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)

A formal Ethics Consultation Service (ECS) can provide significant help to patients, families and hospital staff. As with any other form of clinical consultation, documentation of the process and the advice rendered is very important. Upon review of the published consult documentation practices of other ECSs, we judged that none of them were sufficiently detailed or structured to meet the needs and purposes of a clinical ethics consultation. Thus, we decided to share our method in order to advance the practice (...) of ethics consultation. Here, we describe a method of ECS documentation practice, including use of a formal consult report template, as well as a log for maintaining a chronological record of the consultations performed. These two documents facilitate order and organisation of the ECS. They also enable the ECS to keep an account of professional time and experience, enable quick consult trend assessments (by consult theme or ward, for example) and establish a potential registry of consults for future research study. This method of documentation, we believe, not only contributes significantly to the primary purpose of the consultation—namely, the evincing and sharing of ethical opinion about a case—but also enables consultants to improve their practice and to pursue research on clinical ethics consultation. (shrink)

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)

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)

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.

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)

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)

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

In the setting of transplant medicine, decision making needs to take into account the multiple clinical and psychosocial case variables, rather than turn to arbitrary rules that cannot be scientifically supportedThe yearly demand for liver transplants far exceeds the supply of available organs .1 Additionally, alcoholic cirrhosis has been a controversial indication for transplant as these recipients can be viewed as having caused their own illness—an illness that is preventable by abstaining from alcohol . While not categorically denying liver transplantation (...) to those with alcoholic cirrhosis, many hospitals have incorporated a six month alcohol abstinence criterion 2 in an effort to select optimal candidates. The six month rule has two purposes; namely, allowing the liver a chance to recover in the absence of alcohol , and also observation of the patient to verify that he/she remains alcohol free, with the hope of reducing the risk of relapse. Everhart et al,3 determined that 85% of US liver transplant programmes and 43% of third party payers require a defined period of abstinence—for example, three or six months—as part of the waiting list process.Liver transplantation does not cure alcoholism, as evidenced by the fact that roughly 20% of these patients use alcohol following transplant, with one third exhibiting “repetitive or heavy drinking”.4 Arguments abound as to the scientific merit of a six month abstinence criterion in reducing the risk of alcohol relapse following transplant. Some propose that a minimum of six months abstinence itself predicts a lower relapse rate,5 while others argue that six months is not predictive or that other factors—for example, illicit drug use—in combination with a minimum number of months abstinent is predictive.6,7 Even the United …. (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)

Objective: To provide an ethical analysis of whether the Ethiopian and Tanzanian national HIV/AIDS treatment guidelines can be considered legitimate and fair rationing tools.Method: Qualitative study and ethical analysis involving guideline documents and interviews with nine key members involved in the development of the guidelines. The analysis followed an editing organising style. The theoretical framework was a guideline-specific framework based on theories of just resource allocation in healthcare and conditions that ensure fair processes in guideline development. According to this framework, (...) legitimate rationing requires reasons for patient selection to be explicit, public and relevant, and decisions must be open to question and revision.Results: The only explicit rationing criteria that both guidelines recommended were clinical antiretroviral treatment indications. Explicit non-clinical rationing criteria were expressed in a separate Ethiopian implementation guideline. Neither of the guideline development processes fully satisfies minimal requirements of procedural fairness. There is a lack of transparency. The reasons for decisions are rarely given and are not publicly available. This reduces the opportunity for public questioning, debate and revisions. The guidelines were based on expert opinion and consensus. Recommendations from the WHO were copied without much discussion, disagreement or adjustment.Conclusions: The two national HIV treatment guidelines discussed are de facto mechanisms for rationing but were developed using methods that do not fully satisfy the requirements of fair processes. (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)