XLRI, in association with a few Tata Group companies, established the XLRI-JRD Tata Foundation in Business Ethics in 1991 to mark their long-standing commitment and contribution to business ethics in India. The foundation seeks to address this by publicly affirming the urgent need for ethics in business and the need to bring about a conducive culture in which it can thrive.

Open peer commentary on the article “The Autopoiesis of Social Systems and its Criticisms” by Hugo Cadenas & Marcelo Arnold. Upshot: The authors claim that it is justified to extend the concept of autopoiesis from its biological origin to other disciplines, predominately those that have a social character. However, the authors do not lay strong enough conceptual grounds to justify this extension of autopoiesis because it is unclear what concept of autopoiesis it is that would achieve this objective, or why (...) the concept of autopoiesis itself should be crucial to this endeavor. (shrink)

Thirteenth-century India saw a huge revival of religious devotion among the common folk, similar to the waves of religious fervor that swept over late medieval Europe. One of the pillars of this revival was the poet-saint Jnaneshwar, author of an exquisite commentary on the Bhagavad Gita. Like his contemporary Dante, Jnaneshwar was a poet of the vernacular, who wrote in Marathi, the language of ordinary villagers, rather than the Sanskrit of the brahmin orthodoxy. Over the centuries, the Jnaneshwari, as his (...) commentary is known, has become a scripture in its own right. Expanding the Gita’s seven hundred verses to approximately nine thousand, and using the images of ordinary life to explain its lofty teachings, Jnaneshwar fashioned from human language one of the most sublime visions of the Absolute that has ever been put into speech. The Jnaneshwari is one of the marvels of world literature. The greatest study of the Jnaneshwar is still this work by the philosopher R. D. Ranade, originally published in 1933. In addition to being a renowned scholar, Ranade was also a mystic and an initiated disciple, and he brings all these broad currents of the Indian tradition to his analysis of the Jnaneshwari. Readers who are sometimes intoxicated by the richness of Jnaneshwar’s imagery, will appreciate the way Ranade has here uncovered the work’s inner structure, and how he has briefly summarized its approach to the Gita’s great themes: action vs. renunciation; devotion and dharma; the form and the formless aspects of God; and the subject dearest to Jnaneshwar’s heart, the nature of the spiritual Master. This book also includes Ranade’s study of Jnaneshwar’s abhangas, his religious songs, as well as an analysis of his magnificent Amritanubhav, “The Nectar of Self-Awareness,” an inspired synthesis of Samkhya and Shaivism. (shrink)

Purpose: Physicians are often reluctant to discuss “Do Not Resuscitate” orders with patients. Although perceived self-efficacy is a known prerequisite for behavioural change, little is understood about the confidence of physicians regarding DNR discussions.Subjects and methods: A survey of 217 internal medicine attendings and 132 housestaff at two teaching hospitals about their attitudes and confidence regarding DNR discussions.Results: Participants were significantly less confident about their ability to discuss DNR orders than to discuss consent for medical procedures , and this was (...) true for both attendings and housestaff . In a multivariate logistic model of confidence regarding DNR discussions, women were less confident than men ; house officers were less confident than attendings , those who were less confident of their ability to discuss medical procedures were less confident discussing DNR , and those who found talking to patients about DNR orders very difficult reported less confidence than those who did not .Conclusion: We conclude that physicians’ confidence regarding DNR discussions is low compared with their confidence regarding other medical discussions and that confidence varies by sex and perceived difficulty of the task. Efforts to improve DNR discussions should explore the need to tailor educational interventions to fit these characteristics. (shrink)

Open peer commentary on the article “Second-Order Science of Interdisciplinary Research: A Polyocular Framework for Wicked Problems” by Hugo F. Alrøe & Egon Noe. Upshot: The authors propose that a perspective is an autopoietic system. This commentary challenges the feasibility of this claim by pointing out the conceptual difficulties associated with such a proposal. But even granting that a perspective is, or can be, an autopoietic system, what sort of autopoietic system might best ground the authors’ concept of perspective? This (...) last question is also pursued here. (shrink)

In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)

Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)