational Decision-making in the Care of the Dying" Colin Farrelly, "Justice and the Aging of the Human Species". (shrink)

The main publicity poster for Olivier Nakache’s and Eric Toledano’s recent film Intouchables (The Intouchables [2011]) features two men side-by-side, grinning ear-to-ear. The image is oddly difficult to interpret. For French cinema initiates, the contrast should be striking. Seated to the left is François Cluzet, long one of the France’s more versatile leading actors; huddled over him on the right is Omar Sy, a French-born comedian of Senegalese and Mauritanian descent who, prior to playing this role, was largely unknown to (...) the French public. Those unfamiliar with the actors will note, at the very least, their different attire; Cluzet’s patterned ascot and Sy’s green hooded sweatshirt signal clear class .. (shrink)

We are happy to present the Winter 2017 Edition of Constellations that is comprised of six outstanding undergraduate works. The edition is loosely tied together by a theme of material history and showcases the diverse, but consistently excellent work of our undergraduate students here at the University of Alberta. The Winter 2017 Edition includes:Curries, Chutneys and Imperial Britain investigates the intriguing correlation between British imperialism in India and Indian food in British society. Incredibly relevant to the world today “Your Tired, (...) Your Poor, Your Huddled Masses” American Responses to the Indochinese and Syrian Refugee Crises explores the the contributing factors to American’s feelings to refugees.Revolutionary Gender Equality: The Dimensions and Limits of Female Emancipation in the Sandinista Revolution provides an intriguing analysis of the changes to women’s expected roles during revolution. Neither Full Nor Flat: Women, Representation and Politics in Walter Scott's Rob Roy an analysis of women’s role in the novel as indication of the contemporary politics. ‘Daring to Ride Skirtless’: Anti-Fashion and Emancipation for the New British Woman, 1880-1910 provides an interesting look into the role of fashion in women’s emancipation. Custodians of Morality, Motherhood, and Whiteness: Sex Education for Girls in American Schools During the 1920s explores the emergence of sex education programs in the United States the implications on the social roles of young girls and women. Thank you for your interest in Constellations. We are indebted to our volunteers for all of their hard work that went into this edition. We would like to thank the Department of History and Classics for their support of Constellations.Co-Editors: Emily Kaliel and Jean MiddletonAssistant Editors:Lee Klippenstein and Sean OliverSenior Reviewers:Connor ThompsonEmily TranBronte Wells. (shrink)

This chronological collection of Moore's most compelling and dramatic images, taken as the movement progressed through Alabama, Mississippi, Tennessee, and Georgia, highlights activity from 1958 to 1965. Included are the iconic scenes of black protestors huddled in a doorway to escape the crippling blasts of fire hoses in Birmingham; a white bigot swinging a baseball bat seconds before cracking it on the head of a black woman during the desegregation of the Capitol Cafeteria in Montgomery; a young and stunned Dr. (...) Martin Luther King Jr. pinned to the counter of a police precinct, his arm twisted behind his back; the devastating aftermath of "Bloody Sunday" on the Edmund Pettus Bridge in Selma; and Bull Connor's police dogs tearing mercilessly at the legs of a protestor in downtown Birmingham. Celebrity protestors--comedian Dick Gregory, poet Galway Kinnell, singers Joan Baez, Mary Travers, Pete Seeger, and Harry Bellafonte, actor Pernell Roberts, and writer James Baldwin--are featured alongside the many nameless but committed participants and the recognized major leaders of the movement. (shrink)