We present the case of a 36-year-old woman who has experienced three lost pregnancies; during the most recent loss, a full term pregnancy, she almost died from complications of placental abruption. She is now completing the 34th week of gestation and is experiencing symptoms similar to those under which she lost the previous pregnancy. Despite a lack of specific medical indications, the patient and her husband firmly but politely request that the attending obstetrician/perinatologist perform an immediate cesarean section in order (...) to alleviate the couple’s anxiety about possibly never having a family. Discussing the case are an experienced perinatologist, a neonatologist, a regional perinatal center coordinator, and a clinical ethicist. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

Psychiatric polypharmacy refers to the prescription of two or more psychiatric medications concurrently to a patient. It can be categorised as same-class, multi-class, adjunctive, augmentation and total polypharmacy. Despite advances in psychopharmacology and a better understanding of the principles of therapeutics, its practice is increasing rapidly. The prevalence of polypharmacy in psychiatry varies between 13%-90%. There are various clinical and pharmaco-economic factors associated with it. Dealing with polypharmacy requires an understanding of its associated factors. Education, guidelines and algorithms for the (...) appropriate management of various conditions are effective ways to avoid irrational polypharmacy. (shrink)

In recent decades, advances in information technology have given rise to a post-industrial society in which emphasis on the manufacture of material goods has been supplanted by the creation of intellectual property. Indeed, this new “knowledge economy” can be tracked by the exponential growth in patented products across a range of sectors since the 1980s. According to the United States Patent and Trademark Office, the number of annual patent applications submitted grew from 112,379 to 520,277 over the past three decades, (...) a 464% increase.The transformation in the industrial markets has been accompanied by the rise of a new, global institution for coordinating intellectual property rights : the World Trade Organization. (shrink)

Medical student and resident participation in global health experiences (GHEs) has significantly increased over the last decade. In response to growing student interest and the proven impact of such experiences on the education and career decisions of resident physicians, many medical schools have begun to establish programmes dedicated to global health education. For the innumerable benefits of GHEs, it is important to note that medical students have the potential to do more harm than good in these settings when they exceed (...) their actual capabilities as physicians-in-training. While medical training programmes are beginning to provide students with the knowledge to put their GHEs in context, they must remember that they also bear the responsibility of training their students in a framework to approach these experiences in a principled and professional way. It is necessary that these institutions provide adequate and formalised preparation for both clinical and ethical challenges of working in resource-poor settings. This paper outlines potential benefits and risks of GHEs and delineates recommendations to some of the current issues. (shrink)

The Handbook considers the State of Qur'anic Studies; Historical Setting; Textual Transmission and Codification; Structural and Literary Features; Content and Concepts; Applied Discourses; and an Overview of Qur'anic Interpretation.

The present commentary on it greatly contributes to the understanding of thisvery important work. In fact, it is a good expositary commentary, lucidly explaning the knotty points. It evinces deep study and understanding of Navya-Nyaya and its methodology.yhus, the sukhabodhika Tippanika represents a positive and distinctive contribution to the vast commercial literature on the Tattvacimtamani.

This important and comprehensive work of 18th-century Islamic religious thought written in Arabic by a pre-eminent South Asian scholar provides an extensive and detailed picture of Muslim theology and interpretive strategies on the eve of the modern period.

A published case report of an infant who inadvertently developed remission of HIV viral expression has prompted research to determine if this observation is reproducible and can offer a potentially novel clinical approach to inducing sustained viral remission of HIV.Typically HIV-infected mothers receive antiretroviral therapy before delivery and infants receive between one and three drugs at “low doses” for prevention. In the case report, the mother delivered before she could receive ART. The infant was placed on a three-drug approach with (...) “higher” doses by her doctor than are typically used for treatment. When HIV infection was confirmed, the three-drug regimen was continued. For most.. (shrink)

The proposed study would be a single-arm interventional trial in a community where HIV is endemic. The proposed observational design can provide confirmatory data for the initial clinical observation, data that would be necessary before considering whether a randomized controlled trial is appropriate. A previous ethical analysis has argued for conducting such a study in a country with limited resources and with higher HIV prevalence, and to recruit those with the highest risk of transmission. The primary rationale was to address (...) the scientific question in the most efficient timeframe and to expose the smallest number of infants to the uncertain benefits and risks of the study. However, there are.. (shrink)

The Declaration of Helsinki and the Council of the International Organization of Medical Sciences provide guidance on standards of care and prevention in clinical trials. In the current and increasingly challenging research environment, the ethical status of a trial design depends not only on protection of participants, but also on social value, feasibility, and scientific validity. Using the example of a study assessing efficacy of a vaccine to prevent human papilloma virus in HIV-1 infected adolescent girls in low resource countries (...) without access to the vaccine, we compare several trial designs which rank lower on some criteria and higher on others, giving rise to difficult trade-offs. This case demonstrates the need for developing more nuanced guidance documents to help researchers balance these often conflicting criteria. (shrink)

Innovation and organizational environment are greatly influenced by leadership styles. Innovation-friendly workplaces are fostered by leaders because of their emphasis on inspiration and vision. The leaders place more emphasis on structure and compensation, which might have a distinct effect on organizational environment (OE) and creativity. The variations in leadership styles and how they are applied in various organizational settings. The connection among organizational environment, innovative creativity and leadership styles might be influenced by industry-specific aspects. The study’s aim is to comprehend (...) how various leadership styles affect the organizational environment and corporate innovations (CI). This study included a total of 233 participants, including male (120) female (110) and non-binary/other (3) for leadership styles. Utilizing SPSS software, a statistical analysis of the data was carried out. The data was analyzed using a t-test, ANOVA, and regression analyses. These analysis demonstrated the leadership style fostering an innovative organization.The studyemphasizes the organizational environment and corporate innovationstrongly influenced by leadership styles. Creating an atmosphere that encourages creative thinking and a collaborative culture through leadership styles. (shrink)

Decisions regarding life-sustaining medical treatments for young children with profound disabilities can be extremely challenging for families and clinicians. In this study, Brick and colleagues1 surveyed adult residents of the UK about their attitudes regarding withdrawal of treatment using a series of vignettes of infants with varying levels of intellectual and physical disability, based on real and hypothetical cases.1 This is an interesting study on an important topic. We first highlight the limitations of using these survey data to inform public (...) policy and then offer a different interpretation from the authors’ regarding their findings about the value the public appears to place on relational capacity. The authors asked members of the lay public to interpret a disabled child’s best interest in a series of vignettes. The respondents were 92% white; 59% were atheist or reported no religious affiliation. Though the authors note this lack of diversity as a limitation, we would add that this limitation is particularly problematic in this context. Minority views on this issue may differ significantly from the majority perspective. When the stakes are high (as is the case for questions about withdrawing life-sustaining therapy from infants over parental objections), use of public opinion data to directly inform policy requires, at a minimum, a representative sample reflecting both the true diversity of views within the public and a method to justly account for the alternate views of the minority. Even if the sampled population were more …. (shrink)

Heidegger’s reading of Kant is deciphered to have illuminated his own project concerning the basic question of Ontology, Time, Space and History [Temporality, Spatiality and Historicity] embodying the novel description of Human reality in terms of Mit-Dasein and Mit-welt [Subjectivity with the public face]. Kant’s Critique of Pure Reason led Heidegger develop his own project of Existential Phenomenology contrary to Husserilian Phenomenology. We will discuss the Kantian Heidegger following the two main issues: one, Heidegger appreciates Kant on his identifying and (...) exploring the difference of ontic/ontological. Two, Kant prioritizes time over space. Heidegger would explore the subject of ontic/ontological difference in the sense that ontic knowledge is the knowledge of particular beings, whereas ontological knowledge is described as the a priori condition inferring the ontic knowledge. In this sense ontological knowledge pertains to question of being rather than beings. This is how Heidegger’s Kant interpretation would differ from the Neo-Kantianism of Marburg School which argued that Critique of Pure Reason is a work of epistemology. In contrast to this position, Heidegger held that Critique is a unique work of transcendental philosophy; it is theory of ontological knowledge but not ontic knowledge. Ontic knowledge of beings must conform to Being of beings [ontological foundation]. Heidegger holds that this should be Kant’s “Copernican Revolution”. However, Heidegger would appropriate the Kantian notion of time in the form of temporality of Dasein. Being manifests itself on beings through Being-there [Human reality] who purely understands Being. For Heidegger, temporality of Dasein is the foundation of ontological knowledge indeed. (shrink)

In their paper, “Helpful Lessons and Cautionary Tales: How Should COVID-19 Drug Development and Access Inform Approaches to Non-Pandemic Diseases?” Holly Fernandez Lynch and colleagues have present...

Lower plasma levels of high-density lipoproteins in adolescents with type 2 diabetes have been associated with a higher pulse wave velocity, a marker of arterial stiffness. Evidence suggests that HDL proteins or particle subspecies are altered in T2D and these may drive these relationships. In this work, we set out to reveal any specific proteins and subspecies that are related to arterial stiffness in youth with T2D from proteomics data. Plasma and PWV measurements were previously acquired from lean and T2D (...) adolescents. Each plasma sample was separated into 18 fractions and evaluated by mass spectrometry. Then, we applied a validated network-based computational approach to reveal HDL subspecies associated with PWV. Among 68 detected phospholipid-associated proteins, we found that seven were negatively correlated with PWV, indicating that they may be atheroprotective. Conversely, nine proteins show positive correlation with PWV, suggesting that they may be related to arterial stiffness. Intriguingly, our results demonstrate that apoA-I and histidine-rich glycoprotein may reverse their protective roles and become antagonistic in the setting of T2D. Furthermore, we revealed two arterial stiffness-associated HDL subspecies, each of which contains multiple PWV-related proteins. Correlation and disease association analyses suggest that these HDL subspecies might link T2D to its cardiovascular-related complications. (shrink)

There is evidence of continued food insecurity and malnutrition in Pakistan despite significant progress made in terms of food production in recent years. According to “Vision 2030” of the Planning Commission of Pakistan, about half of the population in the country suffers from absolute to moderate malnutrition, with the most vulnerable being children, women, and elderly among the lowest income group. The Government of Pakistan has been taking a series of policy initiatives and strategic measures to combat food insecurity issues. (...) These range from increasing production to food imports, implementation of poverty reduction strategies, nutritional improvement programs, as well as provision of social safety nets. The article aims to instill some fresh thinking into the debate regarding the challenges of food security. It underscores the limitations of hitherto policy response, and suggests crucial measures to improve the present grim scenario. Policy makers, planners, practitioners, and academicians in countries with comparable socio-political and economic setup can view this discussion as a case study and may apply the findings in their domain accordingly. (shrink)

South Asia is one of the most densely populated regions of the world, where despite a slow growth, agriculture remains the backbone of rural economy as it employs one half to over 90 percent of the labor force. Both extensive and intensive policy measures for agriculture development to feed the massive population of the region have resulted in land degradation and desertification, water scarcity, pollution from agrochemicals, and loss of agricultural biodiversity. The social and ethical aspects portray even a grimmer (...) picture of the region with growing poverty mainly, amongst small farmers, food scarcity, and overall poor quality of life. This article reviews the historical perspective of agriculture development in the region and gives a panoramic view of the policy initiatives and their environmental as well as social and ethical spin-offs. The aim is to explore the environmental and ethical dimensions of the agricultural development in South Asia and recommend a holistic approach in formulating plans and programs to combat environmental degradation, hunger, and poverty resulting from unsustainable agricultural practices. (shrink)

The ethical principle of ‘respect for persons’ in clinical research has traditionally focused on protecting individuals’ autonomy rights, but respect for participants also includes broader, although less well understood, ethical obligations to regard individuals’ rights, needs, interests and feelings. However, there is little empirical evidence about how to effectively convey respect to potential and current participants. To fill this gap, we conducted exploratory, qualitative interviews with participants in a clinical genomics implementation study. We interviewed 40 participants in English or Spanish (...) about their experiences with respect in the study and perceptions of how researchers in a hypothetical observational study could convey respect or a lack thereof. Most interviewees were female, identified as Hispanic/Latino or non-Hispanic white, reported annual household income under US$60 000 and did not have a Bachelor’s degree ; 30% had limited health literacy. We identified four key domains for demonstrating respect: personal study team interactions, with an emphasis on empathy, appreciation and non-judgment; study communication processes, including following up and sharing results with participants; inclusion, particularly ensuring materials are understandable and procedures are accessible; and consent and authorisation, including providing a neutral informed consent and keeping promises regarding privacy protections. While the experience of respect is inherently subjective, these findings highlight four key domains that may meaningfully demonstrate respect to potential and current research participants. Further empirical and normative work is needed to substantiate these domains and evaluate how best to incorporate them into the practice of research. (shrink)

Two prejudices have hampered our understanding of John Stuart Mill’s central argument for free speech. One prejudice is that arguments for free speech can only be made in terms of values or rights. This prejudice causes us to miss the depth of Mill’s argument. He does not argue that silencing speech is harmful or violates rights, but instead that silencing speech is a uniquely self-undermining act; it undermines the ground upon which it is based. But even if we overcome this (...) prejudice and appreciate the self-undermining character of Mill’s argument, the prejudice that epistemic justification is a completable task blinds us to the role of open-mindedness in his argument; and failing to see this leads us to wrongly conclude that his argument is invalid. It is only once we have overcome both prejudices that we can appreciate the depth and power of Mill’s argument for free speech. (shrink)

Workers can be fired from jobs, citizens sent to jail, and adolescents more likely to experience depression, all because of algorithms. Algorithms have considerable impacts on our lives. To increase user satisfaction and trust, the most common proposal from academics and developers is to increase the transparency of algorithmic design. While there is a large body of literature on algorithmic transparency, the impact of unethical data collection practices is less well understood. Currently, there is limited research on the factors that (...) affect users’ trust in data collection practices and algorithmic transparency. In this research, we explore the relative impact of both factors as they relate to important outcome measures such as user’s trust, comfort level, and moral acceptability. We conducted two pilot studies to learn what real users consider to be ethical and unethical data collection practices, as well as high and low transparency for algorithms. We then used these findings in a 2 × 2 design to examine how transparency and the acceptability of data collection practices impact users’ acceptance, comfort, and trust in algorithms. Our results suggest that the singular emphasis on algorithmic transparency may be misplaced. Given the difference in their impact to increase acceptance, trust, and user satisfaction, a more effective strategy would be to also understand and abide by users’ views of ethical data collection practices. (shrink)

: This article is a humble attempt at highlighting the controversiesregarding the legitimacy of popular resistance or revolutionary movement tobring down Muslim political regime that claimed to be despotic, unjust andeven un-Islamic. Having the fact on the existence of another view by majorityscholars that more inclined towards pacifist ideology which stressed onpolitical stability as a prerequisite to prosperity, the article emphasizes moreon the revolutionary school, while the second shall be highlighted when it isnecessary for comparison. Employing qualitative method of study, (...) the articleseeks to examine the arguments provided by both movements. This will bedone by analyzing their textual and rational grounds of evidences used bythe two schools to legitimize their political stance. Associating with what ishappening in Muslims nation nowadays, current study compelled to review theradical revolutionary movement from the perspective of moderate Islam schoolof thought. (shrink)

This research study was aimed to examine the cross-national coverage and framing patterns about Jamal Khashoggi’s murder in international media through focusing on newspapers. Khashoggi; an internationally acclaimed US based Saudi journalist was brutally assassinated at Kingdom’s consulate in Turkey which created the global outcry. As this issue made headlines worldwide for several months, the media from USA, Kingdom of Saudi Arabia, and Turkey; the most substantially and politically involved countries presumably used certain framing patterns in their coverage. To find (...) out the difference in coverage intensity and media frames, a content analysis based comparative study of US, Saudi and Turkish newspapers was conducted which is guided by the framing theory of Mass Communication. The results showed that the media from three selected countries dealt the same issue with significant differences in coverage and framing patterns. We concluded based on our findings that such differences in cross-national coverage patterns were influenced by the respective state’s ideology, interests, governance system, public narrative, or media settings. This study also explored some facts regarding freedom of expression and about journalists who have been targeted in reprisal of their professional work all over the world. The findings of the study elaborate that most of the newspapers used anti-Saudi frames in their coverage. So far as overall coverage is concerned Turkish and US papers provided a significant coverage to the issue while newspapers from Saudi Arabia provided least coverage to the issue as their media are highly state bound. (shrink)

The main focus of this essay is to closely engage with the role of scientist-subjectivity in the making of objectivity in Lorraine Daston and Peter Galison’s book Objectivity, and Daston’s later and earlier works On Scientific Observation and The Moral Economy of Science. I have posited four challenges to the neo-Kantian and Foucauldian constructions of the co-implication of psychology and epistemology presented in these texts. Firstly, following Jacques Lacan’s work, I have argued that the subject of science constituted by the (...) mode of modern science suffers from paranoia. It is not the fear of subjectivity interfering with objectivity but the impossibility of knowing the truth of the real that causes paranoia. Here, I have argued that it is not the ethos of objectivity that drives epistemology as Daston and Galison suggest, but the pathos of paranoia. The second challenge builds upon Kant’s own denial that the perfect correspondence between the human will and the moral law is possible. Kant himself thought that an ethical human act is impossible without the component of “pathology.” This questions Daston and Galison’s argument that there is always ethical imperative at the core of epistemic virtue. The third challenge contests the way Daston and Galison take appearance for being in their application of the Foucauldian concept of technologies of the self in modeling the master scientist-self. The fourth challenge questions the notion of the psychological and unconscious in the making of epistemology in Daston’s later and earlier work. Against this background, I aim to make a claim that understanding and disclosing “entities” in the scientific domain presupposes an understanding of “being” in general. My goal is to open up the discussion for an alternative conception of the scientist-subject and thereby an affective and existential formulation of science. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:From Impatience to EmpathyStephanie Pierce and Kavita Shah AroraWe gave J.H. a label the first time we met her, as many often do—“Uncooperative.” She was a patient with autism and intellectual delay who had presented to the emergency department (ED) with vaginal bleeding. After receiving the gynecology consult request from the emergency medicine physicians, we were already mentally formulating our recommendations based on the information they told us (...) over the phone. “Does not cooperate with exam,” “no acute surgical intervention is currently warranted,” and “recommend outpatient follow–up.”When we arrived in her room, she was sitting in the hospital bed surrounded by a protective shield of caregivers from her group home. We introduced ourselves as the gynecology team but it was obvious that J.H. could not communicate verbally. Upon speaking with her caregivers we learned that she had Cowden syndrome, a genetic disease that confers significantly increased risks for several types of cancer including endometrial, thyroid, and breast cancers. J.H. had also been having heavy vaginal bleeding, which was difficult for her caregivers to manage, and this was the reason she was brought into the emergency department. After attempting to gain as much information as we could from the caregivers, we started to perform an abdominal exam, which made J.H. extremely agitated. We quickly stopped the exam and the caregivers helped to calm J.H. We remember our mixture of emotions—bewilderment at the agitation and commotion in the exam room full of people, frustration at not being able to complete our exam fully, and annoyance that this “difficult patient” was taking up our limited time between surgical cases. Thankfully, these knee–jerk reactions were quickly replaced by feelings of concern for the patient and the realization of how frightening an experience this must be for her—being in a strange place with white walls and unfamiliar people, unable to communicate her thoughts.J.H.’s mother, her surrogate decision–maker, was not at the hospital that day but the caregivers told us that she had expressed a strong desire for her daughter to have a prophylactic hysterectomy due to her lifetime risk for developing uterine cancer as well as a permanent solution to the bleeding concerns. What had initially started as a simple ED consult was now turning into a complex question. The ethical and legal dilemma was obvious—whether to perform a major surgery that would irreversibly sterilize a patient who could not consent on her own behalf in order to minimize the potential risk of cancer later in life. While medical management could improve the bleeding and potentially reduce the risk of cancer, frequent exams would be necessary [End Page 19] to ensure that the medication was working and that premalignant changes were not occurring in J.H.’s uterus. However, based on our experience in the emergency department, J.H. would need anesthesia for such exams and it was doubtful the medications would completely normalize her elevated risk of uterine malignancy. We knew that in order to address this question, we would need to see J.H. again along with her mother to have a frank discussion about the risks and benefits of such a decision, and so we made plans to see her in our outpatient clinic.Several days later, J.H., her mother, and the group home caregivers arrived in the office. Anticipating a complex discussion, we had requested a representative from the hospital ethics committee to join us at the visit. We didn’t know what to expect meeting J.H.’s mother for the first time but as we sat in the room talking, it was obvious that she was truly trying to act in her daughter’s best interest. Similarly, it was touching to watch the faces of the caregivers from the group home as they nodded in solidarity with J.H.’s mother, also clearly wanting what was best for her and supporting her mother in this difficult decision. J.H., meanwhile, seemed content to sit silently with us during the discussion, surrounded as she was by people who cared deeply for her well–being.After extensive partnership with the ethics consultants... (shrink)

Tom has mounting evidence that he has incurable cancer, but he also believes that he would be happier, regardless of the truth, were he to believe that he is healthy. W.K.Clifford, who famously claimed, “It is wrong, always, everywhere, and for anyone, to believe anything upon insufficient evidence,” would, depending upon the sufficiency of Tom’s evidence, direct him to believe that he has incurable cancer, no matter the results for his happiness. The legendary pragmatist William James, on the other hand, (...) might deem this one of those situations in which it is permissible to follow one’s passions, and therefore might advise Tom to trust in his health in the face of the evidence to the contrary. Which one is right: the evidentialist or the pragmatist? The core of my research to date has aimed at resolving this central debate in the ethics of belief. (shrink)

The “dead-donor rule” states that, in any case of vital organ donation, the potential donor should be determined to be dead before transplantation occurs. In many countries around the world, neurological criteria can be used to legally determine death (also referred to as brain death). Nevertheless, there is considerable controversy in the bioethics literature over whether brain death is the equivalent of biological death. This international legal review demonstrates that there is considerable variability in how different jurisdictions have evolved to (...) justify the legal status of brain death and its relationship to the dead-donor rule.In this article, we chose to review approaches that are representative of many different jurisdictions—the United States takes an approach similar to that of many European countries; the United Kingdom’s approach is followed by Canada, India, and influences many other Commonwealth countries; Islamic jurisprudence is applicable to several different national laws; the Israeli approach is similar to many Western countries, but incorporates noteworthy modifications; and Japan’s relatively idiosyncratic approach has received some attention in the literature. Illuminating these different justifications may help develop respectful policies regarding organ donation within countries with diverse populations and allow for more informed debate about brain death and the deaddonor rule. (shrink)

In the United States and Europe, an increasing emphasis on equality has pitted rights claims against each other, raising profound philosophical, moral, legal, and political questions about the meaning and reach of religious liberty. Nowhere has this conflict been more salient than in the debate between claims of religious freedom, on one hand, and equal rights claims made on the behalf of members of the lesbian, gay, bisexual, and transgender community, on the other. As new rights for LGBT individuals have (...) expanded in liberal democracies across the West, longstanding rights of religious freedom -- such as the rights of religious communities to adhere to their fundamental teachings, including protecting the rights of conscience; the rights of parents to impart their religious beliefs to their children; and the liberty to advance religiously-based moral arguments as a rationale for laws -- have suffered a corresponding decline. Timothy Samuel Shah, Thomas F. Farr, and Jack Friedman's volume, Religious Freedom and Gay Rights brings together some of the world's leading thinkers on religion, morality, politics, and law to analyze the emerging tensions between religious freedom and gay rights in three key geographic regions: the United States, the United Kingdom, and continental Europe. What implications will expanding regimes of equality rights for LGBT individuals have on religious freedom in these regions? What are the legal and moral frameworks that govern tensions between gay rights and religious freedom? How are these tensions illustrated in particular legal, political, and policy controversies? And what is the proper way to balance new claims of equality against existing claims for freedom of religious groups and individuals? Religious Freedom and Gay Rights offers several explorations of these questions. (shrink)