This paper analyses the relationship between lack and possibilities of bearing witness in a post-historical context. We wanted to see how discussions about indeterminacy and testimony change the way in which we understand possibilities of truth in relation to the confessing subject. The limit of the language of testimony and memory generate experiences of incompleteness and inadequacy which make us negotiate the position of the confessing subject between an impossible historical truth and the non-discursive truth of revelation. We argued that (...) the resistance to representation which drives the language of testimony reflects the improper position of the witness between historicity and existence. There is always an already lost historical event that we have to testify for and that foreshadows possibilities of significance. The witness can only generate discourse from inside a dislocated position which also marks the understanding of revelation. (shrink)

SIRThere are some important flaws in Michael Ardagh's reasoning.11. Cardiopulmonary resuscitation is a “blanket term” for different interventions. Curative and supportive treatments have different ethical contexts and cannot be discussed at the same level. It is imperative to ascribe curative interventions within CPR the same status as any other curative intervention, such as antibiotics for infections or surgery for appendicitis. Then we will be able to discuss the ethical context of purely supportive measures such as chest compressions. To address the (...) “ethics of CPR” is a dangerous misnomer.The preferences of emergency personnel2 suggest the willingness to undergo curative interventions early during CPR, but not protracted supportive interventions. Conversely, withholding curative interventions during CPR should only be considered when any curative treatments would also be withheld.2. Cardiopulmonary resuscitation is performed to offer the patient a benefit. However, CPR as a whole is only marginally effective. …. (shrink)

Religious leaders are being viewed as agents with influence over environmental opinion and attitude building. In public environmental project impact debate the Christian religious leaders may play an increasingly complex role due to their anthropocentric position. Roşia Montană Gold Corporation is such a project where The Romanian Orthodox Church has taken a position right from the beginning. Our study explores the local impact area religious leaders' attitudes as to the mining project in particular and the overall view of environmental concerns (...) in religious sermon in general. Orthodox, Catholic, Reformed and Baptist representatives have been interviewed. The main conclusion we drew is that environmental concerns can create leadership style dissonances between different hierarchical levels of the same religious hierarchies, but with benefits at the communitarian-religious levels. The practical implications that arise from this and the possible directions for future research are outlined in the final chapter of our study. (shrink)

Prioritization in public health has long been contentious, which necessitates ethical discussions. Despite efforts to develop frameworks that address these considerations, universally accepted models remain elusive, leaving decision-makers to manage independently. This study explores the previously underexplored topic of ethical principles guiding prioritization within different domains of health promotion and prevention at a local level. Interviews with decision-makers (n = 21) from Danish municipalities were analyzed thematically to uncover ethical dimensions of local prioritization of public health services. The study showed (...) that when confronted with resource constraints, decision-makers tended to prioritize preventive services for patients, often at the expense of broader health promotional initiatives. This decision appears rooted in ethical principles of assisting individuals who are deemed to be in the most immediate need. Analyzed against principles of justice and the broader literature on prioritization, the results reflect a prioritization common in the hospital sector: the principle of need. This contrasts with broader societal discussions of public health that are often based on principles of maximization of health benefits and equity. The study highlights the importance of weighing diverse ethical principles when prioritizing among and within initiatives and of considering the purpose of different domains of prevention and health promotion. (shrink)

In this paper, I will argue that the current discussions about regulating certain activities concerning the pharmaceutical industry do miss a crucial point. The Pharmaceutical Industry is a story of success, providing a wealth of new discoveries and applied technologies, which have greatly enhanced our lives. The current call for strict regulation of the Pharmaceutical Industry makes the unwarranted assumption that such regulation will not disturb the mechanisms of the Industry’s success. I will claim that a centralised regulation profoundly transforms (...) the direction of travel. I will also claim that the role of the executive in bypassing regulations creates a parallel industry of subsidiary regulations to counter such bypassing. The predictable consequence is the increasing role of central regulatory control and the progressive slowing down of the success of the Pharmaceutical Industry leading towards an undesirable mediocrity. The conclusion I wish to advance is that our choices are not limited to ‘a wild open market’ and ‘a regulated open market’ scenarios, and the strategy to avoid a robustly regulated but mediocre Pharmaceutical Industry may involve ‘non-open market scenarios’ which have so far been absent from the alternatives discussed. (shrink)

In this paper I will briefly discuss flourishing and freedom, relating them to health and disease; discuss the tensions between flourishing and freedom; and exemplify how those discussions are relevant to chronic disease suffering. The concept of freedom has significant connections with the concepts of health, disability and disease. Understanding disease and disability in terms of the loss of aspects of freedom may help our understanding of the suffering that arises from chronic disease. On the other hand, flourishing may require (...) a degree of adversity. Therefore disability and disease may be conducive to flourishing. Flourishing may be understood as subordinated to freedom, as a path to freedom, or as transcending freedom. It is suggested that freedom and flourishing are expressed as mutually enhancing cycles, actualized according to the personal circumstances that will ground their expression. In a distant horizon of innocent spontaneous self-expression, flourishing and freedom may become coincident. Regarding chronic disease as a constraint on ‘species-typical’ abilities to fulfill one’s significant life interests, as well as an unwanted intrusion into the patient’s life, presents chronic disease suffering as a loss of both positive and negative freedom. The conceptual relation between flourishing and freedom will thus organise the possibilities the sufferer sees as open to their self. (shrink)

The present work approaches a series of wide exploratory investigations in the Romanian rural area, most recently in Livezile-Rimetea micro-region (Apuseni Mountains). Within the civil society and public participation debate context, the study focuses on the variable of religious affiliation (orthodox, non-orthodox), which differentiates the real potential public participation at the population level in the studied area. The immediate conclusion to be drawn is that in the differences in religious affiliation induce variations in expressing the civic activism and in the (...) real or the potential public participation. At the end of our study, the paradox of public participation as diminishing factor of the civil society role is taken into account and this concerns new reflections and investigations on the subject. (shrink)

Medical practitioners owe much of the significant progress made in the diagnosis and treatment of disease to industrial research. Hence, co-operation between providers of medical services, most notably medical practitioners, and the pharmaceutical industry is in the best interest of patients. Yet, empirical evidence shows how well-directed influence exerted by the pharmaceutical industry impacts physicians’ decision-making. Profit-motivated inducement by the pharmaceutical industry may expose patients to considerable risks. Against what many think to be based on overwhelming evidence, Joao Calinas-Correia takes (...) the view that the criticism levelled at the pharmaceutical industry as well as the call for transparency in the relationships between physicians and the industry are exaggerated. In his polemic he praises “Big Pharma” as a success and espouses the view that the undesired consequences of its activities are allegedly inherent in the underlying market environment shaped by politics. Moreover, he believes that the proposals made to control and eliminate such undesired effects will lead to mediocrity. Astonishingly, his polemic reaches out to contest the appropriateness of setting rules at all—even if being set by a democratic process. Calinas-Correia’s assertions are based on the wrong premises. They fail to recognize that today individual civil rights and liberties often enough do not have to be defended against encroachments by governmental authorities. Rather, it is incumbent on the state to create rules designed to defend the individual against infringements by overly powerful non-governmental institutions, in our case the medical-industrial complex. Given the power exercised by physicians and the special nature of their role in public health, clear-cut rules have to be enacted and implemented with respect to their relationship to Big Pharma. (shrink)

Medical practitioners owe much of the significant progress made in the diagnosis and treatment of disease to industrial research. Hence, co-operation between providers of medical services, most notably medical practitioners, and the pharmaceutical industry is in the best interest of patients. Yet, empirical evidence shows how well-directed influence exerted by the pharmaceutical industry impacts physicians’ decision-making. Profit-motivated inducement by the pharmaceutical industry may expose patients to considerable risks. Against what many think to be based on overwhelming evidence, Joao Calinas-Correia takes (...) the view that the criticism levelled at the pharmaceutical industry as well as the call for transparency in the relationships between physicians and the industry are exaggerated. In his polemic he praises “Big Pharma” as a success and espouses the view that the undesired consequences of its activities are allegedly inherent in the underlying market environment shaped by politics. Moreover, he believes that the proposals made to control and eliminate such undesired effects will lead to mediocrity. Astonishingly, his polemic reaches out to contest the appropriateness of setting rules at all—even if being set by a democratic process. Calinas-Correia’s assertions are based on the wrong premises. They fail to recognize that today individual civil rights and liberties often enough do not have to be defended against encroachments by governmental authorities. Rather, it is incumbent on the state to create rules designed to defend the individual against infringements by overly powerful non-governmental institutions, in our case the medical-industrial complex. Given the power exercised by physicians and the special nature of their role in public health, clear-cut rules have to be enacted and implemented with respect to their relationship to Big Pharma. (shrink)