Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Torah, the name of the first five books of the ?sacred history? comprised by the Hebrew Bible, tends to be translated as ?Law? and to be affiliated with the separating ?Law of the Father.? But Torah means ?teaching.? Venerable tradition allies this teaching with feminine Wisdom, ?a tree of life.? Theories of poetic language elaborated by such scholars as Julia Kristeva and Hélène Cixous facilitate discovering beneath the Torah's fractured and labyrinthine surface a way of return to the mother. This (...) way is embodied in the inversions, textuality, and concentricity of the rhetorical trope of chiasmus, which exceeds the bounds of the Law to provide a form for the expression of ?woman's desire? and so for the feminine text. Exploring as such the doubly chiastic poem in which, when naming woman in Eden, a human being (adam) changes its name to man (iysh) challenges man's biblical history, while restoring the memory of interconnection with the mother and all life. Reduplications of this transformative moment expand upon sacred history in terms of the Torah's central injunction to love one's neighbor as oneself. (shrink)

The founders of reformational philosophy, H. Dooyeweerd and D.H.Th. Vollenhoven, each published in short succession, viz. 1949 and 1950, a voluminous study in the history of philosophy. Whoever reads both works is struck by the remarkable differences in treatment. In this contribution these differences are analysed, but there is also indication of agreement. The article ends with a number of conclusions based on the analysis.

Commentary and supercommentary, with text, on Īśvarapratyabhijñā, classical verse work, expounding the Trika philosophy in Kashmir Sivaism, by Utpala, fl. 900-950.

This is a review of the biographic drama Love and Mercy. More than a story of the evolution of The Beach Boys, it is the story of the lead Beach Boy, Brian Wilson, and his struggle with substance abuse, mental illness, family stress, emerging love, and a controlling psychologist. Interwoven are many bioethics themes, including the doctor–patient relationship, conflict of interest, autonomy, and patient welfare. For those unaware of the sadness and torment running directly alongside the sunny, bubbly life of (...) The Beach Boys, this film is an eye-opener. It is also a great reminder of the importance of boundaries between clinicians and their patients. (shrink)

Objective We sought to understand ethics and education needs of emergency nurses and physicians in paediatric and adult emergency departments in order to build ethics capacity and provide a foundation for the development of an ethics education programme. Methods This was a prospective cross-sectional survey of all staff nurses and physicians in three tertiary care EDs. The survey tool, called Clinical Ethics Needs Assessment Survey, was pilot tested on a similar target audience for question content and clarity. Results Of the (...) 123 participants surveyed, 72% and 84% of nurses and physicians fully/somewhat agreed with an overall positive ethical climate, respectively. 69% of participants reported encountering daily or weekly ethical challenges. Participants expressed the greatest need for additional support to address moral distress, conflict management with patients or families and resource issues. Of the 23 reported occurrences of moral distress, 61% were associated with paediatric mental health cases. When asked how the ethics consultation service could be used in the ED, providing education to teams was the most desired method. Conclusions Nurses report a greater need for ethics education and resources compared with their physician colleagues. Ethical challenges in paediatric EDs are more prevalent than adult EDs and nurses voice specific moral distress that are different than adult EDs. These results highlight the need for a suitable educational strategy, which can be developed in collaboration with the leadership of each ED and team of hospital ethicists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Interpreting a Classic: Demosthenes and His Ancient CommentatorsK. KapparisCraig A. Gibson. Interpreting a Classic: Demosthenes and His Ancient Commentators. Berkeley and Los Angeles: University of California Press, 2002. xii + 261 pp. Cloth, $55.This book aims to provide a comprehensive account of the ancient scholarship on Demosthenes. Gibson points out that Demosthenes was widely read in later antiquity, and this created the need for linguistic and historical commentaries (...) on his speeches. Of these, some have partially survived on papyrus, while excerpts have also been preserved in later lexicographers and the Byzantine scholia found in the margins of Demosthenic manuscripts. The purpose of Gibson's study is to clarify some confusing and difficult issues related to the ancient scholarship on Demosthenes and to provide the text and commentary on the main sources. [End Page 481]Gibson's introduction includes an informative outline of key parameters in the debate, such as the accuracy of excerption from an ancient commentary, the significance of date and place, and the intended readership of these commentaries. The first chapter discusses the form and transmission of ancient commentaries, their relation with lexicographic works, and their impact on the Byzantine scholia. Gibson convincingly argues that the scholia do not reveal direct dependency upon the surviving ancient commentaries but were compiled from lexicographic works such as Harpocration or the Suda, and possibly other works lost for us. The second chapter deals with the sources, critical agenda, and readership of the ancient commentaries. Here, Gibson provides a clear account of the purposes and guiding principles behind the composition of these works. He concludes that ancient commentators were familiar with interpretative problems of the Demosthenic text and tried to explain allusions and references to specific events, people, and places and also provide semantic, etymological and textual explanations of difficult or unusual terms. In this and the third chapter, Gibson discusses in considerable detail the scholarship on Didymus. He rejects the view that Didymus was merely a filter for a "golden era" of Alexandrian scholarship and argues that his prominent position as a commentator is due to the vast quantity of his work and its impact on later scholars. In sum, the first part of the study offers an informative account of ancient Demosthenic scholarship written in a clear and accessible style.The second part of the book contains the texts of ancient commentators of Demosthenes, with English translations, and also linguistic and historical commentary. In the translation, Gibson chooses to leave out many lines from the papyrus texts where only single words or fragments of words are legible; he translates only the most extant sections of the text. This is a valid choice, but readers should be aware of the fact that many important details may be hiding in the leftovers and fragments that have been omitted. Gibson does not provide the readily available text of P.Berol.inv. 9780, the most extensive surviving work of Didymus, while he cites the rest of the texts from reliable modern editions. In the commentary there are interesting discussions on the Spartan mora, the building of the Parthenon, the Helliastic courts, and many other topics noted by the ancient commentators on Demosthenes. An appendix presents and discusses P.Lond.Lit. 179, a prologue and commentary on Dem. 21. The reader will probably find useful the indexes and rich bibliography provided in the last part of this study.Gibson's commentary is certainly thorough but contains a number of errors in detail, and important bibliography is missing on individual topics. For example:Page 113: Gibson adopts the text of Pearson-Stephens. The adjective is, or, as here (later Greek),. Therefore the text should be (see LSJ s.v.).Page 120: Gibson has missed several important contributions to the issue of the theoric fund in recent years (M. H. Hansen, GRBS 17 [1976] 235-46; E. M. [End Page 482] Harris in E. M. Harris and R. Wallace, eds., Transitions to Empire: Essays in Greco-Roman History 360-146 B.C., in Honor of E. Badian [Norman, Okla., 1996]; C. Carey, Apollodoros Against Neaira [Warminster, 1992] 152-57). As a result, his note on P.Berol. 9780, Col. 8.32-44 is... (shrink)

Tertiary healthcare ethics (HCE) consultation occurs when an HCE consultant at a healthcare facility requests guidance from one or more senior HCE consultants who are not members of that facility’s HCE consultation service. Tertiary HCE consultants provide advanced HCE guidance and/or mentoring to facility (secondary) HCE consultants, mirroring healthcare consultation in clinical practice. In this article, we describe advantages and challenges of providing tertiary HCE consultation through a hub-and-spoke model administered by a national integrated HCE service.

In this close analysis of Hume’s moral psychology, John Bricke treats Hume as a thoroughly systematic thinker who aims for a comprehensive theory of mind. Bricke seeks to reveal the systematic structure of Hume’s thought by a process he calls “regimenting” the text. Bricke also has the aim of placing Hume’s theory in the context of contemporary action theory, the terms of which are inspired in large part by Davidsonian analyses.

Malgré l’accent porté sur les aspects publics, ritualistes de la pratique ancienne, les images et les objets grecs attestent des rencontres privées et personnelles avec des dieux. Cet article recourt à la documentation archéologique pour explorer les traits personnels, vécus, de la vie religieuse de l’Athènes attique. Bien qu’elles soient parfois décrites comme des « transactions », le développement des relations personnelles avec les dieux et de la manipulation de choses matérielles semble être l’un des éléments les plus saillants de (...) l’expérience religieuse des Grecs. Cette étude examine la matérialité religieuse et l’attitude dévotionnelle telle qu’elle existait en dehors de systèmes rituels organisés et des espaces sacrés. La documentation grecque suggère que la culture matérielle était « de la religion » sous forme physique et une part des méthodes des dévots pour développer des relations remarquablement intimes avec des figures sacrées dans un processus appelé « dévotionalisme ». Les femmes athéniennes utilisaient un objet commun de la vie quotidienne comme une forme de médium religieux: la tainia (ruban). Les femmes l’employaient dans tous les lieux de leur vie, y compris les maisons, les lieux de fêtes et les sanctuaires. La céramique suggère que les Athéniens ont employé de tels média dévotionnels pour interagir avec les défunts dans les cimetières. (shrink)

The article is devoted to almost unknown monastery of the Russian Orthodox Church, a Holy Trinity Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia that was one of the important pilgrimage places of the royal family in the 17th century. Despite the fact that the monastery was founded in the reign of Tsar Alexei Mikhailovich, it is an important link in the historical and cultural development of our Fatherland, primarily because the extant architectural monuments of outstanding artistic qualities. That is why the architectural ensemble (...) of the monastery occupies a prominent place in the history of Russian culture. In addition, Novo-Solovetskaya poustinia is an important historical object providing data on the development of Russian spiritual and artistic culture of the late seventeenth century. The question of cultural-historical and social roles that Orthodox monasteries played in the history of Russia is still not sufficiently studied is. The modern development of the Russian state cannot be complete without the restoration of the positive legacy that has been lost in our culture and morality. In this regard, the study of development and formation of the Orthodox monastic culture may fill this gap. Historical development of the Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia, its architecture can contribute to the restoration of our historical memory, which is an important factor in the revival of our national identity. The author of the article also tells about the history of monastery in tough years of godless power and about the people, who died for their faith and who are called now the new martyrs. (shrink)

Изложено понимание рассуждения как метода рационального познания, рассмотрены его разновидности: аргументативные, интерпретативные, прогностические, квалификационные и вычислительные. Для аспирантов и соискателей.

Passive frame theory attempts to illuminate what consciousnessis, in mechanistic and functional terms; it does not address the “implementation” level of analysis (how neurons instantiate conscious states), an enigma for various disciplines. However, in response to the commentaries, we discuss how our framework provides clues regarding this enigma. In the framework, consciousness is passive albeit essential. Without consciousness, there would not be adaptive skeletomotor action.

Self-understanding is to a great extent defined by narrative: who we are as human beings is determined by the stories we, and others, tell about ourselves. Yet many are unable to compose coherent personal narratives, as their experiences do not fall within the scope of an accepted conceptual framework. Survivors of trauma are particularly apt to fall into this “narrative rift,” where there can be no words to describe, and hence can be no assimilation of, their experiences. Using the example (...) of child sexual abuse, and drawing on the work of Bass, Spence, Schafer, and Guignon, I propose an examination of the nature of narrative fragmentation itself. Philosophical counselling may succeed where psychoanalysis might not: for where the latter has theoretical commitments to specific narratives, the former, through its reluctance to force epistemological or metaphysical assumptions on the narrator, may well facilitate a more comprehensive self-understanding. (shrink)

Les fouilles effectuées au cours de ces dernières dizaines d’années, ont modifié profondément le tableau qu’on se faisait de la préhistoire chinoise. Au début du xxe siècle, les savants les plus connus pouvaient encore mettre en doute l’existence d’une époque néolithique chinoise — mais depuis lors, l’activité de l’archéologie a mis à jour un vaste matériel et paléolithique et néolithique. Le présent article, extrait du premier volume d’une histoire économique et sociale de la Chine, donne une vue d’ensemble du matériel (...) nouvellement acquis et cherche à le mettre en valeur pour une considération sociologique.L’homo pekinensis, l’ancien habitant de la Chine paléolithique du Nord connaissait le feu ; il se servait d’instruments et d’armes en pierre travaillée. Aux deux degrés de son évolution de chasseur primitif et de chasseur évolué, correspondent deux degrés de perfection de ces instruments. Il semble bien que les prisonniers aient été tués (et mangés?) sans distinction d’âge et de sexe. Les chasseurs ne sauraient que faire du travail d’esclave.Vers la fin de l’époque néolithique chinoise se produisit un épanouissement que la rare perfection de la céramique „rouge“ et „noire“ indique assez bien. La filiation somatique de l’homo pekinensis et du Chinois des époques ultérieures est probable ; il semble hors de doute que l’homme de l’époque néolithique soit du même type que celui de la Chine historique. Primitivement, l’agriculture (à la houe) était faite par les femmes, qui en même temps confectionnaient à la main — par la suite au moyen d'une plaque très simple — la céramique,,rouge“ ; les hommes continuaient à s'occuper de la chasse et de la pêche. Dès lors apparaît, encore qu'assez vaguement, une civilisation démocratique et paysanne, caractérisée probablement par des éléments matriarchaux. Vers l'époque de la céramique „noire“ se produit la transition vers l'élevage et à la céramique qui connaît alors le tour de potier — ces deux sortes de travaux incombent aux hommes. L'agriculture se fait plus intense, c'est peut-être ici qu'il convient de supposer les premiers débuts de la construction de terrasses et de l'irrigation. Les esclaves trouvent un emploi, une différenciation sociale se produit, c'est l'origine des villes. La société agraire primitive fait place à un ordre nouveau. Celui-ci s'exprime socialement parlant par une noblesse de clan primitive, politiquement par l'État.Les découvertes les plus récentes de l'archéologie chinoise apportent de nombreuses preuves pour l'évolution telle qu'elle vient d'être esquissée. L'analyse des mythes archaïques et des contes populaires de la Chine confirme, par la suite, au moyen de l'anthropologie ce que l'étude avait jusqu'ici rendu hautement probable par les méthodes de l'archéologie.Die Ausgrabungen der letzten Jahrzehnte haben das Bild der chinesischen Frühgeschichte grundlegend geändert. Während noch zu Anfang des 20. Jahrhunderts führende Gelehrte die Existenz eines chinesischen Neolithikums bezweifelten, hat seither die Tätigkeit der Archäologie sowohl paläolithische wie neolithische Funde in grosser Reichhaltigkeit zutage gefördert. Der vorliegende Aufsatz — Sektion I des ersten Bandes einer Wirtschafts-und Sozialgeschichte Chinas — gibt einen Überblick über das neu gewonnene Material und sucht es sozialwissenschaftlich auszuwerten.Homo pekinensis, der (früh) altsteinzeitliche Bewohner Nordchinas kannte das Feuer ; er benutzte Werkzeuge und Waffen aus behauenem Stein. Zwei Stufen der Bearbeitung seiner Geräte deuten zwei Stufen seiner ökonomischen Entwicklung an, die des „niederen“ und des „höheren“ Jägertums. Gefangene scheinen ohne Unterschied von Alter und Geschlecht getötet (und verzehrt?) worden zu sein. Jäger haben für Sklavenarbeit keine Verwendung.Reich entwickelt ist Chinas (spätes) Neolithikum, dessen „rote“ und „schwarze“ Töpferei von seltener Vollkommenheit ist. Der Zusammenhang des homo pekinensis mit den späteren Chinesen ist somatisch wahrscheinlich, die Zugehörigkeit der Bewohner des chinesischen Neolithikums zu dem geschichtlichen Chinesentum scheint ausser Zweifel. Ursprünglich wurde offenbar der Ackerbau (Hackbau) von Frauen betrieben, die zugleich mit der Hand — und später mit einem einfachen Drehrad — die „rote“ Töpferei herstellten, während die Männer fortfuhren zu jagen und zu fischen. Das Bild einer primitiven demokratischen Dorfkultur mit vermutlich mutterrechtlichen Zügen wird andeutungsweise sichtbar. Es folgt zur Zeit der „schwarzen“ Töpferei der Übergang zur von Männern betriebenen Viehzucht und zu einer mit der Töpferscheibe von Männern durchgeführten Töpferei. Der Ackerbau wird intensiver, die ersten Anfänge von Terrassenbau und Bewässerung liegen vielleicht hier. Sklaven werden verwendbar, soziale Differenzierung tritt ein. Städte entstehen. Die primitive Agrargesellschaft verwandelt sich in eine Ordnung neuer Art, deren sozialer Ausdruck ein primitiver Clan-Adel, deren politischer Ausdruck der Staat ist.Die jüngsten Entdeckungen auf dem Gebiete der chinesischen Archäologie erbringen zahlreiche Beweise für einen derartigen Entwicklungsgang. Die Analyse von Chinas archaischen Mythen und Volkserzählungen bestätigt im Fortgang der Untersuchung mit den Mitteln der Anthropologie, was die hier gebotene Darstellung mit den Methoden der Archäologie bereits in hohem Grad wahrscheinlich gemacht hat. (shrink)

Jehovah’s Witnesses should be required to sign transfusion contracts in order to be eligible for transplant.Human donor organs continue to be in short supply, and many potential transplant recipients die while waiting for an allograft to become available.1 Because the organ supply is so limited and the offering of organs is based on the generosity of patients and families, proper stewardship of these organs is an ethical obligation for transplant teams, as well as organ recipients. Preventable graft loss must be (...) protected against, and factors that foster preventable graft loss—for example, non-compliance must be proactively contemplated when patients are reviewed as potential transplant candidates. Post-transplant treatment refusal is one example of behaviour that can compromise transplant success.JEHOVAH’S WITNESSES AS TRANSPLANT RECIPIENTSIt is widely known that one of the most significant teachings of the Jehovah’s Witness church is abstinence from receiving blood transfusions.2 Believers derive this tenet from the Bible verse: “You are to abstain from …blood”.3 While blood loss is a risk of transplant surgery, some centres do not view patient refusal of blood transfusion as a transplant exclusion criterion. The first published case of transplantation of a Jehovah’s Witness appeared in 1986 from the University of California Los Angeles heart transplant team.4 Since then, numerous other cases have been published, including liver,5 kidney,6 pancreas,6 and lung.7 For experienced centres with superior blood management skills, transplant can indeed be a surgical success; however, optimal blood management before and during surgery are only two thirds of the patient’s clinical time clock. In the remaining third, the post-transplant period, the patient has received his/her organ, yet the potential for clinical need of blood transfusion remains.THE DILEMMAWhether due to postoperative complication, or future illness or trauma, all transplant recipients have …. (shrink)