As a patient approaches death, family members often are asked about their loved one’s preferences regarding treatment at the end of life. Advance care directives may provide information for families and surrogate decision makers; however, less than one-third of Americans have completed such documents. As the U.S. population continues to age, many surrogate decision makers likely will rely on other means to discern or interpret a loved one’s preferences. While many surrogates indicate that they have some knowledge of their loved (...) one’s preferences, how surrogates obtain such knowledge is not well understood. Additionally, although research indicates that the emotional burden of end-of-life decision making is diminished when surrogates have knowledge that a loved one’s preferences are honored, it remains unclear how surrogates come to know these preferences were carried out. The current study examined the ways that next of kin knew veterans’ end-of-life preferences, and their ways of knowing whether those preferences were honored in Veteran Affairs Medical Center inpatient settings. (shrink)

Kurrâ’ya nispet edilen aynı kelimelerdeki edâ farklılıklarının tartışmalara sebep olmasından ötürü kıraat ihtilafı olan kelimelerde ihticâc yapılmasına gereksinim duyulmuştur. Delil getirmek manasında kullanılan ihticâc kavramı, kıraat ihtilafları için söz konusu olduğunda ise kıraat ihtilaflarının sıhhat zemininin ortaya konması kastedilmektedir. Ayrıca 2. asrın sonlarında kıraat tevcîhlerinin yapıldığı müstakil eserler ortaya çıkmakla birlikte kıraat alan yazınına ait genel telifatlarda da kıraat ihticâclarının yapıldığı görülmektedir. Kıraat müelliflerinden biri olan İbnu’l-Cezerî de Neşru’l-ḳırââti’l-‘aşr adlı eserinde zaman zaman kıraat ihticâcına yer vermektedir. Mezkûr eserdeki kıraat ihticâcları (...) hakkında tespit edilebildiği kadarıyla yapılmış tek bir çalışma bulunmaktadır. Fakat bu çalışmada, kıraatten ve bunun dışındaki disiplinlerden yeterince istifade edilmediği belirlenmiştir. Ayrıca selef ulemasının Neşru’l-ḳırââti’l-‘aşr adlı esere ihticâc konusunda etkisi özelinde bir çalışmaya da rastlanmamıştır. Buradan hareketle elinizdeki bu çalışmada, İbnu’l-Ce-zerî’nin kıraat ihticâcına dair uygulamaları Neşru’l-ḳırââti’l-‘aşr adlı eser özelinde incelenmiş, me‘âni’l-Kur’ân ve me‘âni’l-kıraat literatürlerinin ortaya çıktıkları dönem dikkate alınarak h. 2.-4. asırlarda kaleme alınan bu literatürlere ait eserlerin İbnu’l-Cezerî’ye ait kıraat tevcîhlerine etkisinin olup olmadığı araştırılmıştır. Çalışmanın neticesinde İbnu’l-Cezerî’nin yaptığı kıraat tevcîhlerinden ele alınanların bir kısmına, söz konusu üç asırda kaleme alınan me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında ekseriyetle yer verilmediği saptanmıştır. İbnu’l-Cezerî’nin ise kıraat ihtilafının olmadığı yerlerde dahi ilgili edâ için ihticâc yaptığı müşahede edilmiştir. Buna ilaveten İbnu’l-Cezerî’nin Neşr’de yaptığı ihticâc uygulamalarının me‘âni’l-Kur’ân ve me‘âni’l-kıraat telifatında yapılan ihticâc işlemleriyle benzeştiği görülmüştür. Yine Neşr’in tevcîh eseri olmaması hasebiyle de İbnu’l-Cezerî tarafından yapılan ihticâcların ihtiyaç merkezli olarak kendini gösterdiği belirlenmiştir. (shrink)

Background Professional autonomy, which directly affects the quality of professional nursing in patient care, and cognitive flexibility, which is an important factor for adaptation to change and developing nursing roles, are important concepts for nursing. Research objectives This research was carried out to determine the effect of cognitive flexibility on attitudes towards professional autonomy in nurses. Research design This was a descriptive study. Participants and research context The research was conducted with 415 nurses working in a city hospital of a (...) province, meeting the inclusion criteria and agreeing to participate in the study. A questionnaire form, The Cognitive Flexibility Inventory (CFI), and the Attitude Toward Professional Autonomy Scale for Nurses (APASN) were used to collect data. Ethical considerations Ethical approval was obtained from the university ethics committee before starting the study. Institutional permission was obtained from the city hospital where the study was conducted. Electronic informed consent was obtained from the nurses included in the study. Findings In the study, the mean CFI score was 80.62 ± 11.55 and the mean APASN score was 70.42 ± 18.79. There was a weak positive correlation (r = 0.270; p < 0.05) between CFI and APASN scores. Moreover, the effect of the CFI mean score on the APASN mean score was found to be statistically significant (β = 0.278; p < 0.001). Furthermore, CFI explains 7.7% of APASN. Conclusion In the study, nurses’ attitudes towards professional autonomy and cognitive flexibility scores were found to be at a good level. Cognitive flexibility has a positive effect on attitudes towards professional autonomy. Interventional studies that will increase the level of cognitive flexibility are recommended in the development of nurses' attitudes towards professional autonomy. (shrink)

Social media applications such as Twitter, YouTube and Facebook have attained huge popularity, with more than three billion people and organizations predicted to have a social networking account by 2015. Social media offers a rapid avenue of communication with the public and has potential benefits for communicable disease control and surveillance. However, its application in everyday public health practice raises a number of important issues around confidentiality and autonomy. We report here a case from local level health protection where the (...) friend of an individual with meningococcal septicaemia used a social networking site to notify potential contacts. (shrink)

Background and objectives: Definitions of medical futility, offered by healthcare professionals, bioethicists and other experts, have been rigorously debated by many investigators, but the perceptions of patients of futility have been explored only by a few. Patients were allowed to discuss their concerns about end-of-life care, so that their ideas about treatment futility or utility could be extrapolated by us.Methods: In this cross-sectional study, in-depth, semistructured interviews were conducted with 30 elderly people who were receiving outpatient care in a large, (...) urban Veterans Affairs medical centre in the US. Each of their healthcare providers was also interviewed. Participants were asked to consider four terms commonly used in advance directive forms and to discuss what these terms meant to them. Audiotapes of the open-ended interviews were transcribed and responses were coded and categorised by constant comparison, a commonly used qualitative method.Results: The following four factors were taken into account by the participants when discussing end-of-life interventions and outcomes: expected quality of life; emotional and financial costs of treatment; likelihood of treatment success; and expected effect on longevity.Conclusions: Although the terms “utility” or “futility” were not generally used by the participants, segments of speech indicating their perceptions of these terms were identified. Treatment was not always discussed in the same way by patients and providers, but seemed to reflect the same four concerns. Therefore, it may be fruitful for providers to focus on these concerns when discussing end-of-life treatment options with their patients. (shrink)

There are a number of problematic features within the current treatment of time in physical theories, including the “timelessness” of the Universe as encapsulated by the Wheeler–DeWitt equation. This paper considers one particular investigation into resolving this issue; a conditional probability interpretation that was first proposed by Page and Wooters. Those authors addressed the apparent timelessness by subdividing a faux Universe into two entangled parts, “the clock” and “the remainder of the Universe”, and then synchronizing the effective dynamics of the (...) two subsystems by way of conditional probabilities. The current treatment focuses on the possibility of using a realistic clock system; namely, a coherent-state description of a damped harmonic oscillator. This clock proves to be consistent with the conditional probability interpretation; in particular, a standard evolution operator is identified with the position of the clock playing the role of time for the rest of the Universe. Restrictions on the damping factor are determined and, perhaps contrary to expectations, the optimal choice of clock is not necessarily one of minimal damping. (shrink)

Electrical membrane fluctuations are treated as due to sequences of ion pulses passing through the membrane. A mathematical procedure is developed which permits calculation of the power spectra for sequences in which the pulses can have Poisson or non-Poisson interval distributions and may or may not have coupled pulse parameters. It is shown that there probably exist specific sequences which are intimately related to membrane 1/f and burst noise. In particular, emphasis is placed upon sequences with non-Poisson interval distributions and (...) their implications for membrane structure. A variety of experiments is suggested which will help to distinguish among the alternatives presented. (shrink)

In humanities departments across the country Allan Bloom is condemned and reviled—but for what misconduct? The present investigation into our distorted view of Bloom begins by reframing his transgressions. Bloom has offended eminent philosophy professors by boosting students' desire for a philosophic education. He has emboldened promising young people by teaching them to bear up under the deforming forces of convention and corruption and edge their way towards the question, ‘How should I live my life?’ A philosophic education as Bloom (...) sees it ‘means precisely helping students to pose this question to themselves, to become aware that the answer is neither obvious nor simply unavailable, and that there is no serious life in which this question is not a continuous concern’. The philosopher's interests are not shared by most people. Hostility to philosophy is the natural condition of man. This surprising fact, plainly stated, invites so much anger that Bloom—standing in for the philosopher—is forced to defend himself. The story of Bloom, like Socrates', gives an account of philosophy's emergence, distinctive features and always imaginable suppression. Plato's artful writing captured Socrates' way of life for posterity. This essay explores the nature and function of Bloom's bestselling book The Closing of the American Mind (1987), as well as the purpose of Saul Bellow's final novel, Ravelstein (2000), a fictive account of Bloom's life and death. Together these books amount to the true Apology of Allan Bloom. (shrink)

Yūsuf al-Ardabīlī is one of the Shāfiʿī jurists who lived in Azerbaijan in the 8th century of Hijri. This scholar, whose birth date we couldn’t find any information about, even though it has been searched in both local and foreign literature, died in Ardabīl in the year 799/1397 as bibliographical scholars agreed on. Ardabīlī is a person known by his work al-Anwār li-aʿmāl al-abrār, which he dedicated to Shāfiʿī jurisprudence, and someone with jurisprudential knowledge whom Shāfiʿī jurists benefit from. In (...) his work on jurisprudence (furūʿ al-fiqh), al-Anwār, he discussed the issues without delving deeply into evidences and partially mentioned uṣūl al-fiqh. Yūsuf al-Ardabīlī addressed the topics in his work by classifying them as acts of worship (ʿibādāt), transactions (muʿāmalāt), inheritance (farāʾiḍ), marriage and divorce (munākaḥāt-mufāraqāt), punishments (ʿuqūbāt), the conduct of judges (adab al-qāḍī), and freeing slaves (ʿitq). Moreover, in his work, he provides explanations that shed light on recent studies by addressing the subject of fatwā in detail. By addressing the fatwā institutions, Ardabīlī includes information on topics like the etiquette of istiftāʾ, fatwā with sharīʿah tricks (ḥiyal sharʿiyyah), and exceptions in divorce (ṭalāq). Because no academic studies have been done on his explanations in this field, the subject requires further attention. Additionally, presenting his explanations on the fatwā institution to the scholarly community is greatly important for shedding light on future studies. Islamic jurists recognize fatwā activities as a duty that requires responsibility in terms of religion and worldly life. Therefore, they do not favor the participation of those who lack knowledge and the capability of deducing religious rulings from sharīʿah evidences in fatwā activities.This study aims to contribute to the Islamic jurisprudence literature by addressing the principles of fatwā procedure through Ardabīlī’s perspective in his work, al-Anwār. (shrink)

Patrick Lee, professeur de philosophie à l'Université franciscaine de Steubenville, vient de publié un livre excellent sur la question de l'avortement : Abortion and Unborn Human Life . L'A. en présente le contenu et en commente l'actualité ainsi que la pertinence.

Recent research has highlighted the application of moral foundations theory in counseling settings as it can provide a complex framework to understand the concept of morality, moral diversity, values, and decision-making processes. The emergence and development of social justice and multicultural counseling competencies has particularly raised important concerns regarding the application of values in counseling. The present study examined moral foundations as predictors of counseling students’ universality – diversity orientation. Three hundred and fifty-six counseling students at the undergraduate level participated (...) in the research (Mage = 21.86, SD = 2.26, 77.1% female). The results of a series of multiple regression analyses indicated that individualizing foundations were stronger predictors of universality – diversity orientation. Fairness was the only significant predictor of the behavioral aspect of universality – diversity orientation (diversity of contact), while fairness and care robustly predicted the cognitive aspect of universality – diversity orientation (relativistic appreciation). Care, authority, and loyalty significantly predicted the emotional aspect (comfort with differences). Overall, these results suggest that the participating counselor candidates were more likely to rely on individualizing foundations for cultural competence. (shrink)

Spinoza has been appropriated as a philosophical forefather of deep ecology. I identify what I take to be the relevant components of Spinoza ’s metaphysics, which, at face value, appear to be harmonious with deep ecology’s commitments. However, there are central aspects of his moral philosophy which do not appear to be “environmentally friendly,” in particular the sentiments expressed in the Ethics IV35C1 and IV37S1. I describe environmental ethics’ treatment of these passages and then indicate what I take to be (...) a more satisfactory route toward “ecologizing Spinoza.”. (shrink)

L'auteur accepte la position d'auteurs comme Germain Grisez et John Finnis selon laquelle l'immoralité de l'homosexualité est connectée en quelque manière au dualisme esprit-corps de la recherche du plaisir. Il s'efforce pourtant, par une analyse de ce que Platon et Aristote disent au sujet du plaisir dans le Philebus et l'Ethique de Nichomaque, de décrire le genre - ou, plutôt, les genres - de dualisme dont il s'agit. Le résultat, pense-t-il, est une analyse qui évite la position insoutenable selon laquelle (...) le plaisir n'est en aucune manière à être poursuivi pour lui-même. Il est d'accord avec Aristote et Thomas d'Aquin que le plaisir est «une sorte de fin», qui reçoit son intelligibilité complète seulement lorsqu'elle accompagne des pratiques humaines pleinement intelligibles de façon isomorphique. (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

In addition to the transmission of the science of hadith from the Eastern Islamic world to the west, particularly to Andalusia, a rich literature also developed in Andalusia. Therefore, the development of the science of hadith and hadith methodology in the Andalusian region and the impact of scholars from that region on these sciences is an important issue that deserves attention. This article examines how the intellectual atmosphere of Andalusia was enriched by the hadith works that came from the East (...) and the scholarly activity these works generated. It also addresses the hadith methodology literature that emerged in the Andalusian region and the reflections of this literature in the hadith methodology works of the From this perspective, the study first briefly highlights the hadith and hadith methodology literature that reached Andalusia from the Mashriq region, followed by the works written by Andalusian scholars that contributed to the hadith methodology literature. Subsequently, the influence of hadith methodology works by hadith scholars from the Eastern Islamic world on Andalusian literature is examined. Furthermore, the study evaluates how Andalusian scholars were referenced in the Mashriq hadith methodology literature and their influence on these works. Through this analysis, the interaction between the Mashriq and Andalusian regions within the context of hadith methodology is demonstrated. The contribution of Andalusian scholars to the hadith literature by enriching the knowledge and expertise they received from the East with their interpretations and original works increased the importance of the region in the Islamic world. Additionally, the influence of the hadith methodology works written in Andalusia on Eastern literature reveals the reciprocal nature of cultural interaction. (shrink)