The purpose of this article is not to affirm or deny particular philosophical positions, but to explore the limits of intelligibility about what post-mortem harm means, especially in the light of improper post-mortem procedures at Bristol and Alder Hey hospitals in the late 1990s. The parental claims of post-mortem harm to dead children at Alder Hey Hospital are reviewed from five different philosophical perspectives, eventually settling on a crucial difference of perspective about how we (...) understand harm to the dead. On the one hand there is the broadly 'analytical' tradition1 of thinking that predicates the notion of harm on the basis of an existing subject. Since the dead are non-existent persons, it makes little sense to view the dead as being harmed. On the other hand, there is a phenomenological perspective, where the dead, in respect to the experience of grief, are existentially absent. This forms the basis that it is possible to harm grieving parent's experiences of how their dead are treated. The article ends with a short examination of what harming the dead implies for traditional bioethical concerns, namely, obtaining informed consent from significant others when planning medical research on the newly dead. (shrink)

Can a materialist look for the resurrection of the dead and the life of the world to come? Dean Zimmerman’s Falling Elevator Model is a speculative account of how persons, understood as material beings, might survive in a post-mortem resurrected state—a just-so story. It assumes endurantism, the doctrine that persons and other ordinary objects are three-dimensional beings which are wholly present at every time they exist. I argue that neither endurantism, nor purdurantism, according to which persons are four-dimensional (...) ‘worms’ who have proper temporal parts at every time that they exist, provides a plausible account of personal survival. If you want to be a Christian materialist you should embrace exdurantism, the ‘stage theory’, according which persons are instantaneous stages and are not identical to their temporal successors either in this world or in any world to come. Exdurantism provides a plausible account of survival in ordinary cases and extraordinary cases of this-worldly fission, and of post-mortem survival. (shrink)

Discussions of the sources for Levinas’s philosophy have tended to focus on Greece and the Bible to the neglect of his Russo-Lithuanian cultural heritage. Almost no work has been done examining the impact of Russian literature on Levinas’s thinking. The present essay seeks to overcome this neglect by examining the influence that Dostoyevsky in particular exerted on the development of Levinas’s philosophy. I am aware that the notion of “influence” is philosophically vague, and not something whose truth can easily be (...) ascertained. Might there be nothing more than simply a confluence between the thinking of Dostoyevsky and that of Levinas? Could it be that Levinas was attracted to the work of Dostoyevsky because he found there what he was already looking for? Although Levinas credits Dostoyevsky with introducing him to philosophy, it would be facile to draw the conclusion that St. Petersburg occupies as important a place in Levinas’s intellectual itinerary as Athens or Jerusalem. Dostoyevsky provided neither an ontology nor any of the “pre-philosophical experiences” (EI 24) on which, according to Levinas, all philosophical thought rests. But he did give Levinas a way to think about art, religion, and, most importantly of all, ethics after the Holocaust, an event that more than any other, according to Levinas, demonstrated the absolute failure of philosophical theodicy. It was Dostoyevsky, I submit, rather than the Bible, the Greeks, or Kant who taught Levinas that the moral imperative, addressed to the singular existing individual, supersedes the religious imperative, whose validity is placed in question by the suffering of innocents and the absence of the all-powerful and providential God of theism. (shrink)

In this article, we use the theory of Information Ethics to argue that deceased people have a prima facie moral right to privacy in the context of health data research, and that this should be reflected in regulation and guidelines. After death, people are no longer biological subjects but continue to exist as informational entities which can still be harmed/damaged. We find that while the instrumental value of recognising post-mortem privacy lies in the preservation of the social contract (...) for health research, its intrinsic value is grounded in respect for the dignity of the post-mortem informational entity. However, existing guidance on post-mortem data protection is available only in the context of genetic studies. In comparing the characteristics of genetic data and other health-related data, we identify two features of DNA often given as arguments for this genetic exceptionalism: relationality and embodiment. We use these concepts to show that at the appropriate Level of Abstraction, there is no morally relevant distinction between posthumous genetic and other health data. Thus, genetic data should not automatically receive special moral status after death. Instead we make a plea for ‘contextual exceptionalism’. Our analysis concludes by reflecting on a real-world case and providing suggestions for contextual factors that researchers and oversight bodies should take into account when designing and evaluating research projects with health data from deceased subjects. (shrink)

Background The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. Main body This article discusses some of the ethical challenges that were encountered in (...) these research projects. Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. Conclusion It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa. (shrink)

The use of tissue collected at a forensic post-mortem for forensic genetics research purposes remains of ethical concern as the process involves obtaining informed consent from grieving family members. Two forensic genetics research studies using tissue collected from a forensic post-mortem were recently initiated at our institution and were the first of their kind to be conducted in Cape Town, South Africa. This article discusses some of the ethical challenges that were encountered in these research projects. (...) Among these challenges was the adaptation of research workflows to fit in with an exceptionally busy service delivery that is operating with limited resources. Whilst seeking guidance from the literature regarding research on deceased populations, it was noted that next of kin of decedents are not formally recognised as a vulnerable group in the existing ethical and legal frameworks in South Africa. The authors recommend that research in the forensic mortuary setting is approached using guidance for vulnerable groups, and the benefit to risk standard needs to be strongly justified. Lastly, when planning forensic genetics research, consideration must be given to the potential of uncovering incidental findings, funding to validate these findings and the feedback of results to family members; the latter of which is recommended to occur through a genetic counsellor. It is hoped that these experiences will contribute towards a formal framework for conducting forensic genetic research in medico-legal mortuaries in South Africa. (shrink)

I develop an exploratory analysis of “post-mortem photography”, a social practice existing in different cultures. The study, part of a larger project in Denmark, “The culture of grief”, combines Dialogical Self Theory, mainly concerning verbal and textual objects, with the iconic framework of affective semiosis to discuss the function of taking and keeping pictures of dead persons as if they were still alive or just sleeping. How can this practice and artifact culturally mediate the experience of death and (...) the elaboration of grief? What kind of inner dialogue is developed through the internalization of this specific kind of presence/absence? These are some of the preliminary questions I will try to answer by discussing some examples of post-mortem photography from the 19th and 20th centuries in different countries. (shrink)

John F. Post argues that physicalistic materialism is compatible with a number of views often deemed incompatible with it, such as the objectivity of values, the irreducibility of subjective experience, the power of the metaphor, the normativity of meaning, and even theism.

To ask the question "Why does anything at all exist?" is equivalent to asking "What is the explanation of why anything at all exists." Thus the question presupposes that there is an explanation, known or unknown or unknowable, of why anything at all exists.

The questions of observational error and ambiguity of interpretation that have been raised in connection with the reported observation of a magnetic monopole have precipitated a situation calling for some further insight into the pairing principles of nature. A basic distinction relates to whether or not a pair is “ordered” (e.g., sexual pair) or without a priori order (e.g., mirror pair). It is shown that the polarity of electric charge is to be regarded as an example of pairing without an (...) intrinsic a priori order. It then follows that “action” also exhibits a pairing without a priori order. The relation ofPC andTC to unordered and ordered pairing is discussed, with neutral kaon pairing as a striking example of ordered pairing. The pairing of magnetic charge, if it exists, becomes an ordered pairing! (shrink)

Outlines a conceptual argument against the Principle of Sufficient reason. The argument is presented in detail in earlier work, and is based on deductive inferences from PSR's own concept of explanation. The argument shows that not everything can have an explanation of the sort claimed by PSR. So far from being a presupposition of reason itself, as some think, PSR can be refuted by reason, arguing only from PSR's own concept of explanation. Hence PSR cannot be used to argue that (...) there must be some explanation or reason for existence, invisible at least to science, or that because we do not or cannot know the explanation, there must be irreducible mystery about why there is anything at all rather than nothing, including why there was a Big Bang in the first place. (shrink)

Although studies show that those who are physically or psychologically overwhelmed by the needs of others do experience a stressful burden that can have significant negative health consequences, little attention has been given to whether there are health benefits from helping behaviour that is fulfilling, not overwhelming. In this book, Stephen Post brings together distinguished researchers from basic science to address this question in objective terms. The book provides heuristic models, from evolution and neuroscience, to explain the association between (...) altruism and health, and examine potential public health and practical implications of the existing data. (shrink)

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by (...) responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity. (shrink)

The technology required for tissue-engineering food is the same as for medical applications, and in fact is derived from it. There are major differences in the implementation of those technologies, primarily related to the enormous scale required for food production and the different economical framework. In addition, the emotional context of food tissue engineering is also more complex than for medical applications. On the other hand, the tissues that are generated do not need to integrate in the body, with less (...) risk of adverse effects in the event of incomplete functional, neuronal or humoral adaptation. The implementation of tissue engineering for food is still in its infancy. No products exist yet. It will be extremely challenging to make these products a reality for the consumer, but the reward and return in terms of value for our society will be tremendous. (shrink)

Richard Gale and Alexander Pruss raise a number of excellent questions in their separate responses to my comments on Gale’s book, On the Nature and Existence of God. They focus on aspects of my discussion that need at least to be clarified, if not retracted, in ways I explain in this reply.

One of the major roadblocks in conducting Environmental Corporate Social Responsibility (ECSR) research is operationalization of the construct. Existing ECSR measurement tools either require primary data gathering or special subscriptions to proprietary databases that have limited replicability. We address this deficiency by developing a transparent ECSR measure, with an explicit coding scheme, that strictly relies on publicly available data. Our ECSR measure tests favorably for internal consistency and inter-rater reliability, as well as convergent and discriminant validity.

Health care decision making has changed profoundly during the past several decades. Advances in scientific knowledge, technology, and professional skill enable medical providers to extend and enhance life by increasing the ability to cure disease, manage disability, and palliate suffering. Ironically, the same interventions can prolong painful existence and protract the dying process. Recognizing that medical interventions, especially lifesustaining measures, are not always medically appropriate or even desired by a patient or family, health care professionals endeavor to determine who (...) should make health care decisions and according to what standards. The importance that Western culture places on individual rights and self-determination is reflected in the growing advocacy for patient autonomy and the discrediting of physician paternalism. However, the question of autonomy becomes more complex when patients lack the capacity to decide for themselves.Advance directives represent one response to the dilemma of decision making for incapacitated patients. The original advance directive, the living will, is a written list of instructions reflecting the individual's wishes about care, usually at the end of life. (shrink)

Health care decision making has changed profoundly during the past several decades. Advances in scientific knowledge, technology, and professional skill enable medical providers to extend and enhance life by increasing the ability to cure disease, manage disability, and palliate suffering. Ironically, the same interventions can prolong painful existence and protract the dying process. Recognizing that medical interventions, especially lifesustaining measures, are not always medically appropriate or even desired by a patient or family, health care professionals endeavor to determine who (...) should make health care decisions and according to what standards. The importance that Western culture places on individual rights and self-determination is reflected in the growing advocacy for patient autonomy and the discrediting of physician paternalism. However, the question of autonomy becomes more complex when patients lack the capacity to decide for themselves.Advance directives represent one response to the dilemma of decision making for incapacitated patients. The original advance directive, the living will, is a written list of instructions reflecting the individual's wishes about care, usually at the end of life. (shrink)

‘Plastinates’ (i.e. corpses conserved through plastics) are lab created artifacts which since the nineties have been the subject of a cultural field experiment via an anatomical exhibition. Similarly to brain-dead or digitalized bodies, they constitute an ambiguous form of post-mortem existence. The article inquires after the ways in which the ontological status of these entities is constituted through the practices of body donors, anatomists and visitors. Plastinates owe their ambiguity to an oscillation between two different frames of (...) perception. Their meaning is determined by the extent to which an anatomy exhibition can impose a ‘medical gaze’ over a non-professional way of perception, which would stubbornly associate bodies with persons. This association depends on two qualities of plastinates, which refer back to the donor: on the one hand, they draw the observer into a communicational relationship, since the body is the archetypal medium of the self-representation of persons. On the other hand, the plastinated body, considered as ‘bequest’, acquires a biographical dimension: though the exhibition tries to appropriate the individual body anatomically, as an exemplar of a timeless, abstract idea of the human, the visitor’s mundane perspective reintegrates the exhibit into history. Plastinates are the embodied expression of the last will of those people whom the public meets in the exhibition. (shrink)

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by (...) responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity. (shrink)

Intraspecific niche variation can differentially impact community processes and can represent the initial stages of adaptive radiation. Here we test for intraspecific differences in niche use in a keystone species, the alewife (Alosa pseudoharengus). To test whether feedbacks between predator foraging traits and prey communities have led to differences in niche use, we compare the diet composition and trophic position of anadromous and landlocked alewife populations. These populations differ in phenotypic traits related to foraging (gill raker spacing, gape width, and (...) prey selectivity). Trait differences appear to have resulted from eco-evolutionary feedbacks between alewives and their zooplankton prey, and suggest that these two life history forms are exploiting different niches. Direct diets show that anadromous alewives consume a greater biomass of predatory copepods than do landlocked alewives. Anadromous alewives also consume more ostracods—a littoral prey item—as the growing season progresses. These diet differences do not translate into a significant difference in trophic position, as estimated from stable isotopes. However, stable-isotope estimates of diet source show that during early fall, anadromous alewives obtain significantly more of their dietary carbon from the littoral food web. This increased reliance on littoral prey is likely a result of a diet switch that occurs in response to the alewife-driven exhaustion of large-bodied prey items available in the pelagic zone, i.e., alewife niche construction. These findings show the existence of important intraspecific niche differences in the alewife and support the role of eco-evolutionary feedbacks in shaping these niche differences. The initiation of alewife divergence is the result of dam building by humans. Therefore, alewife niche differentiation can be considered to be an eco-evolutionary byproduct of human cultural niche construction. (shrink)

Death is an undeniable fact of life. Whether it is a bad or feared thing is an important discussion that can be brought back to the ancient Greek philosophers. This article is primarily concerned with the discussion on what grounds Epicurus's thesis "death, is nothing to us; since when we exist, death is not yet present, and when death is present, then we do not exist," and to what extent satisfactory results are reached. Later, it tries to investigate how Lucretius, (...) who is regarded as the successor of Epicurus, derives the result of meaningless of fear of death from the symmetrical relationship between prenatal and post-mortem non-existences. Finally, it refers to the modern asymmetric approaches which argue that, contrary to Lucretius's claim, the relationship between these two periods of non-existence is not symmetrical, because there are serious differences between the later birth and the later death of people, given their deprivations. This article argues that death has a mystery that raises the anxiety that comes from the nature of death; however, it defends the idea that it makes a significant contribution to the meaning of life. (shrink)

BackgroundOrgan transplantation represents the most effective and acceptable therapy for end-stage organ failure. However, its frequent practice often leads to a shortage of organs worldwide. To solve this dilemma, some countries, such as Portugal, have switched from an opt-in to an opt-out system, which has raised concerns about respect for individual autonomy. We aimed to evaluate whether young university students are aware of this opt-out system so that they can make informed, autonomous and conscious decisions, as well as to identify (...) the factors that determine a positive attitude toward post-mortem organ donation.MethodsAn observational, cross-sectional study was developed and a questionnaire was administered to first-year students from six faculties of the University of Porto.ResultsOf the 841 participants, 60% were unaware that Portugal had adopted an opt-out system. Among the informed individuals, their main sources of information included social media, internet, and family. Furthermore, only 48% of all participants agreed with the current opt-out system. Female sex (p = 0.049; OR 1.393), knowledge of the law (p < 0.001; OR 4.749) and family being the primary source of information (p < 0.001; OR 2.855) were independent factors associated with a positive attitude toward post-mortem organ donation law.ConclusionsThere is a significant lack of knowledge among young university students regarding the presumed post-mortem organ donation law and how it works. Female sex, having family as a primary source of information and being aware of the presumed post-mortem organ donation law are the strongest independent factors that determine a positive attitude toward the opt-out system. (shrink)

Purpose The search for cause of death is important to improve knowledge and provide answers for the relatives of the deceased. Medical autopsy following unexplained death in hospital is one way to identify cause of death but is difficult to carry out routinely. Post mortem sampling (PMS) of tissues via thin biopsy needle or ‘mini incisions’ in the skin may be a useful alternative. A study was undertaken to assess how this approach is perceived by intensive care doctors (...) and also to evaluate how this practice is considered in ethical terms in France. Methods A study of PMS practices immediately after death in 10 intensive care departments was performed. The medical director of each centre was interviewed by telephone and asked to describe practices in their unit and to outline the questions raised by this practice. Results PMS is routinely performed in 70% of the units which responded, without systematically obtaining formal consent and without precise rules for communicating results. Approaches to PMS differed between centres, but all physicians felt that PMS is useful for the scientific information it gives and also for the information it provides for relatives. All physicians regret the lack of standards to structure PMS practices. Conclusion Information from post mortem examinations is important for society to inform about causes of death, for doctors to improve practices and for decision-makers responsible for organising care. Debate persists regarding the balance between individual rights and community interests. It is suggested that an approach for identifying cause of death could easily be integrated into the relationship between carers and relatives, provided full transparency is maintained. (shrink)

Introduction Death is an inevitable part of clinical practice and affects, in its very own way, not only next of kin and friends but also the members of the clinical team, in particular physicians and nurses, as those who take care of a patient in the very last moments of his or her life. Nevertheless, in clinical everyday life, it is no matter of course to meet the end of human life not only on a physical but also metaphysical level. (...) Definition of the problem In Western sociocultural contexts, silence is commonly regarded as an adequate expression of respect in the context of death. Considering that time is a more than limited resource in Western healthcare systems, it can, however, be challenging for the clinical team to pause and pay respect to the life that has passed and to generally deal with the unfathomability of human finiteness. Instead, death tends to become drowned out by a strident clinging to the common routines of patient care, in the course of which everyday clinical noises can turn into a roaring, almost inhuman cacophony—a cacophony that may not do justice to the dignity of the deceased, the relatives, or the clinic team. Objective With that said, this article focuses on forms of bidding farewell in clinical patient care, with an emphasis on post-mortem silence. Drawing on examples from literature, medical ethics, and the law, I will plead for a moment of silence in everyday clinical practice as a possible means to interrupt the noise of medicine in the immediate aftermath of death to honor the dignity of both the dead and the living. (shrink)

Why would we ever take a picture of a dead person? This practice began as a way to perpetuate the image of the deceased, rendering their memory eternal – Victorians thought that it could be useful to have portraits of their dead loved ones. Certainly, subjects in post-mortem photos will be remembered forever. However, we must ask two more questions. Are they people portrayed as if they were still alive? Or on the other hand, are they bodies that (...) represent death? Our paper takes an in-depth look at different iconographical styles as well as photographic techniques and religious and ethical reasons behind memento mori photos during the Victorian Age. (shrink)

The current state of British sociology of education is reviewed; noting its decline, but suggesting that its influence has been dispersed throughout educational research in Britain. It is argued that its fate is not simply a product of external attack but also derives from internal problems. Against this background, it is suggested that postmodernism can be treated as a stimulus for a fundamental reconsideration of the proper nature and role of academic research on education.

The current state of British sociology of education is reviewed; noting its decline, but suggesting that its influence has been dispersed throughout educational research in Britain. It is argued that its fate is not simply a product of external attack but also derives from internal problems. Against this background, it is suggested that postmodernism can be treated as a stimulus for a fundamental reconsideration of the proper nature and role of academic research on education.

Background Voluntary post-mortem donation to science (PDS) is the most appropriate source for body dissection in medical education and training, and highly useful for biomedical research. In Mexico, unclaimed bodies are no longer a legal source, but PDS is legally possible, although scarcely facilitated, and mostly ignored by the general population. Therefore, we aimed to evaluate the attitude and willingness for PDS and to identify a sociodemographic profile of people with willingness toward PDS. Methods A validated on-line survey (...) was distributed by the convenience method via the social networks of a Catholicism-inspired, private university in northern Mexico. Frequency analyses of all variables and coded free comments were complemented with association studies. Results Although the responder cohort (n = 143) was too small and biased to be representative of the university community (n = 13,500), willingness to post-mortem organ donation was 90.7% and to PDS 70.7%. In this cohort, PDS willingness had the strongest association with mature age (> 40 years old; P, 0.0008). Among young adults, willingness to PDS was the lowest among volunteers from technical and business schools and the highest among those from the social sciences (P, 0.009). Respondents from the social sciences were also the most consistent between attitude and behavior with respect to organ donation. A free comment option revealed respondents were interested in the unusual taboo topic. Conclusions A small, but sufficiently large proportion expressed willingness toward PDS. In our university cohort, which was biased in higher education and altruism, mature age and social interest were associated with PDS willingness. (shrink)

Thomas Aquinas presents an account of human immortality and bodily resurrection intended to be both faithful to Christian Scripture and metaphysically sound as following from the Aristotelian view of human nature. One central question is whether a human person persists between death and resurrection by virtue of her soul, given Aquinas’s hylomorphic account of human nature and assertion that a human person is not identical to her soul. Robert Pasnau contends that only a part of a person exists between death (...) and resurrection; whereas Eleonore Stump argues that a person substantially exists, albeit deficiently, during the interim period as composed of, but not identical to her soul. In this essay, I will adjudicate this dispute through textual and metaphysical analysis. (shrink)

This paper is devoted to the deliberations on the vision of communist society as the phase of modernity. Author argues that the modern communism was nothing more than dusted offset of ideas inapplicable to the current circumstances. But there is something more important than disparagement of communism in itself. In critical analysis of modernity as some kind of „response to inefficiency of ancien régime” the author presents evidence to social reforms bounded up with the appearance of capitalism. Modernity in Bauman’s (...) paper is presented as an inevitable confrontation between Marxist prophesy about revolution of the proletariat and socio-political aspects of capitalist order which undermined theoretical principles of socialism and its strategy. Despite the critical commentaries on the communist regime, author ponders on the substantial promise of communism in itself, which realized its potential in the past and in the globalized world is one of the most significant aspects to discussion and the crux of the contemporary reflection.Key words COMUNISM. (shrink)

Recent advances in medical technology have provided healthcare staff with the possibility of maintaining the life of a brain-dead pregnant woman on life-support in order to achieve a successful delivery of the foetus. Management of Post-Mortem Pregnancy examines the legal and ethical difficulties surrounding such post-mortem management.

Parents of children who died following complex heart surgery have recently discovered that organs were removed and retained in post-m.

Faithful persons tend to relate to their religious beliefs as truth claims, particularly inasmuch as their beliefs have soteriological implications for those of different religions. For Christians the particular claims which matter most in this regard are those made by Jesus of Nazareth and his claims are primarily relational in nature. I propose a model in which we understand divine grace from Jesus as being mediated through relational knowledge of him on a compassionately exclusivist basis, including post-mortem. Supporting (...) this model, I draw from Eleonore Stump’s hypothesis in her 2018 Atonement that the crucifixion of Jesus opens the divine psyche to all human psyches sufficiently for salvific mutual indwelling to occur, and from Gavin D’Costa’s conception of the descensus Christi ad inferos as the mechanism for grace’s accessibility post-mortem presented in his 2009 Christianity and World Religions. This model seeks to address ongoing, justified pastoral concern for the soteriological status of non-Christians while still treating Christianity as objectively true. (shrink)

Background: Post-mortem needle biopsies have been used in resource-poor settings to determine cause of death and there is interest in using them in Bangladesh. However, we did not know how families and communities would perceive this procedure or how they would decide whether or not to consent to a post-mortem needle biopsy. The goal of this study was to better understand family and community concerns and decision-making about post-mortem needle biopsies in this low-income, predominantly (...) Muslim country in order to design an informed consent process. Methods: We conducted 16 group discussions with family members of persons who died during an outbreak of Nipah virus illness during 2004-2008 and 11 key informant interviews with their community and religious leaders. Qualitative researchers first described the post-mortem needle biopsy procedure and asked participants whether they would have agreed to this procedure during the outbreak. Researchers probed participants about the circumstances under which the procedure would be acceptable, if any, their concerns about the procedure, and how they would decide whether or not to consent to the procedure. Results: Overall, most participants agreed that post-mortem needle biopsies would be acceptable in some situations, particularly if they benefitted society. This procedure was deemed more acceptable than full autopsy because it would not require major delays in burial or remove organs, and did not require cutting or stitching of the body. It could be performed before the ritual bathing of the body in either the community or hospital setting. However, before consent would be granted for such a procedure, the research team must gain the trust of the family and community which could be difficult. Although consent may only be provided by the guardians of the body, decisions about consent for the procedure would involve extended family and community and religious leaders. Conclusions: The possible acceptability of this procedure during outbreaks represents an important opportunity to better characterize cause of death in Bangladesh which could lead to improved public health interventions to prevent these deaths. Obstacles for research teams will include engaging all major stakeholders in decision-making and quickly building a trusting relationship with the family and community, which will be difficult given the short window of time prior to the ritual bathing of the body. (shrink)