Consented autopsy is almost non-existent in the Middle-East where established social and cultural beliefs regarding the procedure might discourage family members from requesting a consented autopsy. Evidence suggests that new information is obtained from consented autopsies. It would not be in the best interest of medicine if social and cultural misconceptions succeed in erasing the existence of consented autopsies entirely.

The State may require an autopsy when foul play is suspected in the death of one of its citizens.[1] This is so regardless of any objections to such invasive procedures expressed by the deceased before their deaths or afterward by their families. There is not even a religious exemption. The most obvious explanation for why consent is not needed is that apprehending a murderer with information obtained from the autopsy can save lives. However, taking organs without consent from (...) the deceased for transplantation into those suffering vital organ failures can also save lives. But doing so is considered beyond the pale. The question then becomes why are mandatory autopsies permitted but organ conscription prohibited? Our aim is to explore whether such divergent attitudes can be justified. (shrink)

All modern critics have read verses 128–36 of Pseudo-Scymnus’ iambic Periodos to Nicomedes (c.133–110/109 b.c.e.) as a description of the personal autopsies of the author. However, close analysis of both the literary dynamics of the poem and the syntax of the lacunose text that precedes this passage shows that this cannot be the case. This article proposes that Timaeus of Tauromenium (c.350–260 b.c.e.) is a superior candidate for the referent of these lines, and offers a coherent approach to emending the (...) manifestly corrupt text. This reinterpretation makes better sense of the extant text of the Periodos, and allows these verses to be read as a second-century witness to Timaeus’ autoptic prowess. (shrink)

The central purpose of this paper is to address the tension between legal and medical discourses within the coronial system. Medical expertise, based largely upon internal autopsy, becomes positioned as providing the more important information, rather than the legal model which focuses on evidence gathering at the scene. This paper will examine the aspects of the history, philosophy and consequences of the processes by which the medical model gained its current dominance and will conclude that, while autopsies are necessary, (...) they are also over-used in the coronial system. (shrink)

A lot of attention has been devoted to the study of discoveries in high energy physics, but less on measurements aiming at improving an existing theory like the standard model of particle physics, getting more precise values for the parameters of the theory or establishing relationships between them. This paper provides a detailed and critical study of how measurements are performed in recent HEP experiments, taking examples from differential cross section measurements with the ATLAS detector at the LHC. This study (...) will be used to provide an elucidation of the concept of event used in HEP, in order to determine what constitutes an observation and what does not. It will highlight the essential place taken by theory-ladenness in order to produce observational facts, and will show how uncertainty and sensitivity estimates constitute an operational approach to robustness, inside the practice of science, avoiding potential circularity problem traditionally implied by theory-ladenness. This is in contrast to robustness analyses typically considered in the literature. A careful analysis of systematic uncertainty estimates and of statistical tests used to set empirical conclusions from the observations will however demonstrate that quantitative statements obtained from these statistical tests cannot be more than simple guiding arguments for the production of knowledge, but do not determine it. This indicates that the frontier between theory and observation is blurry and that the dichotomy theory-experiment should be revised. (shrink)

Laws requiring autopsies have generated little controversy. Yet it is considered unconscionable to take organs without consent for transplantation. We think an organ draft is justified if mandatory autopsies are. We reject the following five attempts to show why a mandatory autopsy policy is legitimate, but organ conscription is not: (1) The social contract gives the state a greater duty to protect its citizens from each other than from disease. (2) There is a greater moral obligation to prevent murders (...) than disease-caused deaths because killing people is morally worse than allowing people to die. (3) Autopsies do not confiscate body parts, but organ transplants do. (4) The citizenry's knowledge that their organs are very likely to be taken will generate more anxiety than the remote possibility of a mandatory autopsy. (5) A religious conviction that one's organs will be needed in order to be resurrected is threatened by organ transplantation but not by autopsies that "return" body parts. (shrink)

This article considers historical facts and investigates the particular relationship between a factual and a valuative dimension within them. The operation is an autopsy of a particular historical fact, which works as an example. On this basis, the article will elucidate the similarities and the differences between historical facts and natural facts, with an emphasis on the observation that the former are more subject to the influence of interpretation than the latter. This feature of historical facts explains why social (...) and political struggles for recognition arise with respect to historical events. (shrink)

Part I. Ireland and beyond. SacrumProfanum : mapping cultural damage through music ; Second glance at Ted Hughes's Crow : transcendence interrupted ; Joycean aesthetics and mythic imagination in the music of Frank Corcoran ; 'In exile anyway' : Jonathan Creasy interviews Benjamin Dwyer ; ...eleven reflections on Beckett, music and silence ; 'Insight - deeper' : Benjamin Dwyer interviews Kevin Volans ; Umbilical : the story of Oedipus, the story of Jocasta -- Part II. Beyond Ireland. 'O master of (...) secret configurations' : reflections on the Adorno-Berg correspondence ; Laughing at the chaos : György Ligeti (1923-2006) ; Teleology or transcendence? : perspectives on Ligeti's collusion with automatism ; '...a gentle kind of political' : Benjamin Dwyer interviews George Crumb and David Starobin ; Leonard Bernstein : reflections on a centenary ; 'Dios los cría' : Barry Guy and Maya Homburger ; Barry Guy's Time passing ; 'We are using who we are' : Benjamin Dwyer interviews Mats Gustafsson ; Toward a transcendental philosophy of improvisation. (shrink)

Context Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. Objective To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes (...) of physicians practising at Japanese teaching hospitals. Design, setting and participants We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Results Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (p<0.0001). Currently in Japan the debate about the role autopsy should play in the case of error related to death is underway. The results from this study will be important in informing related decisions. (shrink)

BackgroundVerbal autopsy is a pragmatic approach for generating cause-of-death data in contexts without well-functioning civil registration and vital statistics systems. It has primarily been conducted in health and demographic surveillance systems (HDSS) in Africa and Asia. Although significant resources have been invested to develop the technical aspects of verbal autopsy, ethical issues have received little attention. We explored the benefits and burdens of verbal autopsy in HDSS settings and identified potential strategies to respond to the ethical issues (...) identified.MethodsThis research was based on a case study approach centred on two contrasting HDSS in Kenya and followed the Mapping-Framing-Shaping Framework for empirical bioethics research. Data were collected through individual interviews, focus group discussions, document reviews and non-participant observations. 115 participants were involved, including 86 community members (HDSS residents and community representatives), and 29 research staff (HDSS managers, researchers, census field workers and verbal autopsy interviewers).ResultsThe use of verbal autopsy data for research and public health was described as the most common potential benefit of verbal autopsy in HDSS. Community members mentioned the potential uses of verbal autopsy data in addressing immediate public health problems for the local population while research staff emphasized the benefits of verbal autopsy to research and the wider public. The most prominent burden associated with the verbal autopsy was emotional distress for verbal autopsy interviewers and respondents. Moral events linked to the interview, such as being unsure of the right thing to do (moral uncertainty) or knowing the right thing to do and being constrained from acting (moral constraint), emerged as key causes of emotional distress for verbal autopsy interviewers.ConclusionsThe collection of cause-of-death data through verbal autopsy in HDSS settings presents important ethical and emotional challenges for verbal autopsy interviewers and respondents. These challenges include emotional distress for respondents and moral distress for interviewers. This empirical ethics study provides detailed accounts of the distress caused by verbal autopsy and highlights ethical tensions between potential population benefits and risks to individuals. It includes recommendations for policy and practice to address emotional and moral distress in verbal autopsy. (shrink)

The increased interest in contemporary relations of culture and governance that has been prompted by the post-Foucauldian literature on governmentality has paid insufficient attention to the need to redefine the concept of culture, and to rethink its relation to the social, that such work requires. This paper contributes to such an endeavour by arguing the need to eschew the view that culture works by some general mechanism in order to focus on the ways in which specific cultural knowledges are translated (...) into distinctive technical and operational forms in the context of particular institutions and programmes of governance. In doing so, it draws on the perspectives of science studies and actor network theory and applies these to examine how the fabrication of the prehistoric past that resulted from the endeavours of the nineteenthcentury historical sciences was translated into distinctive technical forms in the context of typological museum displays. These developments are related to the changing objectives of liberal government and the emergence of an archaeologized structure of the self. (shrink)

RésuméCette revue résume les méthodes qui ont été utilisées jusqu'ici pour analyser les protéines et déterminer leurs séquences. Elle contient aussi quelques brèves indications concernant de nouvelles méthodes et certains problèmes qui restent à résoudre.SummaryThe goal of this review is to indicate the way in which the analysis of proteins and the determination of their sequences has been carried out until now. It contains also a short outlook concerning unsolved problems and possible new methods.ZusammenfassungDieser Artikel fasst einige Methoden zusammen, die (...) bisher erlaubten, die Proteine zu analy‐sieren und ihre Primärstruktur aufzustellen. Er enthalt auch einige Angaben über mögliche neue Methoden sowie über einige noch zu lösende Probleme. (shrink)

Definition of the problem: In Germany, the dissection rate of the deceased is distinctly lower than in many other European countries. Although critics of autopsies use to put forward ethical objections and religious scruples, neither the Christian church nor piety stand opposite to the practise of autopsies.Arguments: From an ethical point of view, there are numerous arguments for an increase in the number of autopsies. It can be shown that not only the deceased, his relations and the physicians but also (...) the population as a whole could take advantage of a higher percentage of dissections. In Germany, law authorities put much more emphasis on the regulation of birth and origin of life than on problems concerning dying and death of human beings. Legal obstacles and tendentious reporting by the mass media are serious reasons for the poor popularity of dissections of the corpse.Conclusion: For many reasons, comprehensive and unbiassed information about autopsies, fundamental legislative reforms and an increase of the dissection rate have to be claimed. (shrink)

Verbal autopsy presents the opportunity to understand the disease burden in many low-income countries where vital registration systems are underdeveloped and most deaths occur in the community. Advances in technology have led to the development of software that can provide probable cause of death information in real time, and research considering the ethical implications of these advances is necessary to inform policy. Our research explores these ethical issues in rural Nepal using a public health ethics framework. We considered the (...) burdens and benefits of VA and giving cause of death information to families of the deceased through qualitative research with VA interviewers, community members, national policy stakeholders and international academics. Burdens can be experienced differently, and it is important to balance the emotional burden of VA with utilization of the data to inform planning and increased access to health services. The training, support and supervision of VA interviewers should be prioritized if VA is taken to scale. Initial and ongoing community engagement is recommended in addition to engaging ethical, legal, health and policy personnel in developing protocols and systems. Integrating rigorous research while cautiously moving forward is recommended to ensure systems and responses to concerns are relevant to contexts. (shrink)

Use of normothermic regional perfusion (NRP) for organ recovery in donation after circulatory death (DCD) raises two crucial, and intertwined, ethical questions. The first is whether the use of NRP...

The theme of poverty has recently dominated various scholarly platforms, including academic presentations and public debates. Nevertheless, it has emerged that the rhetoric about poverty reduction seems to be the project of the elite who apparently write and speak on behalf of the poor. The plight of the majority of the poor is problematised so that transformation is superficially democratised with the ultimate aim of benefitting the elite. The present study reflects on Eben Scheffler’s contributions on poverty and the poor (...) in the Old Testament books of the Pentateuch, the Psalms and the Proverbs. Although this study refers to Scheffler’s other works on poverty from time to time, particular attention is paid to four of them, namely, ‘The poor in the Psalms: A variety of views’; ‘Of poverty prevention in the Pentateuch as a continuing contemporary challenge’; ‘Poverty in the Book of Proverbs: Looking from above’; ‘Pleading poverty : On the ideology of Psalm 109’. Scheffler points out that it was the ancient Israelite elite who played the role of writing and speaking on behalf of the poor. It is essential to note that Scheffler’s thrust is not an appropriation exercise, although in some places he makes reference to the ‘contemporary world’. Thus, the present study attempts to explore the land debate in our contemporary world, with a special focus on South Africa’s land expropriation without compensation debate and the foiled fast-track land reform programme in Zimbabwe, as elitist projects. The Zimbabwean Fast-Track Land Reform Programme was a prototype of LEWIC in SA. It is argued that the poor rural communities in Zimbabwe continue to languish in poverty in a country endowed with abundant natural resources, including land. The study argues that land allocation in Zimbabwe benefitted the elite. (shrink)

While another von Hagens style public autopsy should not be encouraged, the public should nevertheless be able to experience such events as a public autopsy.During 2002 and 2003 there was considerable discussion about the work of Gunter von Hagens, famed for his Body Worlds exhibition,1 which was publicised extensively and with considerable success. The exhibition is a tribute to, and celebration of, his method of preserving organic life through the process of plastination, developed by von Hagens in the (...) 1980s. The process entails a form of preservation, whereby body parts are dehydrated and filled with polymer resin, making them more robust than conventional formaldehyde does.While it was in the United Kingdom, the exhibit was housed at a back street gallery in Brick Lane, London, though the exhibition has toured throughout the world. Despite many millions having flocked to see the exhibition, the reasons for its success are open to interpretation and have provoked strong opinions from the medical community as to whether this physician ought to be entitled to create exhibits from real bodies. Von Hagens would argue that these works are justifiable because they have artistic merit. Others would claim that viewers are being brought to the gallery by the immense publicity. Alternatively, one might suppose that those who attend the exhibition do so mainly because of a fascination with the extraordinary and with the grotesque. Indeed, such fascination with death, and human remains specifically, was the focus of a meeting hosted by the Institute of Ideas and the Royal College of Physicians in May 2003, which was entitled Morbid Fascinations: the Body and Death in Contemporary Culture.The controversy arising from the Body Worlds exhibition pales in comparison, however, to von Hagens’s most recent performance—the first “public autopsy” in Britain …. (shrink)

It has been demonstrated that death certificates do not accurately record the actual cause of death in up to one-fourth of cases, as determined from subsequent autopsy findings. The purpose of this study was to explore the use of natural language autopsy data bases as an automated quality assurance mechanism. We translated the account of the major process leading to death, or the primary diagnosis, from all 45,564 narrative autopsy reports obtained at The Johns Hopkins Hospital between (...) May 28, 1889, and June 30, 1987, into the hierarchical system of Medical Subject Heading (MeSH) titles. We obtained a total of 125,772 MeSH title translations, 1,563 of them distinct (average 2.8 per case), ranging in frequency from 6,029 occurrences of LUNG to 1 occurrence apiece of 357 MeSH titles. The natural-language-to-MeSH translations showed expected trends over the past century: fewer infectious diseases; more cardiovascular and neoplastic disease among adults; and more respiratory diseases and congenital malformations in the pediatric age group. The greater availability of autopsy documents in electronic form should increase the value of this resource for quality assurance. (shrink)

There is growing interest in tissue procurement for cancer research through autopsy. Establishing an autopsy/tissue donation programme for breast cancer research within an academic medical centre i...

This article takes inspiration from Allan Sekula’s remarks on New Topographics photography, as well as his own ‘geography lessons’, to interrogate how photographs of ‘man-altered landscapes’ give visual form to the problems of temporality, natural history and historical agency that mark life in the Capitalocene. It proposes that combining Fredric Jameson’s analysis of the way that capital congeals ‘quantities of the past’ into dead labour with Andreas Malm’s diagnosis of our ‘warming condition’ allows us both to diagnose and counter the (...) temptation to a sublime inhumanity that so often haunts contemporary panoramas of ecological devastation. (shrink)

This paper addresses questions about how the levels of causality (generic and single-case causality) are related. One question is epistemological: can relationships at one level be evidence for relationships at the other level? We present three kinds of answer to this question, categorised according to whether inference is top-down, bottom-up, or the levels are independent. A second question is metaphysical: can relationships at one level be reduced to relationships at the other level? We present three kinds of answer to this (...) second question, categorised according to whether single-case relations are reduced to generic, generic relations are reduced to single-case, or the levels are independent. We then explore causal inference in autopsy. This is an interesting case study, we argue, because it refutes all three epistemologies and all three metaphysics. We close by sketching an account of causality that survives autopsy—the epistemic theory. (shrink)

This article presents for the first time complete descriptions of four codices of the Austrian National Library at Vienna, viz. 1617, 5237, 5248 and 5377. Cod. 1617 is a fragment of Henry Totting of Oyta’s 13 Quaestiones Sententiarum, comprising part of q.7 and qq.8-13 in 198 ff.. The other three manuscripts contain mainly logical texts, e.g., Albert of Saxony’s Sophismata in Cods. 5237 and 5377, his Insolubilia in Cod. 5248, and his Quaestiones Posteriorum in Cod. 5377; 11 of the 12 (...) Tractatus by Peter of Spain in Cod. 5248; an apparently unnoticed copy of Porphyry’s Isagoge translated by Boethius and treatises by Thomas Manlevelt, Richard Billingham and John of Holland along with several anonymous texts in Cod. 5248; a fragment of John Buridan’s Quaestiones breves veteris artis in Cod. 5377. The latter codex has also two interesting sets of anonymous Quaestiones quodlibetales and an erratic leaf with questions on Peri heremeias. Charters or charter-like texts are to be found in Cods. 1617 and 5248 , which may be of value for the prosopography of the fourteenth century. (shrink)

Should government be neutral "on the question of the good life, or of what gives value to life"?1 Some political theorists propose that governmental neutrality is a core commitment of any liberalism worth the name and a requirement of justice. For them, neutrality is the appropriate generalization of the ideal of religious tolerance. The state should be neutral in matters of religion, and neutral also in all controversies concerning the nature of the good or the ways in which it is (...) valuable and worthwhile to live. (shrink)

The use of human tissue for scientific research is a highly sensitive issue. A lack of confidence in patient recruitment is one reason for the failure of many studies to be funded and it is important therefore that recruitment procedures are as effective and sympathetic as possible. The authors recruited patients with uveal melanoma into a postmortem study investigating tumour latency in this cancer. Two approaches were used—firstly a direct approach when patients attended clinic and secondly an initial approach by (...) mail followed by telephone contact. In the first year of study the authors had a take up rate of 88.5%, significantly higher than the average rate of 40% quoted by the National Institute for Clinical Excellence . Key features are a sympathetic personal approach by experienced oncology nurses, the provision of clear information, and the inclusion of the next of kin in the recruitment procedure. (shrink)

There is a national movement supporting the retention and use of bio-specimens from deceased individuals for the purpose of genetic testing. This manuscript discusses the significance of postmortem genetic testing in the context of death determination by medical examiners. We highlight distinctive concerns that are raised in the areas of consent, confidentiality, and return of results when genetic testing is performed as part of a public molecular autopsy. We believe our manuscript will contribute to the development of a robust (...) ethical and legal framework for genetic testing in this context. (shrink)

Was there resistance in the Catholic Church during the Middle Ages to human dissection? Was autopsy thought to be a desecration of the body? The belief that the Church is opposed to dissection was due in part to the misinterpretation of a papal bull issued during the fourteenth century. Dissection of a corpse and autopsy were never in fact decreed by the Church. Rejection of these was based not on Church teaching but on a perceived violation of social (...) honor because of the unappealing public nature of the practices. To this day, the Catholic Church does not view dissection and autopsy as desecration of the body; the practices remain theologically compatible with Catholic doctrine. National Catholic Bioethics Quarterly 12.1 (Spring 2012): 37–42. (shrink)