A clear case for conscience in healthcare practice.

PubMed

Birchley, Giles

2012-01-01

The value of conscience in healthcare ethics is widely debated. While some sources present it as an unquestionably positive attribute, others question both the veracity of its decisions and the effect of conscientious objection on patient access to health care. This paper argues that the right to object conscientiously should be broadened, subject to certain previsos, as there are many benefits to healthcare practice in the development of the consciences of practitioners. While effects such as the preservation of moral integrity are widely considered to benefit practitioners, this paper draws on the work of Hannah Arendt to offer several original arguments in defence of conscience that may more directly benefit patients, namely that a pang of conscience may be useful in rapidly unfolding situations in which there is no time to reflect satisfactorily upon activities and that, given the hierarchical nature of healthcare institutions, a right to defy authority on the basis of conscience may benefit junior staff who lack the institutional power to challenge the orders of superiors.

Maltreatment, Conscience Functioning and Dopamine Beta Hydroxylase in Emotionally Disturbed Boys.

ERIC Educational Resources Information Center

Galvin, Matthew R.; And Others

1997-01-01

Nineteen hospitalized, emotionally disturbed boys screened for maltreatment either before or after age 3 were compared with a normal control group for enzyme activity and conscience functions in moral valuation. Subjects who experienced early maltreatment had more developmental delays and more interferences with conscience functions than other…

Freedom of Conscience and Catholic Schools

ERIC Educational Resources Information Center

Donlevy, J. K.; Gereluk, D.; Patterson, P.; Brandon, J.

2014-01-01

This paper's purpose is to extensively review the historical understanding of conscience and the current juridical interpretation of freedom of conscience under section 2(a) of the Canadian Charter of Rights and Freedoms (1982). It then briefly notes that given the challenge faced by Ontario's Catholic schools in providing for inclusionary…

Making decisions about decision-making: conscience, regulation, and the law.

PubMed

Miola, José

2015-01-01

The exercise of conscience can have far reaching effects. Poor behaviour can be fatal, as it has occurred in various medical scandals over the years. This article takes a wide definition of conscience as its starting point, and argues that the decision-making processes open to society--legal regulation and professional regulation--can serve to limit the options available to an individual and thus her ability to exercise her conscience. The article charts the law's changing attitude to legal intervention, which now seeks to limit the use of conscience by individuals, and addresses concerns that this may serve to 'de-moralise' medicine. It also examines the reasons for this legal change of approach. © The Author [2015]. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

22 CFR 17.4 - Equity and good conscience.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Equity and good conscience. 17.4 Section 17.4... PENSION SYSTEM (FSPS) § 17.4 Equity and good conscience. (a) Defined. Recovery is against equity and good... a valuable right or changed positions for the worse; or (3) Recovery could be unconscionable under...

Citizen Responsibility, Conscience, War and the Draft, A Kit for Counselors and Teachers.

ERIC Educational Resources Information Center

Garvey, Helen; Pickus, Robert

This publication for secondary students, with additional materials for counselors and teachers, deals with the topics of citizen responsibility, conscience, war, and the draft. There are five major sections. Section I, containing three questionnaires, includes questions for students to consider if they are confronting problems of conscience, war,…

Multiple Pathways to Conscience for Children with Different Temperaments: From Toddlerhood to Age 5.

ERIC Educational Resources Information Center

Kochanska, Grazyna

1997-01-01

Assessed children's temperament and maternal socialization at age 2-3. Assessed children's conscience at ages 4 and 5 by observing children's cheating behavior in a game. Found that for children fearful as toddlers, maternal gentle discipline promoted conscience at age 5. For children fearless as toddlers, alternative maternal socialization…

The Conscience as a Regulatory Function: Empathy, Shame, Pride, Guilt, and Moral Orientation in Delinquent Adolescents.

PubMed

Schalkwijk, Frans; Stams, Geert Jan; Stegge, Hedy; Dekker, Jack; Peen, Jaap

2016-05-01

This study examines an emotion-based theory of the conscience, which provides forensic practitioners tools for assessing the state of the conscience. It is operationalized as an emotion-regulating function, making use of empathy, self-conscious emotions, such as shame, pride or guilt, and moral judgment. This was put to test in a questionnaire survey with 59 delinquent and 275 non-delinquent juveniles. As was hypothesized, the functioning of the conscience of these groups differed, with offenders having lower levels of some aspects of empathic capacity, being less prone to experiencing shame and guilt, being more prone to experiencing pride, and being more punishment oriented than victim oriented. The research confirmed that operationalization of the conscience in terms of empathy, self-conscious emotions, and moral orientation is feasible. © The Author(s) 2014.

Children's Conscience during Toddler and Preschool Years, Moral Self, and a Competent, Adaptive Developmental Trajectory

ERIC Educational Resources Information Center

Kochanska, Grazyna; Koenig, Jamie L.; Barry, Robin A.; Kim, Sanghag; Yoon, Jeung Eun

2010-01-01

We investigated whether children's robust conscience, formed during early family socialization, promotes their future adaptive and competent functioning in expanded ecologies. We assessed two dimensions of conscience in young children (N = 100) at 25, 38, and 52 months in scripted laboratory contexts: internalization of their mothers' and fathers'…

Dimensions of Conscience in Mid-Adolescence: Links with Social Behavior, Parenting, and Temperament

ERIC Educational Resources Information Center

Laible, Deborah; Eye, Jessica; Carlo, Gustavo

2008-01-01

The purpose of this study was to determine whether aspects of conscience cohere into broader dimensions and to examine how these broader dimensions of conscience relate to parenting, temperament, and social behavior. One hundred and thirteen adolescents (M age = 15.88 years, 51% female) completed measures of sympathy, guilt, empathic anger, shame,…

Reframing Conscientious Care: Providing Abortion Care When Law and Conscience Collide

PubMed Central

Lassiter, Dragana; Mercier, Rebecca; Bryant, Amy; Lyerly, Anne Drapkin

2016-01-01

While the concept of conscience has broad philosophical underpinnings relating to moral judgment, agency, and discernments of right and wrong, debates in bioethics have tended to engage the concept primarily vis-à-vis rights of conscientious refusal. Here, we suggest a broader frame for thinking about claims of conscience in healthcare. Drawing on empirical findings from our research with abortion providers in North Carolina, we elucidate an empirically grounded approach to ethically justified care when healthcare providers face legal or institutional policy mandates that raise possible moral conflicts. We highlight, in particular, how providers may be motivated by matters of conscience, including relational concerns, in the active provision of certain forms of care. In so doing, we challenge the dichotomy between conscientious refusal and morally compromised action, demonstrating how providers may work within the constraints of laws or institutional policies that raise moral challenges and act in accordance with conscience. PMID:27120281

Beyond "I'm Sorry": The Educator's Role in Preschoolers' Emergence of Conscience

ERIC Educational Resources Information Center

Smith, Charles A.

2013-01-01

People are not born with a conscience. Conscience does not appear because of "message" books with moral lessons or a grade school campaign for character or a high school course on ethics. Just as children are born to talk and walk, seeking positive social engagement is part of the fabric of humanity. Talking, walking, and caring, however, must…

The Cost of Conscience.

PubMed

Kennett, Jeanette

2017-01-01

The spread of demands by physicians and allied health professionals for accommodation of their private ethical, usually religiously based, objections to providing care of a particular type, or to a particular class of persons, suggests the need for a re-evaluation of conscientious objection in healthcare and how it should be regulated. I argue on Kantian grounds that respect for conscience and protection of freedom of conscience is consistent with fairly stringent limitations and regulations governing refusal of service in healthcare settings. Respect for conscience does not entail that refusal of service should be cost free to the objector. I suggest that conscientious objection in medicine should be conceptualized and treated analogously to civil disobedience.

The Conscience of the Intelligentsia

NASA Astrophysics Data System (ADS)

Bleimaier, John Kuhn

2009-01-01

Our conscience represents our sense of moral compass. It dictates our judgment as to what is right and what is wrong. It influences, often decisively, the choices which we make. While the law codifies morality in the macrocosm, the conscience enforces morality in the individual microcosm. Society may compel the observance of its regulations of conduct by means of the police power of the state. However, it is the conscience which makes social organization possible on the basis of individual internalized compunction. There are never enough gendarmes to insure compliance with the law. It is the presence of conscientious scruple which causes the citizen to conduct himself with rectitude even when nobody is looking...

Two conceptions of conscience and the problem of conscientious objection.

PubMed

Symons, Xavier

2017-04-01

Schuklenk and Smalling argue that it is practically impossible for civic institutions to meet the conditions necessary to ensure that conscientious objection does not conflict with the core principles of liberal democracies. In this response, I propose an alternative definition of conscience to that offered by Schuklenk and Smalling. I discuss what I call the 'traditional' notion of conscience, and contrast this with the existentialist conception of conscience (which I take to be a close cousin of the view targeted by Schuklenk and Smalling). I argue that the traditional notion, grounded in an objective moral order, avoids the criticisms advanced by Schuklenk and Smalling; the existentialist conception, in contrast, does not. I conclude by discussing the benefits and risks of a 'restricted view' of respect for conscience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Conscience and Consciousness: a definition

PubMed Central

Vithoulkas, G; Muresanu, DF

2014-01-01

While consciousness has been examined extensively in its different aspects, like in philosophy, psychiatry, neurophysiology, neuroplasticity, etc., conscience though it is an equal important aspect of the human existence, which remains an unknown to a great degree as an almost transcendental aspect of the human mind. It has not been examined as thoroughly as consciousness and largely remains a “terra incognita" for its neurophysiology, brain topography, etc. Conscience and consciousness are part of a system of information that governs our experience and decision making process. The intent of this paper is to define these terms, to discuss about consciousness from both neurological and quantum physics point of view, the relationship between the dynamics of consciousness and neuroplasticity and to highlight the relationship between conscience, stress and health. PMID:24653768

Conscience and consciousness: a definition.

PubMed

Vithoulkas, G; Muresanu, D F

2014-03-15

While consciousness has been examined extensively in its different aspects, like in philosophy, psychiatry, neurophysiology, neuroplasticity, etc., conscience though it is an equal important aspect of the human existence, which remains an unknown to a great degree as an almost transcendental aspect of the human mind. It has not been examined as thoroughly as consciousness and largely remains a "terra incognita" for its neurophysiology, brain topography, etc. Conscience and consciousness are part of a system of information that governs our experience and decision making process. The intent of this paper is to define these terms, to discuss about consciousness from both neurological and quantum physics point of view, the relationship between the dynamics of consciousness and neuroplasticity and to highlight the relationship between conscience, stress and health.

Conscientious objection in medicine.

PubMed

Wicclair, Mark R

2000-07-01

Recognition of conscientious objection seems reasonable in relation to controversial and contentious issues, such as physician assisted suicide and abortion. However, physicians also advance conscience-based objections to actions and practices that are sanctioned by established norms of medical ethics, and an account of their moral force can be more elusive in such contexts. Several possible ethical justifications for recognizing appeals to conscience in medicine are examined, and it is argued that the most promising one is respect for moral integrity. It is also argued that an appeal to conscience has significant moral weight only if the core ethical values on which it is based correspond to one or more core values in medicine. Finally, several guidelines pertaining to appeals to conscience and their ethical evaluation are presented.

Selling conscience short: a response to Schuklenk and Smalling on conscientious objections by medical professionals.

PubMed

Maclure, Jocelyn; Dumont, Isabelle

2017-04-01

In a thought-provoking paper, Schuklenk and Smalling argue that no right to conscientious objection should be granted to medical professionals. First, they hold that it is impossible to assess either the truth of conscience-based claims or the sincerity of the objectors. Second, even a fettered right to conscientious refusal inevitably has adverse effects on the rights of patients. We argue that the main problem with their position is that it is not derived from a broader reflection on the meaning and implications of freedom of conscience and reasonable accommodation. We point out that they collapse two related but distinct questions, that is, the subjective conception of freedom of conscience and the sincerity test. We note that they do not successfully show that the standard norm according to which exemption claims should not impose undue hardship on others is unworkable. We suggest that the main reason why arguments such as no one is forced to be a medical professional are flawed is that public norms should not constrain citizens to choose between two of their basic rights unless it is necessary. In fine, Schuklenk and Smalling, who see conscience claims as arbitrary dislikes, sell freedom of conscience short and forego any attempts at balancing the competing rights involved. We maintain the authors neglect that most of legal reasoning is contextual and that the blanket restriction of healthcare professionals' freedom of conscience is disproportionate. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

[Physicians conscience and Zeitgeist].

PubMed

Helmchen, H

2015-03-01

According to Luhmann conscience is understood as a value-neutral function for forming identity. Its background is biological in nature but receives its values from the normative context of family and society. In an evolutionary perspective group congruent behavior could offer a survival advantage that will be stabilized by an emotional bonding to a group. This bonding makes the individual dependent on the sociocultural context, including its normative content and its change.This influence becomes clear in different individual as well as time-dependent judgments of a specific moral problem in multicultural societies and with changes of the zeitgeist. Such influences are illustrated by numerous examples and lead to the question whether at all and by which criteria changes of conscience will be recognized by the person concerned. This article aims at a sensitization for questions of formation and vulnerability of the conscience.

Regulation for the enforcement of federal health care provider conscience protection laws. Final rule.

PubMed

2011-02-23

The Department of Health and Human Services issues this final rule which provides that enforcement of the federal statutory health care provider conscience protections will be handled by the Department's Office for Civil Rights, in conjunction with the Department's funding components. This Final Rule rescinds, in part, and revises, the December 19, 2008 Final Rule entitled "Ensuring That Department of Health and Human Services Funds Do Not Support Coercive or Discriminatory Policies or Practices in Violation of Federal Law" (the "2008 Final Rule"). Neither the 2008 final rule, nor this final rule, alters the statutory protections for individuals and health care entities under the federal health care provider conscience protection statutes, including the Church Amendments, Section 245 of the Public Health Service Act, and the Weldon Amendment. These federal statutory health care provider conscience protections remain in effect.

The Teacher as Shaper of Conscience.

ERIC Educational Resources Information Center

Himes, Kenneth

1994-01-01

Discusses the role of conscience in moral decisions and several approaches to moral education. Indicates that moral development is an interactive process between children and their environment and that empathy, delayed gratification, and the courage to withstand social pressure must be encouraged in the moral education of youth. (MAB)

Technological Innovation and Change: A Case Study in the Formation of Organizational Conscience.

ERIC Educational Resources Information Center

McMillan, Jill J.; Hyde, Michael J.

2000-01-01

Discusses how Wake Forest university's adoption of campus-wide computer technology exhibited critical elements of conscience formation. Details how the computer revolution challenged the customary morality of the university; describes how the community engaged in moral deliberation about its technological future; and discusses how the…

45 CFR 30.18 - Interest, penalties, and administrative costs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... equity and good conscience. (2) The Secretary also may waive interest, penalties, and administrative... determination by the Secretary that collection of these charges is: (A) Against equity and good conscience; or... consideration of waiver if statute prohibits collection of the debt during this period. (i) Common law or other...

20 CFR 410.561d - Against equity and good conscience; defined.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Against equity and good conscience; defined. 410.561d Section 410.561d Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.561d Against...

20 CFR 410.561d - Against equity and good conscience; defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Against equity and good conscience; defined. 410.561d Section 410.561d Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Payment of Benefits § 410.561d Against...

Why 'a forest conscienceness'?

Treesearch

M. Calver; H. Bigler-Cole; G. Bolton; J. Dargavel; A. Gaynor; P. Horwitz; J. Mills; G. Wardell-Johnson

2005-01-01

The phrase 'a forest conscienceness' was used in a major statement made by Charles Lane Poole, Western Australia's Conservator of Forests from 1916-1921, for the 1920 British Empire Forestry Conference. It is both relevant and contemporary at the beginning of the 21st century. We chose it as the conference theme to encourage engagement with both a...

Caring, Citizenship, and Conscience: The Cornerstones of a Values Education Curriculum for Elementary Schools.

ERIC Educational Resources Information Center

Braun, Joseph A., Jr.

1992-01-01

Reviews approaches to teaching values in elementary schools. Describes a model consistent with the core values of the United States. Recommends an elementary curriculum resting on three cornerstones: (1) caring, (2) citizenship, and (3) conscience. Points out that controversial issues must be discussed openly within such a curriculum. (CFR)

Huck Finn, Moral Language and Moral Education

ERIC Educational Resources Information Center

Schinkel, Anders

2011-01-01

The aim of this article is twofold. Against the traditional interpretation of "the conscience of Huckleberry Finn" (for which Jonathan Bennett's article with this title is the locus classicus) as a conflict between conscience and sympathy, I propose a new interpretation of Huck's inner conflict, in terms of Huck's mastery of (the) moral language…

Pathways to Conscience: Early Mother-Child Mutually Responsive Orientation and Children's Moral Emotion, Conduct, and Cognition

ERIC Educational Resources Information Center

Kochanska, Grazyna; Forman, David R.; Aksan, Nazan; Dunbar, Stephen B.

2005-01-01

Background: Associations between early mother-child mutually responsive orientation (MRO) and children's conscience have been previously established, but the mechanisms accounting for those links are not understood. We examined three such mediational mechanisms: (a) the child's enhanced enjoyment of interactions with the mother, (b) increased…

Freedom of conscience in health care: distinctions and limits.

PubMed

Murphy, Sean; Genuis, Stephen J

2013-10-01

The widespread emergence of innumerable technologies within health care has complicated the choices facing caregivers and their patients. The escalation of knowledge and technical innovation has been accompanied by an erosion of moral and ethical consensus among health providers that is reflected in the abandonment of the Hippocratic Oath as the immutable bedrock of medical ethics. Ethical conflicts arise when the values of health professionals collide with the expressed wishes of patients or the dictates of regulatory bodies and administrators. Increasing attempts by groups outside of the medical profession to limit freedom of conscience for health providers has raised concern and consternation among some health professionals. The personal and professional impact of health professionals surrendering freedom of conscience and participating in actions they deem malevolent or unethical has not been adequately studied and may not be inconsequential when considering the recognized impact of other circumstances of coerced complicity. We argue that the distinction between the two ways that freedom of conscience is exercised (avoiding a perceived evil and seeking a perceived good) provides a rational basis for a principled limitation of this fundamental freedom.

Moral valuation: a third domain of conscience functioning.

PubMed

Stilwell, B M; Galvin, M; Kopta, S M; Padgett, R J

1996-02-01

To assess development of moral valuation in normal children and adolescents, that is, how moral rules for living are derived and justified, and to examine the relationship of this progression with previously identified stages of conceptualization of conscience. Using three semistructured questions from the Stilwell Conscience Interview, 132 normal volunteers between the ages of 5 and 17 years were assessed. All moral valuation responses were examined within three aspects of social reference: authority-derived, self-derived, and peer-derived. Each aspect was scaled for complexity into six anchored levels. The levels of all three aspects correlated positively with conceptualization stages as well as with each other. When the covariate, age, was taken into consideration, peer-derived valuation was significantly correlated with both age and stage. Moral valuation is a domain of conscience functioning in which moral rules and their justifications are socially referenced in relationship to authority, self, and peers. Anchored levels of these three aspects of moral valuation provide developmental guidelines for mental status examinations in patients between 5 and 17 years of age as well as providing criteria for future comparative studies in various diagnostic categories of psychopathology.

Q. What are conscience clauses, and how do they affect a woman's right to choose?

PubMed

Querido, M

1998-10-01

In the US, state and federal legislatures and regulatory agencies have adopted a variety of conscience clauses to exempt health care organizations and providers from liability if they cite moral or religious reasons for their refusal to 1) provide abortions, sterilizations, or family planning services; 2) refer patients or discuss these services with patients; or 3) fund these services. When participating in the creation of huge medical conglomerates, Roman Catholic hospitals routinely apply conscience clauses to their mergers with secular hospitals and managed care organizations. A conscience clause that permits Medicaid managed care plans to refuse to provide such services also allows them to prohibit their physicians from discussing such services with patients. While Medicaid mandates that if a managed care organization refuses such services, individuals can seek these services from any other Medicaid provider, the language used to inform patients of their rights is often elusive and vague. In some states, legislation is pending that would require employers to cover contraceptives in their health insurance plans. One such bill that was vetoed in California included a conscience clause that clearly provided alternative means for enrollees to obtain contraception. Some states have also considered allowing pharmacists to refuse to dispense medications that offend their moral or religious views. Pharmacist conscious clauses could limit women's access to postcoital contraception, so reproductive rights activists have attempted to modify these clauses and continue to scrutinize proposed legislation.

Higher Education as a Pedagogical Site for Citizenship Education

ERIC Educational Resources Information Center

Davids, Nuraan; Waghid, Yusef

2016-01-01

That the issue of violence sits uneasily on the conscience of higher education is evident in the view that educated people are as likely as uneducated people to participate in violence. The concern of conscience is equally prevalent in the view that the public role of the university is "the responsibility of a community of thinking".…

Professional Ethics, Personal Conscience, and Public Expectations.

PubMed

Haupt, Claudia E

2016-01-01

Examining to what extent physicians are, or ought to be, defined by the profession when giving advice to patients, this commentary seeks to offer a better understanding of the potential conflicts that the American Medical Association's (AMA's) "Opinion 1.1.7, Physician Exercise of Conscience," addresses. This commentary conceptualizes the professions as knowledge communities, and situates the physician-patient relationship within this larger conceptual framework. So doing, it sheds light on how and when specialized knowledge is operationalized in professional advice-giving. Physicians communicate the knowledge community's insights to the patient. Thus, departures from professional knowledge as a matter of the professional's personal conscience are appropriately circumscribed by the knowledge community. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Eternal hate and conscience: on the filiation between Freudian psychoanalysis and sixteenth and early seventeenth century Protestant thought.

PubMed

Westerink, Herman

2011-01-01

In his seminar on ethics Jacques Lacan suggests there exists a "filiation or cultural paternity" between Freudian psychoanalysis and a "new direction of thought" that starts with Luther's conceptualization of God's eternal hate of man, and is then futher continued in Calvinism. In this article this thesis is explored. The author argues that there is not only a familiarity between the Protestant doctrines of predestination and Freud's reconstruction of prehistoric events and primal scenes, but also that Lacan's views on conscience formation and his elaborations of the complexity of moral decisions resembles Calvinist thought on civil and spiritual conscience, and the longing for restoration of a lost image of God.

20 CFR 416.554 - Waiver of adjustment or recovery-against equity and good conscience.

Code of Federal Regulations, 2010 CFR

2010-04-01

... eligible couple that is legally separated and/or living apart for that part of an overpayment not received... subsequently found that the money was improperly paid. Recovery would be considered “against equity and good conscience.” Example 3: Mr. and Mrs. Smith—members of an eligible couple—separate in July. Later in July, Mr...

Mothers' Perceptions of Citizenship, Practices for Developing Citizenship Conscience of Their Children and Problems They Encountered

ERIC Educational Resources Information Center

Ersoy, A. Figen

2012-01-01

Family plays an important role in the development of citizenship awareness of children. The purpose of the present study is to figure out the citizenship perceptions of mothers, their practices for developing citizenship conscience of their children and to explore the problems they have encountered. In this study, critical case sampling method has…

20 CFR 30.517 - Under what circumstances would recovery of an overpayment be against equity and good conscience?

Code of Federal Regulations, 2010 CFR

2010-04-01

... must be shown that the decision made would not otherwise have been made but for the receipt of benefits... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Under what circumstances would recovery of an overpayment be against equity and good conscience? 30.517 Section 30.517 Employees' Benefits OFFICE OF WORKERS...

Dispensing with conscience: a legal and ethical assessment.

PubMed

Wernow, Jerome R; Grant, Donald G

2008-11-01

For over 30 years, pharmacists have exercised the right to dispense medications in accordance with moral convictions based upon a Judeo-Christian ethic. What many of these practitioners see as an apparent shift away from this time-honored ethic has resulted in a challenge to this right. To review and analyze pharmacy practice standards, legal proceedings, and ethical principles behind conflicts of conscientious objection in dispensing drugs used for emergency contraception. We first searched the terms conscience and clause and Plan B and contraception and abortion using Google, Yahoo, and Microsoft Networks (2006-September 26, 2008). Second, we used Medscape to search professional pharmacy and other medical journals, restricting our terms to conscience, Plan B, contraceptives, and abortifacients. Finally, we employed Loislaw, an online legal archiving service, and did a global search on the phrase conscience clause to determine the status of the legal discussion. To date, conflicts in conscientious objection have arisen when a pharmacist believes that dispensing an oral contraceptive violates his or her moral understanding for the promotion of human life. Up to this time, cases in pharmacy have involved only practitioners from orthodox Christian faith communities, primarily devout Roman Catholics. A pharmacist's right to refuse the dispensing of abortifacients for birth control according to moral conscience over against a woman's right to reproductive birth control has created a conflict that has yet to be reconciled by licensing agents, professional standards, or courts of law. Our analysis of prominent conflicts suggests that the underlying worldviews between factions make compromise improbable. Risks and liabilities are dependent upon compliance with evolving state laws, specific disclosure of a pharmacist's moral objections, and professionalism in the handling of volatile situations. Objecting pharmacists and their employers should have clear policies and procedures in place to minimize workplace conflicts and maximize patient care.

Conscientious objection and refusal to provide reproductive healthcare: a White Paper examining prevalence, health consequences, and policy responses.

PubMed

Chavkin, Wendy; Leitman, Liddy; Polin, Kate

2013-12-01

Global Doctors for Choice-a transnational network of physician advocates for reproductive health and rights-began exploring the phenomenon of conscience-based refusal of reproductive healthcare as a result of increasing reports of harms worldwide. The present White Paper examines the prevalence and impact of such refusal and reviews policy efforts to balance individual conscience, autonomy in reproductive decision making, safeguards for health, and professional medical integrity. The White Paper draws on medical, public health, legal, ethical, and social science literature published between 1998 and 2013 in English, French, German, Italian, Portuguese, and Spanish. Estimates of prevalence are difficult to obtain, as there is no consensus about criteria for refuser status and no standardized definition of the practice, and the studies have sampling and other methodologic limitations. The White Paper reviews these data and offers logical frameworks to represent the possible health and health system consequences of conscience-based refusal to provide abortion; assisted reproductive technologies; contraception; treatment in cases of maternal health risk and inevitable pregnancy loss; and prenatal diagnosis. It concludes by categorizing legal, regulatory, and other policy responses to the practice. Empirical evidence is essential for varied political actors as they respond with policies or regulations to the competing concerns at stake. Further research and training in diverse geopolitical settings are required. With dual commitments toward their own conscience and their obligations to patients' health and rights, providers and professional medical/public health societies must lead attempts to respond to conscience-based refusal and to safeguard reproductive health, medical integrity, and women's lives. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Physician-assisted suicide and euthanasia: German Protestantism, conscience, and the limits of purely ethical reflection.

PubMed

Bartmann, Peter

2003-01-01

In this essay I shall describe and analyse the current debate on physician assisted suicide in contemporary German Protestant church and theology. It will be shown that the Protestant (mainly Lutheran) Church in Germany together with her Roman Catholic sister church has a specific and influential position in the public discussion: The two churches counting the majority of the population in Germany among their members tend to "organize" a social and political consensus on end-of-life questions. This cooperation is until now very successful: Speaking with one voice on end-of-life questions, the two churches function as the guardians of a moral consensus which is appreciated even by many non-believers. Behind this joint service to society the lines of the theological debate have to be ree-discovered. First it will be argued that a Protestant reading of the joint memoranda has to be based on the concept of individual conscience. The crucial questions are then: Whose conscience has the authority to decide? and: Can the physician assisted suicide be desired faithfully? Prominent in the current debate are Ulrich Eibach as a strict defender of the sanctity of life, and on the other side Walter Jens and Hans Kung, who argue for a right to physician assisted suicide under extreme conditions. I shall argue that it will be necessary to go beyond this actual controversy to the works of Gerhard Ebeling and Karl Barth for a clear and instructive account of conscience and a theological analysis of the concepts of life and suicide. On the basis of their considerations, a conscience-related approach to physician assisted suicide is developed.

Five year olds with good conscience development.

PubMed

Stapert, Willem; Smeekens, Sanny

2011-01-01

Results from a longitudinal study on factors influencing conscience development contributed to our appreciation of the importance of moral internalization for a child's well-being. In this article we first present a summary of the research on moral development in children, including findings from infant research, with emphasis on the work of Robert N. Emde. Characteristics of classical psychoanalytic theory about superego development are compared with more recent insights. This is followed by a short description of two cheating games--as a measure of conscience development--played with 101 preschoolers. Some contrasts in our empirical data between the fair-play group and the children that cheated are presented and discussed in the light of the theoretical points of view. Finally some reflections on future research and the implications for parenting, prevention and clinical work are followed by suggestions for psychoanalytic theory.

Practical virtue ethics: healthcare whistleblowing and portable digital technology

PubMed Central

Bolsin, S; Faunce, T; Oakley, J

2005-01-01

Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety. Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development. PMID:16199607

[A Chinese Philosophical Foundation for the Sacred Mission of Nurses: The Ways of Heaven and Life are Correlated].

PubMed

Lee, Mei-Hsiu

2016-08-01

Clinical nursing practice uses professional nursing techniques, empathy, and moral judgment to help relieve the pain of patients who are suffering physically or mentally from trauma or illness. Thus, nursing involves sacred tasks. According to Confucian reasoning, morality is expressed through everyday actions. Providing care to patients arouses concern and sympathy in the caregiver, which induces him or her to fully apply professional knowledge to this task. This conduct demonstrates the moral conscience of nurses. The Chinese adage "Tian-tao hsing-ming hsiang kuan tung" (the way of heaven and life are correlated), attributed to Northern Song dynasty scholar Zhang Tsai, aptly explains the sacred mission of the nursing profession. Zhang held that all humans are born with a conscience that is given by heaven. However, human senses and desires may suppress this conscience. As Zhang Tsai suggested, the conscience must be cultivated in order to be manifested. The increase in recent years of international academic discussion / research related to the value and meaning of nursing and of exploration into how to promote the moral competence of nurses, not only provide support to Zhang's argument that "tian-tao" and "hsing-ming" are correlated but also provide positive momentum toward enhancing the self-worth of nurses and enabling patients to receive better care.

A resolution designating June 1, 2010, as "Declaration of Conscience Day" in commemoration of the 60th anniversary of the landmark "Declaration of Conscience" speech delivered by Senator Margaret Chase Smith on the floor of the United States Senate.

THOMAS, 111th Congress

Sen. Snowe, Olympia J. [R-ME

2010-05-20

Senate - 05/20/2010 Submitted in the Senate, considered, and agreed to without amendment and with a preamble by Unanimous Consent. (All Actions) Tracker: This bill has the status Agreed to in SenateHere are the steps for Status of Legislation:

Conscientious objection: a call to nursing leadership.

PubMed

Ford, Natalie J; Fraser, Kimberly D; Marck, Patricia B

2010-09-01

In this paper we argue that nurse leaders need to work actively to create morally supportive environments for nurses in Canada that provide adequate room to exercise conscientious objection. Morally supportive environments engender a safe atmosphere to engage in open dialogue and action regarding conflict of conscience. The CNA's 2008 Code of Ethics for Registered Nurses has recognized the importance of conscientious objection in nursing and has created key guidelines for the registered nurse to follow when a conflict in conscience is being considered or declared. Nurse leaders need to further develop the understanding of conflicts of conscience through education, well-written guidelines for conscientious objection in workplaces and engagement in research to uncover underlying barriers to the enactment of conscientious objections. With advancements in technology, changing healthcare policies and increasing scope of practice, both reflection and dialogue on conscientious objection are critical for the continuing moral development of nurses in Canada.

[Freedom of conscience. Biojuridical conflicts at multicultural societies].

PubMed

Albert Márquez, Marta

2010-01-01

The paper analyzes the right of healthcare professionals to conscientious objection at multicultural societies. the ethical relativism, characteristic of these societies, lives together with an apparently paradoxical reduction of the exercise of freedom of conscience. It is wrote "Apparently" because, at the end, the ethical relativism tends to the adoption of dogmatic attitudes. Special attention is paid to the situation of Spanish healthcare in relation with euthanasia and abortion. With regard to euthanasia, the "dignified dead" draft bill of Andalucía is considered. With regard to abortion, we will pay attention to the reform of the Penal Code in the context of a new regulation about "reproductive health" of women, which means the adoption of a system of time limits, and the characterization of abortion as a women's right. It is concluded that the freedom of conscience of healthcare professionals would be probably at risk if proposed legal policies doesn't change.

First and second things, and the operations of conscience in science.

PubMed

Charlton, Bruce G

2010-01-01

Why is modern science less efficient than it used to be, why has revolutionary science declined, and why has science become so dishonest? One plausible explanation behind these observations comes from an essay First and second things published by CS Lewis. First Things are the goals that are given priority as the primary and ultimate aim in life. Second Things are subordinate goals or aims - which are justified in terms of the extent to which they assist in pursuing First Things. The classic First Thing in human society is some kind of religious or philosophical world view. Lewis regarded it as a 'universal law' that the pursuit of a Second Thing as if it was a First Thing led inevitably to the loss of that Second Thing: 'You can't get second things by putting them first; you can get second things only by putting first things first'. I would argue that the pursuit of science as a primary value will lead to the loss of science, because science is properly a Second Thing. Because when science is conceptualized as a First Thing the bottom-line or operational definition of 'correct behaviour' is approval and high status within the scientific community. However, this does nothing whatsoever to prevent science drifting-away from its proper function; and once science has drifted then the prevailing peer consensus will tend to maintain this state of corruption. I am saying that science is a Second Thing, and ought to be subordinate to the First Thing of transcendental truth. Truth impinges on scientific practice in the form of individual conscience (noting that, of course, the strength and validity of conscience varies between scientists). When the senior scientists, whose role is to uphold standards, fail to posses or respond-to informed conscience, science will inevitably go rotten from the head downwards. What, then, motivates a scientist to act upon conscience? I believe it requires a fundamental conviction of the reality and importance of truth as an essential part of the basic purpose and meaning of life. Without some such bedrock moral underpinning, there is little possibility that individual scientific conscience would ever have a chance of holding-out against an insidious drift toward corruption enforced by peer consensus.

Stigma, conscience, and science in psychiatry: past, present, and future.

PubMed

Sadler, John Z

2009-04-01

In his response to Reynolds and colleagues' "The Future of Psychiatry as Clinical Neuroscience," the author considers three themes prominent in the history of psychiatry: stigma, conscience, and science, considering each in the past, present, and into the future. A series of conclusions follow these historical perspectives. One, unraveling the web of stigma in the future depends more on moral, educational, and political achievements than neuroscientific ones. Two, psychiatry's future depends upon the public trust, which has fluctuated over its history and into the present era, during which legacies of undue influence and failed regulation have damaged this trust. While explaining the mechanisms for mental disorders is crucial, the returns from these scientific investments are decades away, and failures of conscience today undermine the vital public trust and impede psychiatry's abilities to immediately address the plight of the mentally ill. Three, the researcher-entrepreneur in perennial search of funding has replaced the old model of the curious researcher-practitioner. This drive for funding promotes hubris and failures of conscience in psychiatric science. Moreover, the information explosion and superspecialization of contemporary academic medicine has led to an intellectual fragmentation analogous to the service fragmentation at the beginnings of psychiatry. Attention to integrative synthesis of research information, as well as conscientious moral reflection on scientific advances, will promote humility over hubris: enhancing the public trust, assuring public confidence in psychiatric science, and empowering patients.

Science, conscience, consciousness.

PubMed

Hennig, Boris

2010-01-01

Descartes' metaphysics lays the foundation for the special sciences, and the notion of consciousness ("conscientia") belongs to metaphysics rather than to psychology. I argue that as a metaphysical notion, "consciousness" refers to an epistemic version of moral conscience. As a consequence, the activity on which science is based turns out to be conscientious thought. The consciousness that makes science possible is a double awareness: the awareness of what one is thinking, of what one should be doing, and of the possibility of a gap between the two.

Practical virtue ethics: healthcare whistleblowing and portable digital technology.

PubMed

Bolsin, S; Faunce, T; Oakley, J

2005-10-01

Medical school curricula and postgraduate education programmes expend considerable resources teaching medical ethics. Simultaneously, whistleblowers' agitation continues, at great personal cost, to prompt major intrainstitutional and public inquiries that reveal problems with the application of medical ethics at particular clinical "coalfaces". Virtue ethics, emphasising techniques promoting an agent's character and instructing their conscience, has become a significant mode of discourse in modern medical ethics. Healthcare whistleblowers, whose complaints are reasonable, made in good faith, in the public interest, and not vexatious, we argue, are practising those obligations of professional conscience foundational to virtue based medical ethics. Yet, little extant virtue ethics scholarship seriously considers the theoretical foundations of healthcare whistleblowing. The authors examine whether healthcare whistleblowing should be considered central to any medical ethics emphasising professional virtues and conscience. They consider possible causes for the paucity of professional or academic interest in this area and examine the counterinfluence of a continuing historical tradition of guild mentality professionalism that routinely places relationships with colleagues ahead of patient safety.Finally, it is proposed that a virtue based ethos of medical professionalism, exhibiting transparency and sincerity with regard to achieving uniform quality and safety of health care, may be facilitated by introducing a technological imperative using portable computing devices. Their use by trainees, focused on ethical competence, provides the practical face of virtue ethics in medical education and practice. Indeed, it assists in transforming the professional conscience of whistleblowing into a practical, virtue based culture of self reporting and personal development.

Attitudes towards conscientious objection among community pharmacists in Poland.

PubMed

Piecuch, Anna; Gryka, Malwina; Kozłowska-Wojciechowska, Małgorzata

2014-04-01

The European Council Resolution 1763 (2010), ‘‘The right to conscientious objection in lawful medical care’’, provoked a discussion among Polish pharmacists on the necessity for granting them the right to refuse to dispense medicinal products which invoke conscientious objection. To explore attitudes of Polish pharmacists towards the conscience clause. Pharmacies with public e-mail addresses in various parts of Poland (Lower Silesia Province, Mazovia Province, Kuyavia-Pomerania Province, and West Pomeranian Province). An online survey questionnaire addressed to 1,454 pharmacies. The participants were asked 8 questions,including a question addressed only to pharmacy managers and owners. Attitudes towards the right to conscientious objection for pharmacists. Ultimately, responses of 126 pharmacists (83 women, 43 men, average age-39 years of age) were taken into consideration. Most participants (92 %) have never refused to fill a prescription due to their beliefs; however, 15 % of participants state that if the conscience clause were legally sanctioned, they would exercise this right. Most participants(73 %) think that pharmacists should not have the right to conscientious objection. Almost half of participants who support implementation of the conscience clause would grant this right to pharmacists on a conditional basis, if the pharmacists were obliged to present other real options to the patient about obtaining a specific product. Pharmacists are rather reluctant to the idea of implementing the conscience clause, but despite a clear majority of its opponents, there seems to be a necessity for introducing such a regulation.

Implementing national guidelines for person-centered care of people with dementia in residential aged care: effects on perceived person-centeredness, staff strain, and stress of conscience.

PubMed

Edvardsson, David; Sandman, P O; Borell, Lena

2014-07-01

Person-centeredness has had substantial uptake in the academic literature on care of older people and people with dementia. However, challenges exist in interpreting and synthesizing the evidence on effects of providing person-centered care, as the person-centered components of some intervention studies are unclear - targeting very different and highly specific aspects of person-centeredness, as well as not providing empirical data to indicate the extent to which care practice was actually perceived to become more person-centered post-intervention. The study employed a quasi-experimental, one-group pre-test-post-test design with a 12-month follow-up to explore intervention effects on person-centeredness of care and the environment (primary endpoints), and on staff strain and stress of conscience (secondary endpoints). The intervention resulted in significantly higher scores on person-centeredness of care at follow-up, and the facility was rated as being significantly more hospitable at follow-up. A significant reduction of staff stress of conscience was also found at follow-up, which suggests that, to a larger extent, staff could provide the care and activities they wanted to provide after the intervention. The results indicated that an interactive and step-wise action-research intervention consisting of knowledge translation, generation, and dissemination, based on national guidelines for care of people with dementia, increased the staff self-reported person-centeredness of care practice, perceived hospitality of the setting, and reduced staff stress of conscience by enabling staff to provide the care and activities they want to provide.

State contraceptive coverage laws: creative responses to questions of "conscience".

PubMed

Dailard, C

1999-08-01

The Federal Employees Health Benefits Program (FEHBP) guaranteed contraceptive coverage for employees of the federal government. However, opponents of the FEHBP contraceptive coverage questioned the viability of the conscience clause. Supporters of the contraceptive coverage pressed for the narrowest exemption, one that only permit religious plans that clearly states religious objection to contraception. There are six of the nine states that have enacted contraceptive coverage laws aimed at the private sector. The statutes included a provision of conscience clause. The private sector disagrees to the plan since almost all of the employees¿ work for employers who only offer one plan. The scope of exemption for employers was an issue in five states that have enacted the contraceptive coverage. In Hawaii and California, it was exemplified that if employers are exempted from the contraceptive coverage based on religious grounds, an employee will be entitled to purchase coverage directly from the plan. There are still questions on how an insurer, who objects based on religious grounds to a plan with contraceptive coverage, can function in a marketplace where such coverage is provided by most private sector employers.

Conscientious Objection in Healthcare Provision: A New Dimension.

PubMed

West-Oram, Peter; Buyx, Alena

2016-06-01

The right to conscientious objection in the provision of healthcare is the subject of a lengthy, heated and controversial debate. Recently, a new dimension was added to this debate by the US Supreme Court's decision in Burwell vs. Hobby Lobby et al. which effectively granted rights to freedom of conscience to private, for-profit corporations. In light of this paradigm shift, we examine one of the most contentious points within this debate, the impact of granting conscience exemptions to healthcare providers on the ability of women to enjoy their rights to reproductive autonomy. We argue that the exemptions demanded by objecting healthcare providers cannot be justified on the liberal, pluralist grounds on which they are based, and impose unjustifiable costs on both individual persons, and society as a whole. In doing so, we draw attention to a worrying trend in healthcare policy in Europe and the United States to undermine women's rights to reproductive autonomy by prioritizing the rights of ideologically motivated service providers to an unjustifiably broad form of freedom of conscience. © 2015 John Wiley & Sons Ltd.

Hard to Believe : Produced by Ken Stone and Irene Silber, 2015, Swoop Films and Stone Soup Productions (New York, 56 minutes, unrated).

PubMed

Northam, Holly Louise

2016-06-01

This article presents a review of Hard to Believe, a compelling documentary reporting the forced organ procurement and death of Chinese prisoners of conscience. The documentary is targeted to ignite political and public pressure to stop these practices that are thought to be motivated by financial and political gain. Narrated by journalist and author Ethan Gutmann, the documentary pricks at the collective conscience, as credible witnesses provide evidence that point to an abrogation of every ethical principle ascribed to legitimate organ procurement.

The Effect of Mantram Repetition on Burnout and Stress Among VA Staff.

PubMed

Leary, Sheryl; Weingart, Kimberly; Topp, Robert; Bormann, Jill

2018-03-01

In this study, the authors determined the effect of a structured Internet-delivered Mantram Repetition Program (MRP) on burnout and stress of conscience (SOC), stress related to ambiguity from ethical or moral conflicts among health care workers (HCWs) within the Veteran Affairs (VA) Healthcare System. A secondary purpose was to determine whether practicing meditation prior to the study combined with MRP affected burnout or SOC. The MRP teaches the mindful practices of repeating a mantram, slowing down, and one-pointed attention for managing stress. Thirty-nine HCW volunteers who provided direct patient care completed the Internet-delivered MRP. The outcomes of burnout (i.e., exhaustion, cynicism, and professional efficacy) and SOC (i.e., frequency of stressful events and troubled conscience about those events) were measured at baseline (T1), postintervention (T2), and 3-months postintervention (T3). Repeated measures ANOVA indicated that exhaustion significantly ( p < .05) declined between T1 and T3; professional efficacy and cynicism did not change during the study. The same statistical model also indicated the frequency of stressful events significantly declined between T1 and T2 and troubled conscience declined between T1 and T3. Secondary analysis demonstrated that individuals who did not practice meditation at baseline ( n = 16, 41%) significantly decreased exhaustion, frequency of stressful events, and troubled conscience between T1 and T3, and improved professional efficacy between T1 and T2. Individuals who practiced meditation at baseline ( n = 23, 59%) did not demonstrate significant change on any study outcomes. An MRP intervention may reduce burnout and SOC in those individuals who are naïve to practicing meditation.

[Bioethics today: Heidegger’s questions].

PubMed

Figueroa, Gustavo

2011-10-01

Bioethics was born not only as an aftermath of medical technological advance but also from underlying philosophical conceptions about man, that determine scientific research. Analyzing occidental ethics, Heidegger showed that animalism was the only human dimension considered and thereby the domain of measurable objectiveness. He postulated that the essence of human existence as being-in-the-world is ethical and revealed through an original consciousness. Unlike moral conscience, original conscience calls to authenticity, to hear his constitutive nihilism as a "Being-referred-to-death". The founding ground of bioethics may be to listen to this primary being-guilty prior to the derived guilts, e.g. faults, deficiencies and shortcomings of specific daily actions.

An (un)clear conscience clause: the causes and consequences of statutory ambiguity in state contraceptive mandates.

PubMed

VanSickle-Ward, Rachel; Hollis-Brusky, Amanda

2013-08-01

Since 1996, twenty-eight states have adopted legislation mandating insurance coverage of prescription contraceptives for women. Most of these policies include language that allows providers to opt out of the requirement because of religious or moral beliefs-conscience clause exemptions. There is striking variation in how these exemptions are defined. This article investigates the sources and consequences of ambiguous versus precise statutory language in conscience clauses. We find that some forms of political and institutional fragmentation (party polarization and gubernatorial appointment power) are correlated with the degree of policy specificity in state contraceptive mandates. This finding reinforces previous law and policy scholarship that has shown that greater fragmentation promotes ambiguous statutory language because broad wording acts as a vehicle for compromise when actors disagree. Interestingly, it is the more precisely worded statutes that have prompted court battles. We explain this with reference to the asymmetry of incentives and mobilizing costs between those disadvantaged by broad (primarily female employees) versus precisely worded statutes (primarily Catholic organizations). Our findings suggest that the impact of statutory ambiguity on court intervention is heavily contextualized by the resources and organization of affected stakeholders.

Gene therapy, human nature and the churches.

PubMed

Dunstan, G R

1991-12-01

Moral analysis must begin with respect for the empirical features, the "facts of the case". Major advances in genetic knowledge and technology -- as in other sciences -- inevitably change mental attitudes. But they could not change human nature, a product of the distinctively human cerebral cortex. Human capacities like compassion and justice are our own and for us to guard. To ask (as some do) about a "right" to inherit a non-manipulated genome is to ask an unanswerable question: the language of rights is inappropriate in this context. Parents have a duty to safeguard and to serve the interests of their potential child. The medical duty is to help in that task in ways which they have limited freedom to choose. The role of churches is to be faithful to their deposit of faith and their theological principles, including that of freedom of conscience. Churches are too easily led in practice to over-rule conscience on grounds of authority, ecclesiastical or biblical, not sustained by convincing reason. This is most evident in some declarations concerning human reproduction. Better were it for them to help their faithful in moral reasoning, the ethics of choice; to keep consciences tender.

Ethical Diversity and the Role of Conscience in Clinical Medicine

PubMed Central

Genuis, Stephen J.; Lipp, Chris

2013-01-01

In a climate of plurality about the concept of what is “good,” one of the most daunting challenges facing contemporary medicine is the provision of medical care within the mosaic of ethical diversity. Juxtaposed with escalating scientific knowledge and clinical prowess has been the concomitant erosion of unity of thought in medical ethics. With innumerable technologies now available in the armamentarium of healthcare, combined with escalating realities of financial constraints, cultural differences, moral divergence, and ideological divides among stakeholders, medical professionals and their patients are increasingly faced with ethical quandaries when making medical decisions. Amidst the plurality of values, ethical collision arises when the values of individual health professionals are dissonant with the expressed requests of patients, the common practice amongst colleagues, or the directives from regulatory and political authorities. In addition, concern is increasing among some medical practitioners due to mounting attempts by certain groups to curtail freedom of independent conscience—by preventing medical professionals from doing what to them is apparently good, or by compelling practitioners to do what they, in conscience, deem to be evil. This paper and the case study presented will explore issues related to freedom of conscience and consider practical approaches to ethical collision in clinical medicine. PMID:24455248

Professions as the conscience of society.

PubMed

Sieghart, P

1985-09-01

Ethics is no less of a science than any other. It has its roots in conflicts of interest between human beings, and in their conflicting urges to behave either selfishly or altruistically. Resolving such conflicts leads to the specification of rules of conduct, often expressed in terms of rights and duties. In the special case of professional ethics, the paramount rule of conduct is altruism in the service of a 'noble' cause, and this distinguishes true professions from other trades or occupations. If professional ethics come into conflict with national laws, the professional today can test the legitimacy of such laws by reference to internationally agreed legal standards in the field of human rights, and so help to perform the role of 'professions as the conscience of society'.

Conscientious refusal and health professionals: does religion make a difference?

PubMed

Weinstock, Daniel

2014-01-01

Freedom of Conscience and Freedom of Religion should be taken to protect two distinct sets of moral considerations. The former protects the ability of the agent to reflect critically upon the moral and political issues that arise in her society generally, and in her professional life more specifically. The latter protects the individual's ability to achieve secure membership in a set of practices and rituals that have as a moral function to inscribe her life in a temporally extended narrative. Once these grounds are distinguished, it becomes more difficult to grant healthcare professionals' claims to religious exemptions on the basis of the latter than it is on the basis of the former. While both sets of considerations generate 'internal reasons' for rights to accommodation, the relevant 'external' reasons present in the case of claims of moral conscience do not possess analogues in the case of claims of religious conscience. However, the argument applies only to 'irreducibly religious' claims, that is to claims that cannot be translated into moral vocabulary. What's more, there may be reasons to grant the claims of religious persons to exemptions that have to do not with the nature of the claims, but with the beneficial effects that the presence of religious persons may have in the context of the healthcare institutions of multi-faith societies. © 2013 John Wiley & Sons Ltd.

[The Christian virtues medical practice].

PubMed

de Santiago, Manuel

2014-01-01

The return to an ethic of virtues in dialogue with the moral tradition of Medicine and biomedical ethics is the backbone of Pellegrino's proposed reform of medical ethics. The question why this author proposes this reform is answered in this paper that summarizes his book "The Christian Virtues in Medical Practice". Perceiving the changes in the practice of medicine in their country, Pellegrino and Thomasma, men of deep faith, concerned about the darkening of medical conscience and the intuition of danger to the Christian faith, they address the commitment of Christian physicians and those who join them in the mode and form of practicing medicine. Deeply loyal to the Gospel message, the book represents a wake-up call to the conscience of believing professionals, leading to a demanding, enriching and committed vision of the practice of medicine.

Jehovah's Witnesses' refusal of blood: obedience to scripture and religious conscience.

PubMed Central

Ridley, D T

1999-01-01

Jehovah's Witnesses are students of the Bible. They refuse transfusions out of obedience to the scriptural directive to abstain and keep from blood. Dr Muramoto disagrees with the Witnesses' religious beliefs in this regard. Despite this basic disagreement over the meaning of Biblical texts, Muramoto flouts the religious basis for the Witnesses' position. His proposed policy change about accepting transfusions in private not only conflicts with the Witnesses' fundamental beliefs but it promotes hypocrisy. In addition, Muramoto's arguments about pressure to conform and coerced disclosure of private information misrepresent the beliefs and practices of Jehovah's Witnesses and ignore the element of individual conscience. In short, Muramoto resorts to distortion and uncorroborated assertions in his effort to portray a matter of religious faith as a matter of medical ethical debate. PMID:10635500

Professions as the conscience of society.

PubMed Central

Sieghart, P

1985-01-01

Ethics is no less of a science than any other. It has its roots in conflicts of interest between human beings, and in their conflicting urges to behave either selfishly or altruistically. Resolving such conflicts leads to the specification of rules of conduct, often expressed in terms of rights and duties. In the special case of professional ethics, the paramount rule of conduct is altruism in the service of a 'noble' cause, and this distinguishes true professions from other trades or occupations. If professional ethics come into conflict with national laws, the professional today can test the legitimacy of such laws by reference to internationally agreed legal standards in the field of human rights, and so help to perform the role of 'professions as the conscience of society'. PMID:4057214

31 CFR 391.2 - Equitable considerations.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., AND PENALTIES § 391.2 Equitable considerations. For reasons of equity and good conscience, late charges may be waived under the circumstances identified in this section. (a) Where, without fault or bad...

Health Care Conscience Rights Act

THOMAS, 113th Congress

Sen. Coburn, Tom [R-OK

2013-06-20

Senate - 06/20/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

The Rights of Parents.

ERIC Educational Resources Information Center

Fischer, Louis; Schimmel, David

1978-01-01

This article describes the rights of parents as they relate to the education of their children. Topics include legal sources of parents' rights; parent involvement; freedom of religion, conscience, and expression; and political rights. (DS)

Freud's "bad conscience": The case of Nietzsche's Genealogy.

PubMed

Greer, Scott

2002-01-01

This article develops the argument that Friedrich Nietzsche influenced several aspects of Freud's later writings by illustrating, in particular, the impact of Nietzsche's On the Genealogy of Morals on Freud's Civilization and its Discontents. The theoretical and conceptual schemes represented in Freud's Discontents are found to bear a remarkable similarity to Nietzsche's Genealogy on a number of highly specific points. It is suggested that "DAS ES," "Uber-ich," and "bad conscience," concepts central to Freud's moral theory of mind, are at least partly derived from Nietzsche. Moreover, Freud's phylogenetic theory of guilt is based upon premises found in Nietzsche, as are specific details relating to ideas on human prehistory and the ancestral family. Based on this evidence, a re-examination of the moral and social dimensions of Freud's "structural" model may be in order. Copyright 2002 Wiley Periodicals, Inc.

Time Together: A nursing intervention in psychiatric inpatient care: Feasibility and effects.

PubMed

Molin, Jenny; Lindgren, Britt-Marie; Graneheim, Ulla Hällgren; Ringnér, Anders

2018-04-25

The facilitation of quality time between patients and staff in psychiatric inpatient care is useful to promote recovery and reduce stress experienced by staff. However, interventions are reported to be complex to implement and are poorly described in the literature. This multisite study aimed to evaluate the feasibility and effects of the nursing intervention Time Together, using mixed methods. Data consisted of notes from participant observations and logs to evaluate feasibility, and questionnaires to evaluate effects. The primary outcome for patients was quality of interactions, and for staff, it was perceived stress. The secondary outcome for patients was anxiety and depression symptom levels, and for staff, it was stress of conscience. Data were analysed using visual analysis, percentage of nonoverlapping data, and qualitative content analysis. The results showed that Time Together was a feasible intervention, but measurements showed no effects on the two patient outcomes: quality of interactions and anxiety and depressive symptoms and, questionable effects on perceived stress and stress of conscience among staff. Shared responsibility, a friendly approach, and a predictable structure enabled Time Together, while a distant approach and an unpredictable structure hindered the intervention. In conclusion, the intervention proved to be feasible with potential to enable quality interactions between patients and staff using the enabling factors as supportive components. It also had some effects on perceived stress and stress of conscience among staff. Further evaluation is needed to build on the evidence for the intervention. © 2018 Australian College of Mental Health Nurses Inc.

Health Care Provider and Hospital Conscience Protection Act

THOMAS, 113th Congress

Sen. Casey, Robert P., Jr. [D-PA

2013-01-24

Senate - 01/24/2013 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Health Care Provider and Hospital Conscience Protection Act

THOMAS, 112th Congress

Sen. Casey, Robert P., Jr. [D-PA

2011-08-02

Senate - 08/02/2011 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Respect for Rights of Conscience Act of 2011

THOMAS, 112th Congress

Sen. Blunt, Roy [R-MO

2011-08-02

Senate - 08/02/2011 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Managment Styles to Avoid: Some Observations.

ERIC Educational Resources Information Center

Guttschalk, George E.; Cangemi, Joseph P.

1987-01-01

Analyzes management styles of numerous leaders who failed. Presents these categories of styles not associated with success: dictator, blocker, withholder, brownnoser, butcher, non-delegator, worrier, troublemaker, malcontent, weakling, jealous executive, and no-conscience administrator. (Author/ABL)

Nissan Showcases the Results of an Energy-Wise Corporate Culture

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2010-06-11

The corporate leadership at Nissan cultivates a culture of energy efficiency, encouraging employees to practice good energy management at work and in every part of their lives. Read about Nissan's energy-conscience culture.

A Matter of Conscience: Five Newsmen Explain Their Stands

ERIC Educational Resources Information Center

Farr, William; And Others

1973-01-01

Five articles by newsmen who have been jailed for refusing to answer questions regarding news sources are given. Each article describes the circumstances of these confrontations between individual freedoms and state laws. (KM)

Ethics in psychiatry and psychoanalysis.

PubMed

Lothane, Z

1999-01-01

Ethics plays a dual role in psychiatry. The extrinsic role is in defining the rules of ethical conduct for the psychiatrist as a professional dealing with patients, peers and society at large. The intrinsic role is in defining ethical or moral conflict as a determining component in the construction of symptoms of mental disorder. Ethical considerations play a role in the truthful description of the disorder, diagnosis, dynamic formulation and the doctor-patient relationship in treatment. In treatment, there is a need to acknowledge 2 dimensions of psychological conflict: (1) an appraisal of the actual realistic moral conflicts due to symptomatic unethical conduct that goes against one's normative conscience, and (2) resolution of past conflicts arising from unconscious or repressed aspects of the neurotic conscience or superego, i.e. a holdover of unreflected obedience to parental authority. The resolution of past and ongoing conflicts promotes growth toward autonomy of moral judgment, free choice and moral responsibility.

"Who should survive?: one of the choices on our conscience": mental retardation and the history of contemporary bioethics.

PubMed

Antommaria, Armand Matheny

2006-09-01

The film "Who Should Survive?: One of the Choices on Our Conscience" contains a dramatization of the death of an infant with Down syndrome as the result of the parents' decision not to have a congenital intestinal obstruction surgically corrected. The dramatization was based on two similar cases at The Johns Hopkins Hospital and was financed by the Joseph P. Kennedy, Jr., Foundation. When "Who Should Survive?" was exhibited in 1971, the public reaction was generally critical of the parents' decision and the physicians' inaction. Although technological developments in medicine were a necessary condition for the production of this film and its unanticipated reception, they were not a sufficient condition. The proximate cause was a changed understanding of the capabilities of individuals with Down syndrome. Part of the impetus for this change was data showing the adverse effects of institutionalization on normal children.

MANDATING DISCLOSURE OF CONSCIENCE-BASED LIMITATIONS ON MEDICAL PRACTICE.

PubMed

Sawicki, Nadia N

2016-01-01

Stakeholders in law, medicine, and religion are unable to reach consensus about how best to address conflicts between healthcare providers' conscientious objections to treatment and patients' rights to access medical care. Conscience laws that protect objecting providers and institutions from liability are criticized as too broad by patient advocates and as too narrow by defenders of religious freedom. This Article posits that some of the tension between these stakeholders could be mitigated by statutory recognition of a duty on the part of healthcare institutions or providers to disclose conscientiously motivated limitations on practice. While this solution would not guarantee a patient's access to treatment, referral, or information from any given provider, it would prevent some of the more egregious cases of denial of treatment--those where patients are not made aware that a legal and clinically defensible treatment option is excluded from a provider's or institution's scope of practice and so have no opportunity to seek care elsewhere.

The Weight of a Guilty Conscience: Subjective Body Weight as an Embodiment of Guilt

PubMed Central

Day, Martin V.; Bobocel, D. Ramona

2013-01-01

Guilt is an important social and moral emotion. In addition to feeling unpleasant, guilt is metaphorically described as a “weight on one's conscience.” Evidence from the field of embodied cognition suggests that abstract metaphors may be grounded in bodily experiences, but no prior research has examined the embodiment of guilt. Across four studies we examine whether i) unethical acts increase subjective experiences of weight, ii) feelings of guilt explain this effect, and iii) whether there are consequences of the weight of guilt. Studies 1–3 demonstrated that unethical acts led to more subjective body weight compared to control conditions. Studies 2 and 3 indicated that heightened feelings of guilt mediated the effect, whereas other negative emotions did not. Study 4 demonstrated a perceptual consequence. Specifically, an induction of guilt affected the perceived effort necessary to complete tasks that were physical in nature, compared to minimally physical tasks. PMID:23936041

The weight of a guilty conscience: subjective body weight as an embodiment of guilt.

PubMed

Day, Martin V; Bobocel, D Ramona

2013-01-01

Guilt is an important social and moral emotion. In addition to feeling unpleasant, guilt is metaphorically described as a "weight on one's conscience." Evidence from the field of embodied cognition suggests that abstract metaphors may be grounded in bodily experiences, but no prior research has examined the embodiment of guilt. Across four studies we examine whether i) unethical acts increase subjective experiences of weight, ii) feelings of guilt explain this effect, and iii) whether there are consequences of the weight of guilt. Studies 1-3 demonstrated that unethical acts led to more subjective body weight compared to control conditions. Studies 2 and 3 indicated that heightened feelings of guilt mediated the effect, whereas other negative emotions did not. Study 4 demonstrated a perceptual consequence. Specifically, an induction of guilt affected the perceived effort necessary to complete tasks that were physical in nature, compared to minimally physical tasks.

5 CFR 550.206 - Waiver of repayment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... or in part a right of recovery of an advance payment under 5 U.S.C. 5524a and this subpart if he or she determines that recovery would be against equity and good conscience or against the public...

10 CFR 15.37 - Interest, penalties, and administrative costs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... collection proceedings; or (4) Collection would be against equity and good conscience or not in the best... not subject to 31 U.S.C. 3717, in accordance with common law. [55 FR 32380, Aug. 9, 1990, as amended...

Techniques of Punishment and the Development of Self-Criticism

ERIC Educational Resources Information Center

Grusec, Joan E.; Ezrin, Sharyn A.

1972-01-01

The results of this study indicate that induction combined with withdrawal of love is no more effective as a punishment technique for the development of at least one aspect of conscience--self-criticism--than withdrawal of material reward. (Authors)

The Age of Lawlessness and the Idea of Mankind

ERIC Educational Resources Information Center

Starr, Isador

1972-01-01

Civil disobedience, the type of lawlessness characterized by an appeal to natural law, natural right, or conscience, should be the subject of special study and incorporated into our course, wherever relevant, with a view to analyzing its nature and implications. (Author/JB)

Being a close family member of a person with dementia living in a nursing home.

PubMed

Seiger Cronfalk, Berit; Ternestedt, Britt-Marie; Norberg, Astrid

2017-11-01

To illuminate how family members of persons with dementia describe their own experiences, before and after placing their relative in a nursing home. In the Western world and with a growing population of older people, the number of persons with dementia increases. Family members often become carers in their own homes creating stressful and exhausting situation that eventually leads to relocating the person to a nursing home. This may lead to troubled conscience among family members. This is a qualitative study with descriptive design based on interviews with ten family members to residents with dementia at one small nursing home ward. Data were analysed using content analysis. Five categories were derived from data: relocating a person with dementia - a responsibility; visiting the resident - a relief or a burden; the participants taking part in and monitoring the residents' care needs; participants meeting their own needs; and thoughts about the future and resident's death. The result shows both positive and negative aspects of being a family member to persons with dementia. Family members described feeling relief as well as having a troubled conscience when placing a relative in a nursing home. They held themselves responsible for monitoring and evaluating the quality of the care. Family members expressed fearing a slow death for the person with dementia as well as for their own sake. Most felt well treated by the staff. Family members were responsible for relocating the residents to the nursing home. This in itself was found to cause feelings of moral concerns and generating troubled conscience. Staff at nursing homes needs to exercise family-centred care to benefit the persons with dementia, their family members and the staff themselves. © 2017 John Wiley & Sons Ltd.

Reel Politik: Great Conservative Cinema.

ERIC Educational Resources Information Center

Smith, Michael

1994-01-01

This viewer's guide reflects some of the best classic and contemporary film titles available. These are films that reflect the traditional values of faith, family, and freedom. Seventy-five films are reviewed in the categories of achievement, communism, conscience, entrepreneurship, faith, family, freedom, crime and justice, regulation and…

In Defense of Harry...but Not His Defenders: Beyond Censorship to Justice

ERIC Educational Resources Information Center

Glanzer, Perry L.

2004-01-01

The weaknesses of the Harry Potter series and other controversial literatures, which protect student's liberty of conscience and accomplish the ends of public education, are examined. The ways in which educators show justice to different worldviews when assigning literature are discussed.

Educational Leadership in the New Millennium: A Vision for 2020.

ERIC Educational Resources Information Center

Miller, Thomas W.; Miller, Jean M.

2001-01-01

In assessing educational leadership dimensions for 2020, one must consider the effects of technology and automation in education, important influences of changes in society, and progress in developing and understanding administrators' personal/professional needs. Conscience, creative imagination, and interpersonal skill development are essential…

25 CFR 513.5 - What is the Commission's policy on interest, penalty charges, and administrative costs?

Code of Federal Regulations, 2011 CFR

2011-04-01

... not subject to 31 U.S.C. 3717 to the extent authorized under common law or other applicable statutory... these charges would be against equity and good conscience or not in the Commission's best interest. (2...

25 CFR 513.5 - What is the Commission's policy on interest, penalty charges, and administrative costs?

Code of Federal Regulations, 2010 CFR

2010-04-01

... not subject to 31 U.S.C. 3717 to the extent authorized under common law or other applicable statutory... these charges would be against equity and good conscience or not in the Commission's best interest. (2...

42 CFR 489.102 - Requirements for providers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... such individuals concerning— (i) An individual's rights under State law (whether statutory or... accept or refuse medical or surgical treatment and the right to formulate, at the individual's option... conscience objection. (2) Document in a prominent part of the individual's current medical record, or patient...

42 CFR 489.102 - Requirements for providers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... such individuals concerning— (i) An individual's rights under State law (whether statutory or... accept or refuse medical or surgical treatment and the right to formulate, at the individual's option... conscience objection. (2) Document in a prominent part of the individual's current medical record, or patient...

42 CFR 489.102 - Requirements for providers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... such individuals concerning— (i) An individual's rights under State law (whether statutory or... accept or refuse medical or surgical treatment and the right to formulate, at the individual's option... conscience objection. (2) Document in a prominent part of the individual's current medical record, or patient...

Conscientious Objection and "Effective Referral".

PubMed

Trigg, Roger

2017-01-01

Complicity in an immoral, and even criminal, activity, such as robbery or murder, is itself regarded as involving responsibility for those acts. What should the position be of health professionals who are expected to participate in actions that they believe are morally wrong? Professional responsibilities may clash with private conscience. Even referring a patient to someone else, when what is in question may be assisted suicide, or euthanasia, seems to involve some complicity. This is a live issue in Canada, but similar dilemmas occur elsewhere. Physicians and others should not be coerced into involvement of any kind in what they regard as wrong. Such coercion goes against the very principles of liberal democracy. Conscience matters. Reasonable accommodation should be given to those whose moral judgment may be at variance with prevailing professional norms. Moral questions should still be given weight within medicine, and disagreements respected. Dedication to the promotion of human welfare should be paramount, but it should be recognized that there may be different visions of what such welfare consists of.

Consciences, Compasses, Codes, and Common Principles. Teaching Strategy.

ERIC Educational Resources Information Center

Blum, Ann

1996-01-01

Describes a lesson plan that examines the needs and benefits of moral behavior standards that extend beyond the strictly "legal." Procedures include a guided discussion concerning legal but reprehensible actions (participating in destructive gossip). Informative handouts precede moving the discussion to a more global perspective. (MJP)

When Teachers Get Too Tough.

ERIC Educational Resources Information Center

Dowling-Sendor, Benjamin

2000-01-01

In a case involving use of physical force against a misbehaving eighth grader, a federal court judge concluded that the teacher's conduct did not violate the student's due-process rights, after applying the "shock the conscience" test. However, the case proceeded to trial, since district policy supported such force. (MLH)

20 CFR 404.509 - Against equity and good conscience; defined.

Code of Federal Regulations, 2014 CFR

2014-04-01

... awarded benefits for herself and daughter, entered her daughter in private school because the monthly... widow has no other funds with which to pay the daughter's private school expenses. Having entered the daughter in private school and thus incurred a financial obligation toward which the benefits had been...

20 CFR 404.509 - Against equity and good conscience; defined.

Code of Federal Regulations, 2013 CFR

2013-04-01

... awarded benefits for herself and daughter, entered her daughter in private school because the monthly... widow has no other funds with which to pay the daughter's private school expenses. Having entered the daughter in private school and thus incurred a financial obligation toward which the benefits had been...

20 CFR 404.509 - Against equity and good conscience; defined.

Code of Federal Regulations, 2012 CFR

2012-04-01

... awarded benefits for herself and daughter, entered her daughter in private school because the monthly... widow has no other funds with which to pay the daughter's private school expenses. Having entered the daughter in private school and thus incurred a financial obligation toward which the benefits had been...

48 CFR 352.270-9 - Non-discrimination for conscience.

Code of Federal Regulations, 2010 CFR

2010-10-01

... States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, as amended, provides that an... section 104A of the Foreign Assistance Act of 1961, under the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, under the Tom Lantos and Henry J. Hyde United States Global Leadership...

Continuing Education and Social Conscience.

ERIC Educational Resources Information Center

Smith, L. L.

Public education has both political, or social, and personal, or self-improvement objectives; in addition it provides much of the moral quality of a democratic society. Each function--personal, political, and moral--has special significance for continuing education. Adults continue their education to update their job skills or to seek satisfaction…

"Neither Dewey nor Dubya": An Alternative

ERIC Educational Resources Information Center

Carpenter, Wade A.

2005-01-01

As amply documented by "evangelical/liberal" Jim Wallis in his new "God's Politics", any country can be profoundly improved by voices of faith, hope, and love whose appeals are to reason, conscience, and civility, and who have avoided the entrapments of partisanship. Among such voices have been those of Martin Luther King,…

Family Meltdown in the Classroom.

ERIC Educational Resources Information Center

Zinsmeister, Karl

1996-01-01

Students today receive less care and oversight from their parents than in previous years; many lack the direction at home needed to develop a conscience. Research consistently demonstrates the importance of family patterns to student achievement. As schools try to take over that role, teachers become overloaded. Private schools do a much better…

What Does Sport Do for People? A Sociological Approach to the Functions of Sport in Modern Society.

ERIC Educational Resources Information Center

Wilkerson, Martha; Dodder, Richard A.

1979-01-01

A sociological framework is presented for analyzing the role of sport in modern society in terms of the social functions sport may be providing. These include emotional release, affirmation of identity, social control, socialization, social change, collective conscience, and success. (JMF)

Moral Reasoning and Religious Belief: Does Content Influence Structure?

ERIC Educational Resources Information Center

Norman, Antony D.; Richards, Herbert C.; Bear, George G.

1998-01-01

Studies the inference from Kohlbergian theory that content and structure in moral development are independent. Administered Kohlberg's moral dilemmas of life versus law, punishment versus conscience, and authority versus contract. Finds differences in choices and reasoning between students in private Christian schools and public schools, as well…

36 CFR 1201.18 - What interest, penalty charges, and administrative costs will I have to pay on a debt owed to NARA?

Code of Federal Regulations, 2011 CFR

2011-07-01

... to 31 U.S.C. 3717 to the extent authorized under common law or other applicable statutory authority... collection of these charges would be against equity and good conscience or not in the best interest of NARA...

Measure against Measure: Responsibility versus Accountability in Education

ERIC Educational Resources Information Center

Senechal, Diana

2013-01-01

In education policy, practice, and discussion, we find ourselves caught between responsibility--fidelity to one's experience, conscience, and discernment--and a narrow kind of accountability. In order to preserve integrity, we (educators and leaders) must maintain independence of thought while skillfully articulating our work to the outside world.…

Three Differing Systems of Discipline and Their Impact on Conscience and Culture.

ERIC Educational Resources Information Center

Snyder, Ross

Three basic approaches to discipline and child care are the obedience-oriented/punitive, the indulgent/permissive, and the person-enabling/justice approaches. The obedience-oriented/punitive approach, primarily concerned with obedience, sometimes uses praise and rewards manipulatively. When they fail, coercive punishment is used. The…

48 CFR 352.270-9 - Non-discrimination for conscience.

Code of Federal Regulations, 2011 CFR

2011-10-01

... States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, as amended, provides that an..., Tuberculosis, and Malaria Act of 2003, under the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, or under any amendment to the...

48 CFR 352.270-9 - Non-discrimination for conscience.

Code of Federal Regulations, 2014 CFR

2014-10-01

... States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, as amended, provides that an..., Tuberculosis, and Malaria Act of 2003, under the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, or under any amendment to the...

48 CFR 352.270-9 - Non-discrimination for conscience.

Code of Federal Regulations, 2013 CFR

2013-10-01

... States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, as amended, provides that an..., Tuberculosis, and Malaria Act of 2003, under the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, or under any amendment to the...

48 CFR 352.270-9 - Non-discrimination for conscience.

Code of Federal Regulations, 2012 CFR

2012-10-01

... States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, as amended, provides that an..., Tuberculosis, and Malaria Act of 2003, under the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, or under any amendment to the...

The Personnel Function Today--Trends for the Future.

ERIC Educational Resources Information Center

Cox, Arne

The personnel function in industrial society has been marked by crisis, reappraisals, struggles for power, and guilty conscience. The profession is again under pressure; company management often questions its contribution to the solution of strategic personnel matters, while employees and their unions question its values, and wish to place its…

Beating the Apple Tree: How the University Coerces Activism

ERIC Educational Resources Information Center

Thorne, Ashley

2010-01-01

Universities in the United States are increasingly trading their academic mission for a social mission. They see themselves as responsible for contributing to solutions for the great problems of today. These conscience-troubling problems include racism, the unequal distribution of wealth, and impending environmental catastrophe. To combat these…

75 FR 82215 - National Slavery and Human Trafficking Prevention Month, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

... forms. Whether forced labor or sexual trafficking, child soldiering or involuntary domestic servitude, these abuses are an affront to our national conscience, and to our values as Americans and human beings. There is no one type of victim--men and women, adults and children are all vulnerable. From every corner...

Libya: Unrest and U.S. Policy

DTIC Science & Technology

2011-03-29

carried a report on March 9 from the government General Bureau for Criminal Investigation offering, “A reward of half a million Libyan dinars [about...entire city to run.”52 • Ahmed al Zubayr al Sanusi. Serves as a Council member. He is known as “Libya’s longest-serving ‘prisoner of conscience

The Problem of Absolute Knowledge. Metaphysics as Intellectual Intuition in Classic Modern European Philosophy

ERIC Educational Resources Information Center

Torubarova, Tatyana V.

2016-01-01

Classic modern European philosophy explicate, reflect; leaving own history in fundamental metaphysical position, where the existence is understood as conscience. This position is representative in the process of historic development, transition of philosophical thought from R. Dekart to G. Hegel. It appears exactly the field of key metaphysical…

Achieving Peace through Education.

ERIC Educational Resources Information Center

Clarken, Rodney H.

While it is generally agreed that peace is desirable, there are barriers to achieving a peaceful world. These barriers are classified into three major areas: (1) an erroneous view of human nature; (2) injustice; and (3) fear of world unity. In a discussion of these barriers, it is noted that although the consciousness and conscience of the world…

26 CFR 1.5000A-3 - Exempt individuals.

Code of Federal Regulations, 2014 CFR

2014-04-01

... under section 501(a); (ii) Members of which share a common set of ethical or religious beliefs and share... recognized religious sects—(1) In general. An individual is an exempt individual for a month that includes a day on which the individual has in effect a religious conscience exemption certification described in...

Stop High-Stakes Testing: An Appeal to America's Conscience

ERIC Educational Resources Information Center

Johnson, Dale; Johnson, Bonnie; Farenga, Steve; Ness, Daniel

2007-01-01

This book is a compelling indictment of the use of high-stakes assessments with punitive consequences in public schools. The authors trace the history of the policy and document the inequities for children of poverty that undergird high-stakes testing practices. Lack of dental and medical care, environmental violence, insufficient school funding,…

Bullying, Empathic Concern, and Internalization of Rules among Preschool Children: The Role of Emotion Understanding

ERIC Educational Resources Information Center

Camodeca, Marina; Coppola, Gabrielle

2016-01-01

The present study examined whether bullying, defending, and outsider behaviors in preschool children were associated with two conscience aspects (empathic concern and internalization of rules) and with emotion understanding. We also investigated whether emotion understanding moderated the relationship between these dimensions and bullying roles.…

Neoliberalism and the Academic as Critic and Conscience of Society

ERIC Educational Resources Information Center

Harland, Tony; Tidswell, Toni; Everett, David; Hale, Leigh; Pickering, Neil

2010-01-01

This paper provides a critique of academic experiences of neoliberal economic reform at a New Zealand (NZ) university. The authors engaged in a collaborative inquiry that was based upon a developing theoretical perspective of the reform process and how this affected their academic lives. We were keen to develop an understanding of liberal…

ESSA and Migrant Youth. Policy Update. Vol. 23, No. 19

ERIC Educational Resources Information Center

Parsi, Ace; Losh, Maryann

2016-01-01

Edward R. Murrow's 1960 documentary, "Harvest of Shame," pricked the national conscience on the issue of migrant workers. Five years later, migrant youth were included as part of the scope of the Elementary and Secondary Education Act (ESEA). The 2015 reauthorization of that law, the Every Student Succeeds Act (ESSA), turns over more…

Exposure to Theories of Conscience as a Determinant of Cheating.

ERIC Educational Resources Information Center

Dienstbier, Richard A.

Cheating behavior has been found to relate to emotion-attribution explanations. Prior research with second-grade children has indicated that increased self-control occurs in a watching task when the child's emotional response is attributed to internal rather than external actions. In the present study, freshman women (N=221) took a reading…

20 CFR 404.509 - Against equity and good conscience; defined.

Code of Federal Regulations, 2010 CFR

2010-04-01

.... 404.509 Section 404.509 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS.... Example 2. After being awarded old-age insurance benefits, an individual resigned from employment on the... insured status. Due to his age, the individual was unable to get his job back and could not get any other...

20 CFR 404.509 - Against equity and good conscience; defined.

Code of Federal Regulations, 2011 CFR

2011-04-01

.... 404.509 Section 404.509 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS.... Example 2. After being awarded old-age insurance benefits, an individual resigned from employment on the... insured status. Due to his age, the individual was unable to get his job back and could not get any other...

The "War Poets": Evolution of a Literary Conscience in World War I.

ERIC Educational Resources Information Center

Galambos, Ellen

1983-01-01

Pre-World War I poetry often used picturesque images which blinded people to the actual horrors of war. The war poets, who experienced the destruction of World War I, led the way in expressing new images of the devastation and death of war, rather than focusing on honor and glory. (IS)

Engaging Critically with "Objective" Critical Analysis: A Situated Response to Openshaw and Rata

ERIC Educational Resources Information Center

Andreotti, Vanessa

2009-01-01

Roger Openshaw and Elizabeth Rata conceptualise Kaupapa Maori as a dominant intellectual orthodoxy in New Zealand, which creates a "culturalist ideological conformity" that limits the university's ability to serve as the critical conscience of society. They argue for the primacy of academic objectivity as the criteria for what counts as…

The Result of Developing Secondary School Students' Public Conscience through Process-Knowledge Management in Thailand

ERIC Educational Resources Information Center

Homsin, Nawattakorn; Chantarasombat, Chalard; Yeamsang, Theerawatta

2015-01-01

This research uses Mixed-Methodology applied research and development together with participatory action research. The model is appropriate for the context environment. The participants were able to complete the learning activities in participatory forms of knowledge management, using the following five-step model: 1) Knowledge Identification, 2)…

Leadership with a Conscience: Educational Leadership as a Moral Science

ERIC Educational Resources Information Center

Palestini, Robert

2011-01-01

Leaders and aspiring leaders are constantly searching for role models who are successful in placing leadership theory into effective practice. This book identifies ten such role models whose heroic leadership behavior is analyzed in order to reveal what particular abilities and skills made them successful and how those attributes can be applied to…

A Place for Shame in Religious Education

ERIC Educational Resources Information Center

Resnick, David

2017-01-01

An 18th-century parable based on the Adam story offers a model of moral education rooted in communitarianism. Individual conscience arises from social norms, with a vital role for shame and pride. Emphasizing the nobility of being created in the divine image, this model overcomes shortcomings of rationalist, Enlightenment education. Moreover, the…

Travaux Neuchatelois de linguistique (TRANEL) (Neuchatel Works in Linguistics). Number 8.

ERIC Educational Resources Information Center

Travaux Neuchatelois de linguistique (TRANEL), 1985

1985-01-01

The five papers in this collection include: "Apprendre a apprendre les langues: 'Mais je veux etre un handicape linguistique!'" (Learning To Learn Languages: But I Want To Be Linguistically Handicapped!) (Richard Duda); "Pedagogie integree des langues maternelle et seconde. La conscience des problemes chez les enseignants et chez les enseignes"…

Quality in Work-Based Studies Not Lost, Merely Undiscovered

ERIC Educational Resources Information Center

Gibbs, Paul

2009-01-01

The argument made in this paper is that good quality is subsumed into the practices of skillful participants and that institutions should act upon their consciences. This is particularly important in the complex blending of the workplace and the academy, where codified quality may disrupt learning rather than support a flourishing environment for…

75 FR 25101 - National Day of Prayer, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... freedom both to believe and to live our beliefs, and for the many other freedoms and opportunities that... address the great challenges of our time. We are blessed to live in a Nation that counts freedom of conscience and free exercise of religion among its most fundamental principles, thereby ensuring that all...

The Holocaust and Genocide: A Search for Conscience. A Curriculum Guide.

ERIC Educational Resources Information Center

Flaim, Richard F., Ed.; Reynolds, Edwin W., Jr., Ed.

Designed to facilitate teacher development of a secondary unit on the Holocaust and genocide, this multidisciplinary curriculum guide provides a wide variety of classroom-tested objectives, learning activities, and materials. The guide is organized into six units which may be taught in sequence or used in part as supplementary materials: the…

32 CFR Appendix B to Part 284 - Standards for Waiver Determinations

Code of Federal Regulations, 2013 CFR

2013-07-01

... bound in equity and good conscience to make restitution. If a benefit is bestowed by mistake, no matter how careless the act of the Government may have been, the recipient must make restitution. In theory... (including travel and transportation allowances). A waiver is not a matter of right. It is available to...

32 CFR Appendix B to Part 284 - Standards for Waiver Determinations

Code of Federal Regulations, 2011 CFR

2011-07-01

... bound in equity and good conscience to make restitution. If a benefit is bestowed by mistake, no matter how careless the act of the Government may have been, the recipient must make restitution. In theory... (including travel and transportation allowances). A waiver is not a matter of right. It is available to...

32 CFR Appendix B to Part 284 - Standards for Waiver Determinations

Code of Federal Regulations, 2014 CFR

2014-07-01

... bound in equity and good conscience to make restitution. If a benefit is bestowed by mistake, no matter how careless the act of the Government may have been, the recipient must make restitution. In theory... (including travel and transportation allowances). A waiver is not a matter of right. It is available to...

32 CFR Appendix B to Part 284 - Standards for Waiver Determinations

Code of Federal Regulations, 2012 CFR

2012-07-01

... bound in equity and good conscience to make restitution. If a benefit is bestowed by mistake, no matter how careless the act of the Government may have been, the recipient must make restitution. In theory... (including travel and transportation allowances). A waiver is not a matter of right. It is available to...

Conscience and Dividends: Churches and the Multinationals.

ERIC Educational Resources Information Center

Oden, Thomas C.

Over the past 20 years there has been agreement in religious circles that the church's economic power and ties with the corporate world entail a moral responsibility. Church leaders within the corporate-responsibility (CR) movement have taken one of two approaches to corporations and their activities. The reformist approach assumes the market and…

Parental Discipline and Externalizing Behavior Problems in Early Childhood: The Roles of Moral Regulation and Child Gender

ERIC Educational Resources Information Center

Kerr, David C.R.; Lopez, Nestor L.; Olson, Sheryl L.; Sameroff, Arnold J.

2004-01-01

We tested whether individual differences in a component of early conscience mediated relations between parental discipline and externalizing behavior problems in 238 3.5-year-olds. Parents contributed assessments of discipline practices and child moral regulation. Observations of children's behavioral restraint supplemented parental reports.…

The scientist's education and a civic conscience.

PubMed

Donald, Kelling J; Kovac, Jeffrey

2013-09-01

A civic science curriculum is advocated. We discuss practical mechanisms for (and highlight the possible benefits of) addressing the relationship between scientific knowledge and civic responsibility coextensively with rigorous scientific content. As a strategy, we suggest an in-course treatment of well known (and relevant) historical and contemporary controversies among scientists over science policy or the use of sciences. The scientific content of the course is used to understand the controversy and to inform the debate while allowing students to see the role of scientists in shaping public perceptions of science and the value of scientific inquiry, discoveries and technology in society. The examples of the activism of Linus Pauling, Alfred Nobel and Joseph Rotblat as scientists and engaged citizens are cited. We discuss the role of science professors in informing the social conscience of students and consider ways in which a treatment of the function of science in society may find, coherently, a meaningful space in a science curriculum at the college level. Strategies for helping students to recognize early the crucial contributions that science can make in informing public policy and global governance are discussed.

[Evolution, emotion, language and conscience in the postrationalist psychotherapy].

PubMed

De Pascale, Adele

2011-01-01

A complex system process oriented approach, in other words a constructivistic postrationalist cognitive one to psychology and to psychopathology, stresses the close interdependency among processes as evolution, emotion, language and conscience. During evolution, emotions, whose biological roots we share with superior primates, should be specialized and refined. Along this process should become necessary a more and more abstract way of scaffolding the enormous quantity of data a brain could manage. Cognitive abilities, rooted in the emotional quality of experience, allow - during the phylogenetic development - more and more complex patterns of reflexivity until to the necessary ability of recognizing other's intention and consequently of lying. Language, abstract ability usefull to give increasing experiential data scaffolding, probably coming from motor skills development, brings at the same time the possibility, for a human knowing system, of self-consciousness: to do this it's owed to detach from itself, that is experience a deep sense of loneliness. Here it is that the progressive cognitive skills development is linked to the possibility of lying and of self-deception as long as the acquiring of advanced levels of selfconsciousness.

The Awakening of the Social Conscience: Jane Maud Campbell, 1869-1947

ERIC Educational Resources Information Center

Jones, Plummer Alston, Jr.

2012-01-01

Jane Maud Campbell's career demonstrated her commitment and passion for library services with immigrants and minorities as one of the first advocates for multiculturalism in librarianship. She began her career working in the Newark Public Library and soon was employed as the librarian of the Passaic Public Library. She was the first woman employed…

Moral Values in Secondary Education. Bulletin, 1917, No. 51

ERIC Educational Resources Information Center

Neumann, Henry

1918-01-01

The purpose of this bulletin is to stimulate the thought of teachers in discovering their innumerable opportunities for quickening the conscience and clarifying the moral vision of their pupils. The attention of teachers is here directed also to the other reports of the commission, in which are elaborated many of the ideas presented in this…

How Did Honor Evolve?

ERIC Educational Resources Information Center

Barash, David P.

2008-01-01

Blowing the whistle on liars, cheaters, or thieves is likely to impose a cost on the whistle-blower, while everyone else benefits from this act of conscience. If this is so, then why don't people just mind their own business and let someone else do the dirty work? A conceivable explanation is that if no one else perceives the transgression or,…

Everything New Is Old Again: The American Catholic Bishops' Politics of Conscience

ERIC Educational Resources Information Center

O'Keefe, Meaghan

2012-01-01

Over the last ten years, American Catholic bishops have suffered a catastrophic loss of authority in the wake of sexual abuse scandals. In the midst of these scandals, the United States Conference of Catholic Bishops [USCCB] has issued voting guides for presidential elections. In this dissertation, I investigate the American Catholic church's…

One World: Service Bees

ERIC Educational Resources Information Center

Thomason, Rhonda

2009-01-01

Bees are a vital part of the ecology. People of conscience are a vital part of society. In Nina Frenkel's "One World" poster, the bee is also a metaphor for the role of the individual in a diverse society. This article presents a lesson that uses Frenkel's poster to help early-grades students connect these ideas and explore both the importance of…

Moral Stress in Teaching Practice

ERIC Educational Resources Information Center

Colnerud, Gunnel

2015-01-01

The purpose of this article is to study whether moral stress is a phenomenon relevant to teaching practice and which may make a significant contribution to understanding why teachers repeatedly reported feeling burdened by work. Moral stress can be caused by acting in conflict with one's own conscience, e.g. when one knows the right thing to…

Rudolf Steiner's Philosophy of Freedom as a Basis for Spiritual Education?

ERIC Educational Resources Information Center

Oberski, Iddo

2011-01-01

The spiritual well-being of children is often thought to be an important goal and outcome of education. Such spiritual well-being is also implicitly assumed by the Human Rights Act, which includes the right to "freedom of thought, conscience and religion" [Article 18]. I argue that such freedom requires an education that fosters development of…

What Future for the Amerindians of South America? Minority Rights Group Report 15.

ERIC Educational Resources Information Center

O'Shaughnessy, Hugh

Accounts of massacres, rumors of slavery, reports of exploitation and the fashionable preoccupation with ecology have all combined to create a conscience about the Amerindian peoples of South America. There now seems to be generalized feelings in Western Europe and elsewhere that something ought to be done about these peoples. The purpose of this…

76 FR 9968 - Regulation for the Enforcement of Federal Health Care Provider Conscience Protection Laws

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-23

.... ACTION: Final rule. SUMMARY: The Department of Health and Human Services issues this final rule which... sterilization procedure or an abortion, if it would be contrary to the individual's religious beliefs or moral... basis of religious beliefs or moral convictions; or 3. The entity to provide personnel for the...

Considering "Robinson Crusoe's Liberty of Conscience" in an Age of Terror

ERIC Educational Resources Information Center

Cooney, Brian C.

2007-01-01

This essay explores a reading of "Robinson Crusoe" that suggests the novel has taken on new gravity after the first "preemptive" war in U.S. history, a war justified by the attempt to "spread freedom" to Iraq. It examines how Crusoe comes to understand the relationship between the state and the individual. Robinson…

20 CFR 10.437 - Under what circumstances would recovery of an overpayment be against equity and good conscience?

Code of Federal Regulations, 2010 CFR

2010-04-01

... valuable right or changes his or her position for the worse. In making such a decision, OWCP does not... receipt of benefits, and that this decision resulted in a loss. ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Under what circumstances would recovery of an...

Farmhands and Factory Workers, Honesty and Humility: The Portrayal of Social Class and Morals in English Language Learner Children's Books

ERIC Educational Resources Information Center

Sano, Joelle

2009-01-01

Background/Context: Although much research has evaluated children's books for depictions of gender, little has centered on the portrayal of immigrants and social class. This investigation utilizes Bourdieu's theory of capital reproduction in education, Durkheim's conception of collective conscience and morals, and Bowles and Gintis's critique of…

How Full Is Your Luggage? Background Knowledge of Zoo Visitors Regarding Sharks

ERIC Educational Resources Information Center

das Neves, João Pedro Correia; Monteiro, Rute Cristina Rocha

2013-01-01

For the general population, sharks have a reputation that does not really fit with their biological and ecological nature. Informal surveys often classify sharks as dangerous, aggressive and/or man-eaters. This apparent common knowledge seems difficult to detach from the conscience of many worldwide zoo visitors, even with the help of…

Freedom of Religion. American Issues in Perspective: A Documentary Approach.

ERIC Educational Resources Information Center

Worton, Stanley N.

The historical development of First Amendment freedoms and recent events refining their interpretation, particularly in regard to religious freedom, are presented in this first of a series of three books on the Bill of Rights. The book contains primary sources dealing with freedom of conscience and religious liberty from the 17th, 18th, 19th, and…

Images of the "Other" with "Alien" Ethnicity in the Conscience of Russian Population Living in Border Regions

ERIC Educational Resources Information Center

Omelchenko, Daria A.; Maximova, Svetlana G.; Noyanzina, Oksana E.; Maximov, Maxim B.; Avdeeva, Galina S.

2016-01-01

In the age of dense international relations, heightened by intensive migration flows and local ethnic identity strengthening, the study of social representations of ethnic "others" in public consciousness permit to fulfill the evaluation of the current interethnic situation in the country, explore the latent unconscious groundings for…

20 CFR 255.13 - When recovery is against equity or good conscience.

Code of Federal Regulations, 2013 CFR

2013-04-01

... seniority rights when he quit his railroad job, he cannot get his job back. It is determined that the... a private school. The widow did not have substantial assets and her income, apart from the annuities... obligation to send her daughter to private school. In order to pay for the schooling she took out a loan and...

20 CFR 255.13 - When recovery is against equity or good conscience.

Code of Federal Regulations, 2012 CFR

2012-04-01

... seniority rights when he quit his railroad job, he cannot get his job back. It is determined that the... a private school. The widow did not have substantial assets and her income, apart from the annuities... obligation to send her daughter to private school. In order to pay for the schooling she took out a loan and...

20 CFR 255.13 - When recovery is against equity or good conscience.

Code of Federal Regulations, 2014 CFR

2014-04-01

... seniority rights when he quit his railroad job, he cannot get his job back. It is determined that the... a private school. The widow did not have substantial assets and her income, apart from the annuities... obligation to send her daughter to private school. In order to pay for the schooling she took out a loan and...

20 CFR 255.13 - When recovery is against equity or good conscience.

Code of Federal Regulations, 2011 CFR

2011-04-01

... seniority rights when he quit his railroad job, he cannot get his job back. It is determined that the... a private school. The widow did not have substantial assets and her income, apart from the annuities... obligation to send her daughter to private school. In order to pay for the schooling she took out a loan and...

20 CFR 255.13 - When recovery is against equity or good conscience.

Code of Federal Regulations, 2010 CFR

2010-04-01

... seniority rights when he quit his railroad job, he cannot get his job back. It is determined that the... a private school. The widow did not have substantial assets and her income, apart from the annuities... obligation to send her daughter to private school. In order to pay for the schooling she took out a loan and...

The National Student Association in the Fifties: Flawed Conscience of the Silent Generation

ERIC Educational Resources Information Center

Altbach, Philip G.

1973-01-01

Traces the development of the NSA, places it in the context of the 1950s, in which it developed into a major national organization, evaluates its role on campus, and fills in some historical gaps in the growth of student activism and politics in the U.S., since NSA has received little analytic attention. (Author/JM)

Automatically Discounted: Using Black Feminist Theory to Critically Analyze the Experiences of Black Female Faculty

ERIC Educational Resources Information Center

Davis, Shametrice; Brown, Kelly

2017-01-01

Black female faculty (BFF) automatically face a number of (un)conscience struggles as they enter into the academy as junior faculty. As a result, there is often a sense of burnout and overcompensation to mitigate the oppressive experiences related to race and gender. This article conceptualizes a thorough review of the literature of the struggle…

Closing the Gender Gap in the Technology Major

ERIC Educational Resources Information Center

Jung, Laura; Clark, Ulku; Patterson, Laurie; Pence, Toni

2017-01-01

Technology makes up our daily lives and is a part of everything we do. The tech job market is expanding with more and more jobs needing to be filled by those with the necessary qualifications. Students are realizing the vast opportunities a career in technology can offer them and many are making the conscience decision to major in a technical…

"Landscapes of Remembrance" and Sites of Conscience: Exploring Ways of Learning beyond Militarising "Maps" of the Future

ERIC Educational Resources Information Center

Herborn, Peter J.; Hutchinson, Francis P.

2014-01-01

War memorials and related exhibition spaces are commonplace in Australian cities and towns. As critically reflected upon in this paper, there is much "hidden" or alternative history that tends to get ignored when it comes to official memorials and conventional places of remembrance. The particular focus of our paper is the exploration of…

Coming to Terms with Perfection: The Case of Terri Schiavo

ERIC Educational Resources Information Center

Hyde, Michael J.; McSpiritt, Sarah

2007-01-01

Our project is intended to supplement and extend research that emphasizes how the rhetoric informing the euthanasia debate admits a call of conscience and how this call would have us act heroically as we acknowledge what is arguably some particular truth that is at work in the debate (e.g., only God has the right to take a life). The relationship…

The American Indian Reader: History. Book Four of a Series in Educational Perspectives.

ERIC Educational Resources Information Center

Costo, Rupert; Henry, Jeannette, Ed.

In an attempt to rewrite American history incorporating "long hidden facts" pertinent to the American Indian, this book endeavors to relate the "truth in history" and make "humanity see itself face to face without fear and in spite of the pangs of conscience". Each of 7 chapters addresses a specific aspect of American history relevant to the…

42 CFR 62.12 - Under what circumstances can the service or payment obligation be canceled, waived or suspended?

Code of Federal Regulations, 2014 CFR

2014-10-01

... requested action. The Secretary may approve a request for a suspension for a period of 1 year. A renewal of... obligation will be considered impossible if the Secretary determines, on the basis of information and... good conscience, the Secretary, on the basis of information and documentation as may be required, will...

42 CFR 62.12 - Under what circumstances can the service or payment obligation be canceled, waived or suspended?

Code of Federal Regulations, 2010 CFR

2010-10-01

... requested action. The Secretary may approve a request for a suspension for a period of 1 year. A renewal of... obligation will be considered impossible if the Secretary determines, on the basis of information and... good conscience, the Secretary, on the basis of information and documentation as may be required, will...

42 CFR 62.12 - Under what circumstances can the service or payment obligation be canceled, waived or suspended?

Code of Federal Regulations, 2011 CFR

2011-10-01

... requested action. The Secretary may approve a request for a suspension for a period of 1 year. A renewal of... obligation will be considered impossible if the Secretary determines, on the basis of information and... good conscience, the Secretary, on the basis of information and documentation as may be required, will...

42 CFR 62.12 - Under what circumstances can the service or payment obligation be canceled, waived or suspended?

Code of Federal Regulations, 2013 CFR

2013-10-01

... requested action. The Secretary may approve a request for a suspension for a period of 1 year. A renewal of... obligation will be considered impossible if the Secretary determines, on the basis of information and... good conscience, the Secretary, on the basis of information and documentation as may be required, will...

42 CFR 68a.13 - Under what circumstances can the service or payment obligation be canceled, waived, or suspended?

Code of Federal Regulations, 2010 CFR

2010-10-01

... be canceled upon the death of the participant. (b) The Secretary may waive or suspend any service or... considered impossible if the Secretary determines, on the basis of such information and documentation as may... good conscience, the Secretary, on the basis of such information and documentation as may be required...

42 CFR 62.12 - Under what circumstances can the service or payment obligation be canceled, waived or suspended?

Code of Federal Regulations, 2012 CFR

2012-10-01

... requested action. The Secretary may approve a request for a suspension for a period of 1 year. A renewal of... obligation will be considered impossible if the Secretary determines, on the basis of information and... good conscience, the Secretary, on the basis of information and documentation as may be required, will...

Celebrating Ten Years. Foundation for Individual Rights in Education Annual Report, 2009

ERIC Educational Resources Information Center

Foundation for Individual Rights in Education (NJ1), 2009

2009-01-01

This paper presents the annual report of the Foundation for Individual Rights in Education (FIRE) for 2009. The year 2009 was momentous for FIRE, for it marked its tenth anniversary. In the last decade, FIRE has been remarkably successful at fighting to secure basic rights of free speech and conscience on college campuses. It has fought for…

Asheville Middle School: A 6-8 Community of Conscience and Intellect

ERIC Educational Resources Information Center

Roberts, Terry; Billings, Laura

2006-01-01

In this article, the authors talk about the Paideia program of the Asheville Middle School (AMS). Paideia is a Greek word that expresses the idea of nurturing the whole child. The Paideia Program is a systemic school transformation project based on the work of philosopher Mortimer Adler. The authors discuss the principles of the Paideia Program.…

JPRS Report, East Europe.

DTIC Science & Technology

1988-06-09

literature, and music to be missing. "Memory is our culture, our conscience, and our truth. Obscurantists should not appropriate to themselves that word...exemplary manner the objectives of economic and social development of the country. On the occasion of the times of special festivity occa- sioned...transportation, posts and telecommunications, trade, cooperative activity, tourism , and municipal administrative activity, and institutions of learning, cul

Explorations on Just War: Has It Ever Existed?

DTIC Science & Technology

2006-06-01

II . C. WORLD WAR II Pope Pius XII, in an address to the United Nations in 1952, said “The enormous violence of modern warfare means that...to the global community, Pope John Paul II cited “conscience of humanity and international humanity law” and claimed that nations and the...Unclassified 19. SECURITY CLASSIFICATION OF ABSTRACT Unclassified 20. LIMITATION OF ABSTRACT UL ii

Critical Consciousness and the Christian Conscience: Making the Necessary Connections between Faith-Based Learning and Critical Pedagogy

ERIC Educational Resources Information Center

Lee, Heekap; Givens, Ruth

2012-01-01

Critical pedagogy is a by product of postmodernism, which argues that reality is always subjective, and truth is identified through each person's experiences and environment. Can critical pedagogy be applied to faith-based education? The authors claim that it can. First, the theories and practices of critical pedagogy have strengthened faith-based…

Organ procurement from executed prisoners in China.

PubMed

Sharif, A; Singh, M Fiatarone; Trey, T; Lavee, J

2014-10-01

Organ procurement from executed prisoners in China is internationally condemned, yet this practice continues unabated in 2014. This is despite repeated announcements from Chinese authorities that constructive measures have been undertaken to conform to accepted ethical standards. While there is unanimous agreement on the unethical nature of using organs from executed prisoners, due to its limitations on voluntary and informed consent, there is insufficient coverage of forced organ procurement from prisoners of conscience without consent. Strategies to influence positive change in China over the last few decades have failed to bring this practice to an end. While organ donation and transplantation services in China have undergone considerable structural changes in the last few years, fundamental attempts to shift practice to ethically sourced organs have floundered. In this article, we discuss the organ trade in China, reflect upon organ procurement from executed prisoners (including both capital prisoners and prisoners of conscience) and provide an overview of contradictory Chinese efforts to halt forced organ procurement from executed prisoners. Finally, we highlight current actions being taken to address this issue and offer comprehensive recommendations to bring this ethically indefensible practice to an immediate end. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.

Amsterdam to Nairobi: The World Council of Churches and the Third World.

ERIC Educational Resources Information Center

Lefever, Ernest W.

Churches, and in a larger sense religion, should serve as the conscience of society. Hence Christian bodies have an obligation to condemn gross evils and to speak out on the great moral issues, but they should not give their full support to any political party or cause. The World Council of Churches (WCC) from its beginning in 1948 showed an…

The Condition of Art Education: Critical Visual Art Education [CVAE] Club, Winter 2010

ERIC Educational Resources Information Center

Hausman, Jerome; Ploof, John; Duignan, James; Brown, W. Keith; Hostert, Nicholas

2010-01-01

Artist Ad Reinhardt's 1991 prediction of the "Future of Art" can be interpreted as the condition of art education in 2010. He writes, "The next revolution will see the emancipation of the university academy of art from its market-place fantasies and its emergence as a center of consciousness and conscience." The focus in the fields of art and art…

The Evolving Domestic Forum for National Security Debates

DTIC Science & Technology

1974-01-01

of USAWC in March 1974, he was Director, Social Science Studies, Westinghouse Center for Advanced Studies and Analyses. He is the author of n umeIOUS...American social and cultural contex ts, which necessarily overlap the areas of politics, economics, foreign relations, and national security affairs. At...preserve its integrity if individual conscience is accorded a priority overriding all other considerations? - Which value, achievement or equality

Russia and the Return of Geopolitics

DTIC Science & Technology

2007-01-01

religion is formally guar- anteed in Russia. Yet the government has adopted regulations that require religious organizations to give local departments of...for minor- ity religions at the regional and local level in some areas, and the restrictive law on freedom of conscience and religion continues to...geopolitics a pseudoscience . The enduring and paramount importance of geopolitics in the thinking and policies of the Russian elite cannot be understood

A Stream of Conscience: Reflecting on Ethics and Representation in Drama with Youth

ERIC Educational Resources Information Center

Alrutz, Megan

2006-01-01

Like art, ethics can be a complex and scary mirror that forces us to consider, practice, and profess specific choices that speak to who we are and what we value. The author of this article observes that confronting specific ethical dilemmas within her work with young people has brought various tensions to the forefront of her practice as a…

Playwise: 365 Fun-Filled Activities for Building Character, Conscience, and Emotional Intelligence in Children.

ERIC Educational Resources Information Center

Weston, Denise Chapman; Weston, Mark S.

Noting that we are raising our children in a morally ambiguous world and we have to do more than just discipline them and hope for the best, this book is a manual for raising children who are emotionally and intellectually capable and confident, by means of play activities that imbue a sense of right and wrong. Each chapter of the manual begins…

Rights of Conscience Protections for Armed Forces Service Members and Their Chaplains

DTIC Science & Technology

2015-07-22

established five categories of religious accommodation requests: dietary, grooming, medical , uniform, and worship practices.2 • Dietary: typically, these... Medical : typically, these are requests for a waiver of mandatory immunizations. • Uniform: typically, these are requests to wear religious jewelry or...service members in their units. Requirements A chaplain applicant is required to meet DoD medical and physical standards for commissioning as an

Crisis, Conscience, and Choices: Weimar Germany and the Rise of Hitler. Choices for the 21st Century Education Project.

ERIC Educational Resources Information Center

Bakker, Don

This unit is part of a series of curriculum materials that applies the choices approach to critical junctures in history. The focus is on Germany's defeat in World War I and conditions in Germany contributing to the rise of Nazism. Students are provided with background readings on the Weimar Republic, the reparations imposed on Germany with their…

Freedom of Religion--Conscience, Religious Education and the Right of Education in the 1961-1982 Constitutions of the Republic of Turkey and Their Developmental Tendencies

ERIC Educational Resources Information Center

Erkiliç, Turan Akman

2013-01-01

Problem Statement: The Constitutions are the main sources of legality for democratic societies. The 1961 and 1982 Constitutions have dominated the last fifty years of Turkey. In this regard, it is essential to examine and comment academically on the way these Constitutions and their amendments address the rights of education, freedom of thought…

"The Effort of Reason, and the Adventure of Beauty": The Aesthetic Rhetoric of Randolph Bourne

ERIC Educational Resources Information Center

Crick, Nathan; Engels, Jeremy

2012-01-01

We are still coming to terms with the legacy of Randolph Bourne. Although he died at the age of 32 just as the United States was cheerfully entering the First World War under the banner of "democracy," the words he penned in an unfinished essay still resonate in the American social conscience: "War is the Health of the State." This maxim, once…

"Brown v. Board of Education" at 50: Reflections on "Plessy", "Brown", and Our Professional Conscience

ERIC Educational Resources Information Center

Wishon, Phillip

2004-01-01

In this article, the author discusses racial and school segregation with the Plessy vs. Ferguson case, as well as the Brown vs. Board of Education case as an example. The Plessy case deals with Louisiana's separate car law, wherein a 30-year-old apprentice shoemaker named Homer Plessy, who was 1/8 Negro, was arrested for sitting in the Whites-only…

On the definition of the concepts thinking, consciousness, and conscience.

PubMed Central

Monin, A S

1992-01-01

A complex system (CS) is defined as a set of elements, with connections between them, singled out of the environment, capable of getting information from the environment, capable of making decisions (i.e., of choosing between alternatives), and having purposefulness (i.e., an urge towards preferable states or other goals). Thinking is a process that takes place (or which can take place) in some of the CS and consists of (i) receiving information from the environment (and from itself), (ii) memorizing the information, (iii) the subconscious, and (iv) consciousness. Life is a process that takes place in some CS and consists of functions i and ii, as well as (v) reproduction with passing of hereditary information to progeny, and (vi) oriented energy and matter exchange with the environment sufficient for the maintenance of all life processes. Memory is a complex of processes of placing information in memory banks, keeping it there, and producing it according to prescriptions available in the system or to inquiries arising in it. Consciousness is a process of realization by the thinking CS of some set of algorithms consisting of the comparison of its knowledge, intentions, decisions, and actions with reality--i.e., with accumulated and continuously received internal and external information. Conscience is a realization of an algorithm of good and evil pattern recognition. PMID:1631060

Freedom of conscience and health care in the United States of america: the conflict between public health and religious liberty in the patient protection and affordable care act.

PubMed

West-Oram, Peter

2013-09-01

The recent confirmation of the constitutionality of the Obama administration's Patient Protection and Affordable Care Act (PPACA) by the US Supreme Court has brought to the fore long-standing debates over individual liberty and religious freedom. Advocates of personal liberty are often critical, particularly in the USA, of public health measures which they deem to be overly restrictive of personal choice. In addition to the alleged restrictions of individual freedom of choice when it comes to the question of whether or not to purchase health insurance, opponents to the PPACA also argue that certain requirements of the Act violate the right to freedom of conscience by mandating support for services deemed immoral by religious groups. These issues continue the long running debate surrounding the demands of religious groups for special consideration in the realm of health care provision. In this paper I examine the requirements of the PPACA, and the impacts that religious, and other ideological, exemptions can have on public health, and argue that the exemptions provided for by the PPACA do not in fact impose unreasonable restrictions on religious freedom, but rather concede too much and in so doing endanger public health and some important individual liberties.

What Are We Really Afraid Of? The Practitioner View of the Terrorist Threat in the United States

DTIC Science & Technology

2005-03-01

theories that provide explanations for the creation of almost all motivated terrorists- anomie and strain. Consider the foundations of Emile ...Durkheim’s classic theory. Durkheim called the uniformity found in a mechanical (modern) society the collective conscience. To the extent that a society...ostracism and later criminal sanctions drive these groups to desperate measures. Durkheim argued, "society cannot be formed without our being

Conflict and Conscience: Ideological War and the Albigensian Crusade

DTIC Science & Technology

2007-06-15

had fallen to the Egyptians twelve years earlier, and the Crusader Kingdom was still unable to regain the Holy City. The newly elected Pope Innocent...for a favorable settlement with the Egyptians . However, instead of proceeding to Egypt, the Venetian fleet coerced the crusaders into attacking the...assassin of Count Raymond murdered the papal legate Peter de Castelnau. With the vivid memory of his visit to Thomas Becket’s tomb firmly in his mind

Ethics and the Military Profession War and Morality,

DTIC Science & Technology

1978-04-01

34The Problem of War in Hegel’s Thought." Journal of the History of Ideas, 22 (1960), 463. Banduro, Albert . Aggression: A Social Learning Analysis...London: Hogarth Press, 1886-1939.. 1933 letter to Albert Einstein in which Freud discusses the causes of war. Does not treat war as caused by innate...Argues against biblical injunctions for pacifism. Marrin, Albert . War and the Christian Conscience. Chicago: Regnery, 1971. A collection of comments

FIRE's Guide to First-Year Orientation and Thought Reform on Campus. FIRE's Guides to Student Rights on Campus

ERIC Educational Resources Information Center

Silverglate, Harvey A.; Lorence, Jordan

2005-01-01

Before one can have the freedom to express ideas in open debate, however, one must have freedom of conscience: the right to arrive at one's private beliefs, without being coerced into an artificial unity by those who wield power over him/her. After all, the freedom to speak is a dead letter if one lacks the freedom to think, to believe, or to…

Annual report to the NASA Administrator by the Aerospace Safety Advisory Panel on the space shuttle program. Part 2: Summary of information developed in the panel's fact-finding activities

NASA Technical Reports Server (NTRS)

1976-01-01

Safety management areas of concern include the space shuttle main engine, shuttle avionics, orbiter thermal protection system, the external tank program, and the solid rocket booster program. The ground test program and ground support equipment system were reviewed. Systems integration and technical 'conscience' were of major priorities for the investigating teams.

Miracles Can Happen: The Unification of Post Partisan Revolutionary South Carolina

DTIC Science & Technology

2009-01-01

happiness but also believed in personal freedom from the freedom of speech , freedom of thought, freedom of conscience, and the right to property. All...town. Cornwallis’s officers, believing the Presbyterian Church was equivalent to “ sedition shops”, burnt down as many churches as possible to punish...establishment of the state’s government. Private retribution and crimes against Tories were not tolerated. The lessons from the Regulator movement twenty

[Conscientious objectors among physicians].

PubMed

Lisker, Rubén; Pérez-Tamayo, Ruy

2006-01-01

Conscientious objection refers to the possibility that an individual decides not to comply with a legal mandate because of his or hers convictions, which is accepted by some political constitutions. The classical example is to refuse participation in obligatory military service for personal reasons of conscience, but in the present paper we refer to its use in medical practice utilizing three examples: euthanasia, abortion and the refusal to prescribe emergency contraception. We conclude that in all situations patients rights supersedes conscientious objection.

Freedom of Religion and Conscience in the Military: Clarifying Policy

DTIC Science & Technology

2013-04-01

curriculum which included Bible reading and a Christian hymnal in the District of Columbia schools, as well as other acts by the early Congresses...regard in his “Letter to the Hebrew Congregation in Newport, Rhode Island” (August 18, 1790), a copy of which is still on display in that...Establishment Clause.97 The Court considered another landmark case only one year later when on an eight-to-one vote it struck down Bible reading in public

an unexpected souvenir

NASA Astrophysics Data System (ADS)

Brooks, David

Most people are genuinely sympathetic to the difficulties encountered by handicapped persons, but probably too often the compassion evaporates when the wheelchair disappears from view or the tapping of crutches fades down the hall. The accessibility of buildings and facilities has certainly improved in recent years; we now take it for granted that curb cuts and wide doors make the going smoother, at least in public places like university campuses, but consciences still are not eased simply by holding the elevator.

Caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD.

PubMed

Ericson-Lidman, Eva; Larsson, Lise-Lotte Franklin; Norberg, Astrid

2014-06-01

Caring for people with dementia and working in dementia care is described as having both rewarding and unpleasant aspects and has been studied to a minor extent. This study aims to explore care providers' narrated experiences of caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD. Nine care providers were interviewed about their experiences, the interviews were recorded, transcribed and analysed using thematic analysis. The analysis revealed that participants were struggling to perform person-centred care, which meant trying to see the person behind the disease, dealing with troublesome situations in the daily care, a two-edged interaction with relatives, feelings of shortcomings and troubled conscience, and the need for improvements in dementia care. The analysis also revealed an ambiguous work situation, which meant a challenging value base, the differently judged work environment, feelings of job satisfaction and the need for a functional leadership and management. The results illuminate participants' positive as well as negative experiences and have identified areas requiring improvements. It seems of great importance to strive for a supportive and attendant leadership, a leadership which aims to empower care providers in their difficult work. Using conscience as a driving force together in the work group may benefit care providers' health. © 2013 Nordic College of Caring Science.

Conscientious refusals to refer: Findings from a national physician survey

PubMed Central

Combs, Michael P.; Antiel, Ryan M.; Tilburt, Jon C.; Mueller, Paul S.; Curlin, Farr A.

2014-01-01

Background Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method We conducted a cross-sectional survey of a random sample of 2000 U.S. physicians from all specialties. Our primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results Of 1895 eligible physicians, 1032 (55%) responded. Fifty-seven percent of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one’s practice (multivariable odds ratios, 1.6 to 2.4). Conclusions Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide. PMID:21335574

Conscientious objection: personal and professional ethics in the public square.

PubMed

Montgomery, Jonathan

2015-01-01

English law expects health professionals to have, and act upon, consciences, but formal conscience clauses are not the main legal recognition of this expectation. Rather, they should be regarded as an anomaly with roots in very specific political settlements between society and health professions, whose legitimacy is historically contingent, and as an aspect of the 'price' to be paid for securing services. There are sound reasons for the protection of conscientious discretion as an aspect of professional identify, but specific rights of personal conscientious objection are difficult to reconcile with legitimate public expectations of comprehensive and non-discriminatory services. Professional identities include moral commitments, such as the privileging of patient safety over administrative convenience. These should not be permitted to be overridden by personal moralities during the course of service delivery (as opposed to debating in the abstract what the proper courses of action should be). Consequently, formal conscientious objection clauses should be reduced to a minimum and regularly revisited. It is generally more satisfactory to address clashes between the personal moralities of professionals and public expectations through more flexible means, enabling accommodation of a plurality of views where possible but acknowledging that this is a matter of striking an appropriate balance. Employment law rather than healthcare law provides the best mechanism for regulating this process. © The Author [2015]. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

[The Brugada Syndrome in a Teenager].

PubMed

Miklashevich, I M; Kuleshova, E V; Termosesov, S A; Shkolnikova, M A

2017-02-01

The Brugada syndrome (BS) belongs to the group of hereditary channelopathies associated with elevated risk of sudden death (SD) in the absence of structural heart diseases. The disorder phenotypically manifests by specific electrocardiographic pattern, associated with ventricular tachycardia (VT). VT can be accompanied by loss of conscience, and after transformation to ventricular fibrillation result in SD. BS is extremely rare among children and adolescents. We present here a clinical case of teenager (age 17 years) with BS manifested by syncopal state at the background of fever.

Native Hawaiians Study Commission: Report on the Culture, Needs and Concerns of Native Hawaiians. Final Report. Volume II. Claims of Conscience: A Dissenting Study of the Culture, Needs and Concerns of Native Hawaiians.

ERIC Educational Resources Information Center

Department of the Interior, Washington, DC.

Volume II of the final report of the Native Hawaiians Study Commission (NHSC) on the culture, needs, and concerns of native Hawaiians, this book contains a formal dissent to the conclusions and recommendations presented in Volume I made by three of the NHSC commissioners. Its principal criticism is that Volume I fails to address the underlying…

The centrality of guilt: working with ultra-orthodox Jewish patients in Israel.

PubMed

Hess, Esther

2014-09-01

The ultra-orthodox Jewish (Haredi) community in Israel is characterized by strict observance of the requirements of orthodox Jewish life. Psychoanalytic psychotherapy within this community brings us into contact with guilt as a central emotion throughout the therapeutic process. The exposure to new concepts, ways of thought and a previously unknown space, together with increased awareness of internal wishes and drives, are experienced as forbidden areas that arouse an awakening of conscience and a sense of guilt. The author's cases illustrate these conflicts.

The social worker as moral citizen: ethics in action.

PubMed

Manning, S S

1997-05-01

Social workers today face some of the most complex ethical dilemmas in the history of the profession. This article presents a framework of moral citizenship to guide ethical social work practice. The framework includes the action philosophies of philosopher Hannah Arendt and Lutheran theologian Paul Tillich integrated with concepts of professional responsibility and the unique contributions of social work pioneer Charlotte Towle. Social conscience and social consciousness, including awareness, thinking, feeling, and action, are major components of the framework.

A Soldier’s Morality, Religion, and Our Professional Ethic: Does the Army’s Culture Facilitate Integration, Character Development, and Trust in the Profession?

DTIC Science & Technology

2014-04-01

Month.” Not all religious Americans consider homosexual behavior to be in vio- lation of their own moral understandings, but many, including within...to join in the institutional endorsement and celebration of homosexual behavior . That, many soldiers of religious faith cannot in good conscience...professions. Of course, the alternative without such trust is for the Services simply to revert to the char- acter and behavior of a government

Navy Chaplains as Religious Advisors: A Combatant Commander’s Strategic Asset in Conflict, Reconstruction and Peace

DTIC Science & Technology

2012-04-05

attempting to foster a climate of fairness, trust, and accountability .40 As the essential advisor, the chaplain operates as the moral conscience for the...local community. In doing so, the chaplain affords the widest possible free exercise of religion in the most cost effective manner. In addition...Operations, JP 1-05 (Washington, DC: Joint Forces Staff, November 2009), i. 13 SACNAVINST 1730.10, 1. 14 Clifford Drury , The History of the

Interrogation of Detainees: Overview of the McCain Amendment

DTIC Science & Technology

2006-09-25

in another); Miller v. City of Philadelphia, 174 F. 3d 368, 375 (3rd Cir.1999) (“The exact degree of wrongfulness necessary to reach the ‘conscience...v. Crosby, 379 F. 3d 1278 (11th Cir. 2004). 17 Haynes v. Washington, 373 U.S. 503 (1963). See also Greenwald v. Wisconsin, 390 U.S. 519 (1968...Kate Zernike & Sheryl Gay Stolberg, Differences Settled in Deal Over Detainee Treatment, NY TIMES, Sept. 23, 2006, at A9. 28 For purposes of

Abortion: a tangle of rights.

PubMed

Curtin, L L

1993-02-01

Management of abortion personnel within a hospital setting involves a number of rights: the patient's rights to privacy and to the provision of competent, compassionate, and understanding nursing care; the right of nurses to refrain from abortion procedures due to conscience; and the right of hospitals to hire employees who will fulfill their contractual obligations. The US Supreme Court has held that the decision to abort is protected under the right to privacy; no one may interfere with a woman's decision. Public institutions do not have an obligation to fund abortion. If the Court had made abortion a right, then society would be obliged to provide abortion. The discussion of abortion rights focuses on the following topics: the legal duties of health professionals, the legal and moral rights and obligations of nurses, the legal rights and obligations of hospitals, and the rights of abortion patients. A case study is provided of a head nurse and staff in the gynecology ward of a large metropolitan hospital in 1974 who objected to the performance of saline abortion on the ward, to disposing of the fetuses, and to the validity of patients' consent. Their concern was for the health and safety of patients and the rights of patients to informed consent. The hospital did not have a right to force the nurses to comply with the directive on saline abortion procedures, because the hospital did not have the right to violate the conscience of an individual citizen. In another example of a transfer of a nurse to another area of the hospital, the hospital was exercising its prerogative to expect fulfillment of contractual obligations in a way that did not interfere with health care workers' objections to abortion. Roe v. Wade and Doe v. Bolton were the 2 cases that established the existence of institutional conscience. Health care workers have an obligation to inform hospitals in writing if they have objections to participation in abortion procedures. Nurses have an obligation to respect the legal right to privacy in making or carrying out an abortion decision, and to provide competent nursing care to all who receive their services. Nurses should not make judgments about their approval or disapproval of abortion or the patient's reasons for abortion. Patients have a right to be protected from emotional and physical harm from objecting nurses; nurses may withdraw their services only if there are other qualified professionals available to provide care.

A new experience: the course of ethics in engineering in the Department of Civil Engineering, University of Granada.

PubMed

Gil-Martín, Luisa María; Hernández-Montes, Enrique; Segura-Naya, Armando

2010-06-01

A course in professional ethics for civil engineers was taught for the first time in Spain during the academic year 2007/08. In this paper a survey on the satisfaction and expectation of the course is presented. Surprisingly the students sought moral and ethical principles for their own ordinary lives as well as for their profession. Students were concerned about the law, but in their actions they were more concerned with their conscience, aware that it can be separate from the law.

Pathomimie de l'enfant: à propos d'une observation

PubMed Central

Abilkassem, Rachid; Dini, Nezha; Ourai, Hakim; Kmari, Mohamed; Agadr, Aomar

2013-01-01

La pathomimie cutanée se définit comme une maladie factice, provoquée dans un etat de conscience claire par le patient lui-même, au niveau du revêtement cutanéo-muqueux et/ou des phanères. Rare chez l'enfant, il s'agit d'une manifestation psychopathologique potentiellement grave et souvent difficile à prendre en charge. Nous rapportons le cas d'une fillette de 10 ans présentant une pathomimie sous forme de lésions excoriées multiples du visage. PMID:23504605

Physicians’ Beliefs About Conscience in Medicine: A National Survey

PubMed Central

Lawrence, Ryan E.; Curlin, Farr A.

2010-01-01

Purpose To explore physicians’ beliefs about whether physicians sometimes have a professional obligation to provide medical services even if doing so goes against their conscience, and to examine associations between physicians’ opinions and their religious and ethical commitments. Method A survey was mailed in 2007 to a stratified random sample of 1,000 U.S. primary care physicians, selected from the American Medical Association Physician Masterfile. Participants were classified into three groups according to agreement or disagreement with two statements: “A physician should never do what he or she believes is morally wrong, no matter what experts say,” and “Sometimes physicians have a professional ethical obligation to provide medical services even if they personally believe it would be morally wrong to do so.” Results The response rate was 51% (446/879 delivered questionnaires). Forty-two percent and 22% believed they are never and sometimes, respectively, obligated to do what they personally believe is wrong, and 36% agreed with both statements. Physicians who are more religious are more likely to believe that physicians are never obligated to do what they believe is wrong (58% and 31% of those with high and low intrinsic religiosity, respectively; multivariate odds ratio, 2.9; 95% CI, 1.2–7.2). Those with moral objections to any of three controversial practices were more likely to hold that physicians should never do what they believe is wrong. Conclusion A substantial minority of physicians do not believe there is ever a professional obligation to do something they personally believe is wrong. PMID:19707071

Conscientious refusals and reason-giving.

PubMed

Marsh, Jason

2014-07-01

Some philosophers have argued for what I call the reason-giving requirement for conscientious refusal in reproductive healthcare. According to this requirement, healthcare practitioners who conscientiously object to administering standard forms of treatment must have arguments to back up their conscience, arguments that are purely public in character. I argue that such a requirement, though attractive in some ways, faces an overlooked epistemic problem: it is either too easy or too difficult to satisfy in standard cases. I close by briefly considering whether a version of the reason-giving requirement can be salvaged despite this important difficulty. © 2013 John Wiley & Sons Ltd.

Pneumomédiastin compliquant une crise d’éclampsie: à propos d'un cas

PubMed Central

Doumiri, Mouhssine; Motiaa, Youssef; Oudghiri, Nezha; Saoud, Anas Tazi

2014-01-01

Le pneumomédiastin associé à l'emphysème sous cutané et le pneumothorax, sont des complications rares de la grossesse et surviennent au cours du travail obstétrical. Nous rapportons l'observation d'une parturiente de 25ans, sans antécédent pathologique particulier, admise pour une crise d’éclampsie à 36 semaines d'aménorrhées avec une mort fœtale et trouble de la conscience. L'examen clinique a montré un emphysème sous cutané étendu du visage jusqu’à l'abdomen sans notion de traumatisme et un score de Glasgow à 10. Après mise en condition, traitement de la crise d’éclampsie, stabilisation de la tension artérielle et retour à l’état de conscience, une TDM cervico-thoraco-abdominale a été demandée et a révélé la présence d'un pneumomédiastin important avec un discret pneumothorax droit postérieur et un pneumopéritoine important qui n'ont pas nécessité de drainage pleural. Deux jours après son admission, la patiente a expulsé un mort-né d'un poids de 1800 grammes avec forceps et sans efforts d'expulsions sous analgésie péridurale. Le contrôle radiologique à une semaine a noté une nette diminution de l'emphysème sous cutané et du pneumomédiastin. La patiente a quitté l'hôpital après dix jours. PMID:25838864

Psychometric properties concerning four instruments measuring job satisfaction, strain, and stress of conscience in a residential care context.

PubMed

Orrung Wallin, Anneli; Edberg, Anna-Karin; Beck, Ingela; Jakobsson, Ulf

2013-01-01

There are many instruments assessing the wellbeing of staff, but far from all have been psychometrically investigated. When evaluating supportive interventions directed toward nurse assistants in residential care, valid and reliable instruments are needed in order to detect possible changes. The aim of the study was to investigate validity in terms of data quality, construct validity, convergent and divergent validity and reliability in terms of the internal consistency and stability of the Job Satisfaction Questionnaire, the Psychosocial Aspects of Job Satisfaction, the Strain in Dementia Care Scale (SDCS), and the Stress of Conscience Questionnaire (SCQ) in a residential care context. The psychometric properties of the instruments were investigated in terms of data quality, construct validity, convergent and divergent validity and reliability, including test-retest reliability, in a residential care context with a sample consisting of nurse assistants (n=114). The four instruments responded with different psychometric-related problems such as internal missing data, floor and ceiling effects, problems with construct validity and low test-retest reliability, especially when assessed on the item level. These problems were however reduced or disappeared completely when assessed for total and factor scores. From a psychometric perspective, the SDCS seemed to stand out as the best instrument. However, it should be modified in order to reduce floor effects on item level and thereby gain sensitivity. The Job Satisfaction Questionnaire seemed to have problems both with the construct validity and test-retest reliability. The final choice of instrument must, however, be made dependent on what one intends to measure. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[Conscientious objection for health professionals in ethics and deontology].

PubMed

Martínez León, Mercedes; Rabadán Jiménez, José

2010-01-01

The main objective of this paper is to highlight the numerous conflicts enters the consciousness and the laws are becoming more frequent health professionals in daily clinical practice. Clarify and define concepts such as ″conscientious objection for health professionals, to avoid confusion with other terms. This is work that aims to address the objection of conscience, not from the law but from the ethics and deontology, reviewing existing regulations both internationally and nationally. In addition to complete the studio, in a last part we discuss the state of the ″conscientious objection″ tars the recent passage of the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy. As a final conclusion we can say that ″conscientious objection″ is recognized in international declarations and even in the european constitution. in spain, the code of ethics and medical ethics, is one of the places where the objection of conscience of health professionals has great development for years, states that the doctor can refrain from the practice of certain professional acts such as abortion, in vitro fertilization or sterilization, if they are in contradiction with its ethical and scientific beliefs. Also recently, the general assembly of october 24, 2009, the central committee of ethics has made a declaration on ″conscientious objection″, insisting on its recognition. Finally, the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy, seems to be recognized ″the right to exercise conscientious objection″ of health professionals directly involved in the voluntary termination of pregnancy, after much discussion, but it is still early to assess the implementation of this right because, until july 5, 2010, will come into force this law, what will the future that we clarify the development of this important right for health professionals.

Through the depths and heights of darkness; mothers as patients in psychiatric care.

PubMed

Blegen, Nina Elisabeth; Eriksson, Katie; Bondas, Terese

2014-12-01

This study attempts to contribute to the knowledge of caring science and mental health care by means of a profound understanding of the patients' existential world when being a mother in receipt of psychiatric care, with focus on inner processes such as health and suffering. Mothers struggle to cope with the demands of the illness and the responsibility for their children. They see themselves through their children and regard the child as an important part of themselves. Mothers experience guilt and shame related to motherhood, and when they have to relinquish their responsibility as a mother, they consider themselves a failure. Despite a range of practical and emotional difficulties, motherhood involved extremely positive experiences, which provide a purpose as well as fulfilment and meaning in life. This study is rooted in philosophical hermeneutics inspired by Gadamer with an inductive-deductive-abductive approach. Interpretation of the data was made on different levels of abstraction described as rational, contextual, existential and ontological. The point of departure was the caring science theory about health and suffering and the hermeneutic philosophy of understanding. The interpretation revealed the mothers' experiences of health and suffering as a struggle between the darkness of suffering and their inner source of strength. In the light of the theory of caring, the conscience became visible as the bearer of the human being's inner ethos of love and compassion. Experiences of health and suffering were interpreted as a struggle between guilt and responsibility, where conscience emerged as the road from ontological guilt to responsibility that leads the human being to what is true, beautiful and good in life. © 2014 Nordic College of Caring Science.

Pressure for a select committee on human embryo research and genetic engineering.

PubMed

McKie, David

1985-11-02

By a commanding majority of almost five million votes, this year's Labour Party conference agreed that Labour Members of Parliament should not be permitted to let their consciences decide their votes on "issues affecting the reproductive rights of women." The targets for this censure were the 44 Labour MPs who backed Enoch Powell's bill to outlaw experiments on embryos. Conservative supporters of the Powell bill are countering their defeat by advocating a Parliamentary select committee to examine "matters of human embryo research and human genetic engineering." McKie comments that they are thus shifting emphasis from "fertility," which has public support, to genetic engineering, which generates fear.

[Duration and temporality].

PubMed

Fouks, L; Guibert, S; Cardon; Montot

1990-01-01

The notion of temporality in living is in perpetual motion between passive temporality and creative conscience. Human existence is not purely immanent, a flow of transcedence continually runs through it. Melancholia is a lose of creativity accompanied by a feeling that time as lived has stopped, time being lived as a new mode of space. Maniac temporality is an improductive and unsociable furious flight toward. The melancholic feeling out of time is crushed by the problematic of alterity, sin and eternity. The maniac lives an imaginary and deceptive problematic. The ambivalent ideal of the schizophrenic is both a return to biological life as well as a fascination by formal thought.

[Contraception and bioethics: between the conscience objection and the autonomy principle].

PubMed

Neyro-Bilbao, José Luis; Ángel Elorriaga, Miguel; Lira-Plascencia, Josefina

2015-02-01

In recent years, in all Western societies has changed the paradigm of the physician-patient relationship. It has passed from the principle of beneficence and abscence of malificence to the patients autonomy, recognizing their sovereignty in making clinical decisions that directly affect them. Occasionally, this principle can clash with certain bioethical aspects of conscientious objection for health professionals and providers, primarily in the areas of contraception and abortion. We discussed aspects that support one or another attitude emphasizing issues relating to contraception and induced abortion and the access and use of contraceptive methods by adolescents recognized as "mature minors" to issues of sexuality, particularly in Spain and Mexico.

Response to: 'Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies' by Schuklenk and Smalling.

PubMed

Glick, Shimon M; Jotkowitz, Alan

2017-04-01

The recent essay by Schuklenk and Smalling opposing respect for physicians' conscientious objections to providing patients with medical services that are legally permitted in liberal democracies is based on several erroneous assumptions. Acting in this manner would have serious harmful effects on the ethos of medicine and of bioethics. A much more nuanced and balanced position is critical in order to respect physicians' conscience with minimal damage to patients' rights. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Harmful Emotional Responses that Patients and Physicians May Have When their Values Conflict.

PubMed

Howe, Edmund G

One of the most difficult decisions a clinician may face is when, if ever, to decline what a patient wants, based on the clinician's own moral conscience. Regardless of what the clinician decides, the outcome may be deeply emotionally painful for both parties, and the pain may last. I will discuss this pain, how it occurs, and what we can do to try to reduce it before, during, and after a conflict arises. Approaches include explaining how we are like the patient or doctor, that no one is perfect, and that what we do is not who we are. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Sex offences.

PubMed

Bush, J P

1978-11-01

The investigation of offences involving sexual assaults and the examination of the victims of such crimes, are matters of concern to the community, to medical people and to law enforcement agencies. Throughout the world, much thought has been given to these matters during the last few years. The subject has stimulated anger and frustration as well as sympathy. The public conscience has been stirred and professional groups--doctors, lawyers, legislators and law enforcement agencies--goaded on many occasions by feminist groups, have deliberated the various aspects of this problem. A deal of practical advice has been given on this subject and throughout the world there has been a number of different approaches to the manner in which the medical examination of these victims is handled.

‘It’s on your conscience all the time’: a systematic review of qualitative studies examining views on obesity among young people aged 12–18 years in the UK

PubMed Central

Rees, Rebecca W; Caird, Jenny; Dickson, Kelly; Vigurs, Carol; Thomas, James

2014-01-01

Objective To explore the perspectives of young people in the UK on obesity, body size, shape and weight. Design Systematic review of qualitative studies using thematic synthesis. Data sources Sensitive searches of 18 electronic databases from 1997 to February 2010 supplemented by grey literature searches. Study selection Studies produced since 1997 using qualitative methods to collect perspectives of people aged 12–18 years in the UK, reporting methods for data collection or analysis. Studies of people with eating disorders and those rated low in reliability and usefulness were excluded. Results Searches identified 30 studies involving over 1400 young people from a range of contexts. Young people of all sizes placed considerable emphasis on personal responsibility, and on the social, rather than health implications of being overweight. Young people with experience of obesity described severe, unrelenting, size-related abuse and isolation. Regardless of their own size, young people were judgemental of individuals who were overweight, but those with experience of obesity described an environment that contained multiple barriers to weight loss. Only one study asked young people directly what might support them to have a healthy body size. Study findings were configured under three main themes, labelled with quotes from included studies: general perceptions of size and society's responses (‘It's on your conscience all the time’); the experiences of young people who were overweight (‘If I had the choice I wouldn't be this size’) and these larger young people's experiences of trying to loose weight and suggestions for action (‘Make sure, even when it's hard, you've got people there’). Conclusions The perspectives of young people in the UK, when synthesised across the spectrum of body sizes, paint a picture of a stigmatising and abusive social world. Research and policy need to engage young people actively so as to address the social implications of obesity. PMID:24785398

Legal briefing: conscience clauses and conscientious refusal.

PubMed

Pope, Thaddeus Mason

2010-01-01

This issue's "Legal Briefing" column covers legal developments pertaining to conscience clauses and conscientious refusal. Not only has this topic been the subject of recent articles in this journal, but it has also been the subject of numerous public and professional discussions. Over the past several months, conscientious refusal disputes have had an unusually high profile not only in courthouses, but also in legislative and regulatory halls across the United States. Healthcare providers' own moral beliefs have been obstructing and are expected to increasingly obstruct patients' access to medical services. For example, some providers, on ethical or moral grounds, have denied: (1) sterilization procedures to pregnant patients, (2) pain medications in end-of-life situations, and (3) information about emergency contraception to rape victims. On the other hand, many healthcare providers have been forced to provide medical treatment that is inconsistent with their moral beliefs. There are two fundamental types of conscientious objection laws. First, there are laws that permit healthcare workers to refuse providing - on ethical, moral, or religious grounds healthcare services that they might otherwise have a legal or employer-mandated obligation to provide. Second, there are laws directed at forcing healthcare workers to provide services to which they might have ethical, moral, or religious objections. Both types of laws are rarely comprehensive, but instead target: (1) certain types of healthcare providers, (2) specific categories of healthcare services, (3) specific patient circumstances, and (4) certain conditions under which a right or obligation is triggered. For the sake of clarity, I have grouped recent legal developments concerning conscientious refusal into eight categories: 1. Abortion: right to refuse 2. Abortion: duty to provide 3. Contraception: right to refuse 4. Contraception: duty to provide 5. Sterilization: right to refuse 6. Fertility, HIV, vaccines, counseling 7. End-of-life measures: right to refuse 8. Comprehensive laws: right to refuse.

Theory and Practice in Nature Conservation - Where to Seek Sustainability?

NASA Astrophysics Data System (ADS)

Mirek, Zbigniew; Witkowski, Zbigniew

2017-12-01

Contemporary nature conservation is the subject of serious disputes, with biocentrists emphasising the superiority of the good of nature, while anthropocentrists believe that conservation space should also take account of the good of humankind. The dispute concerns two very important values perceived differently, and not resolvable within any scientifi c framework. The authors postulate a return to the Christian roots of our civilisation. It was God who gave human beings the goods He had created, expecting them to be used in line with His plan. The man who lost God's plan, destroys the life of nature as well as his own. The postulated solution is the proper shaping of conscience, to condition biodiversity conservation in line with the idea of sustainable development.

Cultural Alimentation in Latin America

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2005-12-15

Le Prof. Paolo Freire(nom?) a dirigé en Brésil un plan national d'alphabétisatation d'adultes. La base de sa méthode est d'essayer de ne pas rester sur la mécanique du mot, mais de le relier avec la réalité sociale et donner un réveillement critique de la conscience populaire en face de la réalité historique du pays. Il était professeur d'histoire et de philosophie de Récife, puis exilé et depuis il était prof. à Harvard, a travaillé à l'Unesco et est maintenant conseiller spécial à l'Office d'Education du centre oecuménique des églises

Ethics in psychiatry--the patient's freedom and bondage.

PubMed Central

Ledermann, E K

1982-01-01

Ethics is defined as the realm of the 'ought', the realm of conscience which postulates that Man has the freedom to carry out what he judges to be morally right. By such acts he realizes his freedom of making himself into a truer, more authentic person than he was before. A libertarian psychotherapy, based on this ethic, is outlined. Medical science (as all science) belongs to the realm of the 'is' and postulates that the phenomena which it studies follow a necessary course. It is therefore deterministic. In psychiatry, allowance is made for a neurological determinism in cases in which personal freedom has been diminished or abolished by mental illness, but the determinisms of behaviour therapy and of psycho-analysis are rejected by the author. PMID:7154034

Rawls and the refusal of medical treatment to children.

PubMed

Macdougall, D Robert

2010-04-01

That Jehovah's Witnesses cannot refuse life-saving blood transfusions on behalf of their children has acquired the status of virtual "consensus" among bioethicists. However strong the consensus may be on this matter, this article explores whether this view can be plausibly defended on liberal principles by examining it in light of one particularly well worked-out liberal political theory, that of Rawls. It concludes that because of the extremely high priority Rawls attributes to "freedom of conscience," and the implication from the original position that parents must act paternalistically toward their children as their protectors, Jehovah's Witnesses cannot legitimately be barred from making decisions on behalf of their children, even when the consequences of such decisions are serious and irremediable.

Combat veterans: impressions of an analytic observer in a non-analytic setting.

PubMed

Stein, Herbert H

2007-01-01

The hallmark presentation of combat trauma-nightmares, waking hallucinations, intrusive traumatic memories, and extreme affective reactions to environmental triggers-may best be conceptualized as part of an adaptive mechanism intended to protect the individual against a repetition of trauma. Combat veterans continuously must cope with the extreme affects that combat induced. Fear, rage, guilt, and grief predominate. Their mental and emotional life is complicated by a conscience split between war zone and civilian morality and by the special group dynamics of combat. Optimal clinical understanding of combat-related trauma, whether in a psychoanalytic or general mental health setting, requires an awareness of the interaction of the personal dynamics of each individual with the specific characteristics of their combat situation.

Smoke and mirrors: unanswered questions and misleading statements obscure the truth about organ sources in China.

PubMed

Rogers, Wendy A; Trey, Torsten; Fiatarone Singh, Maria; Bridgett, Madeleine; Bramstedt, Katrina A; Lavee, Jacob

2016-08-01

This response refutes the claim made in a recent article that organs for transplantation in China will no longer be sourced from executed prisoners. We identify ongoing ethical problems due to the lack of transparent data on current numbers of transplants in China; implausible and conflicting claims about voluntary donations; and obfuscation about who counts as a voluntary donor. The big unanswered question in Chinese transplant ethics is the source of organs, and until there is an open and independently audited system in China, legitimate concerns remain about organ harvesting from prisoners of conscience. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[The frieze of the "Mystery villa" in Pompeii. Contribution to the development of female psychology].

PubMed

Schwabe, G

1979-01-01

The large frieze of the "Villa of the Mysteries" at Pompeji is interpreted on the base of the psychology of C. G. Jung, especially of his student Erich Neumann. According to his psychological theories the frieze is depicting the development of the female principle to individuation, arranged with extraordinary artistic inspiration. Through the myth of Ariadne-Theseus-Dionysus the change of the woman, disappointed from the personal man and hero is shown. Through the experience of the transpersonal male principle in herself she is entering in a new level of conscience, the patriarchism, and so coming to the highest development, to the "Selbst". The experience of the male principle is made through Dionysus, a symbol of change in the theory of the "Archetypen" found by C. G. Jung.

Why Governments That Fund Elective Abortion Are Obligated to Attempt a Reduction in the Elective Abortion Rate.

PubMed

Dumsday, Travis

2016-03-01

If elective abortion is publicly funded, then the government is obligated to take active measures designed to reduce its prevalence. I present two arguments for that conclusion. The first argument is directed at those pro-choice thinkers who hold that while some or all elective abortions are morally wrong, they still ought to be legally permitted and publicly subsidized. The second argument is directed at pro-choice thinkers who hold that there is nothing morally wrong with elective abortion and that it should be both legally permitted and publicly subsidized. The second argument employs premises that generalize beyond the abortion debate and that may serve to shed light on broader questions concerning conscience and the requirements of political compromise in a democracy.

[Medicine and conscientious objection].

PubMed

Martínez, K

2007-01-01

Conscientious objection to democratically accepted laws in democratic societies is a fact, both among citizens and among professionals. Due respect for laws is a prima facie duty in these societies. But democratic justice must at the same time respect peoples' conscience for it constitutes the ethical identity of individuals. And both law and ethics are necessary - although neither of them is sufficient - for its realization. The problem of conscientious objection among healthcare professionals is analysed from this standpoint and the conclusion is that objection is not an absolute right to exemption from several duties, but that the responsibility of the professional and of the institutions towards the citizenry must always be taken into account. Some solutions are suggested that try to protect both the professionals and the citizens in a bi-directional way.

Dishonesty in scientific research.

PubMed

Mazar, Nina; Ariely, Dan

2015-11-02

Fraudulent business practices, such as those leading to the Enron scandal and the conviction of Bernard Madoff, evoke a strong sense of public outrage. But fraudulent or dishonest actions are not exclusive to the realm of big corporations or to evil individuals without consciences. Dishonest actions are all too prevalent in everyone's daily lives, because people are constantly encountering situations in which they can gain advantages by cutting corners. Whether it's adding a few dollars in value to the stolen items reported on an insurance claim form or dropping outlier data points from a figure to make a paper sound more interesting, dishonesty is part of the human condition. Here, we explore how people rationalize dishonesty, the implications for scientific research, and what can be done to foster a culture of research integrity.

Dishonesty in scientific research

PubMed Central

Mazar, Nina; Ariely, Dan

2015-01-01

Fraudulent business practices, such as those leading to the Enron scandal and the conviction of Bernard Madoff, evoke a strong sense of public outrage. But fraudulent or dishonest actions are not exclusive to the realm of big corporations or to evil individuals without consciences. Dishonest actions are all too prevalent in everyone’s daily lives, because people are constantly encountering situations in which they can gain advantages by cutting corners. Whether it’s adding a few dollars in value to the stolen items reported on an insurance claim form or dropping outlier data points from a figure to make a paper sound more interesting, dishonesty is part of the human condition. Here, we explore how people rationalize dishonesty, the implications for scientific research, and what can be done to foster a culture of research integrity. PMID:26524587

Paths to and from poverty in late 19th century novels

PubMed Central

Howden‐Chapman, Philippa; Kawachi, Ichiro

2006-01-01

Late 19th century novels provide graphic descriptions of working and living conditions and their impact on population health, in particular the detrimental effects of hunger, poor housing, environmental conditions, hazardous work and poor pay, smoking and alcohol and crime, but also the transformative possibilities of social and political action. The popularity of these novels helped raise the collective conscience of citizens and illuminated the direction for 20th century welfare reforms. Yet many of these problems remain and the pathways to and from poverty are still recognisable today. Although novels are now less central in conveying social information, re‐reading these novels enables us to understand how social and economic circumstances were understood at the time and what led to social and political change. PMID:16415257

The scope of the conscience-based exemption in Section 4(1) of the Abortion Act 1967: Doogan and Wood v NHS Greater Glasgow Health Board [2013] CSIH 36.

PubMed

Neal, Mary

2014-01-01

Doogan is a judgment of the Inner House of the Scottish Court of Session in an action brought by two midwives ('petitioners' at first instance and 'reclaimers' on appeal) for judicial review of a decision by Greater Glasgow and Clyde Health Board ('respondents'). At issue in the litigation was the scope of the conscience-based exemption contained in section 4(1) of the Abortion Act 1967, which included consideration of where the burden of managing the exemption should fall. The court of first instance (Outer House) had held that section 4(1), which exempts people with a conscientious objection from having to 'participate in any treatment authorised by this Act', ought to be read in light of section 1, which was the authorising provision. On the analysis adopted by the Outer House, any activity which was not unlawful before the 1967 Act came into force, and which therefore did not require to be authorised by section 1, was not covered by section 4(1). Roles which consisted of 'supervision, delegation, and support' were held not to fall within the scope of section 4(1) for this reason. The Inner House rejected the argument that the scope of the exemption in section 4(1) must be coextensive with the scope of the authorisation in section 1, and held that section 4(1) covered the 'whole process of treatment' given for the purpose of terminating a pregnancy. For the Inner House, therefore, 'supervision, delegation, and support' of staff directly involved in the abortion process did constitute the kind of 'participation' that a person could be exempted from under section 4(1). Moreover, the court took the view that the reclaimers' interpretation of section 4(1) was also to be preferred in terms of its likely management consequences. The appeal succeeded, and the Health Board has begun the process of appealing to the UK Supreme Court. © The Author [2014]. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Smoking among patients of selected specialist clinics of Miedzylesie Specialist Hospital in Warsaw].

PubMed

Pytka, Dorota; Doboszyńska, Anna

2011-01-01

The purpose of the study is to examine the issue of smoking among patients of selected clinics of the Miedzylesie Specialist Hospital in Warsaw, assessment of nicotine addiction of smokers and motivation to give up smoking. The survey was carried out in June and July 2009 after obtaining the consent of the Director of Miedzylesie Specialist Hospital in Warsaw. The survey was participated in by 100 patients of selected specialist clinics. The survey was carried out on the basis of a questionnaire consisting of 7 questions. Furthermore, the "Test of motivation to give up smoking" (Schneider's test) and the "Assessment of nicotine addiction level" (Fagerström's test), published in the "Consensus regarding recognition and treatment of nicotine addiction", were used. When processing data, the descriptive statistics were applied. Those surveyed included 53 former cigarette smokers 47 active smokers and. In the group of former smokers, 19 people still were exposed to passive smoking. In the past, the problem regarded 41 people. Thirty former smokers smoked cigarettes among non-smokers, including young children (18 people) and when pregnant and breastfeeding (2 people). Also 30 respondents smoked despite medical contraindications and bad conscience. For 27 people, expenditures on cigarettes constituted a considerable burden of their respective household budgets, and 20 said that it was a significant item in their expenditures. Smokers have been smoking cigarettes for 30 years, on average 20 cigarettes a day. Those patients began to smoke at the age of 20. Thirty one active smokers exposed other people to passive smoking and 38 respondents smoked cigarettes despite medical contraindications and with bad conscience. For 22 people, expenditures related to smoking are a considerable burden of the household budget and for 21 people, it is a significant expenditure. Almost one half of the patients smoke cigarettes although they should brake off smoking for medical reasons. Most of those surveyed (32 people) are motivated to brake off smoking. Those people are highly (13 people) and extremely (9 people) addicted to nicotine.

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools.

PubMed

Mathauer, Inke; Imhoff, Ingo

2006-08-29

There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals.

Health worker motivation in Africa: the role of non-financial incentives and human resource management tools

PubMed Central

Mathauer, Inke; Imhoff, Ingo

2006-01-01

Background There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. Methods The study design entailed semi-structured qualitative interviews with doctors and nurses from public, private and NGO facilities in rural areas. The selection of health professionals was the result of a layered sampling process. In Benin 62 interviews with health professionals were carried out; in Kenya 37 were obtained. Results from individual interviews were backed up with information from focus group discussions. For further contextual information, interviews with civil servants in the Ministry of Health and at the district level were carried out. The interview material was coded and quantitative data was analysed with SPSS software. Results and discussion The study shows that health workers overall are strongly guided by their professional conscience and similar aspects related to professional ethos. In fact, many health workers are demotivated and frustrated precisely because they are unable to satisfy their professional conscience and impeded in pursuing their vocation due to lack of means and supplies and due to inadequate or inappropriately applied human resources management (HRM) tools. The paper also indicates that even some HRM tools that are applied may adversely affect the motivation of health workers. Conclusion The findings confirm the starting hypothesis that non-financial incentives and HRM tools play an important role with respect to increasing motivation of health professionals. Adequate HRM tools can uphold and strengthen the professional ethos of doctors and nurses. This entails acknowledging their professionalism and addressing professional goals such as recognition, career development and further qualification. It must be the aim of human resources management/quality management (HRM/QM) to develop the work environment so that health workers are enabled to meet their personal and the organizational goals. PMID:16939644

Mother, melancholia, and humor in Erik H. Erikson's earliest writings.

PubMed

Capps, Donald

2008-09-01

Erik H. Erikson wrote three articles when he was in his late-twenties and an up-and-coming member of the psychoanalytic community in Vienna. At the time he wrote these articles, he was in a training psychoanalysis with Anna Freud, teaching at the Heitzing School in Vienna, and learning the Montessori method of teaching. These articles focus on the loss of primary narcissism and the development of the superego (or punitive conscience) in early childhood, especially through the child's conflict with maternal authority. They support the idea that melancholia, with its internalized rage against the mother, is the inevitable outcome of the loss of primary narcissism. I note, however, that the third of these articles makes a case for the restorative role of humor, especially when Freud's view that humor is a function of the superego is taken into account.

Cultural Alimentation in Latin America

ScienceCinema

None

2017-12-09

Le Prof. Paolo Freire(nom?) a dirigé en Brésil un plan national d'alphabétisatation d'adultes. La base de sa méthode est d'essayer de ne pas rester sur la mécanique du mot, mais de le relier avec la réalité sociale et donner un réveillement critique de la conscience populaire en face de la réalité historique du pays. Il était professeur d'histoire et de philosophie de Récife, puis exilé et depuis il était prof. à Harvard, a travaillé à l'Unesco et est maintenant conseiller spécial à l'Office d'Education du centre oecuménique des églises

The process of whistleblowing in a Japanese psychiatric hospital.

PubMed

Ohnishi, Kayoko; Hayama, Yumiko; Asai, Atsushi; Kosugi, Shinji

2008-09-01

This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after whistleblowing, wavering emotions were observed, consisting of a guilty conscience, fear of retribution, and pride, which subsequently transformed to stable emotions containing a sense of relief and regret for delayed action. It is necessary for nurses to recognize that their professional responsibility is primarily to patients, not to organizations. Nurses should also have professional judgment about appropriate allegiance and actions.

An Ethics of Permission: A Response to the California End of Life Option Act.

PubMed

Nelson, Craig

2016-01-01

An ethics of permission can be helpful in framing a response to the ethical differences surrounding the California End of Life Option Act. Law does not define morality, and reaching a moral understanding demands thorough reflection. An ethics of permission examines the ethical demands of a permissive law for both clinician and patient. Serving the good of the patient, respecting professional conscience, and following the law are three ethical elements. Although developing an ethics of permission includes these three elements, these elements do not exhaust all the moral implications involved. An ethics of permission also includes the importance of exercising professional tolerance in the honoring of clinicians who choose to participate or refuse to participate. In addition, an ethics of permission also provides insight in implementing just and fair behavior among medical professionals.

The uneasy (and changing) relationship of health care and religion in our legal system.

PubMed

Vischer, Robert K

2013-04-01

This article provides a brief introduction to the interplay between law and religion in the health care context. First, I address the extent to which the commitments of a faith tradition may be written into laws that bind all citizens, including those who do not share those commitments. Second, I discuss the law's accommodation of the faith commitments of individual health care providers-hardly a static inquiry, as the degree of accommodation is increasingly contested. Third, I expand the discussion to include institutional health care providers, arguing that the legal system's resistance to accommodating the morally distinct identities of institutional providers reflects a short-sighted view of the liberty of conscience. Finally, I offer some tentative thoughts about why these dynamics become even more complicated in the context of Islamic health care providers.

The Dynamics of Creativity & the Courage to BE

NASA Astrophysics Data System (ADS)

Abraham, Frederick David

The following sections are included: * Preliminary Note * Definitions Of Creativity * American Heritage (Morris, 1969-78)55 * Howard Gardner (1993)33 * Stephen Nachmanovich (1990)58 * Dynamical Metaphor * Literary, Philosophic, and Religious Roots of Ideas of Creativity * Myth * Mysticism * Existentialism * Psychological Analysis of Creativity * Barman (& Freud), The Two Faces of Creativity (1989)18 * Stephen Nachmanovich, Free Play: Improvisation in Life and Art (1990)58 * Rollo May Man's Search for Himself, Chap 6, The Creative Conscience (1953)53. * Joy P. Guilford, The Psychometric Approach. (1950,1953)37,38 * Wolfgang Köhler, The Mentality of Apes (1925)46,47 * Csitszentmihalyi, Humanistic Attributional Approaches; Flow(1990)25; The Evolving Mind (1993)26 * Howard Gardner, Creating Minds (1993)33 * Summary of Dynamical Concepts Involved In Creativity * Self-Organizational Bifurcations are Creativity * Chaos and Instability Facilitate Creativity * Chaos at the Controls * Summary * Acknowledgement * References

[The last melancholia of Alonso Quijano, the Righteous].

PubMed

Chiappo, L

1994-03-01

In Cervantes' immortal novel, "Don Quixote" is the nom de guerre that Alonso Quijano--a honest Spanish yeoman nicknamed "The Upright One"--adopts under the spell of insanity that has lured him into being a knight rider. A psycho-spiritual analysis of Don Quixote's return to mental health is presented, covering the time-span between Don Quixote's coming back to this native village and his last days. By way of a "historical diagnosis", the author proposes some clinical explanations: Goodman Quijano's last illness might have been a plasmodium falciparum-caused malaria; malaria, however did not contribute to reinstate soundmindedness (as per Wagner von Jauregg's therapeutic criteria, for example). Goodman Quijano's last fit of melancholy disclosed contempu mundi in him, a renunciation giving way to a joyful lucidity--in other words, a psychological awakening to a sublime conscience level of genuine spiritual characteristics.

Open letter to the Vatican.

PubMed

1999-01-01

An open letter was published by Latin American and Caribbean women during the Special Session of the UN General Assembly on the International Conference on Population and Development. The letter generally focused on the Church¿s stand on women's reproductive rights. In particular, it questioned the Church on the following aspects of reproductive health, which include: 1) maternal death related to lack of access to reproductive health care; 2) Vatican representatives insisting that only parents can supervise their children education and health, which also lead to many cases of sexual abuse and incest; 3) women's sexual inequality and daily violence; 4) the Vatican delegation blocking the advances of contraception, sexual education, and HIV prevention; 5) problems of migrants and allocation of resources; and 6) the Church failing to recognize the capacity of young people to make decisions based on their own conscience.

Professional ethics.

PubMed

Downie, R S

1986-06-01

Downie comments on Sieghart's article, "Professions as the conscience of society" (Journal of Medical Ethics 1985 Sep; 11(3): 117-122). He charges that Sieghart is blurring empirical, conceptual, and moral claims when he contends that the professional relationship is unique in that "altruism is paramount and self-interest has no place." Downie holds that there is nothing to distinguish the doctor or lawyer from other occupations in terms of the criteria of self-interest and altruism. Likewise, these occupations have no nobler cause than those of the farmer or merchant. Because it is difficult, if not impossible, to provide necessary and sufficient criteria for defining a profession, the idea of a special "professional ethics" is a pernicious one that serves to protect professionals from public scrutiny. Sieghart briefly defends his earlier article, pointing out that it was addressed to practicing doctors and lawyers rather than to moral philosophers.

Leadership in British nursing: a historical dimension.

PubMed

Lorentzon, M; Bryant, J

1997-09-01

A historical overview of nurse leadership in the late 19th and late 20th centuries is presented, supported by relevant material from the literature. The 19th century material revealed the following main themes: emphasis on practical and domestic aspects of management; prominent input of religious ideals and social conscience and, autocratic and feminized style of leadership. The main themes in the contemporary literature examined were: role models in history, dysfunctional leadership styles, importance of knowledge, gender as an influencing factor on nurse leadership and threats to the autonomy of nurse leaders. It was concluded that formal nurse professionalization has progressed steadily during the past hundred years with associated evolution of nurse leaders to fit in with contemporary needs. It is hoped that future policies for nursing will encourage decision-making nearer the 'bed-side', more resource-driven care and value-based leadership.

A question of conscience. Physicians in defense of human rights.

PubMed

Nightingale, E O; Stover, E

The vital role physicians can play in documenting physical and mental abuse of political prisoners, treating and rehabilitating victims, and preventing the punitive use of medicine is exemplified by the actions of three physicians whose stories are told here. Wendy Orr, a South African prison physician, took her complaint about police torture of political detainees to court after her superiors ignored her reports of prisoner abuse. An internationally known Chilean surgeon, Pedro Castillo, has been arrested twice for his work against the human rights violations of his country's military government. Soviet psychiatrist Anatoly Koryagin is reported to be near death after several years' imprisonment for his activities against involuntary psychiatric commitment of dissidents. Nightingale and Stover remind physicians of their obligation to protest the misuse of medical skills and urge support for professional organizations actively engaged in human rights issues.

An Ethics of Permission: A Response to the California End of Life Option Act

PubMed Central

Nelson, Craig

2016-01-01

An ethics of permission can be helpful in framing a response to the ethical differences surrounding the California End of Life Option Act. Law does not define morality, and reaching a moral understanding demands thorough reflection. An ethics of permission examines the ethical demands of a permissive law for both clinician and patient. Serving the good of the patient, respecting professional conscience, and following the law are three ethical elements. Although developing an ethics of permission includes these three elements, these elements do not exhaust all the moral implications involved. An ethics of permission also includes the importance of exercising professional tolerance in the honoring of clinicians who choose to participate or refuse to participate. In addition, an ethics of permission also provides insight in implementing just and fair behavior among medical professionals. PMID:27541320

The "nation's conscience:" assessing bioethics commissions as public forums.

PubMed

Dzur, Albert W; Levin, Daniel

2004-12-01

As the fifth national bioethics commission has concluded its work and a sixth is currently underway, it is time to step back and consider appropriate measures of success. This paper argues that standard measures of commissions' influence fail to fully assess their role as public forums. From the perspective of democratic theory, a critical dimension of this role is public engagement: the ability of a commission to address the concerns of the general public, to learn how average citizens resolve moral issues in healthcare, and to monitor public opinion on the topics addressed in the commission. Such a public forum role is supported by the critical literature within bioethics, which has deemed some commissions successful, supported more generally by the history of bioethics as a reform discourse that has brought socially important values into the medical domain, and supported more generally still by the example of the great social issues commissions of the 1960s.

Azerbaijan: environmental conditions and outlook.

PubMed

Shelton, Napier

2003-06-01

The author describes present environmental conditions in Azerbaijan in relation to the Soviet legacy and measures taken since independence. Environmental projects have been financed largely by international organizations and foreign companies. The most serious problems are contaminants in the Caspian Sea; air, water, and soil pollution in Sumgait; illegal fishing; poor quality of drinking water; cutting of forests for fuel and pasture; overgrazing; and soil erosion and salinization. Progress in developing an environmental conscience, necessary for sustained protection of the environment, will depend most importantly on environmental education, growth of democratic institutions and attitudes that encourage both governmental and citizen responsibility for the environment, and economic development that produces a substantial middle class. Positive advances include a Constitution and laws that require protection of the environment, and individuals who speak out for environmental care. Negative factors include poverty and the present government's low priority for environmental protection.

"Shocking" masculinity: Stanley Milgram, "obedience to authority," and the "crisis of manhood" in Cold War America.

PubMed

Nicholson, Ian

2011-06-01

Stanley Milgram's study of "obedience to authority" is one of the best-known psychological experiments of the twentieth century. This essay examines the study's special charisma through a detailed consideration of the intellectual, cultural, and gender contexts of Cold War America. It suggests that Milgram presented not a "timeless" experiment on "human nature" but, rather, a historically contingent, scientifically sanctioned "performance" of American masculinity at a time of heightened male anxiety. The essay argues that this gendered context invested the obedience experiments with an extraordinary plausibility, immediacy, and relevance. Immersed in a discourse of masculinity besieged, many Americans read the obedience experiments not as a fanciful study of laboratory brutality but as confirmation of their worst fears. Milgram's extraordinary success thus lay not in his "discovery" of the fragility of individual conscience but in his theatrical flair for staging culturally relevant masculine performances.

Violence against women

PubMed Central

Bohra, Neena; Sharma, Indira; Srivastava, Shruti; Bhatia, M. S.; Chaudhuri, Uday; Parial, Sonia; Sharma, Avdesh; Kataria, Dinesh

2015-01-01

Violence against women (VAW) is a major public health problem in the country. The problem is grossly under-reported. A number of factors have been blamed for crimes against women. An inefficient law enforcing machinery has often been targeted for the increasing number of cases being reported. There is little recognition that psychiatric morbidity can perpetuate such crimes. Of late, there appears to a continuous increase in the number of crimes committed against women; especially the very serious ones like gang rapes. The latter have shaken the very conscience of people. Even harsher legislation does not seem to have made any effect. One wonders how this could be possible in a society heading toward high education, economic and technological development. Media has played a pivotal role by highlighting the problem to the masses. The need for the hour is for mental health professionals to take the challenge and present a comprehensive proposal for definite action to prevent all forms of VAW. PMID:26330651

Poverty blindness: exploring the diagnosis and treatment of an epidemic condition.

PubMed

Ventres, William; Gusoff, Geoff

2014-02-01

Despite the historical and social significance of poverty, scholars from varied ideological and philosophical disciplines have often observed that its most notable feature is its invisibility. We suggest that poverty is not excluded from view, but rather from consciousness. This lack of consciousness is due to a subjective "poverty blindness" on the part of those who fail to take the poor into account. In this article we explore this new concept of "Poverty Blindness" (PB) using a clinical approach. We review the clinical manifestations of PB and the associated condition of Poverty Acuity Disorder (PAD). We conclude by suggesting that the ability to see these circumstances and consequences of poverty is not some ambiguous externalized concept, but lies within our own consciousnesses and consciences. Only through recognizing this are we able to assess honestly the realities of poverty or debate how to go about its alleviation.

Restoring Christ-centered medicine through public policy changes centered around subsidiarity and the doctor–patient relationship

PubMed Central

Donovan, Charles A.; Turner, Grace-Marie

2016-01-01

Many Catholic leaders supported passage of legislation designed to achieve the humanitarian goal of universal or near-universal health coverage. These leaders could not imagine that the resulting law would lead to a severe assault on the practice of Christ-centered medicine. The legislative focus now is on conscience protection and making the Hyde Amendment permanent. But the real change that is needed is a culture that values life and puts doctors and patients, not secular bureaucracies, at the center of healthcare decisions. Many new proposals are being offered with the shared goals of expanding access to affordable health coverage, allowing people to make their own choices without oppressive government mandates, helping the most vulnerable, and protecting the right of citizens and medical professionals to live and work according to their religious values and principles. PMID:28392589

Legacies of the Manhattan Project

NASA Astrophysics Data System (ADS)

Kevles, Daniel

2017-01-01

The Manhattan Project of World War II mobilized thousands of people, including many of the nation's leading physicists, and extensive material resources to design, develop, and manufacture the world's first nuclear weapons. It also established sprawling new facilities for the production of fissionable fuels - notably at Oak Ridge, Tennessee, and Hanford, Washington. It left a set of powerful legacies in the context of the Cold War - endowing scientists with conscience-taxing responsibilities in the nuclear arms race; promoting enormous patronage of academic research by defense and defense-related federal agencies, notably the Office of Naval Research and the Atomic Energy Commission; and turning its wartime facilities into major national laboratories that advanced the fields of high-energy and nuclear physics and stimulated local industrial economies but that in some cases, notably at Hanford, severely polluted the surrounding environment with radioactive waste and disrupted the livelihoods of native peoples. ``Legacies of the Manhattan Project''

As it is in heaven? John Paul II listened to God and misunderstood the message.

PubMed

1993-10-27

This articles focuses on John Paul II's 1993 Veritatis Splendor, an 1798 page encyclical letter to the Church's bishops on the crisis in the Catholic Church of family limitation and the implications for the laity and society. The communication states that a flexible interpretation of theology must be abandoned. Paul VI's 19963 Humanae Vitae is reportedly affirmed. John XXIII's spiritualism and concern with conscience is ignored. This encyclical is identified as not spoken "ex cathedra" or from the throne, which would have made the pronouncement true, unarguable forever, and subject to excommunication for those disobeying. Pope John Paul II is said to be preparing another encyclical on life issues and sexuality. Reference is made in this encyclical to devices that are acceptable to use to gauge a safe period for copulation without impregnation. The devices include the rectal thermometer and the calculator for determining the infertile days in the natural cycle. Veritatis Splendor's position on fertility is viewed as an issue of loyalty to the Church and not as an honest evaluation of the moral implications of artificial birth control. This encyclical comes closer to "ex cathedra" than the Humanae Vitae, which banned the birth control pill, IUD, spermicides, hormonal implants, vasectomies, and tubal ligation. Liberal Catholic theologians are reported to have interpreted Paul VI's statement that "God illuminates from within the hearts of the faithful and invites their assent," as a validation of dissent. Pope John Paul II closes the door to dissent in this proclamation. The Church also closes the door to free will for people to decide for themselves. The Jesuits, with different notions of divine will, are described as potentially concluding that the denial of free will and individual reason for the sake of Papal supremacy must be the work of the devil himself. For good Catholics this encyclical is interpreted as potentially forcing even stronger opposition to the Vatican's teachings and continued adherence to the dictates of their own conscience. A God who gave men and women the power of his reason would not allow the Pope, however infallible, to take this away. Among nonreligious thinkers the Catholic posture is viewed as very wrong on birth control. Divisions within the Church are expected to increase.

[Between sancticity and value of human life: in perspective of human cloning].

PubMed

Dyk, W

2001-01-01

The more we know, the more duties and greater responsibility we have. The dynamic development of biology carries a lot of hope for the freeing of mankind from genetic diseases. But the introduction of scientific thought necessarily has to be bound with the development of technology. It is wrong when technology dictates science a direction of development; when technique comes before ethics; and when technology does not respect the essence of a human being. The uncritical introduction of eugenics, especially cloning of people and rejecting all moral arguments, recalls inglorious acts of science when the ideology of progress determined the range of problems that researchers focused on. The same ideology of progress, although originating from other sources, pushes science toward a second extreme, into utilitarianism. In the article the author wishes to substantiate the necessity for researchers to respect ethical norms. Recognition of natural laws alone does not provide science with full development if the rights of conscience are violated.

Ellis T. Cox: pragmatist with a public conscience. [Power; environmental concerns of Potomac Electric Co. for Washington, DC area

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1978-05-01

A profile of Potomac Electric Power Co. executive Ellis T. Cox EPRI Advisory Board member the obligation he feels for preserving the unique qualities of the Washington, D.C. area by installing power plant pollution equipment, burning low-sulfur coal, and setting an example of concern for other companies and the legislators. Cox feels a commitment to not only meet civic responsibilities, but to demonstrate that an efficient, cost-effective company can also protect the environment. He sets long-term fuel supplies as a high priority for utility research and development and sees no alternative to shifts away from petroleum and further development ofmore » nuclear generating power. His other concerns are for streamlining the regulatory process, demonstrating the Civex process as an alternative fuel cycle, and a continuation of the joint efforts of utilities and the Electric Power Research Institute to solve practical problems of pollution control and develop new fuels and new combustion technologies.« less

Conscience dilemma: to become a bioengineer or to survive as a biologist.

PubMed

Selimoglu, Sureyya Mert

2014-01-01

Bioengineering is the consideration of biological problems from modern engineering, therefore money-oriented, perspective. Today, grant-giving bodies always favor bioengineering projects rather than pure biology projects (like those in ecology, entomology, etc.). Therefore, today's biologist is forced to be on the horns of a dilemma. They have to either submit a very powerful and valid reason for the proposal of their project, or change the project to one having a potential of money-based outcome. On the other hand, because of dealing with the living components of nature, conducting a research in pure biology is like a kind of worship. For this reason, from a believer scientist's view, a deviation (in terms of research) from biology to bioengineering can be considered like committing a sin. Unfortunately, today's wild capitalism has been bringing new sinners day by day, and this system will continue for the foreseeable future unless grant-giving bodies comprehend the real importance of pure biology.

Behavioral Competence as a Positive Youth Development Construct: A Conceptual Review

PubMed Central

Ma, Hing Keung

2012-01-01

Behavioral competence is delineated in terms of four parameters: (a) Moral and Social Knowledge, (b) Social Skills, (c) Positive Characters and Positive Attributes, and (d) Behavioral Decision Process and Action Taking. Since Ma's other papers in this special issue have already discussed the moral and social knowledge as well as the social skills associated in detail, this paper focuses on the last two parameters. It is hypothesized that the following twelve positive characters are highly related to behavioral competence: humanity, intelligence, courage, conscience, autonomy, respect, responsibility, naturalness, loyalty, humility, assertiveness, and perseverance. Large-scale empirical future studies should be conducted to substantiate the predictive validity of the complete set of these positive characters. The whole judgment and behavioral decision process is constructed based on the information processing approach. The direction of future studies should focus more on the complex input, central control, and output subprocesses and the interactions among these sub-processes. The understanding of the formation of behavior is crucial to whole-person education and positive youth development. PMID:22645434

Internet Addiction and Excessive Social Networks Use: What About Facebook?

PubMed Central

Guedes, Eduardo; Sancassiani, Federica; Carta, Mauro Giovani; Campos, Carlos; Machado, Sergio; King, Anna Lucia Spear; Nardi, Antonio Egidio

2016-01-01

Facebook is notably the most widely known and used social network worldwide. It has been described as a valuable tool for leisure and communication between people all over the world. However, healthy and conscience Facebook use is contrasted by excessive use and lack of control, creating an addiction with severely impacts the everyday life of many users, mainly youths. If Facebook use seems to be related to the need to belong, affiliate with others and for self-presentation, the beginning of excessive Facebook use and addiction could be associated to reward and gratification mechanisms as well as some personality traits. Studies from several countries indicate different Facebook addiction prevalence rates, mainly due to the use of a wide-range of evaluation instruments and to the lack of a clear and valid definition of this construct. Further investigations are needed to establish if excessive Facebook use can be considered as a specific online addiction disorder or an Internet addiction subtype. PMID:27418940

Internet Addiction and Excessive Social Networks Use: What About Facebook?

PubMed

Guedes, Eduardo; Sancassiani, Federica; Carta, Mauro Giovani; Campos, Carlos; Machado, Sergio; King, Anna Lucia Spear; Nardi, Antonio Egidio

2016-01-01

Facebook is notably the most widely known and used social network worldwide. It has been described as a valuable tool for leisure and communication between people all over the world. However, healthy and conscience Facebook use is contrasted by excessive use and lack of control, creating an addiction with severely impacts the everyday life of many users, mainly youths. If Facebook use seems to be related to the need to belong, affiliate with others and for self-presentation, the beginning of excessive Facebook use and addiction could be associated to reward and gratification mechanisms as well as some personality traits. Studies from several countries indicate different Facebook addiction prevalence rates, mainly due to the use of a wide-range of evaluation instruments and to the lack of a clear and valid definition of this construct. Further investigations are needed to establish if excessive Facebook use can be considered as a specific online addiction disorder or an Internet addiction subtype.

[Euthanasia 2002-2014: The situation in Belgium].

PubMed

Lossignol, D

2016-10-01

Since 2002, Belgian law has authorized the practice of euthanasia under certain clear conditions. All cases have to be reported to the Assessment and Control Commission (ACC). To date, more than 9000 cases have been reported. To make a statement about the Belgian experience requires consideration of several different essential points: detailed data and information from the ACC reports, their analysis, consequences on medical practice, problems experienced, legal and medical perspectives, criticism and attacks. The concept of individual and institutional conscience is also considered. Euthanasia for minors has been permitted since March 2014 but, to date, no case has been reported. In the light of what has happened in Belgium, we propose to analyse the legal situation in France. The Belgian experience is much more than an example and shows that, in difficult and painful situations, it is possible to meet the expectations of patients experiencing intolerable suffering with great respect and without imposing dogmatically something they do not wish. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

It never dies: assessing the Nazi analogy in bioethics.

PubMed

Campbell, Courtney S

1992-01-01

... As should be evident from the foregoing analysis, I have significant reservations about the moral utility of the Nazi analogy in debates over bioethics issues. Nevertheless, I am unable to dismiss its force entirely. I want to suggest that the real threat to the moral and human values expressed by the analogy will come not from responsibly formulated and clearly articulated proposals that undergo debate and scrutiny in the public forum, and whose practical impact in a democratic society is limited by institutional review and procedural safeguards. My concern instead is with the psychology of moral distancing, in which moral conscience is compartmentalized from vocational interests, such as the pursuit of scientific knowledge through biomedical research. It is the kind of psychology that Robert Jay Lifton has referrred to as "doubling: the division of the self into two functioning wholes, so that a part-self acts as an entire self," and which Lifton believes enabled the transformation of physicians from healers to killers in Nazi Germany....

"Delo Voronova" - vzglyad cherez dve treti veka %t The "Voronov's affair": a look after two thirds of a century

NASA Astrophysics Data System (ADS)

Bronshtehn, V. A.

On the base of extensive archival and published materials a new analysis of the so-called "Voronov's affair" is presented. The Russian astronomer N.M. Voronov (1912 - 1951), working at the Tashkent Astronomical Observatory, become famous for his investigations in the field of celestial mechanics, namely, compilations of the exact theories of motion of minor planets Vesta, Egeria and others. He was invited to the Pulkovo Observatory. But later is was revealed that Voronov had falsified his main results. After short period of working at the Tajik Astronomical Observatory (Dushanbe), Voronov was arrested for the "anti-Soviet so-called propaganda" (1937 - 1939) and worked in a geodetic detachment (1939 - 1943). Arrested again, he was in prison for 8 years, and in 1951 he was released, but his further destiny is unknown. In the author's opinion Voronov was a talented scientist, but he ventured a bargain with his conscience, falcifying his results for perfecting the accordance with the observational data.

Managing ethically questionable parental requests: growth suppression and manipulation of puberty.

PubMed

Isaacs, David; Tobin, Bernadette; Hamblin, Julie; Slaytor, Emma; Donaghue, Kim C; Munns, Craig; Kilham, Henry A

2011-09-01

Doctors sometimes struggle with ethically challenging requests for treatment from children's parents. For instance, we have recently had two requests by parents of children, a girl and a boy, each with a severe developmental disability, for hormonal therapy to suppress growth and puberty: the girl's parents requested, in addition, hysterectomy and mastectomy. We propose a reliable approach to assessing the ethical and legal aspects of these and other requests for 'non-therapeutic' treatment of a minor who lacks the capacity to give informed consent. We argue that a doctor should first assess whether the request is one that he or she can, in conscience, accede to, and then, if it is, seek the authorisation of a court. We outline considerations relevant to the doctor's assessment of both the ethical issues and to the need for court authorisation. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Moving Green Chemistry Forward: Networks as a Foundation

NASA Astrophysics Data System (ADS)

Carter, T.; Lough, G.

2014-12-01

Green chemistry is a growing discipline, but for a variety of reasons, it has not yet become integrated into science curriculum and the greater societal conscience. With its increasing economic benefits to many sectors including business, industry, and academia and its potential to make science more accessible not only to science students but also to the general citizenry, we suggested answers to the questions: Why has greater success not been realized? What are the particular barriers to wider implementation? And what are incentives and ways to move green chemistry forward? We suggest some strategies and options to both increase the use of green chemistry principles and to also increase stakeholders' understanding of the importance and utility of green chemistry in their daily lives. For example, our main suggestions are that an inclusive, multidisciplinary network would aid in coordinating data and in translating the science into user friendly tools, and that an educational component embedded in this greater effort would also serve to move green chemistry forward.

Unbiased consideration of applicants to medical schools.

PubMed

Schweiker, R S

1977-05-01

Medical schools are discriminating against prospective students who do not support abortion on demand. Abortion is an important issue concerning the question of when life begins, the power of the goverment to protect the unborn, and a woman's decision to terminate her pregnancy. Congress enacted legislation that guaranteed freedom of conscience of medical practitioners. Dr. Eugene Diamond reported that on a survey of medical schools he found that a large number asked students their views on abortion and sterilization. Some reported that opposition to abortion would be a detriment to admission. Medical schools are discriminating on the basis of a person's opinion founded on religious or moral grounds. Medical schools may "by the actions they take today, eliminate...dissent" of many doctors who do not approve of the current state of the law on abortion. Senator Schweiker has introduced S 784 "to prevent any school or other institution that receives federal funds from inquiring into the abortion views of prospective students."

Importance and Perspectives of the Earth Sciences Popularization in Mexico

NASA Astrophysics Data System (ADS)

Flores-Estrella, H.; Yussim, S.

2007-05-01

In our days the scientific popularization in Mexico has not a promising future and with the earth sciences is not better; most of the papers in the popularization magazines deal with subjects as earthquakes, volcanoes, plate tectonics, meteorite impacts and the massive extensions associated with them (e.g. Chicxulub). However, these subjects have not been enough to create conscience about the importance of earth sciences in the society and it has even motivated the idea of a community distant scientific with no social obligation, the idea that the earth scientists are responsible for all the problems in the planet (global warming, catastrophes) is wide spread. In these days that we need a change in our consumption, mainly in the energetic one, it's compulsory to change the relation between the subject and its environment; then, as we can not take care of something that we don't know, the scientific popularization has a fundamental role that we must start to pay attention to.

[Post-traumatic coma and pre-traumatic memory].

PubMed

Malacrida, R; Piazza, J; Abraham, G

1990-01-01

Instead of thinking that it is impossible to enter in the internal world of a comatose patient, we are now put before a new and encouraging prospective, that of the possibility, even though minimal, of influencing the vital residual organisation of the patient and to induce him perhaps to accept again external stimulations, which previously were too intense. As loss of conscience often causes loss of memory, our intention was to examine the problem of memory loss in comatose patients after accidents. The analysis of 50 questionnaires distributed to trauma-patients awakening from a comatose state and interviews give clear indications that: 1) the patients remember absolutely nothing during the time of the coma; 2) in the majority of cases (34) the patients remember in the moment preceding the accident a clear autodestructive tendency especially if they were the cause of the accident; and 3) almost all patients (41) agree to have benefited greatly from the trauma itself and from its memory.

Max Weber or Jesus Christ: in whose image?

PubMed

Fitzpatrick, A M; Gaylor, C C

1985-10-01

The bureaucratic model of organization and the model that emerges from the Gospel and Vatican Council II provide a stark contrast for Catholic health care administrators to ponder. As articulated by sociologist Max Weber, a bureaucracy is based on a hierarchical structure with sharply defined and protected levels of authority, centralized decision making, rules that govern personnel behavior, and an impersonalized view of employees that stresses their roles as functionaries. The Christian, Gospel-based model, on the other hand, places a premium on collegiality, shared authority, the mediation of conscience, the common good, and the work of the individual. Even though only a few will shape management policy in a large hospital, policymaking should be viewed as a service, a ministry that entails stewardship. Catholic health care leaders should reflect the spirit of collegiality by bringing various strata of staff together in a dynamic, united effort. Thus the institution's statement of mission will not be an abstract recitation of pieties but a living reality, a philosophy that is "owned" by the workers.

Whistle-blowing; Not always a losing game

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fitzgerald, K.

1990-12-01

In this paper five engineers in nuclear power, aerospace, and air-traffic control recount their experiences in following their consciences. Exposing errors or unethical conduct in any occupation is risky, but when engineering judgement is involved, the risks of blowing the whistle acquire an added dimension. A technical decision cannot always be categorized as strictly right or wrong - unlike situations in which an organization is falsifying documents or overcharging for a product. Consequently, the engineer must be convinced of being right and then wait, sometimes years and even decades after lives are lost or millions of dollars are spent, tomore » be proved right or wrong. Frequently, the whistle-blower's career is destroyed in the meantime. In the following cases, which date from the 1970s and 1980s, the whistle-blowers have by now been vindicated to a degree for their actions, though the verdict may not be unanimous. And the careers of the first group may have even benefitted by blowing the whistle.« less

Applications of the laser

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldman, L.

For those not familiar with lasers, a review of lasers and some remarks on the fascinating new developments in such systems that do affect applications now and in the future are presented. Wave guides to transmit lasers to make them more flexible, the important aspects of measurements, chemistry, bits of botany, and holography are given. The vast expanse of communications, especially through the development of the new and important hybrid discipline of electrooptics is reviewed. The military and law and order programs show their applications; all initiate the study of actual applications. Then follow metalworking, construction, pollution, and a numbermore » of miscellaneous techniques. A critical review of safety programs so necessary for the proper development of laser technology is presented. Then follows the story of the applications in biology, medicine, dentistry, photography, art, and music. Many of the applications cross to other fields. To stimulate the youth to be interested in science, there are brief remarks about the social conscience in laser and, finally, the dreams of the future.« less

Commentary: Integrating callous and unemotional traits into the definition of antisocial behaviour--a commentary on Frick et al. (2014).

PubMed

Rowe, Richard

2014-06-01

Heterogeneity in the presentation, antecedents, prognosis and treatment response of antisocial behaviour has long provided a challenge to developmental psychopathology researchers. As illustrated in the incisive Frick and colleagues' Annual Research Review, there is growing evidence that the presence of high callous-unemotional (CU) traits identifies a subgroup of antisocial young people with a particularly aggressive and pervasive form of disorder. Frick and colleagues extend their developmental psychopathology approach to CU traits by linking in theories of conscience development and considering evidence on the stability of CU traits. This commentary addresses these themes and the area more generally, considering (1) comparison of a CU specifier to alternative approaches to antisocial heterogeneity (2) high CU traits in the absence of antisocial behaviour and (3) aspects of the measurement of CU traits. © 2014 The Author. Journal of Child Psychology and Psychiatry. © 2014 Association for Child and Adolescent Mental Health.

Three Australian whistleblowing sagas: lessons for internal and external regulation.

PubMed

Faunce, Thomas A; Bolsin, Stephen N C

2004-07-05

The protracted and costly investigations into Camden and Campbelltown hospitals (New South Wales), The Canberra Hospital (Australian Capital Territory), and King Edward Memorial Hospital (Western Australia) recently uncovered significant problems with quality and safety at these institutions. Each investigation arose after whistleblowers alerted politicians directly, having failed to resolve the problems using existing intra-institutional structures. None of the substantiated problems had been uncovered or previously resolved by extensive accreditation or national safety and quality processes; in each instance, the problems were exacerbated by a poor institutional culture of self-regulation, error reporting or investigation. Even after substantiation of their allegations, the whistleblowers, who included staff specialists, administrators and nurses, received little respect and support from their institutions or professions. Increasing legislative protections indicate the role of whistleblowers must now be formally acknowledged and incorporated as a "last resort" component in clinical-governance structures. Portable digital technology, if adequately funded and institutionally supported, may help to transform the conscience-based activity of whistleblowing into a culture of self-reporting, linked to personal and professional development.

Lava Flow Simulation for the Disaster Area of the Volcano Eruption

NASA Astrophysics Data System (ADS)

Ishikawa, Tomoya; Muranaka, Noriaki; Ishida, Tkahiro; Hashimoto, Junichi; Tokumaru, Msataka; Imanishi, Shigeru

Japan is the eminent volcanic country in the world, and Suwanose-jima in Kagoshima and Mt. Asama in Gunma are puffing out smoke vigorously at present. In the past, the large-scale eruptions occurred in Sakura-jima and Unzen-Fugendake, and 10 percent of the energy in the earthquake and the volcano eruption of the whole earth is released in Japan. Therefore the prediction for the flow area of lava is very important. Then, we try to develop the simulation system which predicts the flow area of lava and the people want to use it at their homes. Because of this, our system must be able to use on a PC becoming popular in the present time. Our simulation technique can reduce the computing time using the simple way without considering the viscosity dynamics and so on. Also this system can show the simulation result with the three dimensional image and the animation using OpenGL. The user can view the area of the lava flow from the various angles, and we think that this is useful for the improvement of their conscience for the disaster prevention.

The Case for Reasonable Accommodation of Conscientious Objections to Declarations of Brain Death.

PubMed

Johnson, L Syd M

2016-03-01

Since its inception in 1968, the concept of whole-brain death has been contentious, and four decades on, controversy concerning the validity and coherence of whole-brain death continues unabated. Although whole-brain death is legally recognized and medically entrenched in the United States and elsewhere, there is reasonable disagreement among physicians, philosophers, and the public concerning whether brain death is really equivalent to death as it has been traditionally understood. A handful of states have acknowledged this plurality of viewpoints and enacted "conscience clauses" that require "reasonable accommodation" of religious and moral objections to the determination of death by neurological criteria. This paper argues for the universal adoption of "reasonable accommodation" policies using the New Jersey statute as a model, in light of both the ongoing controversy and the recent case of Jahi McMath, a child whose family raised religious objections to a declaration of brain death. Public policies that accommodate reasonable, divergent viewpoints concerning death provide a practical and compassionate way to resolve those conflicts that are the most urgent, painful, and difficult to reconcile.

Decree No. 2737 issuing the Code of Minors, 27 November 1989.

PubMed

1989-01-01

This document contains major provisions of the 1989 Code of Minors of Colombia. This Code spells out the rights of minors to protection, care, and adequate physical, mental, and social development. These rights go into force from the moment of conception. Minors have a specified right to life; to a defined filiation; to grow up within a family; to receive an education (compulsory to the ninth grade and free of charge); to be protected from abuse; to health care; to freedom of speech and to know their rights; to liberty of thought, conscience, and religion; to rest, recreation, and play; to participate in sports and the arts; and to be protected from labor exploitation. Handicapped minors have the right to care, education, and special training. Minors also have the right to be protected from the use of dependency-creating drugs. Any minor in an "irregular situation" will receive protective services. The Code defines abandoned minors and those in danger and provides specific protective measures which can be taken. Rules and procedures covering adoption are included in the Code, because adoption is viewed as primarily a protective measure.

Active learning and leadership in an undergraduate curriculum: How effective is it for student learning and transition to practice?

PubMed

Middleton, Rebekkah

2013-03-01

Nurses are being increasingly asked to develop leadership skills in their practice and to be actively involved in continuous change processes in the workplace. Nursing students need to be developing leadership skills prior to entering the workplace to ensure they are able to meet the challenges associated with organisations and the cultures present in nursing, along with having highly tuned communication skills and leadership attributes that contribute to best patient care and outcomes. This paper looks at how the use of Active Learning in an undergraduate setting enabled the development and implementation of a leadership subject for nursing students preparing for professional practice. Through the use of a specific model of Active Learning, incorporating multiple intelligences into education allows students to bring deeper learning to their conscience so that whole person learning is an engaged experience. It seems apparent that Active Learning is an effective means of learning about leadership in undergraduate students who are developing towards a career as a health professional. Copyright © 2012 Elsevier Ltd. All rights reserved.

A fundamental shift in the approach to international health by WHO, UNICEF, and the World Bank: instances of the practice of "intellectual fascism" and totalitarianism in some Asian countries.

PubMed

Banerji, D

1999-01-01

Navarro has used the term "intellectual fascism" to depict the intellectual situation in the McCarthy era. Intellectual fascism is now more malignant in the poor countries of the world. The Indian Subcontinent, China, and some other Asian countries provide the context. The struggles of the working class culminated in the Alma-Ata Declaration of self-reliance in health by the peoples of the world. To protect their commercial and political interests, retribution from the rich countries was sharp and swift, they "invented" Selective Primary Health Care and used WHO, UNICEF, the World Bank, and other agencies to let loose on poor countries a barrage of "international initiatives" as global programs on immunization, AIDS, and tuberculosis. These programs were astonishingly defective in concept, design, and implementation. The agencies refused to take note of such criticisms when they were published by others. They have been fascistic, ahistorical, grossly unscientific, and Goebbelsian propagandists. The conscience keepers of public health have mostly kept quiet.

Neuroethics scope at a glance

PubMed Central

Rabadán, Alejandra T.

2015-01-01

The term neuroethics defines the bioethics field that deals with the dilemmas arising from the development of the neurosciences. Why are we so sensitive to ponder on neuroethics? Because it involves the brain, the organ responsible for our perceptions, our thoughts, and our conscience; and its knowledge and/or manipulation entail the most genuine and nontransferable aspects of the human being. Since 2002, neuroethics has been recognized as a new discipline that offers an area of consideration for neuroscientific knowledge and the actions regarding human beings as individuals, and the society as an organization. Within its framework, we can distinguish two branches: fundamental neuroethics and applied neuroethics. Neuroethics demands that we are on alert, and we offer the possibility of interdisciplinary exchange programs, encouraging society to participate, promoting the ethical opinions, and even working with anticipation on the dilemmas that are already emerging. Science does not stop, and its development has acquired such an accelerated pace that there has not been enough time to discuss its processes. We are convinced that neuroethics will be for the 21st century, what genetics was for the 20th century. PMID:26677417

Suicide attempt by ingestion of rotenone-containing plant extracts: one case report in French Guiana.

PubMed

Chesneau, Pierre; Knibiehly, Marc; Tichadou, Lucia; Calvez, Mélanie; Joubert, Michel; Hayek-Lanthois, Maryvonne; De Haro, Luc

2009-09-01

Several species of plants in the Fabaceae family are traditionally used for poison fishing because they contain ichthyotoxic rotenoids. In French Guiana two species of Fabaceae belonging to Lonchocarpus genus with a toxic rotenone effect are used for such ancestral practices. Rotenone is of low toxicity for humans when it is diluted, but its neurotoxicity at higher concentrations is well known to users. The purpose of this article is to describe a case of self-poisoning by an 86-year-old woman who ingested a bowl of mashed ichthyotoxic plants. Despite early onset of severe symptoms, the patient regained consciousness and resumed normal breathing within a few hours with only symptomatic treatment. The clinical pattern observed in this patient (onset of digestive manifestations followed quickly by loss of conscience and respiratory insufficiency) is in agreement with the few poisonings reported in the literature involving other Fabaceae species containing rotenoids in Asia or involving concentrated rotenone used in insecticides. In patients, who survive the initial phase, symptoms usually regress quickly.

An Archeology of Corruption in Medicine.

PubMed

Little, Miles; Lipworth, Wendy; Kerridge, Ian

2018-07-01

Corruption is a word used loosely to describe many kinds of action that people find distasteful. We prefer to reserve it for the intentional misuse of the good offices of an established social entity for private benefit, posing as fair trading. The currency of corruption is not always material or financial. Moral corruption is all too familiar within churches and other ostensibly beneficent institutions, and it happens within medicine and the pharmaceutical industries. Corrupt behavior reduces trust, costs money, causes injustice, and arouses anger. Yet it persists, despite all efforts since the beginnings of societies. People who act corruptly may lack conscience and empathy in the same way as those with some personality disorders. Finding ways to prevent corruption from contaminating beneficent organizations is therefore likely to be frustratingly difficult. Transparency and accountability may go some way, but the determined corruptor is unlikely to feel constrained by moral and reporting requirements of this kind. Punishment and redress are complicated issues, unlikely to satisfy victims and society at large. Both perhaps should deal in the same currency-material or social-in which the corrupt dealing took place.

Why some Jehovah's Witnesses accept blood and conscientiously reject official Watchtower Society blood policy

PubMed Central

Elder, L.

2000-01-01

In their responses to Dr Osamu Muramoto (hereafter Muramoto) Watchtower Society (hereafter WTS) spokesmen David Malyon and Donald Ridley (hereafter Malyon and Ridley),1–3 deny many of the criticisms levelled against the WTS by Muramoto.4–6 In this paper I argue as a Jehovah's Witness (hereafter JW) and on behalf of the members of AJWRB that there is no biblical basis for the WTS's partial ban on blood and that this dissenting theological view should be made clear to all JW patients who reject blood on religious grounds. Such patients should be guaranteed confidentiality should they accept whole blood or components that are banned by the WTS. I argue against Malyon's and Ridley's claim that WTS policy allows freedom of conscience to individual JWs and that it is non-coercive and non-punitive in dealing with conscientious dissent and I challenge the notion that there is monolithic support of the WTS blood policy among those who identify themselves as JWs and carry the WTS "advance directive". Key Words: Blood transfusion • Jehovah's Witnesses • Watchtower • autonomy PMID:11055042

Roe v. Wade. Catholic wisdom.

PubMed

Maguire, D

1998-01-01

In this commentary, a Roman Catholic professor of moral theory recounts how, during his doctoral work in Rome, he was taught that abortion was intrinsically evil and could never be justified. He was also taught, however, about Probabilism, a Roman Catholic teaching that held that "where there is doubt, there is freedom." In other words, serious doubts based on a person's own insights allow a person moral freedom to choose a course of action in cases of debated moral issues. This moral teaching, a triumph for the rights of personal conscience, which was formulated in the 16th and 17th centuries, has been well-hidden from the laity and neglected by the clergy during the past 100 years. He also learned about Thomas Aquinas who taught that practical moral principals are valid most of the time but can have exceptions depending on circumstances. In addition, early 17th-century church leaders justified abortions performed to save the life of the women. Thus, the Supreme Court's decision in Roe seems to reflect Catholic thinking more accurately than the Vatican's new-found absolutism against abortion.

A callous and coercive policy.

PubMed

Kissling, F

1999-01-01

This article comments on the Vatican stand on the provision of emergency contraception to women who have been raped during the Kosovo war. The Roman Catholic Church has once again demonstrated its opposition to contraception by denying the rape victim during the Kosovo war access to emergency contraception. Such opposition signifies the church leader's lack of understanding for the reproductive rights of women. One graphic example of this lack of understanding can be found in the message Pope John Paul II sent to Bosnian Muslim women who had been raped during the 1993 conflict. The Pope urged them to turn their rape into an act of love and "accept the enemy into them, making him flesh of their own flesh" by carrying their pregnancies to term. In this article, the characterization by the church leaders on emergency contraception was given due consideration. Instead of church leaders giving raped women inaccurate information about what constitutes a pregnancy or pointing fingers to aid workers as perpetrators of violence for offering voluntary emergency contraception, the church should do better by respecting the conscience and moral rights of the women, including those who have been raped.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marchant, M.; Sesko, S.C.

Objective was to examine the creative process, demonstrated by 5 student participants in a class at the Art Center College of Design in Pasadena CA, from the germ of the creative idea through the final creative product. The students, drawn from classes sponsored by LLNL, were assigned the problem of representing ``big`` science, as practiced at LLNL, in a graphic, artistic, or multimedia product. As a result of this study, it was discovered that the process of creativity with these students was not linear in nature, nor did it strictly follow the traditional creativity 5-step schema of preparation, incubation, insight,more » evaluation, and elaboration. Of particular interest were several emergent themes of the creative process: spontaneous use of metaphor to describe the Laboratory; a general lack of interest in ``school`` science or mathematics by the American art students; a well developed sense of conscience; and finally, the symbolism inherent in the repeated use of a single artistic element. This use of the circle revealed a continuity of thinking and design perhaps related to the idealistic bias mentioned above.« less

[Patients' autonomy and doctors' duties according to the Andalusian bill of "dignified dead"].

PubMed

Díez Fernández, José Antonio

2010-01-01

The provisions of the andalusian Law on rights and guarantees of the dignity of persons in the process of death, also known as "act of dignified death", are based on two pillars: the right to the autonomy of the patient, supported, if it be, in a will expressed in instructions given in advance and the duties of doctors and health centers to give satisfaction, to the extent of their potential and respecting the law, those demands. the core of the question is to find the point of necessary balance between the wishes of the patient and the freedom and responsibility of the doctor. Together with positive aspects, such as the recognition of the right and the implementation of the palliative care, there are other questionable proposals, affecting the rights of doctors: a lack of understanding of freedom and professional responsibility, recognition of the objection of conscience and certain ethics duties, etc. As expressed by the law, remain committed substantial rights of doctors and might favor, in the care activity, introducing practices of defensive medicine.

Le risque de détresse morale dans la pratique contemporaine des soins de santé.

PubMed

Austin, Wendy

2016-05-01

Les professionnels de la santé sont des agents moraux dont la relation fiduciaire avec le public est animée par la responsabilité et la promesse de puiser dans leurs connaissances et leurs habiletés pour aider les personnes sous leurs soins. Lorsque leur capacité à tenir cette promesse est freinée ou compromise, ils risquent de souffrir de détresse morale. Le concept de détresse morale est défini et mis en contexte dans le milieu de la santé. Les contraintes et les facteurs qui en sont à l'origine sont présentés, de même que les moyens utilisés par les professionnels de la santé et les organisations de santé pour la soulager. Un changement transformateur s'impose pour vaincre la culture du silence et maintenir un système de santé où il est possible de vivre avec sa conscience. © 2016 The Canadian College of Health Leaders.

The significance of avoiding household food waste - A means-end-chain approach.

PubMed

Richter, Beate; Bokelmann, Wolfgang

2018-04-01

Many humans suffer from hunger, while edible food is discarded. This study aims at showing the importance of avoiding food waste in households and its causes by applying the means-end-chain analysis. Additional the means-end-chain approach should be examined in how far the method is suitable to get insights towards this topic. Consumer backgrounds in terms of feelings and attitudes regarding food waste should be shown, with the particular question why food waste personally is important. The data collection occurred utilizing the hard laddering method within a quantitative online survey. The results indicate that avoiding food waste is important for the greater part of consumers, as many claim to have a bad conscience, seeing it as morally wrong and reprehensible to waste food. A sample breakdown of gender, age and income points differences among these groups in regards to psychological consequences and value systems. Financial and environmental aspects have a lesser impact on attitudes and feelings regarding food waste in households. Copyright © 2018 Elsevier Ltd. All rights reserved.

Integrity and virtue: The forming of good character

PubMed Central

Mitchell, Louise A.

2015-01-01

Moral character is formed by one's actions. The habits, actions, and emotional responses of the person of good character all are united and directed toward the moral and the good. Because human beings are body/soul unities, actions of the body are actions of the self, that is, human beings are self-possessing, self-governing, and self-determining. In order to be of good character, one must know the good, act in morally good ways, and be disposed and inclined toward the good through the development of virtues. Character and action are intertwined so intimately that one's professional duties, or even what is perceived by others as one's duties, cannot override one's conscience without negatively affecting (and changing) one's character. For the physician to be of good character, it is vital that he or she follow his or her conscience in all things: in private life and also in his or her profession, i.e., in the treatment of patients. Lay summary: Character cannot be separated from the person. To be of good character means that one’s habits, actions, and emotional responses all are united and directed toward the moral and the good. In this, public actions cannot be separated from private actions. Both sets of actions affect one’s character. For example, a physician believes use of contraceptives to be immoral yet prescribes them in the office because he or she feels a duty to provide what the patient asks for, or a pharmacist who believes abortion to be immoral fills prescriptions for the abortifacient RU-486. These public acts affect one’s character even if one’s private belief is the opposite of the action. They leave traces on one’s character. Not only do actions reflect the goodness or badness of one’s character, one’s actions also change one’s character. The more one does an immoral action or recommends an immoral action for others, the more it becomes part of one’s character to be the type of person who condones that immoral action. In order to be of good character one must not only know and desire the good, one must also pursue it in both private and public actions. Virtue is an aid in this; it is the act of good character. Growing in the virtues, especially prudence (knowing what to seek and what to avoid) forms good character. What is at stake is the integrity of the person. The physician who believes that use of contraception is immoral must also act in ways that display that belief and avoid actions that promote contraception use by his or her patients. PMID:25999613

Therapeutic cloning in Australia: one small stem from man, one giant leap for mankind.

PubMed

Nemes, Irene

2008-08-01

In 2002 the Australian Parliament enacted legislation which prohibited both therapeutic and reproductive embryonic cloning. Just four years later, in December 2006, this same legislation was amended, reversing the prohibition on therapeutic cloning, while retaining the ban on reproductive cloning. The Prime Minister, sensing the political mood, allowed a conscience vote. This contrasted with his decision several months earlier against introducing any changes to the 2002 Act, despite 54 recommendations having been made by a Statutory Review Committee. Approval of the legislation had as much to do with the careful drafting of the provisions as with any rational, social or scientific factor. The legislation is narrow in scope, retains an absolute prohibition on reproductive cloning and contains strict regulations with heavy criminal penalties. The Act requires a review after three years. A number of questions remain. Does stem cell research demand a global rather than a local approach, by way of an international Covenant? Does the legal status of a cloned embryo need further examination? Will the embryo have a separate legal standing recognised by law? These are some of the questions which will need addressing as the law tries to keep up with science.

Ethical considerations in dental laser research, education, and practice

NASA Astrophysics Data System (ADS)

Goldstein, Alan T.; Coluzzi, Donald J.; Sulewski, John G.; White, Joel M.

1995-05-01

This presentation addresses the interplay between commerce and conscience. The relationship between industry and academia must be free of both true and apparent conflict of interest. Obviously, the matter is of great importance, since as scientists and clinicians, our integrity is our most valuable asset. This is no less true for the manufacturers of dental laser technology. Ethics, then, is a bottom-line issue for all concerned. Often, in spite of good intentions, there has been no clear-cut policy on this issue. Occasionally, when there has been policy, there has been no mechanism for implementation. Universities have conflict-of-interest requirements, while industry and others in the profession do not. In the academic sphere, we are obligated to be open, thorough, honest and scrupulous in our research and educational activities. Recently, the Board of Directors of the Academy of Laser Dentistry unanimously passed a resolution clarifying their position on conflict-of-interest issues. We offer it to SPIE so that ultimately, we may face our profession and business colleagues squarely, and with full and faithful disclosure. Issues of conflict of interest, principal investigators, financial interests, and recommendations for full disclosure are presented.

The President's Physician: An African Play : Emmanuel Babatunde Omobowale, 2004, All Saints' Publishers (Ibadan, 978-978-37727-3-1, 77 pp.).

PubMed

Mayaki, Joseph Ajagunmolu

2017-12-01

This review examines issues relating to biomedical ethics and literature in the African drama The President's Physician by Emmanuel Babatunde Omobowale. The play investigates the psychological dilemma of Doctor Bituki Warunga, a personal physician to General Kalunga Ntibantunganyah who brutally and inhumanely rules Wavaria, a fictional African country. The doctor is faced with deciding to uphold the ethics of his profession versus terminating the tyrant's life to set the nation free. The play aims to help budding medical doctors rightly inculcate the principles of medical ethics-autonomy, beneficence, competence, and power-by providing a fictional platform to investigate difficult issues that can arise in clinical practice. The play highlights Warunga's complex dilemma as he struggles to uphold the Hippocratic Oath and at the same time satisfy his conscience towards his contribution to his country's freedom. This review explores the difficulties in decision-making when professional duties not only clash with personal preferences but also with the well-being of an entire nation. This discussion is done alongside the ethical concept of utilitarianism and also highlights significant literary concepts such as satire, symbolism, intertextuality, utopian aesthetics, and authorial vision as conveyed in the text.

Trauma and the state with Sigmund Freud as witness.

PubMed

Danto, Elizabeth Ann

Just before and after the end of World War I, Sigmund Freud took on an activist role and in his writings and speeches, redirected the concept of war trauma from individual failure to a larger issue of community responsibility. Testifying in Vienna as an expert witness for the state, Freud said that the military psychiatrists-not the soldiers-had "acted like machine guns behind the front" and were the "immediate cause of all war neurosis." Freud was called on by the legal community when Julius Wagner-Jauregg, a future Nobel Prize winner (and also future Nazi Party adherent), head of the municipal Clinic for Psychiatry and Nervous Diseases, was accused of the lethal use of electrotherapy on shell-shocked soldiers. As sociological as psychoanalytic in his responses, Freud's withering critique came just 2years after he avowed that "it is possible to foresee that the conscience of society will awake." That speech on the human right to mental health care affirmed Freud's alliance to the social democratic position and inspired the second generation of psychoanalysts to develop community-based clinics throughout Europe where treatment was free of cost, for war neurosis and beyond. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adverse impact of industrial animal agriculture on the health and welfare of farmed animals.

PubMed

D'Silva, Joyce

2006-03-01

Industrial animal agriculture is grounded in the concept of maximizing productivity and profit. Selective breeding for maximum productivity in one characteristic of the animal (e.g. milk yield in cows, or breast meat in broiler chickens) has resulted in genotypes and phenotypes that may predispose the animals to poor health and welfare. The conditions in which these individuals are kept may also frustrate many inherited behaviors that they are strongly motivated to perform. In order to curb the resulting harmful aberrant behaviors, such as feather-pecking in chickens, we sometimes resort to mutilating the animals. In many places chickens are routinely de-beaked by means of a hot metal guillotine. Compassion in World Farming (an international organization that promotes the humane treatment of farm animals) believes that it is unethical to treat sentient beings in such ways. We have a duty to respect farm animals' sentience by providing them with housing conditions that take their needs and wants into account, and by reverting to the use of dual-purpose, slower-growing breeds that have the potential for good welfare. Alternatives to current farming practices are available, and we owe it to the animals, and to our consciences, to pursue them.

'I await your apology': a polyphonic narrative interpretation.

PubMed

Cash, Penelope A

2007-10-01

A patient's experience unfolds through a nurse's personal conversation with herself. Conveyed through three voices, the nurse's dialogue highlights her many internal struggles; those with her conscience on what she understands to be best practice, those important to her as a person, those of an ethical nature that profoundly affect one's search for meaning, and those in the personal-professional realm driven in part by institutional culture. These multivoiced knowledges are confronted in ways that foreground language and understanding as performative acts. At the same time, another journey is co-constructed with the reader, one that weaves in-between the symbolic and the real, engaging the imaginary in (inter)play. The nurse's response to the inner conversation with her 'self/selves' problematizes practice, illuminates the patient's perspective while highlighting the nurse's sense of her marginal position. Insight into reified and hegemonic assumptions, strategies of how control is maintained through organizational surveillance, trust and moral agency help to foreground personal expectations as the nurse begins to grapple with her own feelings of betrayal. Tackling these insights offers opportunities to rethink oppressive practices in the provision of care. It also enables an alternative appreciation of the everyday dilemmas confronting nurses and offers new meaning to practice.

The voice of conscience: neural bases of interpersonal guilt and compensation

PubMed Central

Yu, Hongbo; Hu, Jie; Hu, Li

2014-01-01

People feel bad for inflicting harms upon others; this emotional state is termed interpersonal guilt. In this study, the participant played multiple rounds of a dot-estimation task with anonymous partners while undergoing fMRI. The partner would receive pain stimulation if the partner or the participant or both responded incorrectly; the participant was then given the option to intervene and bear a proportion of pain for the partner. The level of pain voluntarily taken and the activations in anterior middle cingulate cortex (aMCC) and bilateral anterior insula (AI) were higher when the participant was solely responsible for the stimulation (Self_Incorrect) than when both committed an error (Both_Incorrect). Moreover, the gray matter volume in the aMCC predicted the individual’s compensation behavior, measured as the difference between the level of pain taken in the Self_Incorrect and Both_Incorrect conditions. Furthermore, a mediation pathway analysis revealed that activation in a midbrain region mediated the relationship between aMCC activation and the individual’s tendency to compensate. These results demonstrate that the aMCC and the midbrain nucleus not only play an important role in experiencing interpersonal guilt, but also contribute to compensation behavior. PMID:23893848

Matters of conscience and conscientiousness: the place of ego development in the Five-factor model.

PubMed

Kurtz, John E; Tiegreen, Sara B

2005-12-01

The Five-factor model (FFM; Digman, 1990; Goldberg, 1990) and Loevinger's (1994) theory of ego development are two active research traditions that are often construed as incompatible approaches to the study of personality. For example, each theory proposes a different view of the concept of conscientiousness. Loevinger argued that FFM conscientiousness, which emphasizes attributes such as order, self-discipline, and achievement striving, lacks a moral component and is more similar to the conformist stage in her theory. To investigate these claims, we administered the Revised NEO-Personality Inventory (NEO-PI-R; Costa & McCrae, 1992) and the Washington University Sentence Completion Test (WUSCT; Hy & Loevinger, 1996) to 120 university students on 2 separate occasions. Together, the five traits of the FFM significantly predicted item sum scores from the WUSCT (multiple R = .54). Unique linear relationships of Openness to Experience and Agreeableness with ego level demonstrated that the two theories proposed similar constructs. We argue that these two FFM dimensions have conceptual relevance to the cognitive and interpersonal aspects of the ego development construct. We draw further connections between these FFM dimensions, ego development, and human values.

Duty and dilemma: Perioperative nurses hiding an objection to participate in organ procurement surgery.

PubMed

Smith, Zaneta

2017-07-01

Perioperative nurses assist in organ procurement surgery; however, there is a dearth of information of how they encounter making conscientious objection requests or refusals to participate in organ procurement surgery. Organ procurement surgical procedures can present to the operating room ad hoc and can catch a nurse who may not desire to participate by surprise with little opportunity to refuse as a result of staffing, skill mix or organizational work demands. This paper that stems from a larger doctoral research study exploring the experiences of perioperative nurses participating in multi-organ procurement surgery used a grounded theory method to develop a substantive theory of the nurses' experiences. This current paper aimed to highlight the experiences of perioperative nurses when confronted with expressing a conscientious objection towards their participation in these procedures. A number of organizational and cultural barriers within the healthcare organization were seen to hamper their ability in expressing a conscience-based refusal, which lead to their reluctant participation. Perioperative nurses must feel safe to express a conscientious objection towards these types of surgical procedures and feel supported in doing so by their respective hospital organizations and not be forced to participate unwillingly. © 2016 John Wiley & Sons Ltd.

Honorary authorship and symbolic violence.

PubMed

Kovacs, Jozsef

2017-03-01

This paper invokes the conceptual framework of Bourdieu to analyse the mechanisms, which help to maintain inappropriate authorship practices and the functions these practices may serve. Bourdieu's social theory with its emphasis on mechanisms of domination can be applied to the academic field, too, where competition is omnipresent, control mechanisms of authorship are loose, and the result of performance assessment can be a matter of symbolic life and death for the researchers. This results in a problem of game-theoretic nature, where researchers' behaviour will be determined more by the logic of competition, than by individual character or motives. From this follows that changing this practice requires institutionalized mechanisms, and change cannot be expected from simply appealing to researchers' individual conscience. The article aims at showing that academic capital (administrative power, seniority) is translated into honorary authorship. With little control, undetected honorary authorship gives the appearance of possessing intellectual capital (scientific merit). In this way a dominant position is made to be seen as natural result of intellectual ability or scientific merit, which makes it more acceptable to those in dominated positions. The final conclusion of this paper is that undemocratic authorship decisions and authorship based performance assessment together are a form of symbolic violence.

Evaluating Callous-Unemotional Traits as a Personality Construct.

PubMed

Frick, Paul J; Ray, James V

2015-12-01

We evaluate the importance of callous-unemotional (CU) traits as a personality construct in isolation from other facets of psychopathy. Specifically, we review research suggesting that these traits are useful for designating a subgroup of youth with serious conduct problems who differ from other antisocial youth on important biological, emotional, cognitive, and social characteristics. In addition, the temperamental features related to CU traits are risk factors for impairments in conscience development in young children. Thus, these traits could advance theoretical models explaining the development of severe antisocial behavior and psychopathy. CU traits also have important clinical utility because they designate a particularly severe and impaired subgroup of antisocial youth, leading to their inclusion in the DSM-5. As a result of this inclusion in diagnostic classification, there has been an increased focus on how to best assess CU traits, and we discuss several key issues in their assessment, highlighting several limitations in existing measures. Finally, the increased use of CU traits, separately from other facets of psychopathy, makes it important to determine how these traits relate to other personality constructs. Thus, we examine how measures of CU traits relate to the broader construct of psychopathy and to other basic personality dimensions. © 2014 Wiley Periodicals, Inc.

Harnessing the Promise of Moral Distress: A Call for Re-Orientation.

PubMed

Carse, Alisa; Rushton, Cynda Hylton

2017-01-01

Despite over three decades of research into the sources and costs of what has become an "epidemic" of moral distress among healthcare professionals, spanning many clinical disciplines and roles, there has been little significant progress in effectively addressing moral distress. We believe the persistent sense of frustration, helplessness, and despair still dominating the clinical moral distress narrative signals a need for re-orientation in the way moral distress is understood and worked with. Most fundamentally, moral distress reveals moral investment and energy. It is the troubled call of conscience, an expression of fidelity to moral commitments seen as imperiled or compromised. It is crucial that we find ways to empower clinicians in heeding this call-to support clinicians' moral agency and voice, foster their moral resilience, and facilitate their ability to contribute to needed reform within the organizations and systems in which they work. These objectives must inform creative expansion in the design of strategies for addressing moral distress in the day-to-day of clinical practice. We include suggestions about promising directions such strategies might take in the hope of spurring further innovation within clinical environments. Copyright 2016 The Journal of Clinical Ethics. All rights reserved.

Assisted suicide: implications for nurses and nursing.

PubMed

Daly, B J; Berry, D; Fitzpatrick, J J; Drew, B; Montgomery, K

1997-01-01

Assisted suicide is an issue of great importance to nurses. This issue reflects our values and beliefs as a society, calls for a clear and precise response as a profession, and challenges individual nurses to think about their own moral views. The history of the debate and the compelling moral arguments on both sides attest to the complexity of the issue and also suggest that it will not soon be resolved. The current position of the profession, as expressed in the ANA Code for Nurses and a specific position statement, were reviewed. The dilemma faced by the individual nurse who perceives an obligation to adhere to the guidelines specified by his or her profession's code and yet whose conscience dictates an act in violation of this code has been discussed as an instance of conscientious objection. While this analysis has been necessarily brief, it was intended to illustrate the importance of being clear about one's personal moral views and equally clear about one's duty to fulfil the obligations stemming from the profession's public statements. It is essential that the profession continue to explore the moral issues involved in requests for assistance in dying and provide additional guidelines for practicing nurses, with sound rationale for the profession's position.

Professional ethics: beyond the clinical competency.

PubMed

Vanaki, Zohreh; Memarian, Robabeh

2009-01-01

Assessment of clinical competency in professional roles especially in crucial situations can improve the nursing profession. This qualitative research was conducted to determine the process of acquiring clinical competency by nurses in its cultural context and within the health care delivery system in Iran. This study, using grounded theory methodology, took place in universities and hospitals in Tehran. Nurses (36) included nurse managers, tutors, practitioners, and members of the Iranian Nursing Organization. Simultaneous data collection and analysis took place using participant semistructured interviews. Three categories emerged: (a) personal characteristics such as philanthropy, strong conscience, being attentive, accepting responsibility, being committed to and respecting self and others; (b) care environment including appropriate management systems, in-service training provision, employment laws, and control mechanisms, suitable and adequate equipment; and (c) provision of productive work practices including love of the profession, critical thinking, nursing knowledge, and professional expertise. Professional ethics has emerged as the core variable that embodies concepts such as commitment, responsibility, and accountability. Professional ethics guarantees clinical competency and leads to the application of specialized knowledge and skill by nurses. The results can be used to form the basis of guiding the process of acquiring clinical competency by nurses using a systematic process.

The paradox of conscientious objection and the anemic concept of 'conscience': downplaying the role of moral integrity in health care.

PubMed

Giubilini, Alberto

2014-06-01

Conscientious objection in health care is a form of compromise whereby health care practitioners can refuse to take part in safe, legal, and beneficial medical procedures to which they have a moral opposition (for instance abortion). Arguments in defense of conscientious objection in medicine are usually based on the value of respect for the moral integrity of practitioners. I will show that philosophical arguments in defense of conscientious objection based on respect for such moral integrity are extremely weak and, if taken seriously, lead to consequences that we would not (and should not) accept. I then propose that the best philosophical argument that defenders of conscientious objection in medicine can consistently deploy is one that appeals to (some form of) either moral relativism or subjectivism. I suggest that, unless either moral relativism or subjectivism is a valid theory--which is exactly what many defenders of conscientious objection (as well as many others) do not think--the role of moral integrity and conscientious objection in health care should be significantly downplayed and left out of the range of ethically relevant considerations.

[Epistemological/methodological contributions to the fortification of an emancipatory con(science)].

PubMed

Ferreira, Marcelo José Monteiro; Rigotto, Raquel Maria

2014-10-01

This article conducts a critical and reflective analysis into the paths of elaboration, sistematization and communication of the results of research in conjunction with colleges, social movements and individuals in the territory under scrutiny. For this, the article embraces as the core analytical theme the process of shared production of knowledge, both in the epistemological-methodological field and with respect to its social destination. The case study was adopted as the methodology, preceded by the use of focused groups and in-depth interviews as technique. To analyze the qualitative material discourse analysis was adopted in line with the assumptions of in-depth hermeneutics. The results are presented in two stages: Firstly, the new possibilities for a paradigmatic reorientation are discussed from the permanent and procedural interlocution with the empirical field and it's different contexts and authors. Secondly, it analyzes in the praxiological dimension, the distinct ways of appropriation of knowledge produced in dialogue with the social movements and the individuals in the territory under scrutiny. It concludes by highlighting alternative and innovative paths to an edifying academic practice. which stresses solidarity and is sensitive to the vulnerable population and its requests.

Psyche--the meeting of mind and soul: current psychoanalytic views on the mental representation of god.

PubMed

Clemens, Norman A

2013-11-01

The author presents an overview of two contemporary, related psychoanalytic perspectives on religious phenomena. Based on data from systematic interviews, Ana-Maria Rizzuto explores the way the human mind forms the idea of God as it evolves through the various stages of childhood and adult development. The object-representation of God is greatly influenced by the mental representations of mother, father, and other important adults in the child's life. Object relations theory and the writings of Winnicott play an important role in these concepts. William Meissner, a Jesuit priest as well as a psychoanalyst, addresses Freud's views of religious belief as an illusion, or when accepted with certainty as real, as a delusion. Instead, Meissner sees religious belief as a developmental process that resides in the mental realm of transitional phenomena where spirituality, creativity, appreciation of beauty, transcendental states, play, and the psychoanalytic process itself also take place. In psychoanalytic treatment, religious phenomena are not exempt from exploration and understanding, perhaps resulting in more mature development of object representations, ego functions, and the superego functions of conscience and ego ideal as well as more mature religious life.

Roe v. Wade. Ardently prochoice.

PubMed

Baldwin, M

1998-01-01

In this commentary, a community activist who is also a retired educator describes how she became ardently in favor of women having the legal right to make abortion decisions. She had converted to Catholicism as an adult in the late 1940s and became a zealot. When the Supreme Court issued its decision in Roe vs. Wade, she tried to determine how she felt about abortion and read some of the publications of Catholics for a Free Choice. In 1980, she ran for office in Vermont and had to declare her views about abortion. She asserted that abortion was a matter to be decided between a woman and her doctor and lost the election to a man in a close race. In 1989, she became a co-founder of Vermont Catholics for Free Choice and served as the president of the organization for 7 years. The Vermont group considered many issues affecting Roman Catholics, including divorce, celibacy, the ordination of women, world population, the rights of homosexuals, contraception, due process, and the local election of bishops as well as abortion. In 1996, the group changed its name to Vermont Catholics for Free Conscience in order to provide an umbrella for all of the dissenting Catholic voices in Vermont.

A Baldrige Process for ethics?

PubMed

Goodpaster, Kenneth E; Maines, T Dean; Weimerskirch, Arnold M

2004-04-01

In this paper we describe and explore a management tool called the Caux Round Table Self-Assessment and Improvement Process (SAIP). Based upon the Caux Round Table Principles for Business--a stakeholder-based, transcultural statement of business values--the SAIP assists executives with the task of shaping their firm's conscience through an organizational self-appraisal process. This process is modeled after the self-assessment methodology pioneered by the Malcolm Baldrige National Quality Award Program. After briefly describing the SAIP, we address three topics. First, we examine similarities and differences between the Baldrige approach to corporate self-assessment and the self-assessment process utilized within the SAIP. Second, we report initial findings from two beta tests of the tool. These illustrate both the SAIP's ability to help organizations strengthen their commitment to ethically responsible conduct, and some of the tool's limitations. Third, we briefly analyze various dimensions of the business scandals of 2001-2002 (Enron, WorldCom, Tyco, etc.) in light of the ethical requirements articulated with the SAIP. This analysis suggests that the SAIP can help link the current concerns of stakeholders--for example, investors and the general public--to organizational practice, by providing companies with a practical way to incorporate critical lessons from these unfortunate events.

The fox and the grapes: an Anglo-Irish perspective on conscientious objection to the supply of emergency hormonal contraception without prescription.

PubMed

Gallagher, Cathal T; Holton, Alice; McDonald, Lisa J; Gallagher, Paul J

2013-10-01

Emergency hormonal contraception (EHC) has been available from pharmacies in the UK without prescription for 11 years. In the Republic of Ireland this service was made available in 2011. In both jurisdictions the respective regulators have included 'conscience clauses', which allow pharmacists to opt out of providing EHC on religious or moral grounds providing certain criteria are met. In effect, conscientious objectors must refer patients to other providers who are willing to supply these medicines. Inclusion of such clauses leads to a cycle of cognitive dissonance on behalf of both parties. Objectors convince themselves of the existence of a moral difference between supply of EHC and referral to another supplier, while the regulators must feign satisfaction that a form of regulation lacking universality will not lead to adverse consequences in the long term. We contend that whichever of these two parties truly believes in that which they purport to must act to end this unsatisfactory status quo. Either the regulators must compel all pharmacists to dispense emergency contraception to all suitable patients who request it, or a pharmacist must refuse either to supply EHC or to refer the patient to an alternative supplier and challenge any subsequent sanctions imposed by their regulator.

Caring for the Environment While Teaching Organic Chemistry

NASA Astrophysics Data System (ADS)

Santos Santos, Elvira; Cruz Gavilan Garcia, Irma; Florencia Lejarazo Gomez, Eva

2004-02-01

In laboratory experiments it is common for students to acquire knowledge and develop the basic abilities needed to solve different types of problems related to synthesis and analysis. The students are so interested in this objective that they do not generally pay any attention to the wastes generated during their lab experiments. It is well known that experiments usually generate small quantities of a large variety of wastes. Nevertheless, the complexity of the wastes generated in the laboratories of educational institutions is large. Thus, detailed studies of their treatment should be undertaken. In North American and European universities the problem has been solved by sending these wastes to specialized companies that treat and dispose of them; however, in Mexico, such alternatives are not available owing to the high cost for waste disposal. Therefore, the Organic Chemistry Department of the Chemistry School at the National Autonomous University of Mexico has started a project concerned with the management and treatment of wastes generated during experimental lab sessions. In the United States and Europe, students do not generally treat their wastes. Therefore, it would be convenient to include this treatment as part of the educational aspects in organic experiments in all parts of the world to develop an environmentally conscience culture among them.

Consequences for patients of health care professionals' conscientious actions: the ban on abortions in South Australia.

PubMed Central

Cannold, L

1994-01-01

The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs' claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action '... invades a patient's autonomy, puts a patient at serious risk ... [and] treats a patient unjustly' (1) Secondly, because the consequences of such refusals turn them into political acts--acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible. PMID:8083879

The human biology--saturated with experience.

PubMed

Getz, Linn; Kirkengen, Anna Luise; Ulvestad, Elling

2011-04-08

The human being is a self-reflecting, relationship-oriented, goal-directed organism in search of meaning. The process of coordinating and developing knowledge about how experience associated with self-conscience, relationships and values can contribute to development of health and disease is a great challenge for the medical profession. We present a theory-guided synthesis of new scientific knowledge from fields such as epigenetics, psycho-neuro-endocrino-immunology, stress research and systems biology. The sources are articles in acknowledged journals and books, chosen to provide insight into associations between life history (biography) and the human body (biology) in a wide sense. Research shows that information about biography, i.e. experienced meaning and relationships, is literally incorporated into the human organism. Epigenetics illustrates the fundamental biological potential for context-dependent adaptation. Further, studies have shown that different types of existential strain may disturb systems for human physiological adaptation, affect structures in the brain and subsequently render the organism vulnerable for disease. However, a sense of belonging and a perception of being supported and acknowledged can contribute to strengthening or restoring health. The traditional approach to increasing biomedical knowledge has prevented insight into the medical significance of experience. The new knowledge necessitates a reorientation of theory and practice within the medical profession both with respect to individuals and society.

Consequences for patients of health care professionals' conscientious actions: the ban on abortions in South Australia.

PubMed

Cannold, L

1994-06-01

The legitimacy of the refusal of South Australian nurses to care for second trimester abortion patients on grounds of conscience is examined as a test case for a theory of permissible limits on the autonomy of health care professionals. In cases of health care professional (HCP) conscientious refusal, it is argued that a balance be struck between the HCPs' claims to autonomous action and the consequences to them of having their autonomous action restricted, and the entitlement of patients to care and the consequences for them of being refused such care. Conscientious action that results in the disruption or termination of health care services, however, is always impermissible on two grounds. Firstly, because it is at this point that the action '... invades a patient's autonomy, puts a patient at serious risk ... [and] treats a patient unjustly' (1) Secondly, because the consequences of such refusals turn them into political acts--acts of civil disobedience. It is arguable that in order for acts of civil disobedience to be legitimate, certain obligations are required of the dissenter by the community. It is concluded that the actions of the South Australian nurses, which have over the last few years both terminated and disrupted second trimester services, are morally impermissible.

Transplant Medicine in China: Need for Transparency and International Scrutiny Remains.

PubMed

Trey, T; Sharif, A; Schwarz, A; Fiatarone Singh, M; Lavee, J

2016-11-01

Previous publications have described unethical organ procurement procedures in the People's Republic of China. International awareness and condemnation contributed to the announcement abolishing the procurement of organs from executed prisoners starting from January 2015. Eighteen months after the announcement, and aligned with the upcoming International Congress of the Transplantation Society in Hong Kong, this paper revisits the topic and discusses whether the declared reform has indeed been implemented. China has neither addressed nor included in the reform a pledge to end the procurement of organs from prisoners of conscience, nor has the government initiated any legislative amendments. Recent reports have discussed an implausible discrepancy of officially reported steady annual transplant numbers and a steep expansion of the transplant infrastructure in China. This paper expresses the viewpoint that, in the current context, it is not possible to verify the veracity of the announced changes, and it thus remains premature to include China as an ethical partner in the international transplant community. Until we have independent and objective evidence of a complete cessation of unethical organ procurement from prisoners, the medical community has a professional responsibility to maintain the academic embargo on Chinese transplant professionals. © 2016 The Authors. American Journal of Transplantation published by Wiley Periodicals, Inc. on behalf of American Society of Transplant Surgeons.

Alacrymie congénitale révélant un syndrome d'Allgrove: à propos de trois cas

PubMed Central

Derrar, Rajae; Boutimzine, Nourredinne; Laghmari, Amina; Alouane, Amal; Daoudi, Rajae

2015-01-01

Le syndrome d'Allgrove ou triple A syndrome est une affection autosomique récessive constatée chez la population pédiatrique, associant dans sa forme complète: Achalasie œsophagienne, Alacrymie, maladie d'Addison (insuffisance surrénale), une dégénérescence neurologique et occasionnellement une instabilité du système autonome. Nous rapportons les cas de 3 enfants issus de mariages consanguins, chez qui l'examen ophtalmologique a révélé une sécheresse sévère avec dans deux cas une kératite envahissant l'axe visuel, ainsi qu'une paresse du reflexe photomoteur. Le bilan radiologique: transit œsogastroduodénal (TOGD) et fibroscopie œsogastroduodénale (FOGD) a révélé un mégaoesophage associé dans un cas à une œsophagite. Un traitement à base de larmes artificielles est instauré aussitôt, ainsi qu'un traitement chirurgical par voie laparoscopique. La connaissance de cette pathologie permettra une prise de conscience de la gravité de cette maladie en plus de suggérer sa prise en charge. PMID:26185551

Survey shows that Swedish healthcare professionals have a positive attitude towards surrogacy but the health of the child is a concern.

PubMed

Armuand, G; Lampic, C; Skoog-Svanberg, A; Wånggren, K; Sydsjö, G

2018-01-01

In February 2016, Sweden upheld its ban on surrogacy following a Government enquiry. This survey investigated attitudes towards surrogacy among primary health professionals working with children and their experiences of working with families following surrogacy abroad. From April to November 2016, nurses, physicians and psychologist working in primary child health care in four counties in Sweden were invited to participate in a cross-sectional online survey about surrogacy. The mean age of the 208 participants was 49.2 years (range 27-68) and nearly 91% were women. Approximately 60% supported legalised surrogacy. Wanting a conscience clause to be introduced in Sweden was associated with not supporting surrogacy for any groups, while personal experiences of infertility and clinical experiences with families following surrogacy were associated with positive attitudes towards surrogacy for heterosexual couples. The majority (64%) disagreed that surrogate children were as healthy as other children, and many believed that they risked worse mental health (21%) and social stigmatisation (21%). We found that 60% supported legalised surrogacy, but many expressed concerns about the children's health and greater knowledge about the medical and psychosocial consequences of surrogacy is needed. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

[Discipline or liberalization of abortion? Proposal for the Fortuna law: its function and applicability in Italy].

PubMed

Fossati, S

1973-06-01

It is impossible to eliminate abortion, and therefore it must be evaluated in all its medical, moral, religious, as well as, unfortunately, convenience aspects. From a religious viewpoint, abortion is inadmissible; there are, however, social, emotional and psychological problems. Many countries have solved the problem of abortion more or less satisfactorily. Conditions in Italy, however, are rather special, as a resllt of a range of factors, not least of which is a powerful religious pressure which conditions many expressions of private and social life. The physician involved in this problem is confronted with very difficult decisions from the viewpoint of conscienc e, morality, and professional ethics. Abortion requests cannot be granted unconditionally and abortions of convenience must be drastically rejected. On the other hand, in many cases humane considerations demand a solution, and in very exceptional cases abortion is appropriate. But it is impossible to draw up a document to codify rigidly invidual cases, and the physician must rely on his own scientific knowledge, perhaps supported by that of a competent colleague, and on his professional cons cience. A thorough program of prevention of damaging or dangerous pregnancies is recommended, by means of health and sex education. Knowledge of both pharmaceutical and mechanical contraceptives must be popularized at all levels.

[Spirituality and ethics in psychosomatic medicine].

PubMed

Irmiš, Felix

2015-01-01

A patient has to cope with an illness on a physical, mental and spiritual level. There exists a difference between religiousness and spirituality even though the approach has a common foundation. Nonreligious spirituality relates to an inner experience, transcendent states of consciousness, meaningfulness, responsibility, sympathy, ethics, humanisation, faith. We encounter the spiritual point of view in humanistic psychotherapy, pastoral medicine, work of hospital chaplains, New Age, psychotherapies with religious and alternative aspects, transpersonal psychotherapy, psycho-spiritual crises, unusual states of consciousness, in meditation, Yoga, relaxation, kinesiology, ethicotherapy, reincarnation therapy, positive motivation, holotropic breathing, etc. There is description of different degrees of spiritual development, rational and irrational feeling of spirituality, Quantum Physics, spiritual intelligence, neuro-theology, physiological change, effects on improving adaptation during stress, drugs addiction, etc. Spirituality in relation with ethics is discussed in terms of socio-biology, evolution, emotions, aggressivity, genetics and social influence. The work analyses the effect of stressful situations on the deterioration of moral attitudes: during lack of time, obedience to authority and order. It is described how temperament and personality disorders can affect perception of spirituality, guilt feeling and conscience. Stressful situations, lack of time, relying only on the auxiliary objective methods leads to alienation of physician with a patient. Spirituality can partially improve the doctor-patient relationship, communication and sense of responsibility.

Implementing evidence-based practices in an emergency department: contradictions exposed when prioritising a flow culture.

PubMed

Kirk, Jeanette W; Nilsen, Per

2016-02-01

An emergency department is typically a place of high activity where practitioners care for unanticipated presentations, which yields a flow culture so that actions that secure available beds are prioritised by the practitioners. How does the flow culture in an emergency department influence nurses' use of a research-based clinical guideline and a nutrition screening routine. Ethnographic fieldwork was carried out over three months. The first author followed nurses, medical secretaries and doctors in the emergency department. Data were also collected by means of semi-structured interviews. An activity system analysis, as described in the Cultural Historical Activity Theory, was conducted to identify various contradictions that could exist between different parts of the activity system. The main contradiction identified was that guidelines and screening routines provided a flow stop. Four associated contradictions were identified: insufficient time to implement guidelines; guilty conscience due to perceived nonadherence to evidence-based practices; newcomers having different priorities; and conflicting views of what constituted being a professional. We found that research-supported guidelines and screening routines were not used if they were perceived to stop the patient flow, suggesting that the practice was not fully evidence based. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

From little white lies to filthy liars: the evolution of honesty and deception in young children.

PubMed

Talwar, Victoria; Crossman, Angela

2011-01-01

Though it is frequently condemned, lie-telling is a common and frequent activity in interpersonal interactions, with apparent social risks and benefits. The current review examines the development of deception among children. It is argued that early lying is normative, reflecting children's emerging cognitive and social development. Children lie to preserve self-interests as well as for the benefit of others. With age, children learn about the social norms that promote honesty while encouraging occasional prosocial lie-telling. Yet, lying can become a problem behavior with frequent or inappropriate use over time. Chronic lie-telling of any sort risks social consequences, such as the loss of credibility and damage to relationships. By middle childhood, chronic reliance on lying may be related to poor development of conscience, weak self-regulatory control, and antisocial behavior, and it could be indicative of maladjustment and put the individual in conflict with the environment. The goal of the current chapter is to capture the complexity of lying and build a preliminary understanding of how children's social experiences with their environments, their own dispositions, and their developing cognitive maturity interact, over time, to predict their lying behavior and, for some, their chronic and problem lying. Implications for fostering honesty in young children are discussed.

The Great Beyond: Higher Dimensions, Parallel Universes and the Extraordinary Search for a Theory of Everything

NASA Astrophysics Data System (ADS)

Halpern, Paul

2005-08-01

Praise for The Great Beyond "A marvelous book-very clear, very readable. A brilliant introduction to the math and physics of higher dimensions, from Flatland to superstrings. Its greatest strength is a wealth of fascinating historical narrative and anecdote. I enjoyed it enormously." -Ian Stewart, author of Flatterland "A remarkable journey from Plato's cave to the farthest reaches of human thought and scientific knowledge. This mind-boggling book allows readers to dream strange visions of hyperspace, chase light waves, explore Klein's quantum odyssey and Kaluza's cocoon, leap through parallel universes, and grasp the very essence of conscience and cosmos. Buy this book and feed your head." -Clifford Pickover, author of A Passion for Mathematics "Halpern looks with a bemused eye at the wildest ideas currently afoot in physics. He takes us into the personal world of those who relish and explore seemingly outlandish notions, and does it with a light, engaging style." -Gregory Benford, author of Foundation's Fear "An informative, stimulating, and thoughtful presentation at the very frontiers of contemporary physics. It is quite on a par with Brian Greene's The Elegant Universe or his more recent The Fabric of the Cosmos, and as such, deserves to receive wide non-specialist coverage among an intelligent, curious, thinking public." -Professor E. Sheldon, Contemporary Physics

Impairment of prosocial sentiments is associated with frontopolar and septal damage in frontotemporal dementia

PubMed Central

Moll, Jorge; Zahn, Roland; de Oliveira-Souza, Ricardo; Bramati, Ivanei E.; Krueger, Frank; Tura, Bernardo; Cavanagh, Alyson L.; Grafman, Jordan

2010-01-01

Poets and philosophers have long acknowledged moral sentiments as key motivators of human social behavior. Prosocial sentiments, which include guilt, pity and embarrassment, enable us to care about others and to be concerned about our mistakes. Functional imaging studies have implicated frontopolar, ventromedial frontal and basal forebrain regions in the experience of prosocial sentiments. Patients with lesions of the frontopolar and ventromedial frontal areas were observed to behave inappropriately and less prosocially, which could be attributed to a generalized emotional blunting. Direct experimental evidence for brain regions distinctively associated with moral sentiment impairments is lacking, however. We investigated this issue in patients with the behavioral variant of frontotemporal dementia, a disorder in which early and selective impairments of social conduct are consistently observed. Using a novel moral sentiment task, we show that the degree of impairment of prosocial sentiments is associated with the degree of damage to frontopolar cortex and septal area, as assessed with 18-Fluoro-Deoxy-Glucose-Positron Emission Tomography, an established measure of neurodegenerative damage. This effect was dissociable from impairment of other-critical feelings (anger and disgust), which was in turn associated with dorsomedial prefrontal and amygdala dysfunction. Our findings suggest a critical role of the frontopolar cortex and septal region in enabling prosocial sentiments, a fundamental component of moral conscience. PMID:20728544

Obsessive-compulsive disorder--A question of conscience? An fMRI study of behavioural and neurofunctional correlates of shame and guilt.

PubMed

Hennig-Fast, Kristina; Michl, Petra; Müller, Johann; Niedermeier, Nico; Coates, Ute; Müller, Norbert; Engel, Rolf R; Möller, Hans-Jürgen; Reiser, Maximilian; Meindl, Thomas

2015-09-01

Shame and guilt can be described as 'self-conscious emotions' and are an essential part of the psychopathology in obsessive-compulsive disorder (OCD). Our primary aim was to explore whether individuals with OCD are processing shame and guilt differently from healthy individuals (N = 20 in both groups; 50% female; age: 20-40 years) on the behavioural and neurobiological level. For the experimental task, participants were scanned with functional magnetic resonance tomography (functional magnetic resonance imaging, 3 T) while imagining neutral, shame inducing and guilt inducing scenarios. In addition to clinical questionnaires, participants were asked to complete questionnaires measuring shame and guilt. The functional data indicate an increased activity in OCD patients in the shame condition in the limbic, temporal and sub-lobar (hypothalamus) areas, in the guilt condition inter alia in frontal, limbic and temporal areas. In summary we found activity in OCD patients in neural networks which are responsible for stimulus filtering, emotion regulation, impulse control and memory. The results from our study may contribute to a better understanding of the origins and maintenance of OCD in association with the pathological processing of shame and guilt on different functional levels. Copyright © 2015 Elsevier Ltd. All rights reserved.

Human Rights Act, 12 February 1987.

PubMed

1987-01-01

This document reprints major provisions of the Yukon's (Canada) 1987 Human Rights Act. The Act furthers the public policy that every individual is free and equal in dignity and rights, seeks to discourage and eliminate discrimination, and promotes the underlying principles of Canadian and international human rights instruments. Part 1 contains a Bill of Rights that protects the right to freedom of: 1) religion and conscience, 2) expression, 3) assembly and association, and 4) to enjoyment and disposition of property. Part 2 prohibits discrimination based on ancestry (including color and race), national origin, ethnic or linguistic background or origin, age, sex (including pregnancy), and marital or family status. Discrimination is also prohibited when offering services, goods, or facilities to the public; in connection with employment; in connection with membership in trade unions or trade, occupational, or professional associations; and in negotiation or performance of public contracts. The Bill of Rights lists reasonable causes for discrimination as well as exemptions, including preferential treatment for organization or family members or employment in a private home. Special programs and affirmative action programs are specifically not considered discrimination under this Act. The Act sets forth rules for providing equal pay for work of equal value and creates a Yukon Human Rights Commission to promote human rights and assist adjudication of complaints.

Science and technology disclosure in the state of Queretaro: Science and Technology for Children program

NASA Astrophysics Data System (ADS)

Contreras Flores, Rubén; Villeda Muñoz, Gabriel

2007-03-01

Science and technology disclosure is an integral part of our scientific work as researches; it is an induction process for children, young people and teachers of primary and secondary schools in the state of Queretaro. Education must be offered in a clear and objective way, it allows to the students apply the acquired knowledge to understand the world and improve his quality of life. Nowadays, the Centro de Investigacion en Ciencia Aplicada y Tecnologia Avanzada of the Instituto Politecnico Nacional Unidad Queretaro (CICATA-IPN Queretaro) together with the Consejo de Ciencia y Tecnologia del Estado de Queretaro (CONCYTEQ) have implemented the "Science and Technology for Children" program (Ciencia y Tecnologia para Ninos - CTN), it allows to the educative sector obtain information through the CONCYTEQ web page. The fist stage of the program was the development of two subjects: the brochure titled "Petroleum, Nonrenewable Natural Resource that Moves the World" and the manual "Experiments of Physics". At the moment we are working with the second stage of the program, it is about the energy generation using renewable sources such as: geothermal, aeolian, solar and biomass. The CTN program allows to students and teachers to create conscience about the importance of the development of the science of technology in our country.

Neutral Caregivers or Military Support? The British Red Cross, the Friends’ Ambulance Unit, and the Problems of Voluntary Medical Aid in Wartime

PubMed Central

2015-01-01

During the First World War the British Red Cross Society (BRCS) served as the coordinating body for voluntary medical aid giving in Britain. Among the many units which came within its purview was the Friends’ Ambulance Unit (FAU), formed by a group of young men whose desire to serve their nation in wartime conflicted with their pacifist principles. Both the BRCS and the FAU were wracked by ideological conflicts in the years which preceded and throughout the war. These struggles over voluntarist identity highlight the contested meanings of service and conscience in wartime. Through a critical examination of the language of official histories and biographies, this article will argue that the war formed a key moment in the relationship between the British state and voluntary medical aid, with the state’s increasing role in the work of such organizations raising questions about the voluntarist principles to which aid organizations laid claim. The struggles that both organizations and individuals within them faced in reconciling the competing pressures that this new relationship created form a legacy of the war which continues to have important implications for the place of medical voluntarism in wartime today. PMID:26213442

Responsible soldiering in the nuclear age: inferences from the Catholic Bishop's Pastoral on nuclear war. Master's thesis, August 1985-June 1986

DOE Office of Scientific and Technical Information (OSTI.GOV)

Smith, M.E.

1986-06-06

This thesis is an attempt to develop an ethic for those who must perform soldierly duties in this era. It is an examination of core values, and how these values have been translated into military ethics and obligations within the context of western civilization. This study uses the most recent application of just-war theory, the Catholic Bishop's Pastoral on nuclear war, The Challenge of Peace: God's Promise and Our Response, and compares its instruction to selected findings of another contemporary application, the Nuremberg War Trials. The manner in which we construct and reinforce our moral values in conscience, coupled withmore » appreciation for the sanctity of human existence, evolve as fundamental underlying principles. After having established the scope of authority from which the Catholic Bishop's Pastoral derives its credibility, these principles are compared against the United States Army Ethic and a contemporary ethic is proposed. The study concludes that ultimately we are responsible for the decisions and choices that we make. Soldiers are not absolved, especially within the Judeo-Christian context, from the obligation to make choices based upon sound moral reasoning, simply because they are engaged in activities that run counter to orderly human existence.« less

Comment: unethical ethics investment boycotts and abortion.

PubMed

Furedi, A

1998-01-01

Ethical investment funds have traditionally boycotted the arms industry, companies known to pollute the environment, and those involved in animal research. However, recent newspaper reports suggest that some investment funds plan to also boycott hospitals and pharmaceutical companies involved in abortion-related activities. Ethical Financial, anti-abortion independent financial advisors, are encouraging a boycott of investment in private hospitals and manufacturers of equipment involved in abortions, and pharmaceutical firms which produce postcoital contraception or conduct embryo research. Ethical Financial claims that Family Assurance has agreed to invest along anti-abortion lines, Aberdeen Investment is already boycotting companies linked to abortion, and Hendersons ethical fund plans to follow suit. There is speculation that Standard Life, the largest mutual insurer in Europe, will also refuse to invest in abortion-related concerns when it launches its ethical fund in the spring. Managers of ethical funds should, however, understand that, contrary to the claims of the anti-choice lobby, there is extensive public support for legal abortion, emergency contraception, and embryo research. Individuals and institutions which contribute to the development of reproductive health care services are working to alleviate the distress of unwanted pregnancy and infertility, laudable humanitarian goals which should be encouraged. Those who try to restrict the development of abortion methods and services simply show contempt for women, treating them as people devoid of conscience who are incapable of making moral choices.

Impairment of prosocial sentiments is associated with frontopolar and septal damage in frontotemporal dementia.

PubMed

Moll, Jorge; Zahn, Roland; de Oliveira-Souza, Ricardo; Bramati, Ivanei E; Krueger, Frank; Tura, Bernardo; Cavanagh, Alyson L; Grafman, Jordan

2011-01-15

Poets and philosophers have long acknowledged moral sentiments as key motivators of human social behavior. Prosocial sentiments, which include guilt, pity and embarrassment, enable us to care about others and to be concerned about our mistakes. Functional imaging studies have implicated frontopolar, ventromedial frontal and basal forebrain regions in the experience of prosocial sentiments. Patients with lesions of the frontopolar and ventromedial frontal areas were observed to behave inappropriately and less prosocially, which could be attributed to a generalized emotional blunting. Direct experimental evidence for brain regions distinctively associated with moral sentiment impairments is lacking, however. We investigated this issue in patients with the behavioral variant of frontotemporal dementia, a disorder in which early and selective impairments of social conduct are consistently observed. Using a novel moral sentiment task, we show that the degree of impairment of prosocial sentiments is associated with the degree of damage to frontopolar cortex and septal area, as assessed with 18-Fluoro-Deoxy-Glucose-Positron Emission Tomography, an established measure of neurodegenerative damage. This effect was dissociable from impairment of other-critical feelings (anger and disgust), which was in turn associated with dorsomedial prefrontal and amygdala dysfunction. Our findings suggest a critical role of the frontopolar cortex and septal region in enabling prosocial sentiments, a fundamental component of moral conscience. Published by Elsevier Inc.

[Pharmacology].

PubMed

González, José; Orero, Ana; Olmo, Vicente; Martínez, David; Prieto, José; Bahlsen, Jose Antonio; Zaragozá, Francisco; Honorato, Jesús

2011-06-01

Two of the main characteristics of western societies in the last fifty years have been the medicalization of the human life and the environmental degradation. The first one has forced human being to consider medicines use related to what would be rational, reasonable and well-reasoned. The second one brought us to a new ecologist conscience. In relation to the "human social system", the effects of medication can be considered very positive as a whole, particularly those related to the amazing increase of expectative and quality of life. But, along with those unquestionable beneficial effects, medicines have also caused some negative effects for other biotic and abiotic systems, such as microbian alterations and their undesirable consequences which have involved the massive use of antibiotics in medicine and veterinary, the uncontrolled elimination of millions of doses of all kind of drugs, additives and excipients, etc., as well as atmospheric contamination and degradation of forests and deep oceans which can have been caused by investigation and production of determinated drugs. In this context Pharmacology appears as a scientific discipline that studies the research (R), development (D), production (P), and utilization (U) of drugs and medical substances in relation to the environment. From a farmaecologic perspective the drugs utilization has its development in three main contexts, all of them closely related: prescription quality, farmaceutical care, and patient's active participation in his own disease and treatment.

The principles of Catholic social teaching: A guide for decision making from daily clinical encounters to national policy-making.

PubMed

Wright, Karen Shields

2017-02-01

Catholic social teaching (CST), a branch of moral theology, addresses contemporary issues within the political, economic, and cultural structures of society. The threefold cornerstone of CST contains the principles of human dignity, solidarity, and subsidiarity. It is the foundation on which to form our conscience in order to evaluate the framework of society and is the Catholic criteria for prudential judgment and direction in developing current policy-making. With knowledge of these social principles, in combination with our faith, we will be more armed and informed as to articulate the Catholic vision of reality, the truthful nature of the human person and society, to apply and integrate the social teachings in our everyday administrative and clinical encounters, and through the virtue of charity take action within the social, political, and economic spheres in which we have influence. Summary: The Church's social encyclicals are a reflection upon the issues of the day using the light of faith and reason. They offer commentary on the ways to evaluate and address particular social problems-also using natural law principles-in the areas of politics, economics, and culture. Quotes were selected from the encyclicals that define and expand upon the primary principles for the purpose of representing them for study, reflection, and use in everyday personal and business encounters and decision making for healthcare professionals.

Meanings of staying healthy in a context where others developed burnout--phenomenological-hermeneutic interpretation of healthcare personnel's narratives.

PubMed

Gustafsson, Gabriella; Strandberg, Gunilla

2009-09-01

Burnout has become a major problem in many industrialized countries, but not everyone at the same work place develops burnout. The present paper aimed to illuminate meanings of staying healthy in a context where others developed burnout as narrated by healthcare personnel. Interviews were conducted with 20 healthcare personnel and were interpreted using a phenomenological-hermeneutic method. The result shows that the meanings of staying healthy are to be rooted in an outlook on life perceiving its many-sidedness and the strengths and weaknesses of oneself and others with forbearance. One is striving to shoulder responsibility for oneself and for others and is also receptive towards the circumstances of life, striving to judge the possibilities of being and acting in order to attempt to influence things in what is believed to be the right direction. Being able to let go of injustice and look after oneself with a clear conscience is also revealed as meanings of staying healthy. In conclusion, forbearance with life's many-sidedness seems to pervade one's experiences, judgements and actions in life when dealing with one's reality, and thus, it is interpreted as essential for staying healthy in a context where others developed burnout. This study is ethically approved. © 2008 The Authors. Journal compilation © 2008 Nordic College of Caring Science.

Historical development and current status of organ procurement from death-row prisoners in China.

PubMed

Allison, Kirk C; Caplan, Arthur; Shapiro, Michael E; Els, Charl; Paul, Norbert W; Li, Huige

2015-12-03

In December 2014, China announced that only voluntarily donated organs from citizens would be used for transplantation after January 1, 2015. Many medical professionals worldwide believe that China has stopped using organs from death-row prisoners. In the present article, we briefly review the historical development of organ procurement from death-row prisoners in China and comprehensively analyze the social-political background and the legal basis of the announcement. The announcement was not accompanied by any change in organ sourcing legislations or regulations. As a fact, the use of prisoner organs remains legal in China. Even after January 2015, key Chinese transplant officials have repeatedly stated that death-row prisoners have the same right as regular citizens to "voluntarily donate" organs. This perpetuates an unethical organ procurement system in ongoing violation of international standards. Organ sourcing from death-row prisoners has not stopped in China. The 2014 announcement refers to the intention to stop the use of organs illegally harvested without the consent of the prisoners. Prisoner organs procured with "consent" are now simply labelled as "voluntarily donations from citizens". The semantic switch may whitewash sourcing from both death-row prisoners and prisoners of conscience. China can gain credibility only by enacting new legislation prohibiting use of prisoner organs and by making its organ sourcing system open to international inspections. Until international ethical standards are transparently met, sanctions should remain.

Involving the health care system in domestic violence: what women want.

PubMed

Usta, Jinan; Antoun, Jumana; Ambuel, Bruce; Khawaja, Marwan

2012-01-01

PURPOSE Domestic violence is prevalent among women using primary health care services in Lebanon and has a negative effect on their health, yet physicians are not inquiring about it. In this study, we explored the attitudes of these women regarding involving the health care system in domestic violence management. METHODS We undertook a qualitative focus group study. Health care professionals in 6 primary health care centers routinely screened women for domestic violence using the HITS (Hurt, Insult, Threaten, Scream) instrument. At each center, 12 women who were screened (regardless of the result) were recruited to participate in a focus group discussion. RESULTS Most of the 72 women encouraged involvement of the health care system in the management of domestic violence and considered it to be a "socially accepted way to break the silence." Women expected health care professionals to have an "active conscience"; to be open minded, ready to listen, and unhurried; and to respect confidentiality. Additionally, they recommended mass media and community awareness campaigns focusing on family relationships to address domestic violence. CONCLUSIONS Addressing domestic violence through the health care system, if done properly, may be socially acceptable and nonoffensive even to women living in conservative societies such as Lebanon. The women in this study described characteristics of health professionals that would be conducive to screening and that could be extrapolated to the health care of immigrant Arab women.

Consciousness: a neural capacity for objectivity, especially pronounced in humans

PubMed Central

Dijker, Anton J. M.

2014-01-01

Consciousness tends to be viewed either as subjective experience of sensations and feelings, or as perception and internal representation of objects. This paper argues that neither view sufficiently acknowledges that consciousness may refer to the brain’s most adaptive property: its capacity to produce states of objectivity. It is proposed that this capacity relies on multiple sensorimotor networks for internally representing objects and their properties in terms of expectancies, as well as on motivational and motor mechanisms involved in exploration, play, and care for vulnerable living and non-living objects. States of objectivity are associated with a very special phenomenal aspect; the experience that subjective aspects are absent and one is “just looking” at the world as it really is and can be. However, these states are normally closely preceded and followed by (and tend to be combined or fused with) sensations and feelings which are caused by activation of sensory and motivational mechanisms. A capacity for objectivity may have evolved in different species and can be conceived as a common basis for other elusive psychological properties such as intelligence, conscience, and esthetic experience; all three linked to crucial behaviors in human evolution such as tool making, cooperation, and art. The brain’s pervasive tendency to objectify may be responsible for wrongly equating consciousness with feelings and wrongly opposing it to well-learned or habitual (“unconscious”) patterns of perception and behavior. PMID:24672506

The principles of Catholic social teaching: A guide for decision making from daily clinical encounters to national policy-making

PubMed Central

2017-01-01

Catholic social teaching (CST), a branch of moral theology, addresses contemporary issues within the political, economic, and cultural structures of society. The threefold cornerstone of CST contains the principles of human dignity, solidarity, and subsidiarity. It is the foundation on which to form our conscience in order to evaluate the framework of society and is the Catholic criteria for prudential judgment and direction in developing current policy-making. With knowledge of these social principles, in combination with our faith, we will be more armed and informed as to articulate the Catholic vision of reality, the truthful nature of the human person and society, to apply and integrate the social teachings in our everyday administrative and clinical encounters, and through the virtue of charity take action within the social, political, and economic spheres in which we have influence. Summary: The Church's social encyclicals are a reflection upon the issues of the day using the light of faith and reason. They offer commentary on the ways to evaluate and address particular social problems—also using natural law principles—in the areas of politics, economics, and culture. Quotes were selected from the encyclicals that define and expand upon the primary principles for the purpose of representing them for study, reflection, and use in everyday personal and business encounters and decision making for healthcare professionals. PMID:28392595

Why physician-assisted suicide perpetuates the idolatory of medicine.

PubMed

Cherry, Mark J

2003-01-01

Adequate response to physician-assisted suicide and euthanasia depends on fundamental philosophical and theological issues, including the character of an appropriate philosophically and theologically anchored anthropology, where the central element of traditional Christian anthropology is that humans are created to worship God. As I will argue, Christian morality and moral epistemology must be nested within and understood through this background Christian anthropology. As a result, I will argue that physician-assisted suicide and euthanasia can only be one-sidedly and inadequately appreciated through rational appeal to central values, such as "human dignity" and "self determination", or through "sola scriptura" biblical interpretation, or individual judgments of conscience. Adequately addressing physician-assisted suicide and euthanasia will depend on a more fundamental spiritual-therapeutic approach. This cluster of moral, epistemological, anthropological, and bioethical claims will be explored by drawing on the texts of St. Basil the Great, St. Maximos the Confessor, and St. Isaac the Syrian. Their reflections on medicine, the human good, and its relationship to worship, spiritual therapy, and God will be used as a basis to indicate a broader philosophical perspective, which will be needed to avoid a one-sided, incomplete approach to the challenges of physician-assisted suicide and euthanasia. Medical morality, I argue, is best understood within categories that transcend the right, the good, the just, and the virtuous; namely, the holy.

Moral courage in nursing: A concept analysis.

PubMed

Numminen, Olivia; Repo, Hanna; Leino-Kilpi, Helena

2017-12-01

Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one's moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. This article is an analysis of the concept of moral courage in nursing. Rodgers' evolutionary method of concept analysis provided the framework to conduct the analysis. The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher's Index. The following key words were used: "moral" OR "ethical" AND "courage" OR "strength" AND "nurs*" with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice.

[Ethical relativism and the modern concept of tolerance].

PubMed

Laffitte, Jean

2008-01-01

History presents many examples of men and women who find themselves in a position of having to disobey civil law. The motives for such disobedience can only be founded on moral conscience, as influenced by other laws - immutable and recognized as true. The author studies the historical context of the appearance, during the Age of the Enlightenment, of a new concept: tolerance. Ceasing to represent the expression of the classical practical virtue of prudence, ideological tolerance achieves the rank of theoretical virtue. Such a pretension has a political in essence but also innumerable ethical consequences. An ideologically tolerant society is created. The author develops this paradoxical thesis according to which an ideologically tolerant society is not prepared to tolerate the idea that there might exist a truth for which to search. Today, we see a secularization of conscientious objection concerning two particular themes: military service and matters connected with the protection of human life. Examining the paradigmatic example of abortion, the author demonstrates how society is no longer capable of reflecting peacefully upon the question of the status of the embryo, for fear of questioning the legislative choice concerning its legalization. Thus, society no longer has the capability of confronting challenges connected to practices that are detrimental to the dignity of human life, the essential criteria that would allow it to face these matters having been declared outside the confines of future reflection.

Les agressions sexuelles des jeunes ayant une incapacité ou une maladie chronique

PubMed Central

Kaufman, M

2011-01-01

Pour diverses raisons, les enfants et les adolescents ayant une incapacité ou une maladie chronique sont plus vulnérables aux agressions sexuelles. Les dispensateurs de soins, de même que les parents et les éducateurs, doivent se méfier davantage de la possibilité d’agression sexuelle au sein de cette population. Les médecins, tout particulièrement, doivent prôner des politiques pour prévenir ou déceler les agressions dans les hôpitaux, les écoles et autres établissements. Ces politiques incluent le dépistage détaillé et la surveillance étroite des employés et des bénévoles, la présence d’un chaperon aux examens physiques et aux interventions thérapeutiques, la supervision des sorties et une culture qui favorise la vie privée du patient en établissement. De plus, les médecins doivent favoriser la conscience de soi et l’habilitation des patients et leur donner très tôt des conseils préventifs au sujet de la sexualité, de l’habilitation personnelle et des risques d’agression. Le présent document de principes remplace celui que la Société canadienne de pédiatrie a publié en 1997.

Resister's logic: the anti-vaccination arguments of Alfred Russel Wallace and their role in the debates over compulsory vaccination in England, 1870-1907.

PubMed

Fichman, Martin; Keelan, Jennifer E

2007-09-01

In the 1880s, Alfred Russel Wallace, the celebrated co-discoverer of natural selection, launched himself into the centre of a politicised and polarised debate over the unpopular compulsory vaccination laws in England. Wallace never wavered in his belief that smallpox vaccination was useless and likely dangerous. Six years before his death, the anti-vaccinationists successfully secured a conscience clause that effectively dismantled the compulsory vaccination laws. Several other important Victorian scientists joined Wallace in the fight to repeal compulsory vaccination arguing that widely held views on the effectiveness of vaccination and evidence for immunity were inconclusive in the light of (then) contemporary standards of evidence. This article situates Wallace's anti-vaccination logic within the broader matrix of sociopolitical and cultural reform movements of the late Victorian era. Additionally it provides the first detailed analysis of his critique of vaccination science, in particular the role statistics played in his arguments. In this period, both pro-vaccinationists and anti-vaccinationists invested great efforts in collating and analysing statistical data sets that either supported or refuted the claims of vaccination's effectiveness. While each side presented 'controlled' case studies to support their assertions, without an unambiguous test to measure or demonstrate vaccination's effectiveness, the anti-vaccinationists continued to mount credible statistical critiques of vaccination science.

Albert Einstein and Wernher von Braun - the two great German-American physicists seen in a historical perspective.

NASA Astrophysics Data System (ADS)

Winterberg, Friedwardt

2008-04-01

It was Albert Einstein who for the first time changed our view of the universe to be a non-euclidean curved space-time. And it was Wernher von Braun who blazed the trail to take us into this universe, leaving for the first time the gravitational field of our planet earth, with the landing a man on the moon the greatest event in human history. Both these great physicists did this on the shoulders of giants. Albert Einstein on the shoulders of his landsman, the mathematician Bernhard Riemann, and Wernher von Braun on the shoulders of Goddard and Oberth. Both Einstein and von Braun made a Faustian pact with the devil, von Braun by accepting research funds from Hitler, and Einstein by urging Roosvelt to build the atom bomb (against Hitler). Both of these great men later regretted the use of their work for the killing of innocent bystanders, even though in the end the invention of nuclear energy and space flight is for the benefit of man. Their example serves as a warning for all of us. It can be formulated as follows: ``Can I in good conscience accept research funds from the military to advance scientific knowledge, for weapons developed against an abstract enemy I never have met in person?'' Weapons if used do not differentiate between the scientist, who invented these weapons, and the non-scientist.

Culture heritage and identity - some cases in Taiwan on the protection of cultural heritage

NASA Astrophysics Data System (ADS)

Wang, R. W.-C.

2015-09-01

The protection of cultural heritage relates to an issue of identity. How a nation or a state tries to face to its history is often revealed on the protection of cultural heritage. Taiwan is as a country with complex history, especially the period after World War II. This article will work on some significant cases, regarded as ideological representation of identity. This article works on the cultural identity by observing and analyzing different cases of classified Historic Monuments. In different political periods, we see how the government tries to fabricate on the identity issue by working on Historic Monuments preservation. During the presidency of Chiang Kai-shek and his son Chiang Ching-kuo, the classification of Historic Monuments tried to focus on those make by former Chinese migrants. They tried hard to establish and reaffirm the ever existing "fact" of people in Taiwan. Whereas after the late 1980s and 1990s, after Chiang's reign, local conscience has been awaken. Political ambience turned to a new era. This freedom of speech of post-Chiang's reign encourages people to seek on their identity. The complex political situation of Taiwan makes this seeking cultural identity related to the seeking of independence of Taiwan. The respect to the aboriginal people also reoriented to include the preservation of their tribes and villages.

Foucault could have been an operating room nurse.

PubMed

Riley, Robin; Manias, Elizabeth

2002-08-01

Operating room nursing is an under-researched area of nursing practice. The stereotypical image of operating room nursing is one of task- and technically-orientated aspects of practice, where nurses work in a medical model and are dominated by constraints from outside their sphere of influence. This paper explores the possibility of understanding operating room nursing in a different way. Using the work of Michel Foucault to analyse the work of operating room nursing, this paper argues the relevance of the framework for a more in-depth analysis of this specialty area of practice. The concepts of power, discipline and subjectivity are used to demonstrate how operating room nursing is constructed as a discipline and how operating room nurses act to govern and construct the specialty. Exemplars are drawn from extensive professional experience, from guidelines of professional operating room nursing associations, as well as published texts. The focus is predominantly on the regulation of space and time to maintain the integrity of the sterile surgical field and issues of management, as well as the use of the ethical concept of the 'surgical conscience'. This form of analysis provides a level and depth of inquiry that has rarely been undertaken in operating room nursing. As such, it has the potential to provide a much needed, different view of operation room nursing that can only help to strengthen its professional foundations and development.

Patient's Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia.

PubMed

Sulaiman, Wahinuddin; Seung, Ong Ping; Ismail, Rosli

2012-11-01

In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients' knowledge and perception regarding the used of NSAIDS. A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient's knowledge and perception on the side effects of NSAIDs were recorded. Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once. This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.

Yes we can! Successful examples of disallowing 'conscientious objection' in reproductive health care.

PubMed

Fiala, Christian; Gemzell Danielsson, Kristina; Heikinheimo, Oskari; Guðmundsson, Jens A; Arthur, Joyce

2016-06-01

Reproductive health care is the only field in medicine where health care professionals (HCPs) are allowed to limit a patient's access to a legal medical treatment - usually abortion or contraception - by citing their 'freedom of conscience.' However, the authors' position is that 'conscientious objection' ('CO') in reproductive health care should be called dishonourable disobedience because it violates medical ethics and the right to lawful health care, and should therefore be disallowed. Three countries - Sweden, Finland, and Iceland - do not generally permit HCPs in the public health care system to refuse to perform a legal medical service for reasons of 'CO' when the service is part of their professional duties. The purpose of investigating the laws and experiences of these countries was to show that disallowing 'CO' is workable and beneficial. It facilitates good access to reproductive health services because it reduces barriers and delays. Other benefits include the prioritisation of evidence-based medicine, rational arguments, and democratic laws over faith-based refusals. Most notably, disallowing 'CO' protects women's basic human rights, avoiding both discrimination and harms to health. Finally, holding HCPs accountable for their professional obligations to patients does not result in negative impacts. Almost all HCPs and medical students in Sweden, Finland, and Iceland who object to abortion or contraception are able to find work in another field of medicine. The key to successfully disallowing 'CO' is a country's strong prior acceptance of women's civil rights, including their right to health care.

Crisis of conscience: reconciling religious health care providers' beliefs and patients' rights.

PubMed

White, K A

1999-07-01

In this note, Katherine A. White explores the conflict between religious health care providers who provide care in accordance with their religious beliefs and the patients who want access to medical care that these religious providers find objectionable. Specifically, she examines Roman Catholic health care institutions and HMOs that follow the Ethical and Religious Directives for Catholic Health Care Services and considers other religious providers with similar beliefs. In accordance with the Directives, these institutions maintain policies that restrict access to "sensitive" services like abortion, family planning, HIV counseling, infertility treatment, and termination of life-support. White explains how most state laws protecting providers' right to refuse treatments in conflict with religious principles do not cover this wide range of services. Furthermore, many state and federal laws and some court decisions guarantee patients the right to receive this care. The constitutional complication inherent in this provider-patient conflict emerges in White's analysis of the interaction of the Free Exercise and Establishment Clauses of the First Amendment and patients' right to privacy. White concludes her note by exploring the success of both provider-initiated and legislatively mandated compromise strategies. She first describes the strategies adopted by four different religious HMOs which vary in how they increase or restrict access to sensitive services. She then turns her focus to state and federal "bypass" legislation, ultimately concluding that increased state supervision might help these laws become more viable solutions to provider-patient conflicts.

Philanthropy's new agenda: creating value.

PubMed

Porter, M E; Kramer, M R

1999-01-01

During the past two decades, the number of charitable foundations in the United States has doubled while the value of their assets has increased more than 1,100%. As new wealth continues to pour into foundations, the authors take a timely look at the field and conclude that radical change is needed. First, they explain why. Compared with direct giving, foundations are strongly favored through tax preferences whose value increases in rising stock markets. As a nation, then, we make a substantial investment in foundation philanthropy that goes well beyond the original gifts of private donors. We should therefore expect foundations to achieve a social impact disproportionate to their spending. If foundations serve merely as passive conduits for giving, then they not only fall far short of their potential but also fail to meet an important societal obligation. Drawing on Porter's work on competition and strategy, the authors then present a framework for thinking systematically about how foundations create value and how the various approaches to value creation can be deployed within the context of an overarching strategy. Although many foundations talk about "strategic" giving, much current practice is at odds with strategy. Among the common problems, foundations scatter their funding too broadly, they overlook the value-creating potential of longer and closer working relationships with grantees, and they pay insufficient attention to the ultimate results of the work they fund. This article lays out a blueprint for change, challenging foundation leaders to spearhead the evolution of philanthropy from private acts of conscience into a professional field.

Genealogical information and the structure of rural Latin-American populations: reality and fantasy.

PubMed

Castilla, E E; Adams, J

1996-01-01

Genetic data organized in the form of genealogies can provide much information regarding the history and genetic structure of human populations. A large proportion of the population of Latin America is organized in small rural semi-isolated communities, with little immigration, and until the last 50-100 years, little emigration. These communities have a strong sense of their genealogical history, and this "genealogical conscience' is a frequent leitmotif in modern Latin-American literature. In this communication, we compare the characteristics of fictitious genealogies described in two masterpieces of Latin-American literature, García Márquez' Cien Años de Soledad (A Hundred Years of Solitude), and Verissimo's O Tempo e o Vento (Time and the Wind), with one existing well-studied population in Argentina, Aicuña. All three populations exhibit a number of common characteristics, such as histories of long periods of civil war, and large pedigrees with complex paths of inheritance resulting in complex patterns of inbreeding. Genetic themes common to all three are: (1) the use of genealogical records to substantiate the property of the land or the political power of a kinship; (2) the genealogical registry of biological descendants, independent of their legal or marital status in the clan; (3) the existence of pedigrees of the aristocratic branches in the same kindreds, which illustrate the legal principle of primogeniture; (4) the value of last names as indicators of kinships and the extent of genetic isolation, and (5) the awareness of the deleterious consequences of consanguinity.

Medical students' attitudes towards conscientious objection: a survey.

PubMed

Nordstrand, Sven Jakob; Nordstrand, Magnus Andreas; Nortvedt, Per; Magelssen, Morten

2014-09-01

To examine medical students' views on conscientious objection and controversial medical procedures. Questionnaire study among Norwegian 5th and 6th year medical students. Five hundred and thirty-one of 893 students (59%) responded. Respondents object to a range of procedures not limited to abortion (up to 19%)-notably euthanasia (62%), ritual circumcision for boys (52%), assisted reproduction for same-sex couples (9.7%) and ultrasound in the setting of prenatal diagnosis (5.0%). A small minority (4.9%) would object to referrals for abortion. In the case of abortion, up to 55% would tolerate conscientious refusals, whereas 42% would not. Higher proportions would tolerate refusals for euthanasia (89%) or ritual circumcision for boys (72%). A majority of Norwegian medical students would object to participation in euthanasia or ritual circumcision for boys. However, in most settings, many medical students think doctors should not be able to refuse participation on grounds of conscience. A minority would accept conscientious refusals for procedures they themselves do not object to personally. Most students would not accept conscientious refusals for referrals. Conscientious objection remains a live issue in the context of several medical procedures not limited to abortion. Although most would want a right to object to participation in euthanasia, tolerance towards conscientious objectors in general was moderate or low. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Comparative analysis of moral distress and values of the work organization between American and Spanish podiatric physicians.

PubMed

Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Fuentes, Paloma Salvadores; Trepal, Michael J

2012-01-01

Moral distress is a stress symptom arising from situations that involve ethical dimensions where the health-care provider believes that he or she is unable to preserve all interests and values at stake. The aims of this study were to evaluate the impact of, and identify possible differences in, moral distress in podiatric physicians in the United States and Spain and to determine the ethical principles most closely related to moral distress. A 2008 e-mail survey of 93 US podiatric physicians and 93 Spanish podiatric physicians (N = 186) presented statements about different ethical dilemmas, values, and goals in the workplace. Although moral distress is strongly present across the sample for all of the questions, the US sample shows higher levels of any kind of moral distress concerning questions about patients' treatment and economic constraints, overload of paperwork, and acting against one's conscience. In the US sample, 91.4% of physicians agreed mostly or completely with the statement that they often had to compromise their own values to cope with the demands of the workplace; 89.25% of US podiatric physicians indicated that their own professional values were congruent with the values of the organization; and a similar percentage (77.5%) reported a strong identification with the goals and framework of their work organization. The Spanish sample had similar results. The results underline the significance of moral distress for both samples, mainly related to time constraints and organizational aspects concerning patients and lack of resources.

Urania in the Marketplace: The Timepieces

NASA Astrophysics Data System (ADS)

Rumstay, Kenneth S.

2014-01-01

During the twentieth century astronomical imagery was frequently incorporated, by makers of a wide variety of consumer goods, into advertisements which appeared in popular magazines in America. These images were usually intended to suggest a level of precision and reliability for the product associated (at least in the public conscience) with the science of astronomical observation. Perhaps more than any other item encountered in daily life, the personal timepiece was expected to exhibit these attributes. During the prosperous 1920’s, two watch manufacturers in particular used astronomical associations to extoll the quality of their wares. One was the Elgin National Watch Company, an American firm founded in Chicago in 1864 which remained in business until 1968. The other was the Swiss firm Longines (more properly the Compagnie des Montres Longines Francillon S.A.); based in Saint-Imier since its founding in 1832, this firm has been producing luxury watches for 182 years. Both produced full-page ads for wide-circulation magazines such as The National Geographic, The Atlantic Monthly, and The Saturday Evening Post. While enticing readers to purchase a new watch as a gift or for oneself, these ads provided a look into the world of the professional astronomer. Examples of advertisements by these and other watch manufacturers, spanning the period 1897 to 1967 are presented. Particularly amusing is a personal testimonial from the English owner of an American Waltham watch, who had chided Britain’s Astronomer Royal for dropping the Greenwich time ball just a tad too early.

Doctors and Witches, Conscience and Violence: Abortion Provision on American Television.

PubMed

Sisson, Gretchen; Kimport, Katrina

2016-12-01

Popular entertainment may reflect and produce-as well as potentially contest-stigma regarding abortion provision. Knowledge of how providers are portrayed on-screen is needed to improve understanding of how depictions may contribute to the stigmatization of real providers. All abortion provision plotlines on American television from 2005 to 2014 were identified through Internet searches. Plotlines were assessed in their entirety and coded for genre, abortion provision space, provider characteristics, method and efficacy of provision, and occurrence of violence. Inductive content analysis was used to identify themes in how these features were depicted. Fifty-two plotlines involving abortion provision were identified on 40 television shows; a large majority of plotlines appeared in dramas, particularly in the subgenre of medical dramas. Medical spaces were depicted as normal and safe for abortion provision, and nonmedical spaces were often portrayed as remote and unsafe. Legal abortion care using medical methods was depicted as effective and safe, and legal providers were presented as compassionate, while providers operating outside of medical and legal authority were depicted as ineffective, dangerous and uncaring. Fictional providers were largely motivated by the belief that abortion provision is a necessary and moral service. Plotlines linked abortion provision to violence. The differing ways in which legal and illegal abortion are portrayed reveal potential consequences regarding real-world abortion provision, and suggest that representations situated in medical contexts may work to legitimate and destigmatize such provision. Copyright © 2016 by the Guttmacher Institute.

Spinning the wheels: a CAPS survey of ethical issues in pediatric surgery.

PubMed

Bagwell, C E; Goodwin, S R

1992-11-01

To evaluate decision-making factors of pediatric surgeons when faced with ethical dilemmas in a clinical setting, questionnaires were mailed to members of the Canadian Association of Paediatric Surgeons. The surgeons were asked to respond to scenarios regarding ethical dilemmas in the treatment of children. Fifty-one responses (57%) were computer analyzed based on chosen responses to the clinical dilemma and demographic factors such as age, sex, marital status, country of citizenship, religion, and "religiousness," a determination of religious conviction as viewed by the respondent. In addition, ethical convictions were sought regarding abortion, fetal research, AIDS, HIV testing, denial of medical care due to religious beliefs (Jehovah's Witness), and limitations in health care access for indigents. In general, respondents found it difficult to separate ethical guidelines for determining aggressive treatment--absolute value of life; best interests of the child; parental authority; and ability of the child to engage in social, intellectual, or emotional attachments (quality of life)--in the face of actual patient care issues. In fact, results of this survey indicate that the operating surgeon applies his/her medical knowledge and surgical "experience" to each individual case, incorporating his or her own ethical beliefs (in a respondent's words: "In the operating room, the surgeon must satisfy his own conscience in making decisions") while cognizant of legal guidelines for "standard care" ("Decisions would be based on personal experience, and what the local society believes to be right").(ABSTRACT TRUNCATED AT 250 WORDS)

Collision course: the privatization of graduate medical education at one university.

PubMed

Klasko, Stephen K; Ekarius, John C

2007-03-01

On December 18, 2003, Tenet Healthcare Corporation, an investor-owned hospital corporation, announced the closure of Medical College of Pennsylvania Hospital, a historic institution that was home to many of Drexel University College of Medicine's (DUCOM's) faculty, residents, and medical students. The authors summarize the steps that were taken and lessons learned to avoid a disruption in the education of over 200 residents. The authors highlight the response by the medical school; the concerns of the Accreditation Council for Graduate Medical Education (ACGME); the interaction between the Center for Medicare and Medicaid Services (CMS) and the ACGME; the importance of the designated institutional official (DIO) in a crisis situation; and the role of residents as students versus employees when their employer wishes to move or "trade" them to another institution. Through the lens of the DUCOM experience, the authors explore the legal, political, and educational conflicts that occur when an investor-owned company or private hospital employs residents but another entity holds moral and academic accountability for their future. Finally, the authors outline five lessons learned: (1) the important role the ACGME plays as the educational conscience of graduate medical education (GME), (2) the dramatically different roles that the ACGME and the CMS play in regulating and funding the national GME system, (3) the need for constant communication with the affected residents, (4) the important role that the DIO plays in GME, and (5) the need for medical school leaders to remain focused on their educational mission and responsibilities to young physicians.

Moral dilemmas of women undergoing pregnancy termination for medical reasons in Poland.

PubMed

Zaręba, Kornelia; Ciebiera, Michał; Bińkowska, Małgorzata; Jakiel, Grzegorz

2017-08-01

We explored the religious views and dilemmas of Polish women making the decision to terminate a pregnancy. The article discusses the highly restrictive legislation and significant influence of the Church on the lives of Polish citizens. This study was designed to investigate the effect of religious and political beliefs, social and moral conditioning and professional support on the decision to abort a fetus. A 65-item questionnaire was administered to 60 participants at the time of their pregnancy termination. Pregnancy termination was performed outside the resident county in 32% of cases. Approximately 88% of respondents declared themselves Catholic, but only 22% intended to admit to the pregnancy termination during confession. Five percent of respondents feared the reaction of the priest, while the remaining respondents did not perceive termination of pregnancy for medical reasons as a sin. Of the women who had previously opposed pregnancy termination, 27% changed their mind once they were personally involved. The decision to abort a pregnancy for medical reasons is sensitive to religious and social determinants, especially in the current political situation in which abortion may become prohibited in Poland. The high response rate (100%) was probably the result of the patients' attitudes: they repeatedly emphasised they were thankful for the help and empathy of the medical personnel and for being allowed to undergo the procedure. In Poland, the majority of centres use conscience clauses to justify their refusal to terminate a pregnancy.

Problems in Mitochondrial DNA forensics: while interpreting length heteroplasmy conundrum of various Sindhi and Baluchi ethnic groups of Pakistan.

PubMed

Bhatti, Shahzad; Aslam Khan, Muhammad; Abbas, Sana; Attimonelli, Marcella; Gonzalez, Gerardo Rodriguez; Aydin, Hikmet Hakan; de Souza, Erica Martinha Silva

2018-05-01

The insight heterodox genetics of mtDNA infer new perspectives at the level of human mitochondrial control region heteroplasmy, which is substantial in evolutionary as well as forensic interpretation. The main goal of this study is to interrogate the recurrence and resolve the ambiguity of blurry spectrum of heteroplasmy in the human mtDNA control region of 50 Baluchi and 116 Sindhi unrelated individuals. Sanger sequencing was employed classically, that was further investigated by minisequencing. Only 20% Baluchi and 25.8% Sindhi were homoplasmic, whereas rest of 80% Baluchi and 74.1% Sindhi exhibited at least one heteroplasmy within the specimen. In total, 166 individuals have length heteroplasmy (LH) found at positions 16189, 303-315, 568-573, and 514-524, whilst point mutation heteroplasmy (PMH) was detected at positions 73, 16093, 16189, and 16234, respectively. Overall LH was observed albeit high frequency in Sindhi ethnic group (82%) rather than Baluchi's (37%), whereas PMH accumulation was relatively extensive (24%) in Baluchi's than Sindhi's (11.2%). The obtained results ascertained that growing knowledge of heteroplasmy assisted to develop consciences in the forensic community that heteroplasmy plays a pivotal role in the legal interpretation on a regular basis and knowledge of its biological underpinnings has a vital niche in the forensic science. Limited studies have focused on heteroplasmy, yet scientific attention should be given, in order to determine its magnitude in different ethnic boundaries.

'A matter of conscience': the moral authority of the World Medical Association and the readmission of the South Africans, 1976-1994.

PubMed

Mbali, Mandisa

2014-04-01

This article describes the role of transnational anti-apartheid activism in South Africa, Britain and the United States in generating international moral outrage over the readmission of the Medical Association of South Africa (MASA) to the World Medical Association (WMA), which had taken place in 1981 after it had withdrawn from that body in 1976. It discusses an example of a controversy where an international health organisation (IHO) lost moral authority as a result of being accused of white supremacy and a pro-American engagement in Cold War politics. At the time of its readmission to the WMA, the MASA was controversial because of its failure to strike off its membership roll one of the doctors implicated the death in detention of Black Consciousness leader Steve Biko in 1977. It details how these activists viewed the American Medical Association as having campaigned for the MASA's readmission. The WMA's readmission of the MASA cost the former its relationships with the World Health Organisation (WHO) and the British Medical Association - a dispute which continued until South Africa's democratic transition of 1994. With its focus on transnational activism in relation to the WMA and the effects of activists' allegations of racism on its internal politics, this article contributes to the literature on the history of IHOs. Ultimately, this controversy shows the deficiency of international medical professional associations as ethical arbitrators of last resort.

The difference of being human: Morality

PubMed Central

Ayala, Francisco J.

2010-01-01

In The Descent of Man, and Selection in Relation to Sex, published in 1871, Charles Darwin wrote: “I fully … subscribe to the judgment of those writers who maintain that of all the differences between man and the lower animals the moral sense or conscience is by far the most important.” I raise the question of whether morality is biologically or culturally determined. The question of whether the moral sense is biologically determined may refer either to the capacity for ethics (i.e., the proclivity to judge human actions as either right or wrong), or to the moral norms accepted by human beings for guiding their actions. I propose that the capacity for ethics is a necessary attribute of human nature, whereas moral codes are products of cultural evolution. Humans have a moral sense because their biological makeup determines the presence of three necessary conditions for ethical behavior: (i) the ability to anticipate the consequences of one's own actions; (ii) the ability to make value judgments; and (iii) the ability to choose between alternative courses of action. Ethical behavior came about in evolution not because it is adaptive in itself but as a necessary consequence of man's eminent intellectual abilities, which are an attribute directly promoted by natural selection. That is, morality evolved as an exaptation, not as an adaptation. Moral codes, however, are outcomes of cultural evolution, which accounts for the diversity of cultural norms among populations and for their evolution through time. PMID:20445091

Patient’s Knowledge and Perception Towards the use of Non-steroidal Anti-Inflammatory Drugs in Rheumatology Clinic Northern Malaysia

PubMed Central

Sulaiman, Wahinuddin; Seung, Ong Ping; Ismail, Rosli

2012-01-01

Objective In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients’ knowledge and perception regarding the used of NSAIDS. Methods A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient’s knowledge and perception on the side effects of NSAIDs were recorded. Result Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once. Conclusion This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients. PMID:23226825

RP-HPLC×HILIC chromatography for quantifying ertapenem sodium with a look at green chemistry.

PubMed

Pedroso, Tahisa M; Medeiros, Ana C D; Salgado, Herida R N

2016-11-01

Ertapenem sodium is a polar and ionizable compound; therefore, it has little retention on traditional C18 columns in reverse-phase high-performance liquid chromatography, even using a highly-aqueous mobile phase that can result in dewetting in the stationary phase. Thus, the most coherent process for ERTM is to develop a method for Hydrophilic Interaction Chromatography. However, for the traditional methods in HILIC, the use of a highly organic mobile phase is necessary; usually an amount exceeding 80% acetonitrile is necessary. On the other hand, the RP-HPLC mode is considered for the analysis technique, which is more often used for quantification of substances, and new columns are often introduced to analyze different groups of compounds. Two new analytical methods have been developed for routine analysis. The proposed chromatographic method was adequate and advantageous by presenting simplicity, linearity, precision, accuracy, robustness, detection limits, and satisfactory quantification. Analytical methods are constantly undergoing changes and improvements. Researchers worldwide are rapidly adopting Green Chemistry. The development of new pharmaceutical methods based in Green chemistry has been encouraged by universities and the pharmaceutical industry. Issues related to green chemistry are in evidence and they have been featured in international journals of high impact. The methods described here have economic advantages and they feature an eco-friendly focus, which is discussed in this work. This work was developed with an environmental conscience, always looking to minimize the possible generated organic waste. Therefore, discussion on this aspect is included. Copyright © 2016 Elsevier B.V. All rights reserved.

Nurse supervisors' actions in relation to their decision-making style and ethical approach to clinical supervision.

PubMed

Berggren, Ingela; Severinsson, Elisabeth

2003-03-01

The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process. Clinical supervision promotes ethical awareness and behaviour in the nursing profession. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.

Reminiscing about Jan Evangelista Purkinje: a pioneer of modern experimental physiology.

PubMed

Cavero, Icilio; Guillon, Jean-Michel; Holzgrefe, Henry H

2017-12-01

This article reminisces about the life and key scientific achievements of Jan Evangelista Purkinje (1787-1869), a versatile 19th century Czech pioneer of modern experimental physiology. In 1804, after completing senior high school, Purkinje joined the Piarist monk order, but, after a 3-yr novitiate, he gave up the religious calling "to deal more freely with science." In 1818, he earned a Medical Doctor degree from Prague University by defending a dissertation on intraocular phenomena observed in oneself. In 1823, Purkinje became a Physiology and Pathology professor at the Prussian Medical University in Breslau, where he innovated the traditional teaching methods of physiology. Purkinje's contributions to physiology were manifold: accurate descriptions of various visual phenomena (e.g., Purkinje-Sanson images, Purkinje phenomenon), discovery of the terminal network of the cardiac conduction system (Purkinje fibers), identification of cerebellar neuronal bodies (Purkinje cells), formulation of the vertigo law (Purkinje's law), discovery of criteria to classify human fingerprints, etc. In 1850, Purkinje accepted and held until his death the Physiology chair at Prague Medical Faculty. During this period, he succeeded in introducing the Czech idiom (in addition to long-established German and Latin) as a Medical Faculty teaching language. Additionally, as a zealous Czech patriot, he actively contributed to the naissance and consolidation of a national Czech identity conscience. Purkinje was a trend-setting scientist who, throughout his career, worked to pave the way for the renovation of physiology from a speculative discipline, ancilla of anatomy, into a factual, autonomous science committed to the discovery of mechanisms governing in-life functions. Copyright © 2017 the American Physiological Society.

Some ethical problems of hazardous substances in the working environment1

PubMed Central

Lee, W. R.

1977-01-01

ABSTRACT Exposure of persons to conditions at work may involve some risk to health. It is not possible always to ensure that exposure can be kept below a level from which it may be categorically stated that there is no risk. The decision that has to be made, what ought to be done, poses an ethical problem. What principles are available for examining such ethical problems? Two theories from the study of ethics seem relevant. On the one hand Intuitionism asserts that we possess a moral sense which, correctly applied, enables us to determine what is a right action. The familiar use of 'conscience' and the teachings of some of the influential Western religions follow this theory. On the other hand Utilitarianism (in particular Objective Utilitarianism) asserts that we may judge the rightness of an action by looking at its consequences. This theory, translated into legislative reform, has provided a substantial basis for much of the social reforming legislation of the last century. In economic terms it appears as cost benefit analysis. Despite its attraction and almost plausible objectivity, Utilitarianism requires the quantification and even costing of consequences which cannot always be measured (for example, emotions) but which from an important part of the totality of life. Decisions about the right course of action are required politically but cannot always be made objectively. They may require an element of judgement—a correct application of the moral sense—to use the Intuitionists' phrase. Doctors, used to making ethical decisions in the clinical setting, must examine carefully their role when contributing to ethical decisions in the industrial setting. PMID:588483

Does 'Time Together' increase quality of interaction and decrease stress? A study protocol of a multisite nursing intervention in psychiatric inpatient care, using a mixed method approach.

PubMed

Molin, Jenny; Lindgren, Britt-Marie; Graneheim, Ulla Hällgren; Ringnér, Anders

2017-08-28

Despite the long-known significance of the nurse-patient relationship, research in psychiatric inpatient care still reports unfulfilled expectations of, and difficulties in, interactions and relationships between patients and staff. Interventions that create structures to allow quality interactions between patients and staff are needed to solve these problems. The aim of this project is to test effects of the nursing intervention Time Together and to evaluate the intervention process. This is a multisite study with a single-system experimental design using frequent measures. The primary outcomes are quality interactions for patients and perceived stress for staff. Secondary outcomes are levels of symptoms of anxiety and depression for patients and stress of conscience for staff. A process evaluation is performed to describe contextual factors and experiences. Data are collected using questionnaires, participant observations and semistructured interviews. For analysis of quantitative data, both visual and statistical methods will be used. Qualitative data will be analysed using qualitative content analysis. Ethical approval was granted by the Ethical Review Board in the region (Dnr 2016/339-31). The findings will contribute to the development of nursing interventions in general, but more specifically to the development of the intervention. This is relevant both nationally and internationally as similar interventions are needed but sparse. The findings will be disseminated through conference presentations and peer-reviewed publications. NCT02981563. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Developing and teaching the virtue-ethics foundations of healthcare whistle blowing.

PubMed

Faunce, Thomas

2004-10-01

Healthcare whistle blowing, despite the benefits it has brought to healthcare systems in many developed countries, remains generally regarded as a pariah activity by many of the most influential healthcare professionals and regulatory institutions. Few if any medical schools or law department health law and bioethics classes, teach whistle blowing in a formal sense. Yet without exception, public inquiries initiated by healthcare whistle blowers have validated their central allegations and demonstrated that the whistle blowers themselves were sincere in their desire to implement the fundamental virtues and principles of medical ethics, bioethics and public health law. In many jurisdictions, the law, this time remarkably in advance of professional opinion, has offered legislative protection for reasonable allegations of whistleblowers made in good faith and in the public interest concerning a substantial and imminent threat to public safety. One reason for this paradoxical position, explored here, is that healthcare whistle blowing lacks a firm virtue-based theoretical bioethical and jurisprudential foundation. The hypothesis discussed is that the lack of this bioethical and jurisprudential substrate has contributed to a situation where healthcare whistle blowing suffers in terms of institutional support due to its lack of academic legitimacy. This article commences the process of redressing this imbalance by attempting to lay the theoretical foundations for healthcare whistle blowing. As a case study, this article concludes by discussing the Personal and Professional Development course at the ANU Medical School where healthcare whistle blowing is a formal part of a virtue-based curriculum that emphasises the foundational importance of conscience. Illustrative elements of that program are discussed.

Using the American Board of Internal Medicine's "Elements of Professionalism" for undergraduate ethics education.

PubMed

Robins, Lynne S; Braddock, Clarence H; Fryer-Edwards, Kelly A

2002-06-01

To examine the feasibility of using the taxonomy of professional and unprofessional behaviors presented in the American Board of Internal Medicine's (ABIM's) Project Professionalism to categorize ethical issues that undergraduate medical students perceive to be salient. Beginning second-year medical students at the University of Washington School of Medicine (n = 120) were asked to respond to three open-ended questions about professional standards of conduct and peer evaluation. Two of the authors read and coded the students' responses according to the ABIM's elements of professionalism (altruism, accountability, excellence, duty, honor and integrity, and respect for others) and the challenges to those elements (abuse of power, arrogance, greed, misrepresentation, impairment, lack of conscientiousness, and conflict of interest). Coding disagreements were solved using review and revision of the category definitions. New categories were created for students' responses that described behaviors or issues that were not captured in the ABIM's categories. A total of 114 students responded. The ABIM's professional code was adapted for students and teachers, making it context- and learning-stage-specific. One new category of challenges, conflicts of conscience, was added, and one category (abuse of power) was expanded to include abuse of power/negotiating power asymmetries. Using the ABIM's taxonomy to name professional and unprofessional behaviors was particularly useful for examining undergraduate medical students' perceptions of the ethical climate for learning during the first year of medical school, and it holds promise for research into changes in students' perceptions as they move into clinical experiences. Using the framework, students can build a unified professional knowledge-and-skills base.

Arpad Gerster and Max Thorek contributions to American surgery.

PubMed

Langer, Robert M

2009-01-01

The legacy and the influence on American surgery is discussed of two Hungarian born surgeons: Arpad Gerster (1848-1923) and Max Thorek (1880-1960). Both of them were born in Northern Hungary, then part of the Austro-Hungarian Monarchy, today Slovakia. Gerster got his medical education in Vienna The influence of Theodor Billroth left everlasting impressions in him. In 1874 he arrived in New York and became the first doctor in town who practiced exclusively surgery. He became an attending surgeon in The German Hospital and later at Mount Sinai Hospital. Gerster modernized the hospital's functions and services, introducing the rotation system, and also made the original observation that dissemination of cancer may be caused by surgery. His aseptic methods were revolutionary at the time. Max Thorek arrived in Chicago in 1897. With a fantastic endurance he overwhelmed all barriers and became a doctor. He started his practice in one of Chicago's poor immigrant neighborhoods, but stepwise he could excel and in 1911 he co-founded The American Hospital. His ideas of modernizing surgery became reality. Thorek is one of the first who practiced plastic surgery, and his contribution by writing about surgical errors and safeguards became a great success. He founded the International College of Surgeons, a result of his widespread relations among surgeons all over the world. The parallels in the lives of these great surgeons: solid education, knowledge of languages, talent for music, literature, and arts, creative thinking combined with hard work, good humor, as well as a social conscience led them to make groundbreaking contributions to American and international surgery.

Subsidiarity: Restoring a sacred harmony

PubMed Central

2017-01-01

The principle of subsidiarity is a bastion of Catholic social teaching. It is also a principle in the philosophy of the American Founding Fathers. In the USA, subsidiarity is ignored without a sense of the proper harmony between authority and responsibility. Human dignity and wise stewardship are compromised. Conscience protection becomes a concerning issue as highlighted by the conflicts arising after passing of the Patient Protection and Affordable Care Act. A reconnection of the patient to be steward of his health care is critical in addressing these issues. Third parties, including the government, business, and insurance companies, are firmly entrenched in health care oftentimes with the result being increased cost and detachment of the patient from the stewardship of his or her care. Vitally needed is a return to the principle of subsidiarity in health care. Hopeful solutions include the Zarephath Health Center, the Surgery Center of Oklahoma, and the clinic of Dr. Juliette Madrigal-Dersch. Summary: The principle of subsidiarity is a bastion of Catholic social teaching. It is a principle in the philosophy of the American Founding Fathers. In the US, subsidiarity is ignored without a sense of the proper harmony between authority and responsibility. Human dignity, wise stewardship, and solidarity are compromised. A reconnection of the patient to personal stewardship of his health care is critical in addressing these issues. Third parties are firmly entrenched in health care oftentimes with the result being increased cost and detachment of the patient from his or her care. Vitally needed is a return to the principle of subsidiarity in health care. PMID:28392594

Screening Out Controversy: Human Genetics, Emerging Techniques of Diagnosis, and the Origins of the Social Issues Committee of the American Society of Human Genetics, 1964-1973.

PubMed

Mitchell, M X

2017-05-01

In the years following World War II, and increasingly during the 1960s and 1970s, professional scientific societies developed internal sub-committees to address the social implications of their scientific expertise (Moore, Disrupting Science: Social Movements, American Scientists, and the Politics of the Military, 1945-1975. Princeton: Princeton University Press, 2008). This article explores the early years of one such committee, the American Society of Human Genetics' "Social Issues Committee," founded in 1967. Although the committee's name might suggest it was founded to increase the ASHG's public and policy engagement, exploration of the committee's early years reveals a more complicated reality. Affronted by legislators' recent unwillingness to seek the expert advice of human geneticists before adopting widespread neonatal screening programs for phenylketonuria (PKU), and feeling pressed to establish their relevance in an increasingly resource-scarce funding environment, committee members sought to increase the discipline's expert authority. Painfully aware of controversy over abortion rights and haunted by the taint of the discipline's eugenic past, however, the committee proceeded with great caution. Seeking to harness interest in and assert professional control over emerging techniques of genetic diagnosis, the committee strove to protect the society's image by relegating ethical and policy questions about their use to the individual consciences of member scientists. It was not until 1973, after the committee's modest success in organizing support for a retrospective public health study of PKU screening and following the legalization of abortion on demand, that the committee decided to take a more publicly engaged stance.

A de-facto end to abortion in USA?

PubMed

1996-04-20

It is argued that the latest attempt by the US Congress to allow medical education institutions and individuals to refuse to teach or to perform abortions violates women's choices and interferes with medical education. The argument is made that medical education under such legislation could refuse to train doctors in procedures that were unpopular or not sufficiently profitable, without a loss of federal dollars or loss of accreditation from the Accreditation Council for Graduate Medical Education (ACGME). Legislation has been proposed by members who assert that a ban against "discrimination" is needed in order to protect institutions and individuals that refuse to teach or learn abortion. Anti-choice groups in Congress have already pressured ACGME into allowing programs the right to refuse to teach abortion as long as these programs also allow medical residents to learn the procedure elsewhere. Prior ACGME posturing strongly supported abortion seekers' right to properly qualified physicians who were not coerced into learning or performing abortions. ACGME and this Lancet editorial support the "conscience clause" that gives residents the right to object on religious or moral grounds to learn how to perform abortions. It is posited that the trends reflect a greater denial of access to abortion services for American women. Trends include actions such as the passage in January 1995 of legislation that bans abortions at US military hospitals, in federal prisons, in health insurance plans covering federal employees, and among women receiving Medicaid. President Clinton vetoed recent legislation that would have banned very late abortions. The current bill in Congress would allow medical residents and programs to refuse abortions on any grounds.

"A morning since eight of just pure grill": a multischool qualitative study of student abuse.

PubMed

Rees, Charlotte E; Monrouxe, Lynn V

2011-11-01

Previous medical student abuse research employed quantitative surveys that failed to explore factors thought to contribute to abuse and students' actions in the face of abuse. This study examined medical student abuse narratives to identify types of perceived abuse, factors cited by students as contributing to abuse, and students' actions at the time of abuse. A qualitative design was adopted employing 22 individual and 32 group interviews to elicit narratives of professionalism dilemmas from 200 medical students at two 5-year undergraduate programs and one 4-year graduate entry program (England, Wales, and Australia) between 2007 and 2009. Thematic analysis of abuse narratives was conducted. Of 833 professionalism dilemma narratives, 86 (10%) involved perceived medical student abuse. Within these narratives, students reported mostly covert, status-related abuse, direct verbal abuse, and sexual harassment and discrimination. Some narrators described multiple factors contributing to abuse (individual, work, and/or organization); most cited factors focusing on individuals. Despite the abuse typically recounted with negative emotion, few participants reported resisting at the time of abuse by challenging or reporting the perpetrator. Participants gave a variety of reasons for this inaction (e.g., anxiety about receiving bad marks from the perpetrator) and for resisting (e.g., the abuse was affecting their education negatively). Although narratives focused predominantly on individual factors contributing to abuse and responses to abuse, educators should focus on the dynamic interplay between individual and organizational factors to combat abuse. Several opportunities to mitigate this continuing blight on the conscience of the profession are described.

Technical Note: A Feasibility Study of Using the Flat Panel Detector on Linac for the kV X-ray Generator Test.

PubMed

Cai, Bin; Dolly, Steven; Kamal, Gregory; Yaddanapudi, Sridhar; Sun, Baozhou; Goddu, S Murty; Mutic, Sasa; Li, Hua

2018-04-28

To investigate the feasibility of using kV flat panel detector on linac for consistency evaluations of kV X-ray generator performance. An in-house designed aluminum (Al) array phantom with six 9×9 cm 2 square regions having various thickness was proposed and used in this study. Through XML script-driven image acquisition, kV images with various acquisition settings were obtained using the kV flat panel detector. Utilizing pre-established baseline curves, the consistency of X-ray tube output characteristics including tube voltage accuracy, exposure accuracy and exposure linearity were assessed through image quality assessment metrics including ROI mean intensity, ROI standard deviation (SD) and noise power spectrums (NPS). The robustness of this method was tested on two linacs for a three-month period. With the proposed method, tube voltage accuracy can be verified through conscience check with a 2% tolerance and 2 kVp intervals for forty different kVp settings. The exposure accuracy can be tested with a 4% consistency tolerance for three mAs settings over forty kVp settings. The exposure linearity tested with three mAs settings achieved a coefficient of variation (CV) of 0.1. We proposed a novel approach that uses the kV flat panel detector available on linac for X-ray generator test. This approach eliminates the inefficiencies and variability associated with using third party QA detectors while enabling an automated process. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Jamesian pragmatism: a framework for working towards unified diversity in nursing knowledge development.

PubMed

McCready, Jason S

2010-07-01

Abstract Nursing is frequently described as practical or pragmatic and there are many parallels between nursing and pragmatism, the school of thought. Pragmatism is often glancingly referenced by nursing authors, but few have conducted in-depth discussions about its applicability to nursing; and few have identified it as a significant theoretical basis for nursing research. William James's pragmatism has not been discussed substantially in the nursing context, despite obvious complementarities. James's theme of pluralism fits with nursing's diversity and plurality; his emphasis on social conscience in our actions matches nursing's fundamental purpose of improving the lives of others; his continuous testing of pluralistic truths in critically reflective practice pairs well with nursing's focus on developing best-available, holistic evidence; and his conceptualization of truth as being born in practice and becoming an instrument in practice is entirely compatible with nursing's theory-practice identity. The oft-discussed theory-practice gap is seen to hinder the development of nursing knowledge. If nursing is to find its identity in knowledge development and potentiate the knowledge developed, it is imperative to identify and address that which is impeding progress. By way of the pragmatic tenets of William James, I will argue that a significant part of the theory-practice gap lies in how nursing knowledge development is operationalized, creating a false dichotomy between practice and research. I will also argue that the research-practice schism has been widened by continued philosophical and methodological infighting in the research community. I will describe how Jamesian pragmatism can be 'what works' for rebuilding relationships and supporting an engaged plurality within nursing research and bring research and practice together into a collaborative and iterative process of developing nursing knowledge.

[Physician versus 'off-label" ordinance].

PubMed

Kordus, Katarzyna; Spiewak, Radosław

2015-01-01

Polish physicians are obliged by legislation to prescribe drugs authorized for the sale in the Republic of Poland, based on registration documentation, including the Summaries of Product Characteristics (SPC). So called 'off label' treatment occurs in case of the conflict between prescription and information contained in the SPC, which may be considered as a 'medical experiment'. In case of adverse drug reactions, such classification excludes the responsibility of the marketing authorization holders, and damages are not covered by obligatory third party insurance, which can pose financial and legal consequences to the doctor. Deviations from SPC-compliant prescription may include a different way of drug administration, drug administration compliant with the indications yet in patients for whom there is no specified drug dosage, or in case of an indication not contained in the SPC. Medicinal products with equivalent active component, form and dose can have different registration indications in the SPC, and the actively promoted dispensation of less expensive substitutes by the pharmacists may, against doctor's will, result in the use that is non-compliant with registration of the substitute drug. Pharmacotherapy of 'orphan diseases', for which there are no registered medicinal products, also becomes an essential issue as it forces doctors into 'off-label' prescriptions. Moreover, the reimbursement of drugs in most cases is limited to medicinal products that are prescribed according to the registration indications. The pleas by medical professionals to make ordination and reimbursement of drugs depend on active pharmaceutical ingredient and evidence of efficacy, as well as to introduce Evidence Based Medicine (EBM) standards for the treatment of diseases, did not receive proper attention from the governing bodies. Therefore, a fundamental question remains unanswered as to what should be the principal gauge for physicians' therapeutic decision: the ethics, conscience, recent scientific evidence or legal and administrative regulations?

Whistleblowing in medicine and in Homer's Iliad.

PubMed

Rodulson, Victoria; Marshall, Robert; Bleakley, Alan

2015-12-01

'Thinking with Homer', or drawing creatively on themes and scenes from Homer's Iliad and Odyssey, can help us to better understand medical culture and practice. One current, pressing, issue is the role of the whistleblower, who recognises and exposes perceived poor practice or ethical transgressions that compromise patient care and safety. Once, whistleblowers were ostracised where medical culture closed ranks. However, in a new era of public accountability, medicine looks to formally embrace whistleblowing to the point that not reporting transgressions can now constitute a transgression of professionalism. Where medical students identify with the history and traditions of medical culture, they inevitably find themselves in situations of conflicting loyalties if they encounter senior clinicians behaving unprofessionally. What are the implications of facing these dilemmas for students in terms of role modelling and shaping of character as a doctor, and how might a study of Homer help with such dilemmas? We suggest that a close reading of an opening scene in Homer's the Iliad can help us to better appreciate such ethical dilemmas. We link this with the early Greek tradition of parrhesia or 'truth telling', where frankly speaking out against perceived injustice is encouraged as resistance to power and inappropriate use of authority. We encourage medical educators to openly discuss perceived ethical dilemmas with medical students, and medicine as a culture to examine its conscience in a transition from an authoritarian to an 'open' society, where whistleblowing becomes as acceptable and necessary as good hygiene on the wards. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Aircraft Noise Perception Study in Brazil: A Perspective on Airport Sustainable Growth and Environmental Awareness

NASA Technical Reports Server (NTRS)

deArantesGomesEller, Rogerio; Urbina, Ligia Maria Soto; Porto, Protogenes Pires

2003-01-01

Aircraft noise perception is related to several variables that are tangible and objective, such as the number of operations, flight schedules. Other variables, instead, are more subjective, such as preferences. However, although their elusiveness, they contribute to determine the individuals' perception of this type of externality. Despite the fact that the complaints related to aeronautical noise have been registered since the decade of 50, it has been observed that the perception of noise seems to have grown, especially since the 80's. It has been argued that this change in noise perception has its roots on the accelerated expansion of air traffic. But, it is necessary to point out the important role played on modeling preferences, by the growing environmental conscience and the higher welfare and quality of life standards and expectations. In that context, the main objective of this paper is to study the aeronautical noise perception in the neighborhoods of the Aeroporto Internacional de Sao Paulo - AISP (the biggest airport of South America). Specifically, it analyzes the relationship between aircraft noise perception and social class, which is expected to be positive. Since noise perception is an intangible variable, this study chose as a proxy the value losses of residential properties, caused by aeronautical noise. The variable social class has been measured utilizing average per capita income of the population who live nearby the airport. The comparison of both, the lowest and the highest social class suggests that the relationship between social class and noise perception is positive in the AISP region. Moreover, it was observed that all social classes are very susceptible to aircraft noise annoyance. In fact, the magnitude of the noise perception proxy for both social classes -the residential value losses- was found to be comparable to levels encountered in developed countries.

[Complexities of the stress experienced by employees of the Fukushima nuclear plants].

PubMed

Sano, Shin-Ya; Tanigawa, Takeshi; Shigemura, Jun; Satoh, Yutaka; Yoshino, Aihide; Fujii, Chiyo; Tatsuzawa, Yasutaka; Kuwahara, Tatsuro; Tachibana, Shoichi; Nomura, Soichiro

2012-01-01

Fukushima Daiichi Nuclear Power Plants suffered serious damage by the Great East Japan Earthquake and Tsunami. The employees of the plant worked very hard to stabilize the nuclear reactor and to prevent any secondary accidents. They were in one of the most severe situations in this disaster, but they were the people who hesitated most to request help for themselves. We started visiting the Fukushima Daini Plant office that was used as the frontline base for Daiichi Plant workers since July, 2011. These visits were held once or twice a month and we offered mental health support to the employees. We have completed interview with the total number of 339 plant workers by April, 2012. We offered several ways of mental support including clinical treatment, continuous counseling, or one time advice, depending on mental condition of each interviewee. Complexity of huge disaster and individuality of suffering from it were discussed in this article. Like local residents, many plant workers also experienced death/missing of family, loss of housing, refuge life, and dispersion of family. Furthermore, they have been suffering from various kinds of criticism and slander against Tokyo Electric Power Company. Many workers, even though they were not in management positions, seemed to have guilty conscience and sense of responsibility that forced them to stay in the risky working site. We could find some struggling coexistence of sense of guilt (as a causer of disaster) and sense of victim in their mind. It was suggested that continuous effort to listen and pay attention to their talk is important in order to support their mission to stabilize the power plant and to prevent them from over-stress and burnout.

Integrity in and Beyond Contemporary Higher Education: What Does it Mean to University Students?

PubMed Central

Wong, Sarah Shi Hui; Lim, Stephen Wee Hun; Quinlan, Kathleen M.

2016-01-01

Research has focused on academic integrity in terms of students’ conduct in relation to university rules and procedures, whereas fewer studies examine student integrity more broadly. Of particular interest is whether students in higher education today conceptualize integrity as comprising such broader attributes as personal and social responsibility. We collected and analyzed qualitative responses from 127 students at the National University of Singapore to understand how they define integrity in their lives as students, and how they envisage integrity would be demonstrated in their lives after university. Consistent with the current literature, our data showed that integrity was predominantly taken as “not plagiarizing (in school)/giving appropriate credit when credit is due (in the workplace)”, “not cheating”, and “completing tasks independently”. The survey, though, also revealed further perceptions such as, in a university context, “not manipulating data (e.g., scientific integrity)”, “being honest with others”, “group work commitments”, “conscience/moral ethics/holding true to one’s beliefs”, “being honest with oneself”, “upholding a strong work ethic”, “going against conventions”, and “reporting others”, as well as, in a workplace context, “power and responsibility and its implications”, “professionalism”, and “representing or being loyal to an organization”. The findings suggest that some students see the notion of integrity extending beyond good academic conduct. It is worthwhile to (re)think more broadly what (else) integrity means, discover the gaps in our students’ understanding of integrity, and consider how best we can teach integrity to prepare students for future challenges to integrity and ethical dilemmas. PMID:27536256

[Euthanasia: the law, a few notions and the question of assisted suicide].

PubMed

Herremans, J

2008-09-01

Conforming to the Belgian Law on Euthanasia of 28 May 2002, the definition of euthanasia is "an act practised by a third party intentionally, ending the life of a person at that person's request". Doctors who practise euthanasia commit no offence if they follow the prescribed conditions and procedures. The voluntary, well considered request for euthanasia must be initiated by an adult patient, complaining of unbearable physical or mental suffering caused by a serious and incurable medical condition, whether accidental or pathological. Consultation with a second doctor is required. If the death is not to be expected within a short period of time--in other words, for not terminally-ill patients--, the intervention of a third doctor is required, either a psychiatrist or a specialist of the patient's pathology. In that case, a delay of at least one month between the request and the euthanasia has to be respected. The doctor must declare the act of euthanasia to a Federal Commission composed of 8 doctors, 4 lawyers and 4 persons familiar with the problems of patients suffering from an incurable disease. This Commission has also to produce every other year a statistical and evaluation report for Parliament. The living will, called "advance declaration", is officially recognized but strictly limited to the state of irreversible unconsciousness of the patient. This law on the de-criminalization of euthanasia recognizes the right of personal autonomy for the patient and the principle of freedom of conscience for everyone. The law refers explicitly to the concept of euthanasia but does not specify the method to be used by the doctor. If it is the wish of the patient, and if the physical condition of the patient allows this solution, "assisted suicide" is permitted.

Abandon the dead donor rule or change the definition of death?

PubMed

Veatch, Robert M

2004-09-01

Research by Siminoff and colleagues reveals that many lay people in Ohio classify legally living persons in irreversible coma or persistent vegetative state (PVS) as dead that additional respondents, although classifying such patients as living, would be willing to procure organs from them. This paper analyzes possible implications of these findings for public policy. A majority would procure organs from those in irreversible coma or in PVS. Two strategies for legitimizing such procurement are suggested. One strategy would be to make exceptions to the dead donor rule permitting procurement from those in PVS or at least those who are in irreversible coma while continuing to classify them as living. Another strategy would be to further amend the definition of death to classify one or both groups as deceased, thus permitting procurement without violation of the dead donor rule. Permitting exceptions to the dead donor rule would require substantial changes in law--such as authorizing procuring surgeons to end the lives of patients by means of organ procurement--and would weaken societal prohibitions on killing. The paper suggests that it would be easier and less controversial to further amend the definition of death to classify those in irreversible coma and PVS as dead. Incorporation of a conscience clause to permit those whose religious or philosophical convictions support whole-brain or cardiac-based death pronouncement would avoid violating their beliefs while causing no more than minimal social problems. The paper questions whether those who would support an exception to the dead donor rule in these cases and those who would support a further amendment to the definition of death could reach agreement to adopt a public policy permitting organ procurement of those in irreversible coma or PVS when proper consent is obtained.

The impact of land use and season on the riverine transport of mercury into the marine coastal zone.

PubMed

Saniewska, Dominika; Bełdowska, Magdalena; Bełdowski, Jacek; Saniewski, Michał; Szubska, Marta; Romanowski, Andrzej; Falkowska, Lucyna

2014-11-01

In Mediterranean seas and coastal zones, rivers can be the main source of mercury (Hg). Catchment management therefore affects the load of Hg reaching the sea with surface runoff. The major freshwater inflows to the Baltic Sea consist of large rivers. However, their systems are complex and identification of factors affecting the outflow of Hg from its catchments is difficult. For this reason, a study into the impact of watershed land use and season on mercury biogeochemistry and transport in rivers was performed along two small rivers which may be considered typical of the southern Baltic region. Neither of these rivers are currently impacted by industrial effluents, thus allowing assessment of the influence of catchment terrain and season on Hg geochemistry. The study was performed between June 2008 and May 2009 at 13 sampling points situated at different terrain types within the catchments (forest, wetland, agriculture and urban). Hg analyses were conducted by CVAFS. Arable land erosion was found to be an important source of Hg to the aquatic system, similar to urban areas. Furthermore, inflows of untreated storm water discharge resulted in a fivefold increase of Hg concentration in the rivers. The highest Hg concentration in the urban runoff was observed with the greatest amount of precipitation during summer. Moderate rainfalls enhance the inflow of bioavailable dissolved mercury into water bodies. Despite the lack of industrial effluents entering the rivers directly, the sub-catchments with anthropogenic land use were important sources of Hg in the rivers. This was caused by elution of metal, deposited in soils over the past decades, into the rivers. The obtained results are especially important in the light of recent environmental conscience regulations, enforcing the decrease of pollution by Baltic countries.

Personality traits as an endophenotype in genetic studies on suicidality in bipolar disorder.

PubMed

Pawlak, J; Dmitrzak-Węglarz, M; Maciukiewicz, M; Kapelski, P; Czerski, P; Leszczyńska-Rodziewicz, A; Zaremba, D; Hauser, J

2017-04-01

Introduction The influence of personality traits on suicidal behaviour risk has been well documented. Personality traits and suicidal behaviour are partially genetically determined and personality has been described as an endophenotype of suicidal behaviour. The aim of this study was to investigate a possible association between personality traits with suicidal behaviour and selected serotonergic gene polymorphisms. In the study we included 156 patients meeting DSM-IV criteria for bipolar disorder (BP) and 93 healthy controls. The personality dimensions were assessed using the Temperament and Character Inventory (TCI). We genotyped two selected polymorphisms of the tryptophan hydroxylase 1 (TPH1) gene (rs1800532 218A>C and rs1799913 779A>C) and polymorphism in the promoter region of serotonin transporter gene (5-HTTLPR, rs25531) related to serotoninergic neurotransmission. Multiple poisson regression, logistic regression and Kruskal-Wallis tests were applied. We found numerous differences between the BP patients and the control group in terms of their TCI dimensions/subdimensions. Significant differences were found between patients with, and without, suicidal attempts in fatigability and asthenia (Ha4), as well as in harm avoidance (Ha). We also found that the interactions between TCI subdimensions (the interaction of disordiness (Ns4) and spiritual acceptance (St3), disordiness (Ns4) and integrated conscience (C5), extravagance (Ns3) and resourcefulness (Sd3)) were significantly contributing for suicidal behaviour risk. We found association between all studied genetic polymorphisms and several TCI dimensions and subdimensions. Our results confirm that personality traits are partially determined by genes. Both personality traits and the interactions between temperament and character traits, may be helpful in predicting suicidal behaviour.

Probing concept of critical thinking in nursing education in Iran: a concept analysis.

PubMed

Tajvidi, Mansooreh; Ghiyasvandian, Shahrzad; Salsali, Mahvash

2014-06-01

Given the wide disagreement over the definition of critical thinking in different disciplines, defining and standardizing the concept according to the discipline of nursing is essential. Moreover, there is limited scientific evidence regarding critical thinking in the context of nursing in Iran. The aim of this study was to analyze and clarify the concept of critical thinking in nursing education in Iran. We employed the hybrid model to define the concept of critical thinking. The hybrid model has three interconnected phases--the theoretical phase, the fieldwork phase, and the final analytic phase. In the theoretical phase, we searched the online scientific databases (such as Elsevier, Wiley, CINAHL, Proquest, Ovid, and Springer as well as Iranian databases such as SID, Magiran, and Iranmedex). In the fieldwork phase, a purposive sample of 17 nursing faculties, PhD students, clinical instructors, and clinical nurses was recruited. Participants were interviewed by using an interview guide. In the analytical phase we compared the data from the theoretical and the fieldwork phases. The concept of critical thinking had many different antecedents, attributes, and consequences. Antecedents, attributes, and consequences of critical thinking concept identified in the theoretical phase were in some ways different and in some way similar to antecedents, attributes, and consequences identified in the fieldwork phase. Finally critical thinking in nursing education in Iran was clarified. Critical thinking is a logical, situational, purposive, and outcome-oriented thinking process. It is an acquired and evolving ability which develops individually. Such thinking process could lead to the professional accountability, personal development, God's consent, conscience appeasement, and personality development. Copyright © 2014. Published by Elsevier B.V.

[Sex/Gender, Violence and Human Rights: Conceptual Perspectives for Approaching Gender-Based Violence against Women from the Health Sector].

PubMed

Bello-Urrego, Alejandra Del Rocío

2013-03-01

Based upon the public health sector perspective, this article explores conceptual approaches to address the issue of gender violence against women. To consider the election of an analysis framework regarding the phenomenon of violence against women in the health sector, in the light of the political implications of becoming a woman in the midst of a specific social order. Expert review of scientific literature published on free-access data bases so as to identify the most commonly used interpretation frameworks with regard to the phenomenon of violence against women in order to explain its political implications according to a specific social order. Becoming woman implies participation in social aspects from an inequity stemming from structural power. This is the reason why violence against women can never be considered away from its roots. i.e., a society that assigns to women social roles that imply diminished possibilities of access to the use of power through a sex/gender system which is binary, hierarchic and exclusive. In public health areas, the selection of interpretation frameworks that do not take into account the structural origin of violence against women contribute to their invisibilization and even to perpetuate it, independently from the conscience of the researcher on the basis of the political burden arising from the use of such frameworks to the detriment of others, or the intention of objectivity regarding frameworks with a heavy political burden that contribute to the maintenance of a sex/gender binary, hierarchic and excluding structure. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Ethical analyses of institutional measures to increase health care worker influenza vaccination rates.

PubMed

Zimmerman, Richard K

2013-12-16

Health care worker (HCW) influenza vaccination rates are modest. This paper provides a detailed ethical analysis of the major options to increase HCW vaccination rates, comparing how major ethical theories would address the options. The main categories of interventions to raise rates include education, incentives, easy access, competition with rewards, assessment and feedback, declination, mandates with alternative infection control measures, and mandates with administrative action as consequences. The aforementioned interventions, except mandates, arouse little ethical controversy. However, these efforts are time and work intensive and rarely achieve vaccination rates higher than about 70%. The primary concerns voiced about mandates are loss of autonomy, injustice, lack of due process, and subsuming the individual for institutional ends. Proponents of mandates argue that they are ethical based on beneficence, non-maleficence, and duty. A number of professional associations support mandates. Arguments by analogy can be made by mandates for HCW vaccination against other diseases. The ethical systems used in the analyses include evolutionary ethics, utilitarianism, principalism (autonomy, beneficence, non-maleficence, and justice), Kantism, and altruism. Across these systems, the most commonly preferred options are easy access, assessment and feedback, declinations, and mandates with infection control measures as consequences for non-compliance. Given the ethical imperatives of non-maleficence and beneficence, the limited success of lower intensive interventions, and the need for putting patient safety ahead of HCW convenience, mandates with additional infection control measures as consequences for non-compliance are preferred. For those who opt out of vaccination due to conscience concerns, such mandates provide a means to remain employed but not put patient safety at risk. Copyright © 2013 Elsevier Ltd. All rights reserved.

Interpersonal ambivalence in obsessive-compulsive disorder.

PubMed

Moritz, Steffen; Niemeyer, Helen; Hottenrott, Birgit; Schilling, Lisa; Spitzer, Carsten

2013-10-01

The social attitudes and interpersonal relationships of patients with obsessive-compulsive disorder (OCD) are subject to a longstanding controversy. Whereas cognitive-behavioural researchers emphasize exaggerated pro-social attitudes in OCD like inflated responsibility and worry for other people (especially significant others), dynamic theories traditionally focus on anti-social attitudes such as latent aggression and hostility. In two recent studies, we gathered support not only for a co-existence of these seemingly opposing attitudes in OCD, but also for a functional connection: inflated responsibility in part appears to serve as a coping strategy (or “defense”) against negative interpersonal feelings. In the present study, we tested a shortened version of the Responsibility and Interpersonal Behaviours and Attitudes Questionnaire (RIBAQ-R). The scale was administered to 34 participants with OCD and 34 healthy controls. The questionnaire concurrently measures pro-social and anti-social interpersonal attitudes across three subscales. In line with our prior studies, patients displayed higher scores on both exaggerated pro-social attitudes (e.g. “I suffer from a strict conscience concerning my relatives”) as well as latent aggression (e.g. “Sometimes I would like to harm strangers on the street“) and suspiciousness/distrust (e.g. “I cannot even trust my own family”). A total of 59% of the patients but only 12% of the healthy controls showed marked interpersonal ambivalence (defined as scores higher than one standard deviation from the mean of the nonclinical controls on both the prosocial and at least one of the two anti-social subscales). The study asserts high interpersonal ambivalence in OCD. Further research is required to pinpoint both the dynamic and causal links between opposing interpersonal styles. Normalization and social competence training may prove beneficial to resolve the apparent problems of patients with OCD regarding anger expression and social conflict management.

[The population questions in Rumania].

PubMed

Birzea, C

1993-03-01

Several months after Romania's dictator, Ceausescu, came to power in 1966, he made abortion the sole method of fertility control, illegal. Births grew in Romania 200% between enactment of this law and 1967. Some other pronatalist actions included taxes on singles and childless couples, assistance to families with many children, discouragement of divorces, and required gynecological exams at large women collectives (e.g. schools and businesses). The population adapted every quickly to these coercive pronatalist measures, however. By 1970, fertility fell steadily. By 1985, it was at the same level as it was pre-Ceausescu (1965). After Ceausescu's fall, repeal of the antiabortion law was one of the first actions taken by the new government, resulting in a 10-fold increase in legal abortions after several months. It also introduced free contraceptive methods which were not available during the Ceausescu years, e.g.. oral contraceptives. This new situation placed the responsibility to make decisions about procreation on people's shoulders. The government chose a population education strategy that emphasizes couples' responsibilities towards upcoming generations and towards improvement of the quality of life. Thus, education networks concerning family life and population grew, principally in 1991. The government created most family life and population education programs in schools, public health institutions and social service agencies, particularly those in large cities. It also called for the media and nongovernmental organizations to also promote programs which encourage parental responsibility, raise the demographic conscience of each person, and explain the moral, social, and economic context of fertility decisions. These education programs have replaced political indoctrination programs and have been integrated into a variety of disciplines. They stress prevention education, including sexual health, prevention of AIDS, drug and alcohol abuse, environmental protection, and human rights.

The Role of Insight in Moderating the Association Between Depressive Symptoms in People With Schizophrenia and Stigma Among Their Nearest Relatives: A Pilot Study.

PubMed

Krupchanka, Dzmitry; Katliar, Mikhail

2016-05-01

There is evidence of a positive association between insight and depression among patients with schizophrenia. Self-stigma was shown to play a mediating role in this association. We attempted to broaden this concept by investigating insight as a potential moderator of the association between depressive symptoms amongst people with schizophrenia and stigmatizing views towards people with mental disorders in their close social environment. In the initial sample of 120 pairs, data were gathered from 96 patients with a diagnosis of "paranoid schizophrenia" and 96 of their nearest relatives (80% response rate). In this cross-sectional study data were collected by clinical interview using the following questionnaires: "The Scale to Assess Unawareness of Mental Disorder," "Calgary Depression Scale for Schizophrenia," and "Brief Psychiatric Rating Scale." The stigmatizing views of patients' nearest relatives towards people with mental disorders were assessed with the "Mental Health in Public Conscience" scale. Among patients with schizophrenia depressive symptom severity was positively associated with the intensity of nearest relatives' stigmatizing beliefs ("Nonbiological vision of mental illness," τ = 0.24; P < .001). The association was moderated by the level of patients' awareness of presence of mental disorder while controlling for age, sex, duration of illness and psychopathological symptoms. The results support the hypothesis that the positive association between patients' depression and their nearest relatives' stigmatizing views is moderated by patients' insight. Directions for further research and practical implications are discussed. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Structure of Resilience among Japanese Adult Patients with Type 1 Diabetes: A Qualitative Study

PubMed Central

Nishio, Ikuko; Chujo, Masami

2017-01-01

Background Resilience is the process of overcoming adversities and difficulties. We clarified the structure of resilience and its motivational power among adult Japanese patients with type 1 diabetes. This is likely to help ensure effective nursing support to empower patients with diabetes and help them recuperate and improve their personal lives. Methods Participants were 17 patients with type 1 diabetes, and data were collected using semi-structured interviews. Participants shared their experiences of coping with self-management and diabetes control issues, the meaning of living with diabetes, and their support from family and friends since their diagnosis. Glaser’s grounded theory was used to analyze the data and the results were used to create a new model of resilience for type 1 diabetes. Results Five categories were extracted: “suffering from a guilty conscience,” “suffering from an insulin-dependent body,” “social disability,” “a driving force to advancement,” and “possessing a strategy to live with the disease.” Conclusion The five categories formed two stages: preparatory resilience and resilience formation. Once patients recognized the presence of empathetic others, they could obtain better disease comprehension and cooperation. Recognizing this support system served as a “driving force to advancement” and was termed the “resilience battery.” Through the resilience battery, patients shifted from preparatory resilience to “resilience formation,” or acquiring “a strategy to live with the disease.” To forge patient resilience, nurses should encourage disease comprehension and cooperation among patients’ significant others. We further propose that high-quality nursing care would involve supporting patients’ inner resilience. PMID:28331415

The emergence of mind and emotion in the evolution of neocortex.

PubMed

Freeman, Walter J

2011-01-01

The most deeply transformative concept for the growth of 21st Century psychiatry is the constellation of the chaotic dynamics of the brain. Brains are no longer seen as rational systems that are plagued with emotional disorders reflecting primitives inherited from our animal ancestors. Brains are dynamical systems that continually create patterns by acting intentionally into the environment and shaping themselves in accord with the sensory consequences of their intended actions. Emotions are now seen not as reversions to animal behaviors but as the sources of force and energy that brains require for the actions they take to understand the world and themselves. Humans are unique in experiencing consciousness of their own actions, which they experience as conscience: guilt, shame, pride and joy. Chaotic brain dynamics strives always for unity and harmony, but as a necessary condition for adaptation to a changing world, it repeatedly lapses into disorder. The successes are seen in the normal unity of consciousness; the failures are seen in the disorders that we rightly label the schizophrenias and the less severe character disorders. The foundation for healthy unity is revealed by studies in the evolution of brains, in particular the way in which neocortex of mammals emerged from the primitive allocortex of reptiles. The amazing facts of brain dynamics are now falling into several places. The power-law connectivity of cortex supports the scale-free dynamics of the global workspace in brains ranging from mouse to whale. That dynamics in humans holds the secrets of speech and symbol utilization. By recursive interactions in vast areas of human neocortex the scale-free connectivity supports our unified consciousness. Here in this dynamics are to be sought the keys to understanding and treating the disorders that uniquely plague the human mind.

E. coli Multiresistant Meningitis after Transrectal Prostate Biopsy

PubMed Central

Alecsandru, Diana; Gestoso, Israel; Romero, Ana; Martinez, Alfonso; García, Ana; Lobo, Julio; Yagüe, M. Ruiz

2006-01-01

Escherichia coli meningitis is a frequent pathology in children younger than 3 years old, but is an uncommon disease in adults. E. coli infection is the main cause of intrahospital bacteremia as a consequence of the employment of different medical procedures. Our patient, male, 69 years old, presented with fever, progressive difficulty in breathing, and shivers 24 h after transrectal prostate biopsy, with an absence of any other symptoms. He received prophylactic treatment with ciprofloxacin and later empirical treatment with ampicillin and tobramicin. After that, the patient presented with fever, headache, behavioral changes, somnolence, disorientation, a fluctuating level of conscience, cutaneous widespread pallor, and acute urinary retention. On physical exploration, we observed generalized hypoventilation, Glasgow 10, stiffness of the neck, inconclusive Kernig; the remaining neurological exploration was normal. Systematic of blood: leukocytes = 8,510/mm3 (94.5% polymorphonuclear), platelet = 87,000/mm3, pH = 7.51, pCO2 = 28.8 mmHg, pO2 = 61 mmHg, O2 saturation = 93.8%, and remaining values were normal. Chest X- ray, cranial CT scan, urine cultures were normal. Blood culture: E. coli. CSF: glucose <0.4 g/l, total proteins = 3.05 g/l, PMN = 7 cells. Microscopic examination of the CSF: Gram-negative bacilli; CSF's culture: abundant E. coli. The case of acute meningitis by multiresistant E. coli after transrectal prostate biopsy presented demonstrates that antibiotic prevention with ciprofloxacin is not absolutely risk free. Besides the use of antibiotic prevention for multiresistant microorganisms, the urologist and other physicians involved in the procedure must not forget that the rate of major complications of transrectal prostate biopsy is 1%, especially when it is performed in patients who will not benefit from that biopsy. PMID:17619698

State policy and teen childbearing: a review of research studies.

PubMed

Beltz, Martha A; Sacks, Vanessa H; Moore, Kristin A; Terzian, Mary

2015-02-01

Teen childbearing is affected by many individual, family, and community factors; however, another potential influence is state policy. Rigorous studies of the relationship between state policy and teen birth rates are few in number but represent a body of knowledge that can inform policy and practice. This article reviews research assessing associations between state-level policies and teen birth rates, focusing on five policy areas: access to family planning, education, sex education, public assistance, and access to abortion services. Overall, several studies have found that measures related to access to and use of family planning services and contraceptives are related to lower state-level teen birth rates. These include adolescent enrollment in clinics, minors' access to contraception, conscience laws, family planning expenditures, and Medicaid waivers. Other studies, although largely cross-sectional analyses, have concluded that policies and practices to expand or improve public education are also associated with lower teen birth rates. These include expenditures on education, teacher-to-student ratios, and graduation requirements. However, the evidence regarding the role of public assistance, abortion access, and sex education policies in reducing teen birth rates is mixed and inconclusive. These conclusions must be viewed as tentative because of the limited number of rigorous studies that examine the relationship between state policy and teen birth rates over time. Many specific policies have only been analyzed by a single study, and few findings are based on recent data. As such, more research is needed to strengthen our understanding of the role of state policies in teen birth rates. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Informed consent, anticipatory regulation and ethnographic practice.

PubMed

Murphy, Elizabeth; Dingwall, Robert

2007-12-01

In this paper we examine the application of informed consent to ethnographic research in health care settings. We do not quarrel with either the principle of informed consent or its translation into the requirement that research should only be carried out with consenting participants. However, we do challenge the identification of informed consent with the particular set of bureaucratic practices of ethical review which currently operate in Canada, the US and elsewhere. We argue that these anticipatory regulatory regimes threaten the significant contribution of ethnographic research to the creation of more efficient, more effective, more equitable and more humane health care systems. Informed consent in ethnographic research is neither achievable nor demonstrable in the terms set by anticipatory regulatory regimes that take clinical research or biomedical experimentation as their paradigm cases. This is because of differences in the practices of ethnographic and biomedical research which we discuss. These include the extended periods of time ethnographers spend in the research setting, the emergent nature of ethnographic research focus and design, the nature and positioning of risk in ethnographic research, the power relationships between researchers and participants, and the public and semi-public nature of the settings normally studied. Anticipatory regulatory regimes are inimical to ethnographic research and risk undermining the contribution of systematic inquiry to understanding whether institutions do what they claim to do, fairly and civilly and with an appropriate mobilisation of resources. We do not suggest that we should simply ignore ethics or leave matters to the individual consciences of researchers. Rather, we need to develop and strengthen professional models of regulation which emphasise education, training and mutual accountability. We conclude the paper with a number of suggestions about how such professional models might be implemented.

Assessment of Temperament and Character Profile with Anxiety and Depression in Patients with Acne

PubMed Central

Öztürk, Perihan; Orhan, Fatma Özlem; Özer, Ali; Karakaş, Tuğba; Öksüz, Ali Nuri; Yetişir, Nur Yalçın

2013-01-01

Background: Acne is the most common skin disease, affecting nearly 85% of the population as well as their lives. Acne can severely affect social and psychological functioning. Patients with acne may have anxiety, depression, decreased self-esteem, interpersonal difficulties, unemployment, social withdrawal, and even suicidal intent. Aims: The aim of this study was to evaluate the temperament and character inventory (TCI) of patients with acne and to compare the results with those of healthy controls. Study Design: Case-control study Methods: The study population consisted of 47 patients with acne, and 40 healthy control subjects. All participants were instructed to complete a self-administered 240-item TCI and the Hospital Anxiety and Depression Scale. Results: In this study, the scores for the temperament properties Worry and pessimism (HA1) and Dependence (RD4) and the character properties Social acceptance (C1) and Integrated conscience (C5) were found to be higher in acne patients than in healthy controls (p<0.05). Compared to the controls, depression and anxiety scores were found to be markedly higher in the patients with acne. Acne type correlated positively with the Disorderliness (NS4) subscale of Novelty seeking (NS) and anxiety. Additionally, acne type correlated negatively with the Attachment (RD3) subscale of Reward Dependence (RD), with the Transpersonal identification (ST2) and Spiritual acceptance (ST3) subscales of Self-Trancendence (ST), and with the Compassion (C4) sub-scale of Cooperativeness (C). Conclusion: Studies in this area may lead to the development of specific and focused interventions for TCI in patients with acne vulgaris. We suggest that the evaluation and treatment of acne should also include psychosomatic approaches in clinical practice. PMID:25207094

[Orthorexia--a new diagnosis?].

PubMed

Janas-Kozik, Małgorzata; Zejda, Jan; Stochel, Martyna; Brozek, Grzegorz; Janas, Adam; Jelonek, Ireneusz

2012-01-01

Orthorexia nervosa (Greek: ortho--correct, right; orexis--appetite, desire) is a term introduced in 1997 by the American doctor Steven Bratman and is defined as a pathological fixation with righteous and healthy eating. Clear classification criteria oforthorexia have not been developed yet and there has been an on-going discussion whether it belongs to the group of eating disorders or the obsessive-compulsive disorders. The aim of this paper is to summarise briefly the current state of knowledge regarding orthorexia and to point out the difficulties connected with an attempt to classify it in a given disorders group as well as with the attempt to establish the classification criteria. Despite the fact that the problem of orthorexia has been signalled in the Polish media, it has neither been discussed nor published in the Polish medical literature yet. Orthorexia starts when a diet becomes an escape from life--everyday activities are dominated by planning, buying and preparing "proper" meals. Each departure from this regime causes anxiety and guilty conscience and leads to even further tightening of the dietary habits. According to Bratmann, orthorexia is connected with an illusory feeling of safety (preventing from diseases), the urge to exercise a full control over one's life (elimination of the unpredictable), "a hidden conformism" (eating philosophy helps in a subconscious way to achieve a culturally accepted model of a beautiful body), a search for spirituality and identity, and a desire for self-deprivation. The arguments presented in this paper substantiate the expediency of implementing the epidemiological studies which will show the scale of the problem, its prevalence and conditionings. Data obtained in this way should facilitate the verification of classification criteria and will also help to formulate the diagnostic criteria of orthorexia.

Management practices associated with pain in cattle on western Canadian cow-calf operations: A mixed methods study.

PubMed

Moggy, M A; Pajor, E A; Thurston, W E; Parker, S; Greter, A M; Schwartzkopf-Genswein, K S; Campbell, J R; Windeyer, M C

2017-02-01

The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

Filosofiya Kanta i sovremennaya kosmologiya %t Kant's philosophy and modern cosmology

NASA Astrophysics Data System (ADS)

Mikhajlov, K. A.

In this article practically for the first time we make an attempt to analyse the essence and solution of a number of important problems of modern cosmology, such as those connected with the so called "anthropic principle" (AP), from the point of view of Kant's transcendental philosophy. With this aim in view, philosophical and methodological bases and consequences of AP, its contents and place in the history of science and philosophy of science are investigated. As well as this, the main principles of Kant's theory of knowledge are analysed. The philosophical contents of Kant's transcendental deduction are similar to B. Karter's AP. Kant's concept of time and his solution of the problem of the objective existence of the Universe are compared with the principles and conclusions of J. Wheeler's quantum theory of Universe creation. In this connection, Kant's interpretation of such concepts as "nature", "external object", "the object of the past", "existence", "the object of experience", "objectivity" are considered. The principal role of human conscience in the construction of the scientific picture of the Universe is shown. The ontological status of the past as the time modus and Time itself is analysed. Objectivity is understood as the necessary knowledge about the object coinciding with the object itself. The second part of the paper is devoted to the analysis of the modern state of research in the field of "SETI-problem" from the point of view of Kant's philosophy. The problem of the possible correlation of the pictures of the Universe by different intelligent beings is considered. G. Panovkin's theory of extraterrestrial civilisations is compared with Kant's theory of the substance of thought.

Environment and health: Probes and sensors for environment digital control

NASA Astrophysics Data System (ADS)

Schettini, Chiara

2014-05-01

The idea of studying the environment using New Technologies (NT) came from a MIUR (Ministry of Education of the Italian Government) notice that allocated funds for the realization of innovative school science projects. The "Environment and Health" project uses probes and sensors for digital control of environment (water, air and soil). The working group was composed of 4 Science teachers from 'Liceo Statale G. Mazzini ', under the coordination of teacher Chiara Schettini. The Didactic Section of Naples City of Sciences helped the teachers in developing the project and it organized a refresher course for them on the utilization of digital control sensors. The project connects Environment and Technology because the study of the natural aspects and the analysis of the chemical-physical parameters give students and teachers skills for studying the environment based on the utilization of NT in computing data elaboration. During the practical project, samples of air, water and soil are gathered in different contexts. Sample analysis was done in the school's scientific laboratory with digitally controlled sensors. The data are elaborated with specific software and the results have been written in a booklet and in a computing database. During the first year, the project involved 6 school classes (age of the students 14—15 years), under the coordination of Science teachers. The project aims are: 1) making students more aware about environmental matters 2) achieving basic skills for evaluating air, water and soil quality. 3) achieving strong skills for the utilization of digitally controlled sensors. 4) achieving computing skills for elaborating and presenting data. The project aims to develop a large environmental conscience and the need of a ' good ' environment for defending our health. Moreover it would increase the importance of NT as an instrument of knowledge.

[Moral and religious issues in health care].

PubMed

Necek, Robert

2012-01-01

The paper summarises the moral and spiritual factors important in care for sick people. Medical care is one of the ancient forms of our activity as humans, expounding care for other people's well-being. The moral aspect of medical care is deeply rooted in constant daily interaction between the patient and the doctor aiming at easing symptoms, support, help, prevention and defense. Such teleological orientation of medicine is, according to John Paul II, made possible not so much by technology but by physician's conscience, wisdom and unlimited honesty. This is where ethics is needed to regulate that particular relation. This ethics stems from Christian morality, which raises our role as humans to that of guardians of dignity of another human being. Man is indeed the measure of all things, and this becomes the context for all relations including man's relation to God, but also relation of God to man. Thus, human dignity assumes the status of unconditional natural rule, inherently forestalling all legal arrangements. The morality of health care requires holistic approach, including care for body, mind, social interaction and spiritual needs. Only then, as explained by dr Ewa Kucharska, is it possible to answer patient's all needs. The moral side of the therapeutic contract bounds the doctor and the patient, alike. From this point of view, it is immoral not to cooperate with physicians in their strife for the preservation of health and life itself. Self negligence or active self harm (drugs, alcohol abuse, HIV/AIDS) are the utmost examples of such dishonesty. Finally, the imperative to bring hope and faith to the suffering, vests special importance in hospital chaplains, who bring good word, but most importantly the sacrament to those in need. The prayer in turn may evoke strong hope for cure, capable of supporting both soul and body. The suffering of man cannot be understood on rational grounds. It requires acceptance, and, above all, it requires faith. And this understanding is reached only by faith and participation in Christ's sufferings.

[Surrogacy in Maternity. A Depersonalising Human Relationship Phenomenology].

PubMed

Casciano, Antonio

2018-01-01

Ethical and bioethical problems, which are typical of the practice of surrogate motherhood, refer to its protagonists: the couple that orders it, due to its demand to satisfy the desire of paternity and maternity and the promptness of having a female body to fulfill its aspirations; the expectant mother, and the physical and psychic repercussions coming from the role performed in the surrogacy contract, as well as the risks of manipulation and exploitation, related to her position; the baby and his right to grow counting on the certainty of his parental relationships and on the preservation of his emotional balance. The human and anthropological importance of these issues, along with the growing development of this practice in the world, has questioned our moral conscience. In this context, the expectant mother, the weakest and the most affected part among the parts involved in the surrogacy contract, demands a particular attention. In this sense, the aim of this work is to lead a phenomenological analysis of the different steps of the practice of surrogacy, from the first stage of collection and classification of the information referring to the candidates, to the stage of the insemination and of its consequences about to the private life of the expectant. On the other hand, this work tries to justify the existence of a parallelism, as for the exploitation of the female body, between the practice of surrogate motherhood and prostitution. Finally, the issue relating to the effective social emancipation of the surrogate women in poor countries, the real autonomy and the freedom of their decision, as well as the typical features of the desire of paternity of the ordering couple are dealt with. The carried out study has allowed to conclude that this practice always implies a degree of physical, psychic and moral exploitation of the expectant mother, which suggests its prohibition at global level.

[Pedro Laín Entralgo, physician and humanist].

PubMed

Goic, Alejandro

2002-01-01

This speech of the president of the Chilean Academy of Medicine, Dr Alejandro Goic, is a tribute to the memory of the Spanish physician, scholar, historian, writer and intellectual Dr. Pedro Laín Entralgo, who died in Madrid on June 4, 2001, at the age of 93. On that occasion, the Spanish newspaper "El Pais" defined him as the last humanist. The Spanish civil war started when Laín was 28 years old and he aligned with Franco's supporters. In 1940, when he founded the magazine "El Escorial", he was separated from the official party. He and other intellectuals declared themselves in an "interior exile". His autobiographical book, "Lightening the burden on the conscience" refers to his painful personal history. He obtained the History of Medicine chair, at the Complutense University, at the age of 34 and remained at that post until his retirement in 1978. His intellectual production is magnificent and calls to a mutual understanding, hope, friendship and love. Outstanding, among others, are his books "The wait and hope", "Theory and reality of the other", "Spain as a problem", "Medicine and history", "The clinical history", "Patient physician relationship", "Medical anthropology". He directed the collective work composed of seven volumes, called "Universal History of Medicine". He was a member of the Royal Academies for Language, History and Medicine. In Chile, he was named honorary member of the Faculty of Medicine of the University of Chile and of the Academies of Language, History and Medicine. He dictated a course of Medical Anthropology that had a profound impact on the thought of Chilean physicians. In 1949 he wrote that Chile was the most solid state of Latin America and that "Chile needs to leave his traditional calm, through a historical gesture, and create the river beds required by his magnificent spiritual and geographical gifts. There is a lack of a beautiful craziness". It was an invocation for an understanding with our neighboring countries "for ever and ever".

A Cultural Conscience for Conservation

PubMed Central

Good, Caroline; Burnham, Dawn; Macdonald, David W.

2017-01-01

Simple Summary This opinion piece explores how implementing a species royalty for the use of animal symbolism in affluent cultural economies could revolutionise conservation funding. A revenue revolution of this scale is urgently necessary to confront the sixth mass extinction that the planet is now facing. But such a revolution can only occur if the approach to conservation now evolves quickly across disciplines, continents, cultures and economies. This piece is a call to action for research-, culture-, and business-communities to implement a new ethical phase in economic policy that recognises the global cultural debt to the world’s most charismatic wildlife species. Abstract On 2 July 2015, the killing of a lion nicknamed “Cecil” prompted the largest global reaction in the history of wildlife conservation. In response to this, it is propitious to consider the ways in which this moment can be developed into a financial movement to transform the conservation of species such as the lion that hold cultural significance and sentiment but whose numbers in the wild are dwindling dangerously. This provocative piece explores how a species royalty could be used effectively by drawing revenue from the heavy symbolic use of charismatic animals in affluent economies. This would, in turn, reduce strain on limited government funds in threatened animals’ native homelands. Three potential areas of lucrative animal symbolism—fashion, sports mascots, and national animals—provide examples of the kind of revenue that could be created from a species royalty. These examples also demonstrate how this royalty could prove to be a desirable means by which both corporations and consumers could positively develop their desired selves while simultaneously contributing to a relevant and urgent cause. These examples intend to ignite a multi-disciplinary conversation on the global cultural economy’s use of endangered species symbols. An overhaul in perspective and practice is needed because time is running out for much of the wildlife and their ecosystems that embellish products and embody anthropocentric business identities. PMID:28726725

Why patients have a moral obligation to give care to clinicians.

PubMed

Buetow, Stephen

2014-12-01

Progress is being made in transitioning from clinicians who are torn between caring for patients and populations, to clinicians who are partnering with patients to care for patients as people. However, the focus is still on what patients and others can do for patients, however defined. For clinicians whose interests must be similarly respected for their own sake and because they are integrally related to those of patients, what can and should patients do? Patients can be exempted from some normal social roles but are generally recognized to have moral obligations in health care. One of these obligations is caregiving to clinicians within the limits of each patient's capability. My paper moves this obligation beyond the ceremonial order of etiquette characterizing public statements on how patients should relate to others. It goes beyond a patient-centred ethic that is consumerist in nature, to a person-centred one that recognizes patients typically as moral agents who are dignified by recognizing the obligation to give as well as receive care as sincere benevolence. This obligation derives objective justification from divine command. It is also consistent, however, both with what people, if ignorant of their social role, would objectively produce for a hypothetical social contract, and with virtues constitutive of human nature and a relational and communitarian understanding of what it is to be a person. Including sentiment (intuition) and personal conscience, this relational identity makes caregiving intrinsically meaningful, yet caregiving also has an instrumental value to patients and clinicians. Its self-enforcement by patients will depend on their moral code and on society making caregiving achievable for them. A moral obligation for patient caregiving may then be specified to require patients to reflect on and invest in relationships in which they can feel and show care for others sincerely and respectfully. © 2014 John Wiley & Sons, Ltd.

Participation of nurses in abortions.

PubMed

Neustatter, P L

1980-11-29

Doctors for a Woman's Choice on Abortion would agree with 1 point in Lord Denning's ruling on the role of nurses in abortions induced by (PGS) prostaglandins (November 15, p. 1091). The nurse should not be doing a doctor's job, as Lord Denning indicated, and we sympathize with any nurse who is doing so (though the 1967 Abortion Act allows any nurse to abstain, on grounds of conscience). However, the ruling that nurses are not legally covered to participate in any way with the "procuring of a miscarriage" (using terminology of the 1861 Offenses against the Persons Act upon which the ruling is based) does not require a radical change in the practice of late abortions (constituting only 7% of the terminations) or any change in the law. PG abortion can be done without a nurse. With the extraamniotic technique, a very cheap pump can be used to give subsequent doses of the PG (a function normally performed by a nurse) through the catheter left inserted through the cervix after the 1st dose has been given by the doctor. Alternatively, the intraamniotic method can be used, where PG is instilled into the amniotic sac via a needle passed through the abdominal wall. This normally requires only 1 dose, given by the doctor. Rarely are subsequent doses needed; however they could be given by the doctor with very little addition to his or her workload. While the fact that PG abortion can be done without nurses is not realized, late abortion will be restricted, a situation which is entirely deplorable. Also deplorable are the comments of an antiabortion nature made by Lord Denning, over and above the legal ruling in his jurisdiction to make. His ruling, furthermore, seems to have been sufficiently confused for the Department of Health to withdraw its circular on abortion and await an interpretation before issuing another.

Ethical reflections on end-of-life signs and symptoms in the intensive care setting: a place for neuromuscular blockers?

PubMed

Daubin, Cédric; Haddad, Lise; Folscheid, Dominique; Boyer, Alexandre; Chalumeau-Lemoine, Ludivine; Guisset, Olivier; Hubert, Philippe; Pillot, Jérôme; Robert, René; Dreyfuss, Didier

2014-01-01

The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable "sight" because the physical manifestations are hard to watch and can lead to subjective interpretation and irrational fears. Ethical unease arises as the dying patient falls prey to death throes and to the manifestations of ebbing life and the physician can only stand by and watch. From this point on, medicine can put an end to suffering by the use of neuromuscular blockade, but in so doing life ceases at the same time. It is difficult, however, not to respond to the distress of loved ones and caregivers. The ethical problem then becomes the shift from the original ethical concern, i.e. the dying patient, to the patient's loved ones. Is such a rupture due to a difference in nature or a difference in degree, given that the dying patient remains a person and not a thing as long as the body continues to lead its own life, expressed through movement and sound? Because there cannot be any simple and unequivocal answer to this question, the SRLF Ethics Commission is offering ethical reflections on end-of-life signs and symptoms in the intensive care setting, and on the use of neuromuscular blockade in this context, with presentations on the subject by two philosophers and members of the SRLF Ethics Commission, Ms Lise Haddad and Prof Dominique Folscheid. The SRLF Ethics Commission hopes to provide food for thought for everyone on this topic, which undoubtedly calls for further contributions, the aim being not to provide ready-made solutions or policy, but rather to allow everyone to ponder this question in all conscience.

Le syndrome d'embolie graisseuse post traumatique

PubMed Central

Berdai, Adnane Mohamed; Shimi, Abdelkarim; Khatouf, Mohammed

2014-01-01

Le syndrome d'embolie graisseuse est une complication grave des fractures des os longs, il est la conséquence de la dissémination des particules graisseuses dans la microcirculation. L'objectif de ce travail est de déterminer le profil épidémiologique, la présentation clinique et paraclinique de ce syndrome et sa prise en charge thérapeutique. Notre étude porte sur 11 cas de syndrome d'embolie graisseuse colligés au service de réanimation A1 au centre hospitalier universitaire Hassan II de Fès, de Janvier 2009 à Juin 2012. Le diagnostic positif est basé sur les critères de Gurd. Les cas collectés se caractérisent par la prédominance du sexe masculin, d'un âge inférieur à 40 ans, présentant une fracture fémorale. Ce syndrome survient souvent dans les 72 heures après le traumatisme. La présentation clinique est dominée par l'hypoxémie et les troubles de conscience. Sur le plan biologique: l'anémie et la thrombopénie sont les manifestations les plus fréquentes. La prise en charge est symptomatique, 63% des patients ont nécessité l'intubation et la ventilation. L’évolution n'est pas toujours bénigne. Nos résultats confirme le polymorphisme de la présentation clinique et paraclinique du syndrome d'embolie graisseuse. Le diagnostic de ce syndrome se base sur des critères cliniques, mais reste essentiellement un diagnostic d’élimination. La prise en charge est symptomatique. La prévention de ce syndrome est essentielle et se base sur une fixation précoce des fractures des os longs. PMID:25452829

Atto-Joule, high-speed, low-loss plasmonic modulator based on adiabatic coupled waveguides

NASA Astrophysics Data System (ADS)

Dalir, Hamed; Mokhtari-Koushyar, Farzad; Zand, Iman; Heidari, Elham; Xu, Xiaochuan; Pan, Zeyu; Sun, Shuai; Amin, Rubab; Sorger, Volker J.; Chen, Ray T.

2018-05-01

In atomic multi-level systems, adiabatic elimination (AE) is a method used to minimize complicity of the system by eliminating irrelevant and strongly coupled levels by detuning them from one another. Such a three-level system, for instance, can be mapped onto physically in the form of a three-waveguide system. Actively detuning the coupling strength between the respective waveguide modes allows modulating light to propagate through the device, as proposed here. The outer waveguides act as an effective two-photonic-mode system similar to ground and excited states of a three-level atomic system, while the center waveguide is partially plasmonic. In AE regime, the amplitude of the middle waveguide oscillates much faster when compared to the outer waveguides leading to a vanishing field build up. As a result, the plasmonic intermediate waveguide becomes a "dark state," hence nearly zero decibel insertion loss is expected with modulation depth (extinction ratio) exceeding 25 dB. Here, the modulation mechanism relies on switching this waveguide system from a critical coupling regime to AE condition via electrostatically tuning the free-carrier concentration and hence the optical index of a thin indium thin oxide (ITO) layer resides in the plasmonic center waveguide. This alters the effective coupling length and the phase mismatching condition thus modulating in each of its outer waveguides. Our results also promise a power consumption as low as 49.74aJ/bit. Besides, we expected a modulation speed of 160 GHz reaching to millimeter wave range applications. Such anticipated performance is a direct result of both the unity-strong tunability of the plasmonic optical mode in conjunction with utilizing ultra-sensitive modal coupling between the critically coupled and the AE regimes. When taken together, this new class of modulators paves the way for next generation both for energy and speed conscience optical short-reach communication such as those found in interconnects.

Further clarity on cooperation and morality.

PubMed

Oderberg, David S

2017-04-01

I explore the increasingly important issue of cooperation in immoral actions, particularly in connection with healthcare. Conscientious objection, especially as pertains to religious freedom in healthcare, has become a pressing issue in the light of the US Supreme Court judgement in Hobby Lobby Section 'Moral evaluation using the basic principles of cooperation' outlines a theory of cooperation inspired by Catholic moral theologians such as those cited by the court. The theory has independent plausibility and is at least worthy of serious consideration-in part because it is an instance of double-effect reasoning, which is also independently plausible despite its association with moral theology. Section 'Case study: Burwell v. Hobby Lobby ' examines Hobby Lobby in detail. Even if the judgement was correct in that case the reasoning was not, as it involved applying a 'mere sincerity' test to the cooperation question. The mere sincerity test leads to absurd consequences, whereas a reasonableness test applied using the theory of cooperation defended here would avoid absurdity. Section 'A question of remoteness: "accommodations" and opt-outs' explores the post- Hobby Lobby problem further, examining opt-outs and accommodations: the Little Sisters of the Poor case shows how opt-outs are misunderstood on a mere sincerity test, which the court rightly rejected. Section 'Application to the medical field: Doogan and Wood ' discusses the UK case of Doogan and Wood , concerning participation in abortion. Again, a judicially recognised ethic of cooperation, if it were part of the fabric of legal reasoning in such cases, would have enabled the conscientious objectors in this and similar situations to have their freedom of conscience and religion respected in a way that it currently is not. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The Moon as a unifying sociological attraction

NASA Astrophysics Data System (ADS)

Barbieri, C.; Pachera, S.; Ciucci, A.

We propose to develop an economic, fully automated telescope to equip a variety of public and private buildings, such as disco dancings, pubs, resting houses, hospitals, schools etc., optimized to image and project the Moon, both in daylight and nightime. We strongly believe that the wide spread conscience of being part of a common Universe, by imaging the real Moon ( not a series of computer files) and following its changing course, distributed in places where the soul is usually taken in a wave of loneliness, can have a profound effect. In fact, living such an experience of observation in places where people of all ages usually meet, can help them to mix up socially and have fun and acquire new interests and fulfillment. They could confront their doubts, opinions, curiosity. The Moon is the natural choice, being visible even in polluted cities, it comes to the Zenith of a large band on the Earth encompassing each emisphere, it has deeply rooted meanings in all civilizations, and it is therefore the perfect astronomical object towards which humanity should direct its view above the ground. The possibility of the instrument to zoom in and out and to move across the surface of the Moon or to observe in real time the slowly moving line of the terminator, is intended just for the sheer wonder of it. No didactic use is meant to begin with, although interest is sure to be stimulated and may be followed up in many ways. Our object is indeed to make young and older people throughout the world feel our satellite nearer and more familiar in the shapes and names of its features, truly a constant presence in our everyday natural surroundings. When the time will come for human coloniz ation, the Moon could no longer be considered such an extraneous, exotic and faraway new home. The telescope can be built in very large quantities by a variety of firms practically even in underdeveloped countries, easily automated and connected to the world wide web.

Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial.

PubMed

Bölenius, Karin; Lämås, Kristina; Sandman, Per-Olof; Edvardsson, David

2017-02-16

The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people. NCT02846246 .

Environmental Education Project for Developing Supersphere Characters in Children's Books

NASA Astrophysics Data System (ADS)

Vasconcelos, G. F.

2014-12-01

To raise awareness and provide basic knowledge about the environment, three children's books have been created to explain, in a simplified language, the basic processes of formation of the Earth, the origin of the universe, the planets and the moon, volcanism, rock formation and the appearance of water, the earliest life forms and their evolution and the main elements of Earth. These phenomena are represented through the main characters who are super heroes or designated Superspheres, such as Hydrosphere (water), Lithosphere (rocks), Biosphere (Polite, a stromatolite and Sarite, the mineral dolomite), Atmosphere (air), which are the 4 components of the Earth System, and the Pyrosphere(fire), which supplies the energy to drive the Earth System through volcanic activity. The characters have each developed super powers that evolved over geological time as they are transformed. They are the basic elements of nature and appear in a specific chronological order. With the emergence of ancient life in the seas, the Biosphere begins to use the energy of the sun, through of the photosynthetic activity of stromatolites, one of the friends of the superheroes, to produce the oxygen for the Atmosphere. Over a vast period of time, the evolution of life continues with the formation of the supercontinent Gondwana. With the arrival of man and his interaction with the Earth, the villain appears in the book as the "Homo incorrectus" (incorrect man), who abuses and tries to destroy the super heroes, the "Superspheres". The importance of these characters for the living Earth is emphasized, creating a connection between children and the characters. The aim of the story is to create a greater ecological conscience in the children and showing them that they should be helping to save the "Superspheres", who are in danger and need to be preserved. Projects for primary schools in the State of Rio de Janeiro have been designed and implemented around these characters, focusing on the rescue of each of these "Superspheres" and their importance for the local geological heritage of the region.

At first glance, informal payments experience on track: why accept or refuse? Patients' perceive in cardiac surgery department of public hospitals, northeast of Iran 2013.

PubMed

Vafaei Najar, Ali; Ebrahimipour, Hossein; Pourtaleb, Arefeh; Esmaily, Habibollah; Jafari, Mehdi; Nejatzadegan, Zohre; Taleghani, Yasamin Molavi

2017-03-14

Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews. We used quantitative content analysis for open-ended questions besides descriptive statistics and nonparametric tests by SPSS 16 at 0.05 Sig level. Sixteen (5.93%) patients made voluntary informal payments. The purpose of payment was: "gratitude" (43.75%), satisfaction with health services provided" (31.25%) and (18.75%) for better quality of services. About 75% of the payments were occurred during receiving health care services. The main causes were "no request for informal payments" (98.14%), "not affording to pay for informal payments" (73.33%) and "paying the hospital expenses by taking out a loan" (55.91%). Responders said they would pay informally in demand situation (51.85%) just for patient's health priority, 40.71% would also "search for other alternative solutions" and 27.33% "accepted the demand as a kind of gratitude culture". Twenty four patients (8.9%) had experienced mandatory informal payments during the last 6 months. The minimum amount of payment was 62.5$ and the maximum was 3125$. There was a significant relationship between the way of referring to medical centers and informal patient's payment (P ≤0.05). Despite the widespread prevalent belief about informal payments in public hospitals -particularly to the well-known physicians - such judgment cannot be generalized. The main reasons for the low informal payments in the current study were the personality characteristics of the physicians and hospital staff, their moral conscience and commitment to professional ethics, cultural factors and social-economic status of the patients. Health care system should notify people about their rights specially the payments calculation mechanism and methods. Better communication with the public and especially the media can help to correct attitude toward these payments.

A kidney from hell? A nephrological view of the Whitechapel murders in 1888.

PubMed

Wolf, Gunter

2008-10-01

In the poor Whitechapel district of the East End of London in the fall of 1888, at least five prostitutes were brutally murdered, and in all but one case, also mutilated. The murderer was never caught and became known by his nickname 'Jack the Ripper'. The left kidney and the uterus were cut out and taken away from one of the victims named Catherine Eddowes. A kidney was also cut out of the body from another victim, but not taken away. Two weeks later, George Lusk, president of the Whitechapel Vigilance Committee, received a small cardboard box with half of a longitudinally divided kidney and a letter entitled 'From hell' claiming that the kidney inside the box was taken from the victim. The kidney was brought to Dr Thomas Horrocks Openshaw, the Curator of the London Pathological Museum, where the kidney could be microscopically examined. The press jumped on the topic and made a circumstantial case that this kidney had been indeed torn from the body of Catherine Eddowes. According to the later memoirs of Major Henry Smith of the City Police published more than 20 years after the incident, the kidney left in the corpse of Catherine Eddowes was in an advanced stage of Bright's disease and the kidney sent to George Lusk was in exactly a similar stage. Today, the majority of criminologists believe that the kidney sent to Mr Lusk was a hoax as were other letters signed with Jack the Ripper. However, the murderer took organs from his victims, and in the case of Catherine Eddowes, the kidney. Serial killers often mutilate their victims and abscond with the removed body parts as trophies. By removing the kidney from Catherine Eddowes, Jack the Ripper may have tried to take possession of the conscience, emotions and desires of one of his victims, attributes residing in the kidney as described in the Bible. Jack the Ripper was never caught; many suspects have been suggested, and the murder series ended as suddenly as it had begun. We will never know who this mentally disturbed 'nephrophilic' was. Today, the story of Jack the Ripper is part of contemporary culture.

The Human Capital of Knowledge Brokers: An analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health.

PubMed

Jessani, Nasreen; Kennedy, Caitlin; Bennett, Sara

2016-08-02

Academic faculty involved in public health teaching and research serve as the link and catalyst for knowledge synthesis and exchange, enabling the flow of information resources, and nurturing relations between 'two distinct communities' - researchers and policymakers - who would not otherwise have the opportunity to interact. Their role and their characteristics are of particular interest, therefore, in the health research, policy and practice arena, particularly in low- and middle-income countries. We investigated the individual attributes, capacities and skills of academic faculty identified as knowledge brokers (KBs) in schools of public health (SPH) in Kenya with a view to informing organisational policies around the recruitment, retention and development of faculty KBs. During April 2013, we interviewed 12 academics and faculty leadership (including those who had previously been identified as KBs) from six SPHs in Kenya, and 11 national health policymakers with whom they interact. Data were qualitatively analyzed using inductive thematic analysis to unveil key characteristics. Key characteristics of KBs fell into five categories: sociodemographics, professional competence, experiential knowledge, interactive skills and personal disposition. KBs' reputations benefitted from their professional qualifications and content expertise. Practical knowledge in policy-relevant situations, and the related professional networks, allowed KB's to navigate both the academic and policy arenas and also to leverage the necessary connections required for policy influence. Attributes, such as respect and a social conscience, were also important KB characteristics. Several changes in Kenya are likely to compel academics to engage increasingly with policymakers at an enhanced level of debate, deliberation and discussion in the future. By recognising existing KBs, supporting the emergence of potential KBs, and systematically hiring faculty with KB-specific characteristics, SPHs can enhance their collective human capital and influence on public health policy and practice. Capacity strengthening of tangible skills and recognition of less tangible personality characteristics could contribute to enhanced academic-policymaker networks. These, in turn, could contribute to the relevance of SPH research and teaching programs as well as evidence-informed public health policies.

Ethical reflections on end-of-life signs and symptoms in the intensive care setting: a place for neuromuscular blockers?

PubMed Central

2014-01-01

The death of a loved one is often an ordeal and a tragedy for those who witness it, as death is not merely the end of a life, but also the end of an existence, the loss of a unique individual who is special and irreplaceable. In some situations, end-of-life signs, such as agonal gasps, can be an almost unbearable “sight” because the physical manifestations are hard to watch and can lead to subjective interpretation and irrational fears. Ethical unease arises as the dying patient falls prey to death throes and to the manifestations of ebbing life and the physician can only stand by and watch. From this point on, medicine can put an end to suffering by the use of neuromuscular blockade, but in so doing life ceases at the same time. It is difficult, however, not to respond to the distress of loved ones and caregivers. The ethical problem then becomes the shift from the original ethical concern, i.e. the dying patient, to the patient’s loved ones. Is such a rupture due to a difference in nature or a difference in degree, given that the dying patient remains a person and not a thing as long as the body continues to lead its own life, expressed through movement and sound? Because there cannot be any simple and unequivocal answer to this question, the SRLF Ethics Commission is offering ethical reflections on end-of-life signs and symptoms in the intensive care setting, and on the use of neuromuscular blockade in this context, with presentations on the subject by two philosophers and members of the SRLF Ethics Commission, Ms Lise Haddad and Prof Dominique Folscheid. The SRLF Ethics Commission hopes to provide food for thought for everyone on this topic, which undoubtedly calls for further contributions, the aim being not to provide ready-made solutions or policy, but rather to allow everyone to ponder this question in all conscience. PMID:25045580

[Review of the effects of mindfulness meditation on mental and physical health and its mechanisms of action].

PubMed

Ngô, Thanh-Lan

2013-01-01

Interventions based on mindfulness have become increasingly popular. This article reviews the empirical literature on its effects on mental and physical health, discusses presumed mechanisms of action as well as its proposed neurobiological underpinning. Mindfulness is associated with increased well-being as well as reduced cognitive reactivity and behavioral avoidance. It seems to contribute to enhance immune functions, diminish inflammation, diminish the reactivity of the autonomic nervous system, increase telomerase activity, lead to higher levels of plasmatic melatonin and serotonin. It enhances the quality of life for patients suffering from chronic pain, fibromylagia and HIV infection. It facilitates adaptation to the diagnosis of cancer and diabetes. It seems to lead to symptomatic improvement in irritable bowel syndrome, chronic fatigue syndrome, hot flashes, insomnia, stress related hyperphagia. It diminishes craving in substance abuse. The proposed mechanism of action are enhanced metacognitive conscience, interoceptive exposure, experiential acceptance, self-management, attention control, memory, relaxation. Six mechanism of actions for which neurological underpinnings have been published are: attention regulation (anterior cingulate cortex), body awareness (insula, temporoparietal junction), emotion regulation (modulation of the amygdala by the lateral prefrontal cortex), cognitive re-evaluation (activation of the dorsal medial prefrontal cortex or diminished activity in prefrontal regions), exposure/extinction/reconsolidation (ventromedial prefrontal cortex, hippocampus, amygdala) and flexible self-concept (prefrontal median cortex, posterior cingulated cortex, insula, temporoparietal junction). The neurobiological effects of meditation are described. These are: (1) the deactivation of the default mode network that generates spontaneous thoughts, contributes to the maintenance of the autobiographical self and is associated with anxiety and depression; (2) the anterior cingulate cortex that underpins attention functions; (3) the anterior insula associated with the perception of visceral sensation, the detection of heartbeat and respiratory rate, and the affective response to pain; (4) the posterior cingulate cortex which helps to understand the context from which a stimulus emerges; (5) the temporoparietal junction which assumes a central role in empathy and compassion; (6) the amygdala implicated in fear responses. The article ends with a short review of the empirical basis supporting the efficacy for mindfulness based intervention and suggested directions for future research.

A critical analysis of the End of Life Choice Bill 2013.

PubMed

Richmond, David E

2014-07-04

This paper aims to alert medical practitioners to the legal and ethical problems that passage of the End of Life Choice Bill (which seeks to legalise euthanasia and physician-assisted suicide) would have for them in New Zealand. Although sponsor MP Maryan Street withdrew the Bill on political grounds in October 2013, she has pledged to reintroduce the Bill after the next Parliamentary elections and remains committed to its objectives. A clause by clause analysis of the Bill was undertaken from a clinical perspective, following the sequence of requesting, validating, providing and reporting episodes of euthanasia or physician-assisted suicide rather than following the administrative sequence in which the Bill has been drawn up for Parliamentary debate. Where possible, the experience of other jurisdictions where these end of life options are legal has been drawn upon to enable inferences to be drawn as to the likely effects of the legislation. The analysis supporting this paper reveals that the legislation would: make it possible for virtually any person over the age of 18 to request and receive euthanasia provided they took care in the way they phrased the request, expose medical practitioners who attempted to deter applicants too vigorously to the possibility of legal action on the grounds of attempting to frustrate the applicant's wishes, compromise the ability of practitioners to opt out on conscience grounds, allow the easy circumvention of reporting requirements for each event, provide minimal protection against some people suffering euthanasia without consent or request, and exempt medical practitioners providing euthanasia services from prosecution for any action in the provision of such services, even if they were negligent. The branch of medical practice that specialises in killing people would be the least regulated of all. If passed into legislation, the End of Life Choice Bill will create the most momentous changes to clinical practice and the regulation of certain professional activities of medical practitioners that this country has ever seen. Whether they choose to be or not, sooner or later every medical practitioner will be affected by the legislation. It therefore behoves every medical practitioner to examine and understand this Bill and its implications.

Caring in context: caring practices in a sample of Hong Kong nurses.

PubMed

Arthur, D; Pang, S; Wong, T

1998-12-01

In an effort to place the international literature and research in nursing in a Chinese cultural context a study was commenced to examine the caring practices of nurses in Hong Kong. In view of a recent study (Wilkes & Wallis, 1993) which utilised Roach's 5Cs of caring (Roach, 1987, 1992), a pilot study was commenced on a sample of 77 Hong Kong Registered Nurses studying a Diploma of Nursing. An open ended questionnaire was designed which asked nurses to respond to questions about caring in general and the 5Cs: compassion, competence, confidence, conscience and commitment. The questions asked what each of the concepts meant to them as a nurse. Data was analysed into themes based on key words for each of the six areas revealing that the sample of Hong Kong nurses viewed caring in a similar light to those in overseas studies. The sample highlighted compassion and competence as their major features and it is suggested that methodological problems may have inhibited a deeper analysis of their caring attributes and behaviours. When asked to expand on the 5 Cs in terms of their own practice they were able to supply themes which were closely related to Roach's definitions but which may have been more 'textbook' in their origin and certainly lacked a richness of response. The paucity of responses in terms of clarity and richness of data, followed by discussions with the participants led to conclusions about the methodological issues of cross-cultural research and recommendations for future research are made. Highlighted are the problems with attempting to use concepts such as the 5 Cs across cultures and the problems encountered with translation of concepts related to caring from Chinese into English, and vice-versa. The study has provided some insights into the concepts of caring in Hong Kong Chinese nurses. In the light of advances in China and unification of previously separate countries these findings provide and offer insights into nursing in China and are encouraging for future research.

Intricate Assessment and Evaluation of Effect of Bruxism on Long-term Survival and Failure of Dental Implants: A Comparative Study.

PubMed

Yadav, Kajal; Nagpal, Abhishek; Agarwal, S K; Kochhar, Aarti

2016-08-01

Dental implants are one of the common lines of treatment used for the treatment of missing tooth. Various risk factors are responsible for the failure of the dental implants and occurrence of postoperative complications. Bruxism is one such factor responsible for the failure of the dental implants. The actual relation between bruxism and dental implants is a subject of long-term controversy. Hence, we carried out this retrospective analysis to assess the complications occurring in dental implants in patients with and without bruxism. The present study included 1100 patients which were treated for rehabilitation by dental implant procedure at 21 dental offices of Ghaziabad (India) from 2004 to 2014. Analyzing the clinical records of the patients along with assessing the photographs of the patients was done for confirming the diagnosis of bruxism. Clinical re-evaluation of the patients, who came back for follow-up, was done to confirm the diagnosis of bruxism. Systemic questionnaires as used by previous workers were used to evaluate the patients about the self-conscience of the condition. Estimation of the mechanical complications was done only in those cases which occurred on the surfaces of the restoration of the dental implants. All the results were analyzed by Statistical Package for Social Sciences (SPSS) software. Student's t-test and Pearson's chi-square test were used to evaluate the level of significance. In both bruxer and non-bruxers, maximum number of dental implants was placed in anterior maxillary region. Significant difference was obtained while comparing the two groups for dimensions of the dental implants used. On comparing the total implant failed cases between bruxers and non-bruxers group, statistically significant result was obtained. Statistically significant difference was obtained while comparing the two study groups based on the health parameters, namely hypertension, diabetes, and smoking habit. Success of dental implant is significantly affected by bruxism. Special attention is required in such patients while doing treatment planning. For the long-term clinical success and survival of dental implants in patients, special emphasis should be given on the patient's deleterious oral habits, such as bruxism as in long run, they influence the stability of dental implants.

[Do you know "Humanae Vitae"?].

PubMed

Gakwaya, D

1993-04-01

This work, appearing on the 25th anniversary of "Humanae Vitae," describes the contents of the encyclical on family planning, summarizes reactions to it from western church leaders, and reflects on its relevance to modern societies. "Humanae Vitae" begins with a statement acknowledging the problems posed by population growth to societies and to individual families. Deteriorating conditions of housing and employment and increasing economic and educational inadequacies often make it difficult to raise large families in the modern world. Views of the role of women in society and of the value of marital love and the significance of the sex act in relation to marital love have undergone change. The document raised the question of whether it is time to entrust to couples greater responsibility in regulating their fertility. The document referred to the reasons why the Pope and the Church have the authority to answer such a question and described the care with which the document was prepared before moving to the second major part of the article, that concerning doctrinal principles. After remarking on the respect due to nature, to the purposes of the conjugal act which were identified as union and procreation, and to faithfulness to God's design, the Pope moved on to condemn means of birth regulation termed illicit, which include abortion and direct sterilization as well as contraception. 2 exceptions were recognized, therapeutic sterilization and recourse to infertile periods for couples who for serious reasons wished to avoid pregnancy. The third section instructed priests, couples, bishops, and others in their duties in relation to the contents of Humanae Vitae. The encyclical was praised by some church leaders but also questioned. The fact that the work was not presented as infallible and possible conflicts with the duty of men affirmed in Vatican II not to act against their consciences were noted. When Humanae Vitae was published, the world population was 3.6 billion. By 1992 it was 5.479 billion. Since the encyclical was not presented as infallible, an opening presumably exist to adapt its message to current realities.

Conscientious objection to sexual and reproductive health services: international human rights standards and European law and practice.

PubMed

Zampas, Christina; Andión-Ibañez, Ximena

2012-06-01

The practice of conscientious objection often arises in the area of individuals refusing to fulfil compulsory military service requirements and is based on the right to freedom of thought, conscience and religion as protected by national, international and regional human rights law. The practice of conscientious objection also arises in the field of health care, when individual health care providers or institutions refuse to provide certain health services based on religious, moral or philosophical objections. The use of conscientious objection by health care providers to reproductive health care services, including abortion, contraceptive prescriptions, and prenatal tests, among other services is a growing phenomena throughout Europe. However, despite recent progress from the European Court of Human Rights on this issue (RR v. Poland, 2011), countries and international and regional bodies generally have failed to comprehensively and effectively regulate this practice, denying many women reproductive health care services they are legally entitled to receive. The Italian Ministry of Health reported that in 2008 nearly 70% of gynaecologists in Italy refuse to perform abortions on moral grounds. It found that between 2003 and 2007 the number of gynaecologists invoking conscientious objection in their refusal to perform an abortion rose from 58.7 percent to 69.2 percent. Italy is not alone in Europe, for example, the practice is prevalent in Poland, Slovakia, and is growing in the United Kingdom. This article outlines the international and regional human rights obligations and medical standards on this issue, and highlights some of the main gaps in these standards. It illustrates how European countries regulate or fail to regulate conscientious objection and how these regulations are working in practice, including examples of jurisprudence from national level courts and cases before the European Court of Human Rights. Finally, the article will provide recommendations to national governments as well as to international and regional bodies on how to regulate conscientious objection so as to both respect the practice of conscientious objection while protecting individual's right to reproductive health care.

A person-centred and thriving-promoting intervention in nursing homes - study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial.

PubMed

Edvardsson, David; Sjögren, Karin; Lood, Qarin; Bergland, Ådel; Kirkevold, Marit; Sandman, Per-Olof

2017-01-17

The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this. The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents' thriving, relatives' satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives' experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention. The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care. The trial was registered at ClinicalTrials.gov March 19, 2016, identifier NCT02714452 .

Measurement of body temperature in adult patients: comparative study of accuracy, reliability and validity of different devices.

PubMed

Rubia-Rubia, J; Arias, A; Sierra, A; Aguirre-Jaime, A

2011-07-01

We compared a range of alternative devices with core body temperature measured at the pulmonary artery to identify the most valid and reliable instrument for measuring temperature in routine conditions in health services. 201 patients from the intensive care unit of the Candelaria University Hospital, Canary Islands, admitted to hospital between April 2006 and July 2007. All patients (or their families) gave informed consent. Readings from gallium-in-glass, reactive strip and digital in axilla, infra-red ear and frontal thermometers were compared with the pulmonary artery core temperature simultaneously. External factors suspected of having an influence on the differences were explored. The cut-off point readings for each thermometer were fixed for the maximum negative predictive value in comparison with the core temperature. The validity, reliability, accuracy, external influence, the waste they generated, ease of use, speed, durability, security, comfort and cost of each thermometer was evaluated. An ad hoc overall valuation score was obtained from these parameters for each instrument. For an error of ± 0.2°C and concordance with respect to fever, the gallium-in-glass thermometer gave the best results. The largest area under the receiver operating characteristic (ROC) curve is obtained by the digital axillar thermometer with probe (0.988 ± 0.007). The minimum difference between readings was given by the infrared ear thermometer, in comparison with the core temperature (-0.1 ± 0.3°C). Age, weight, level of conscience, male sex, environmental temperature and vaso-constrictor medication increases the difference in the readings and fever treatment reduces it, although this is not the same for all thermometers. The compact digital axillar thermometer and the digital thermometer with probe obtained the highest overall valuation score. If we only evaluate the aspects of validity, reliability, accuracy and external influence, the best thermometer would be the gallium-in-glass after 12 min. The gallium-in-glass thermometer is less accurate after only 5 min in comparison with the reading taken after being placed for 12 min. If we add the evaluation of waste production, ease-of-use, speed, durability, security, patient comfort and costs, the thermometers that obtain the highest score are the compact digital and digital with probe in right axilla. Copyright © 2010 Elsevier Ltd. All rights reserved.

Identifying microbial carbon sources during ethanol and toluene biodegradation in a pilot-scale experimental aquifer system using isotopic analysis

NASA Astrophysics Data System (ADS)

Clay, S.; McLeod, H.; Smith, J. E.; Roy, J. W.; Slater, G. F.

2013-12-01

Combining ethanol with gasoline has become increasingly common in order to create more environmentally conscience transportation fuels. These blended fuels are favourable alternatives since ethanol is a non-toxic and highly labile renewable biomass-based resource which is an effective fuel oxygenate that reduces air pollution. Recent research however, has indicated that upon accidental release into groundwater systems, the preferential microbial metabolism of ethanol can cause progressively reducing conditions leading to slower biodegradation of petroleum hydrocarbons. Therefore, the presence of ethanol can result in greater persistence of BTEX compounds and longer hydrocarbon plumes in groundwater systems. Microbial biodegradation and community carbon sources coupled to aqueous geochemistry were monitored in a pilot-scale laboratory tank (80cm x 525cm x 175cm) simulating an unconfined sand aquifer. Dissolved ethanol and toluene were continuously injected into the aquifer at a controlled rate over 330 days. Carbon isotope analyses were performed on phospholipid fatty acid (PLFA) samples collected from 4 different locations along the aquifer. Initial stable carbon isotope values measured over days 160-185 in the bacterial PLFA ranged from δ13C = -10 to -21‰, which is indicative of dominant ethanol incorporation by the micro-organisms based on the isotopic signature of ethanol derived from corn, a C4 plant. A negative shift to δ13C = -10 to -30‰ observed over days 185-200, suggests a change in microbial metabolisms associated with less ethanol incorporation. This generally corresponds to a decrease in ethanol concentrations from day 40 to full attenuation at approximately day 160, and the onset of toluene depletion observed on day 120 and continuing thereafter. In addition, aqueous methane concentrations first detected on day 115 continued to rise to 0.38-0.70 mmol/L at all monitoring locations, demonstrating a significant redox shift to low energy methanogenic metabolisms. On-going archaeal lipid analyses are expected to capture the establishment of methanogenic communities and provide insight into carbon use by these communities. Furthermore, radiocarbon analysis will aid in tracking the biodegradation of ethanol and toluene. Ultimately this research aims to illustrate the preferential biodegradation of ethanol in a gasoline mixture, and identify the carbon sources utilized by an evolving microbial community using isotopic analyses to improve assessments and remediation strategies at sites contaminated with ethanol-blended fuels.

The origins of American health libertarianism.

PubMed

Grossman, Lewis A

2013-01-01

This Article examines Americans' enduring demand for freedom of therapeutic choice as a popular constitutional movement originating in the United States' early years. In exploring extrajudicial advocacy for therapeutic choice between the American Revolution and the Civil War, this piece illustrates how multiple concepts of freedom in addition to bodily freedom bolstered the concept of a constitutional right to medical liberty. There is a deep current of belief in the United States that people have a right to choose their preferred treatments without government interference. Modern American history has given rise to movements for access to abortion, life-ending drugs, unapproved cancer treatments, and medical marijuana. Recently, cries of "Death Panels" have routinely been directed against health care reform proposals that citizens believe would limit the products and procedures covered by government health insurance. Some of the most prominent contemporary struggles for health freedom have been waged in court. But other important recent battles for freedom of therapeutic choice have taken place in other forums, from legislative hearings to Food and Drug Administration advisory committee meetings to public demonstrations. This attitude of therapeutic libertarianism is not new. Drawing mainly on primary historical sources, this Article examines arguments in favor of freedom of therapeutic choice voiced in antebellum America in the context of battles against state licensing regimes. After considering some anti-licensing arguments made before independence, it discusses the views and statements of Benjamin Rush, an influential founding father who was also the most prominent American physician of the early national period. The Article then analyzes the Jacksonian-era battle against medical licensing laws waged by the practitioners and supporters of a school of botanical medicine known as Thomsonianism. This triumphant struggle was waged in explicitly constitutional terms, even though it occurred entirely outside of the courts. The Thomsonian campaign thus offers one of the most striking examples of a successful popular constitutional movement in American history. This article shows that, at its origin, the American commitment to freedom of therapeutic choice was based on notions of not only bodily freedom, but also economic freedom, freedom of conscience, and freedom of injury. Finally, this Article considers ways in which this early history helps illuminate the nature of current struggles for freedom of therapeutic choice.

A simple awareness campaign to promote food waste reduction in a University canteen.

PubMed

Pinto, Renata Soares; Pinto, Renata Machado Dos Santos; Melo, Felipe Fochat Silva; Campos, Suzana Santos; Cordovil, Cláudia Marques-Dos-Santos

2018-03-01

Food waste has important environmental, social and economic impacts and increasing attention has been given lately to the unparalleled scale of food waste in the food supply chain worldwide. An initiative aiming to reduce food waste was tested at the School of Agriculture canteen (University of Lisbon, Portugal). The "Clean dish, clean conscience!" initiative consisted of a simple and inexpensive education campaign to raise awareness of reducing plate waste, by establishing the connection between food waste and personal behaviour. As a first stage plate waste from canteen users was measured over a 10 day period. After this period, a waste consumption index and per capita waste consumption were calculated to evaluate the level of satisfaction of the consumer and the related concern about food wastage, and was classified as Bad. After this first stage it was concluded that the users did not have strong convictions about avoiding food waste. During the second stage of the project an education campaign was implemented with plate waste being monitored for a further 16 days to assess the effectiveness of the campaign. The approach consisted of displaying simple and affordable informative posters in strategic areas of the canteen with simple messages reminding not to accept food they knew they would not eat. This led to a mean reduction in the waste consumption index of ∼15%. A parallel action encouraging separation of organic and inorganic waste was implemented as well, with an active participation of >70% of the users. The initiative achieved its objective of reducing plate waste by raising awareness of the daily food waste problem at the institution's canteen and by suggesting "how-to" actions for reducing such waste. This study showed how avoidable waste can be reduced simply by making students aware of the topic of food waste. Simple strategies may be useful to improve behaviours and increase sustainability of the canteens at Universities although this proved to be only efficient with the collaboration of the canteen staff that needs solid education. From the results, a set of measures was presented to the University Social Services for adoption to ensure a permanent reduction of food waste and recyclables in the University canteens. Copyright © 2018 Elsevier Ltd. All rights reserved.

Historique en grandes enjambées de la thermodynamique de l'équilibre

NASA Astrophysics Data System (ADS)

Hertz, J.

2004-12-01

La Thermodynamique, une science totalement nouvelle au XIXème siècle, a germé en France en contrepoint des idées du siècle des Lumières, dans le milieu particulier des anciens élèves de l’Ecole Polytechnique, officiers supérieurs formés pour l’armée républicaine ou napoléonienne, mais qui ne trouvaient plus leur place dans l’armée de la Restauration. Ils se convertissaient en ingénieurs civils des métiers industriels en pleine expansion, comme le développement de la machine à vapeur ou des chemins de fer. La plupart d’entre eux, plutôt libre-penseurs, adhéraient aux idées scientistes du « positivisme », véhiculées dans les Loges de la Franc-Maçonnerie du Grand Orient de France et plus particulièrement dans les cercles Saint-Simoniens, premiers adeptes du socialisme industriel. C’est ainsi que naquit en 1824, dans le cerveau subtil mais brouillon de Sadi Carnot toute la vision illuminée de cette science nouvelle, incompréhensible pour ses contemporains. Elle ressuscita en 1834 sous la plume d’un Emile Clapeyron qui avait pris conscience de l’immensité de l’œuvre de Sadi Carnot. Mais le rappel de Clapeyron demeura également sans écho pendant dix années. Le réveil de la Thermodynamique se fera désormais hors de France par des hommes de grande pratique religieuse et généralement protestants. C’est ainsi que William Thomson en Ecosse et Rudolph Clausius, venu de Prusse, achevèrent l’œuvre de leurs deux prédécesseurs et que la Thermodynamique mécano-thermique fut définitivement établie en 1864. La thermodynamique chimique peut être attribuée à un seul génie mathématicien, Josiah Willard Gibbs qui travaillait tout seul au Yale College de New-Haven, dans le Connecticut, et rédigea sa nouvelle théorie entre 1875 et 1878. Enfin l’interprétation statistique du second principe sera l’œuvre en 1877 d’un Autrichien, Ludwig Boltzmann, homme génial mais fragile qui eut le temps d’insuffler ses idées sur la quantification de l’énergie à l’Allemand Max Planck, premier prix Nobel de la nouvelle discipline.

Comparison of Mobile Apps for the Leading Causes of Death Among Different Income Zones: A Review of the Literature and App Stores

PubMed Central

2014-01-01

Background The advances achieved in technology, medicine, and communications in the past decades have created an excellent scenario for the improvement and expansion of eHeath and mHealth in particular. Mobile phones, smartphones, and tablets are exceptional means for the application of mobile health, especially for those diseases and health conditions that are the deadliest worldwide. Objective The main aim of this paper was to compare the amount of research and the number of mobile apps dedicated to the diseases and conditions that are the leading causes of death according to the World Health Organization grouped by different income regions. These diseases and conditions were ischemic heart disease; stroke and other cerebrovascular diseases; lower respiratory infections; chronic obstructive pulmonary disease; diarrheal diseases; HIV/AIDS; trachea, bronchus, and lung cancers; malaria; and Alzheimer disease and other dementias. Methods Two reviews were conducted. In the first, the systems IEEE Xplore, Scopus, Web of Knowledge, and PubMed were used to perform a literature review of applications related to the mentioned diseases. The second was developed in the currently most important mobile phone apps stores: Google play, iTunes, BlackBerry World, and Windows Phone Apps+Games. Results Search queries up to June 2013 located 371 papers and 557 apps related to the leading causes of death, and the following findings were obtained. Alzheimer disease and other dementias are included in the diseases with more apps, although it is not among the top 10 causes of death worldwide, whereas lower respiratory infections, the third leading cause of death, is one of the less researched and with fewer apps. Two diseases that are the first and second of low-income countries (lower respiratory infections and diarrheal diseases) have very little research and few commercial applications. HIV/AIDS, in the top 6 of low-income and middle-income zones, is one of the diseases with more research and applications, although it is not in the top 10 in high-income countries. Trachea, bronchus, and lung cancers are the third cause of death in high-income countries but are one of the least researched diseases with regard to apps. Conclusions Concerning mobile apps, there is more work done in the commercial field than in the research field, although the distribution among the diseases is similar in both fields. In general, apps for common diseases of low- and middle-income countries are not as abundant as those for typical diseases of developed countries. Nevertheless, there are some exceptions such as HIV/AIDS, due to its important social conscience; and trachea, bronchus and lung cancers, which was totally unexpected. PMID:25099695

Comparison of mobile apps for the leading causes of death among different income zones: a review of the literature and app stores.

PubMed

Martínez-Pérez, Borja; de la Torre-Díez, Isabel; López-Coronado, Miguel; Sainz-De-Abajo, Beatriz

2014-01-09

The advances achieved in technology, medicine, and communications in the past decades have created an excellent scenario for the improvement and expansion of eHeath and mHealth in particular. Mobile phones, smartphones, and tablets are exceptional means for the application of mobile health, especially for those diseases and health conditions that are the deadliest worldwide. The main aim of this paper was to compare the amount of research and the number of mobile apps dedicated to the diseases and conditions that are the leading causes of death according to the World Health Organization grouped by different income regions. These diseases and conditions were ischemic heart disease; stroke and other cerebrovascular diseases; lower respiratory infections; chronic obstructive pulmonary disease; diarrheal diseases; HIV/AIDS; trachea, bronchus, and lung cancers; malaria; and Alzheimer disease and other dementias. Two reviews were conducted. In the first, the systems IEEE Xplore, Scopus, Web of Knowledge, and PubMed were used to perform a literature review of applications related to the mentioned diseases. The second was developed in the currently most important mobile phone apps stores: Google play, iTunes, BlackBerry World, and Windows Phone Apps+Games. Search queries up to June 2013 located 371 papers and 557 apps related to the leading causes of death, and the following findings were obtained. Alzheimer disease and other dementias are included in the diseases with more apps, although it is not among the top 10 causes of death worldwide, whereas lower respiratory infections, the third leading cause of death, is one of the less researched and with fewer apps. Two diseases that are the first and second of low-income countries (lower respiratory infections and diarrheal diseases) have very little research and few commercial applications. HIV/AIDS, in the top 6 of low-income and middle-income zones, is one of the diseases with more research and applications, although it is not in the top 10 in high-income countries. Trachea, bronchus, and lung cancers are the third cause of death in high-income countries but are one of the least researched diseases with regard to apps. Concerning mobile apps, there is more work done in the commercial field than in the research field, although the distribution among the diseases is similar in both fields. In general, apps for common diseases of low- and middle-income countries are not as abundant as those for typical diseases of developed countries. Nevertheless, there are some exceptions such as HIV/AIDS, due to its important social conscience; and trachea, bronchus and lung cancers, which was totally unexpected.

Law: participate or not?

PubMed

Finch, J

1983-05-04

2 separate and important features of abortion law and practice in the UK which are particularly relevant to nurses participating in the procedure are examined: the nurse's participation in an abortion induced by the injection of prostaglandin into the womb; and the nurse's right to refuse to participate in any form of abortion on the basis of reasons of conscience. Focus is on the position of a predecessor of Karen Smith on a female surgical ward in the mid 1970s. It was then that abortions by the use of prostaglandin solution were becoming prevalent. When the Abortion Act became law in 1967 the most usual abortion method involved surgical intervention, and no legal problem was involved for the surgical intervention would always be performed by a physician. Around 1970 the prostaglandin method of inducing abortion began to be written about in the journals. The method was found to have several advantages, including the deployment of medical and nursing staff. The process is initiated by a registered medical practitioner, as it must be according to the Abortion Act. A catheter is inserted through which prostaglandin solution is administered to the patient. From that time the nurse assumes a crucial role. Nurses carry out in whole or in part the subsequent steps in the process. A prostaglandin pump is connected up with the catheter in order to give the patients the abortifacients. Nurses monitor the process, which can last between 15-30 hours. It usually takes about 18 hours for this method to produce the abortion, and the nurses are involved with the patient during this time. Doctors or "registered medical practitioners," are frequently absent. Following questions raised in senior nursing circles regarding the propriety and legality of this process, the DHSS issued a circular to allay fears. The department advised that, providing a registered medical practitioner personally made the decision and initiated the medical induction process and remained responsible for it throughout, it was unnecessary for the medical practitioner to perform each and every action which was required for the process to realize the intended objective. A legal test case was brought against the DHSS to determine the legality of prostaglandin abortion and nurse participation. A High Court judge ruled such participation to be lawful. When appealed, all 3 Lord Justices in the Court of Appeals unanimously reversed the decision. The DHSS appealed, and the law lords by a majority of 3 to 2 overturned the appeal court's ruling and restored the decision reached by the trial judge in the 1st action. Regarding conscientious objection, nurses and other staff, including surgeons and anesthetists, are included in the provision of the Abortion Act which allows refusal to participate on the basis of conscientious reasons.

Communications for alternative development: towards a paradigm.

PubMed

Kothari, R

1984-01-01

There is a need to redefine the agenda of politics so as to promote the weak, but growing forces, in society which seek to establish a just, demilitarized, and humane society and to counter the strong prevailing forces in society, which, in the pursuit of affluence, promote social inequality, militarism, and the degradation of the environment. These destructive forces will ultimately lead to the destruction of humanity and civilization either through nuclear war or violent conflict between population seeking to gain control over the world's dwindling resources. The new agenda for politics must redefine development and establish human survival as the major goal of development. The weaker force promoting the establishment of a humane society are evidenced in 1) efforts to assert the rights of the people and to challenge elitist authorities, 2) the rediscovery of the value of cultural tradition and diversity, 3) the development of an ecological conscience, and 4) the trend toward decentralization. These forces are expressed in movements which promote women's rights, human rights for minorities and the disadvantaged, self-determination, democraticization, and the preservation of the environment. The destruction forces evidenced in efforts 1) to integrate the world's economy to ensure the economic well-being of the elite segments of society in both developed and 3rd World nations; 2) to uphold economic progress as the major goal of development; 3) to equate development with the establishment of a world capitalistic economic system; 4) to promote technologies which displace human workers, destroy the environment, and reduce cultural diversity; 5) to destroy trade unions; 6) to support government oppression; 7) to promote militarism: and 8) to counter attempts to redistribute the worlds resources. Development needs to be reconceptualized. The current emphasis on technology transfer and cooperation must be explained in reference to the need to promote self-reliance, to fulfill basic needs, and to preserve cultural deversity. The development process must be politicized and controlled by the people rather than by technocrats and bureaucrats. The role of the state must be reevaluated. After World War II, the state was perceived as having the capacity to liberalize and equalize society. The state has failed to live up to this expectation. Social equality must be established through democratization. Social classes must be redefined, the inablity of the proletariat to absorb the poor must be recognized, and consumerism must be curbed. Communication is the tool which can promote the cause of human survival and human dignity and expose the agenda of the strong forces which, in reality, constitutes a global project to end humanity. This agenda is pursued by scientists and elitists around the world. Their activities and policies will doom mankind to nuclear war, or to violent conflict over resources, or to the destruction of the world's poor.

Ever Ready to Go: The Multiple Exiles of Leo Szilard

NASA Astrophysics Data System (ADS)

Frank, Tibor

2005-06-01

I argue that to understand the life and work of Leo Szilard (1898 1964) we have to understand, first, that he was driven by events to numerous departures, escapes, and exiles, changing his religion, his language, his country of residence, and his scientific disciplines; second, that he was a man haunted by major moral dilemmas throughout his life, burdened by a sincere and grave sense of responsibility for the fate of the world; and third, that he experienced a terrible sense of déjà vu: his excessive sensitivity and constant alertness were products of his experiences as a young student in Budapest in 1919. The mature Szilard in Berlin of 1933, and forever after, was always ready to move. I proceed as follows:After a brief introduction to his family background, youth, and education in Budapest, I discuss the impact of his army service in the Great War and of the tumultous events in Hungary in 1918 1919 on his life and psyche, forcing him to leave Budapest for Berlin in late 1919. He completed his doctoral degree under Max von Laue (1879 1960) at the University of Berlin in 1922 and his Habilitationsschrift in 1925. During the 1920s and early 1930s, he filed a number of patents, several of them jointly with Albert Einstein (1879 1955). He left Berlin in March 1933 for London where he played a leading role in the rescue operations for refugee scientists and scholars from Nazi Germany. He also carried out notable research in nuclear physics in London and Oxford before immigrating to the United States at the end of 1938. He drafted Einstein’s famous letter of August 2, 1939, to President Franklin D. Roosevelt, worked in the Manhattan Project during World War II, initiated a petition to President Harry S. Truman not to use the bomb on Japan, and immediately after the war was a leader in the scientists’ movement that resulted in civilian control of nuclear energy. In 1946 he turned to biology, in which his most significant contribution was to formulate a theory of aging. In 1956 von Laue led an effort to invite him to head a new institute for nuclear physics in West Berlin, which he ultimately declined at the end of 1959. He remained in the United States, becoming a highly visible public figure, speaking, writing, and traveling extensively, and even corresponding with Soviet Premier Nikita S.Khrushchev and President John F. Kennedy to promote the international control of nuclear weapons. In retrospect, although Szilard was a man of many missions, his life story could be read as that of a man of conscience with but a single mission, to save mankind.

Hurricane & Tropical Storm Impacts over the South Florida Metropolitan Area: Mortality & Government

NASA Astrophysics Data System (ADS)

Colon Pagan, I. C.

2007-12-01

Since 1985, the South Florida Metropolitan area (SFMA), which covers the counties of Miami-Dade, Broward, and Palm Beach, has been directly affected by 9 tropical cyclones: four tropical storms and 5 hurricanes. This continuous hurricane and tropical storm activity has awakened the conscience of the communities, government, and private sector, about the social vulnerability, in terms of age, gender, ethnicity, and others. Several factors have also been significant enough to affect the vulnerability of the South Florida Metropolitan area, like its geographic location which is at the western part of the Atlantic hurricane track, with a surface area of 6,137 square miles, and elevation of 15 feet. And second, from the 2006 Census estimate, this metropolitan area is the 7th most populous area in the United States supporting almost 1,571 individuals per square mile. Mortality levels due to hurricanes and tropical storms have fluctuated over the last 21 years without any signal of a complete reduction, a phenomenon that can be related to both physical characteristics of the storms and government actions. The average annual death count remains almost the same from 4.10 between 1985 and 1995 to 4 from 1996 to 2006. However, the probability of occurrence of a direct impact of an atmospheric disturbance has increase from 0.3 to 0.6, with an average of three hurricane or tropical storm direct impacts for every five. This analysis suggests an increasing problem with regard to atmospheric disturbances-related deaths in the South Florida Metropolitan area. In other words, despite substantial increases in population during the last 21 years, the number of tropical cyclone-related deaths is not declining; it's just being segregated among more storms. Gaps between each impact can be related to mortality levels. When that time increases in five years or more, such as Bob and Andrew or Irene and Katrina, or decreases in weeks or months, such as Harvey and Irene or Katrina and Wilma, mortality also increases. A relief is also remarkable when that time is between one and four years, which might be related to better government actions during a certain period after a strong hurricane impact. Results reflect a lack of focus on hurricane and tropical storm related themes, while a decrease in funding can be the consequence of less interest and much more attention on less probable hazards with a long term recovery period. Even though the government has an important role in hurricanes and tropical storms mitigation, some of the main ideas to decrease mortality are focused in networking between private and public sector and the understanding of self-vulnerability of each individual.

Psychopathy: clinical features, developmental basis and therapeutic challenges.

PubMed

Thompson, D F; Ramos, C L; Willett, J K

2014-10-01

Psychopathy is a personality disorder characterized by deficits in personality and behaviour. Personality deficits are marked by interpersonal and affective facets, including pathological lying, grandiose sense of self-worth, lack of remorse and callousness. Behavioural deficits are defined by lifestyle and antisocial deficits, including impulsivity, parasitic lifestyle and poor behavioural controls. The objective of this review is to provide clinicians with (i) an appreciation of the clinical features of psychopathy, (ii) an understanding of the structural and functional derangements and the genetic and environmental factors which serve as the basis for the development of psychopathy and (iii) a summary of published reports of pharmacological approaches to the management of this disorder. A literature search of MEDLINE/PubMed (1966-present) was conducted using the MeSH search terms psychopathy and antisocial personality disorder alone and in combination with the subheading drug therapy. Additional databases included Web of Science (1945-present) and International Pharmaceutical Abstracts (1970-present) using the text words psychopath and antisocial personality were searched. A search of Amazon books using the search terms psychopathy and sociopathy was also performed. Bibliographies of relevant articles were searched for additional citations. All data sources in English were considered for inclusion. For background information, broad subject headings were searched for review articles first. Human and animal drug therapy articles were evaluated giving preference to those papers using a controlled trial methodology. Psychopathy is a personality disorder characterized by a lack of conscience, pathologic lying, manipulative behaviour and often superficial charm. The incidence of psychopathy in the general population is generally considered to be 0·6-4% with a higher proportion of males to females. Brain imaging studies of psychopaths suggest a smaller and less active amygdala and prefrontal cortex. There also appear to be physiological derangements in psychopathy, including alterations/dysregulation in neurotransmitter homeostasis (dopamine and serotonin), altered endocrine responses (testosterone and cortisol) and altered autonomic responses to emotional stimuli and stressors. Although both genetic and environmental factors likely contribute to the developmental basis of psychopathy, these factors are poorly understood at present. To date, limited studies with pharmacologic interventions in psychopathy are available and there are insufficient trials to determine efficacy. Psychopathy is a serious personality disorder with profound negative effects on individuals and society. To design rational therapeutic strategies for this disorder, additional research is needed to discover the specific pathological and pathophysiological basis of psychopathy and to further elucidate the genetic and environmental factors responsible for psychopathic development. There is emerging evidence of phenotypic variants in psychopathy, including successful and unsuccessful types. It is important for clinicians to be cognizant of the psychopathic personality. © 2014 John Wiley & Sons Ltd.

EVALUATION OF THE THORACOABDOMINAL MOBILITY OF OBESE SUBJECTS IN PRE-BARIATRIC SURGERY.

PubMed

Veloso, Ana Paula Limongi Richardelli; Cusmanich, Karla Garcez

Obesity can affect the thorax, diaphragm, and alterations in respiratory function even if the lungs are within normality. The respiratory compliance is very reduced by the increase in fat mass. To evaluate the effect of the physical therapeutic respiratory exercises on the thoracoabdominal mobility of obese individuals in pre-bariatric surgery. Cross-sectional and descriptive study, which used the cirtometry (axillary, xiphoid and abdominal) to evaluate the mobility of 74 individuals, 27 men and 47 women, in pre-bariatric surgery, assisted by the team EMAD, after eight weeks of physiotherapy, following a protocol of exercises, reevaluating and compared the measures pre and post intervention. Had positive correlation abdominal mobility in the total volume of all participants (p=0.010) and also for all the measures in the measurement of residual volume in three levels (p=0.000). Comparing genders, in total volume, cirtometry abdominal greater for women (p=0.015) when compared to men and residual volume, significance for either men or women in all measurements (p=0.000). Obese patients that underwent the physiotherapeutic treatment during the preoperative period, had pré respiratory dynamics improved by the increase in the mobility of the chest cavity and by the improvement of respiratory conscience. A obesidade pode afetar o tórax e o diafragma, determinando alterações na função respiratória, mesmo quando os pulmões se apresentam dentro da normalidade. A complacência respiratória é muito reduzida pelo aumento de massa gordurosa. Avaliar o efeito de exercícios fisioterapêuticos respiratórios sobre a mobilidade torácica de indivíduos obesos no pré-operatório de cirurgia bariátrica. Estudo transversal e descritivo, que utilizou a cirtometria (axilar, xifoide e abdominal) para avaliar a mobilidade de 74 indivíduos, 27 homens e 47 mulheres, em pré-operatório de cirurgia bariátrica, assistidos pela equipe EMAD, após oito semanas de fisioterapia, seguindo um protocolo de exercícios, reavaliando e comparado as medidas pré e pós a intervenção. Apresentaram correlação positiva a mobilidade abdominal no volume total de todos os participantes (p=0,010) e também para todas as medidas na mensuração do volume residual nos três níveis (p=0,000). Comparando os sexos, no volume total, a cirtometria abdominal maior das mulheres (p=0,015) quando comparada a dos homens e no volume residual, significância tanto para os homens quanto para as mulheres em todas as mensurações (p=0,000). Obesos que se submeteram ao tratamento fisioterapêutico durante o período pré-operatório, tiveram dinâmica respiratória melhorada pelo aumento da mobilidade da caixa torácica e pela melhora da consciência respiratória.

Big History or the 13800 million years from the Big Bang to the Human Brain

NASA Astrophysics Data System (ADS)

Gústafsson, Ludvik E.

2017-04-01

Big History is the integrated history of the Cosmos, Earth, Life, and Humanity. It is an attempt to understand our existence as a continuous unfolding of processes leading to ever more complex structures. Three major steps in the development of the Universe can be distinguished, the first being the creation of matter/energy and forces in the context of an expanding universe, while the second and third steps were reached when completely new qualities of matter came into existence. 1. Matter comes out of nothing Quantum fluctuations and the inflation event are thought to be responsible for the creation of stable matter particles in what is called the Big Bang. Along with simple particles the universe is formed. Later larger particles like atoms and the most simple chemical elements hydrogen and helium evolved. Gravitational contraction of hydrogen and helium formed the first stars und later on the first galaxies. Massive stars ended their lives in violent explosions releasing heavier elements like carbon, oxygen, nitrogen, sulfur and iron into the universe. Subsequent star formation led to star systems with bodies containing these heavier elements. 2. Matter starts to live About 9200 million years after the Big Bang a rather inconspicous star of middle size formed in one of a billion galaxies. The leftovers of the star formation clumped into bodies rotating around the central star. In some of them elements like silicon, oxygen, iron and many other became the dominant matter. On the third of these bodies from the central star much of the surface was covered with an already very common chemical compound in the universe, water. Fluid water and plenty of various elements, especially carbon, were the ingredients of very complex chemical compounds that made up even more complex structures. These were able to replicate themselves. Life had appeared, the only occasion that we human beings know of. Life evolved subsequently leading eventually to the formation of multicellular structures like plants, animals and fungi. 3. Matter starts to think A comet or an asteroid crashed into Earth about 66 million years ago, ending the dominance of dinosaurs. Small animals giving birth to living offspring were now able to evolve into a multitude of species, among them the primates. A group of primates migrated from Africa to other continents less than 100000 years ago. Their brain developed a special quality, self-conscience. This ability to reflect about oneself boosted their survival considerably. Man (Homo sapiens) had entered the scene, becoming one of the dominant species of this planet. Due to his immense ability today to handle matter and energy he has become something of a caretaker of planet Earth. Man is responsible for sustainable development for the good of his society and of the whole biosphere. If there is a fourth step in the history of the universe, discoveries in astrobiology may provide us with some clues in the next decades.

The opinions of Turkish mental health nurses on physical health care for individuals with mental illness: A qualitative study.

PubMed

Çelik Ince, S; Partlak Günüşen, N; Serçe, Ö

2018-05-01

Individuals with mental illness have significantly higher mortality and morbidity than the general population due to physical illnesses. Mental health nurses play a key role in providing care for common physical problems and protecting and promoting healthy lifestyles. Little is known from previous studies in the international literature about the attitudes, behaviours and thoughts of mental health nurses on providing physical health care. Mental health nurses mostly focus on the existing physical health problems of individuals with mental illness. However, mental health nurses do not include practices of disease prevention and physical health promotion for individuals with mental illness. The desire to see positive changes in individuals with mental illness, receiving positive feedback, feeling useful and happy, and feeling satisfied with their profession motivate mental health nurses in terms of providing physical health care. The knowledge and skill required of mental health nurses to provide physical health care need to be increased. Institutions should employ expert nurses who are able to guide mental health nurses to provide physical health care. It is important to provide adequate physical infrastructure and human resources to provide better physical health care in mental health services. Background Mental health nurses play an important role in improving the physical health of individuals with mental illnesses. However, there are limited studies of their attitudes and practices about physical health. Therefore, there is a need for qualitative studies to clarify the issue. The aim of this study was to determine mental health nurses' opinions about physical health care for individuals with mental illness. This study was carried out in Turkey. A qualitative descriptive approach was taken in the study. The sample consisted of twelve mental health nurses selected by purposeful sampling. In-depth interviews were conducted using a semi-structured interview format. A thematic analysis was used to evaluate the interviews. Four main themes were determined. (1) The barriers to physical healthcare theme included barriers related to patients, illness and treatment, barriers related to patients' caregivers, barriers related to health professionals and barriers related to the healthcare system. (2) The physical healthcare practices theme included common physical health problems and current nursing practices. (3) Motivators theme included the desire to see positive changes in a patient, receiving positive feedback, feeling useful and happy, having a sense of conscience and feeling satisfied with their profession. (4) The needs for better physical healthcare theme included the nurses' recommendations for better physical health care. Mental health nurses believe that the physical health care provided to individuals with mental illness is not adequate. Many barriers to providing care for physical health, such as having psychiatric symptoms that are not seen as a priority by patients and health personnel, were determined. Mental health nurses should integrate physical healthcare practices into their routine care. In addition, mental health nurses' knowledge and skills about physical health care should be improved. © 2018 John Wiley & Sons Ltd.

The condition of health services in the Gaza Strip.

PubMed

1990-01-01

The Association of Israeli and Palestinian Physicians for Human Rights was established during the first months of the uprising, against the background of a severe situation in which people were killed and wounded daily. AIPPHR works for the protection of human dignity and human life; defending physicians and patients in a state of political conflict out of loyalty to the principles of universal morality which constitute an inseparable part of the medical profession. This report, which is the result of months of research and investigation, is aimed, among other purposes, at bringing reliable information to the knowledge of the medical community in Israel and the Israeli Medical Association (IMA)--the body which organizes them. The silence of the medical community in the face of the phenomena described above is foreign to the spirit of doctors and medicine. The association's activity is aimed at creating a change in this situation out of the belief that the silence on the part of a large section of the medical community in Israel stems from a lack of regular and reliable information. In order to describe the situation of the medical services in the Gaza Strip, one must note two contrasting trends: on one hand, there is advancement in the population's health conditions, which is expressed by a decline in the infant mortality rate (from 86/1000 in 1970 to 28.1/1000 in 1988); a decline in the number of cases of whooping cough among children (30.1 in 1970 in contrast to 0 in 1988); and a decline in the number of cases of polio (14.3 in 1970 in contrast to 1 in 1980). On the other hand, the tendency of stagnation must be noted, especially in the development of independent local health services. Medicine in the Gaza Strip has been during the entire period of the occupation, and remains, completely dependent on Israeli medicine. Modern equipment and modern medical technology have been at the service of the residents of the Gaza Strip in Israeli hospitals, but they were not given the chance to develop high-standard medicine in their own hospitals. The Gaza Strip population has no representation at the decision-making level on issues of budget, development and distribution of resources--which are completely in the hands of the Civil Administration and the Israeli authorities. During the uprising there was a steep rise in medical needs. Residents in need of medical services are completely dependent on the decisions of the military government and the state leadership and the giving of these services is tied to political, not medical/professional policy. Since the beginning of the uprising in the Occupied Territories, a new tendency has appeared; the use of medicine as an additional means of repression against the population. This means that medicine has been removed from the status of a basic human right and recruited as a means of punishment. This is a phenomenon which no physician or person of conscience can accept.

[From conduct disorder in childhood to psychopathy in adult life].

PubMed

Tsopelas, Ch; Armenaka, M

2012-06-01

Mental health professionals seldom recognize psychopathy in their daily practice. Usually forensic psychiatrists and psychologists are involved because individuals with psychopathic personality are involved in serious criminal behavior and implicated with the law. Most of the times the profiles of children who evolve in adult psychopaths have components from other disorders, especially conduct disorder. The term psychopathy originates from the Greek words "psyche" (soul) and "pathos" (passion) and was used to identify initially every mental illness. Although in the bibliography the terms Antisocial Personality Disorder, Psychopathic Personality, Psychopathy and Sociopathy are used as synonyms, it has not been clarified if the Antisocial Personality Disorder and Psychopathic Personality constitute two different entities or if the latter constitutes the more serious and hard core subtype of the first. The prevalence of Psychopathic Personality in the general population is estimated as 1%, with the proportion of men: women to be 3:1. The adult male psychopaths are responsible for almost 50% of the serious criminal behavior. Diagnosis of Psychopathic Personality is completed with the use of specific psychometric tools: Psychopathy Checklist-Revised (PCL-R) and Psychopathy Checklist: Screening Version (PCL: SV). The most recognizable elements of psychopathy are the non-existence of conscience and their shallow emotional relations. They are individuals with persuasion, that use the suitable phraseology in order to approach, impress and charm their prey. Nuclear characteristic is the inability to feel guilt, remorse and the nonexistence of moral rules. They lose their temper easily and present aggressiveness without obvious or insignificant reason. They develop various antisocial behaviors that are repeated with success, the gravity of violent behavior tends to increase and they have problems with the law. Nevertheless, people with Psychopathic Personality at one point were children, without diagnosis of Psychopathic Personality, as such a diagnosis is not appropriate at early childhood or adolescence. Psychopathic or/and antisocial tendencies sometimes are recognized in children and early adolescent age. Such behaviors lead usually to the diagnosis of Conduct Disorder or Oppositional Defiant Disorder or Attention Deficit and Hyperactivity Disorder in early years of life and increase the possibility to have a diagnosis of Antisocial Personality Disorder and Psychopathic Personality as an adult. There are many studies on the underlying risk factors for Psychopathic Personality, focusing in genetic, neurobiological, developmental, environmental, social and other factors. There is no effective treatment for Psychopathic Personality in adult life. Children with a specific neurobiological profile or behavioral disturbances that increase the risk of developing a Psychopathic Personality in adult life, have better chances to respond in exceptionally individualized interventions, depending on the character of the child. The parents are educated to supervise their children, to overlook annoying behaviors and to encourage the positive ones. It appears that the punishment does not attribute, on the contrary it strengthens undesirable behaviors. Use of reward appears to have better results. Programs of early highly focused therapeutic interventions in vulnerable members of the population are our best hope for the reduction of fully blown psychopaths in the general adult population.

[Functional pathophysiology of consciousness].

PubMed

Jellinger, Kurt A

2009-01-01

Consciousness (Latin conscientia "moral conscience"), according to the English philosopher John Locke (1632-1704) [103], is the awareness of all that occurs in the mind of a person, whereas the American philosopher John Searle (2000) defined it as "inner qualitative, subjective states and processes of awareness". In modern science it is defined as a continuous state of full awareness of the Self and one's relationship to the external and internal environment, describing the degree of wakefulness in which an organism recognizes stimuli. This widely discussed biological term for complex neuronal processes that allow an individuum to recognize itself and its environment and to act accordingly, has been and still is the subject of much research in philosophy and natural/neuroscience. Its definition is often used for awareness and recognition, too. While the Egyptians in the papyrus Edwin Smith already recognized the brain as the seat of consciousness, René Descartes (1644 [36]) believed its special structure should be "a small gland in the middle", but the anatomical structures and physiological processes involved in consciousness were elucidated only in the middle of the 20th century. Neuronal substrates include several functional networks that are hierarchically organized and cooperate functionally. The lowest level is the mesencephalic formatio reticularis and its projections to the thalamus that were identified als ascending reticular system (ARAS) by the classical experiments of Moruzzi and Magoun, whereas later analyses of patients with impaired consciousness provided further insights. The mesencephalic ARAS as motor of the function of higher structures projects 1. via the reticular thalamus diffusely to the cortex, 2. via hypothalamus to the basal forebrain and limbic system, and 3. to the medial raphe of the brainstem and locus coeruleus and their diffuse cortical projections. The reticular system is stimulated directly and indirectly via numerous collaterals from important somatic and sensory pathways and acts as a control system of neuronal activities of the cerebral cortex. The principal function of the ARAS is to focus our alertness on specific stimuli or internal processes, which run via complex neuronal cell groups and numerous neurotransmitters that influence various aspects of consciousness and wakefulness. Stimulation of the ARAS produces an arousal reaction as the electric correlate of consciousness; its destruction causes coma and related states. The highest level are cortical (prefrontal and association) networks for recognition, motor activity, longterm memory and attention, the left hemisphere being considered as the dominant one. Different levels of consciousness are distinguished: 1. hyperalertness, 2. alertness (normal state of wakefulness), 3. somnolence or lethargy, 4. obtundation with tendency to fall asleep, 5. stupor, 6. coma and its subtypes, like akinetic mutism, apallic syndrome or persistent vegative state, locked-in syndrome, delirium, and catatonia. They are caused by damages in various functional levels of the brain, by psychogenic factors or experimentally, and are accompanied by characteristic neurological and psychiatric disorders. The relevant morphological lesions can be detected by electrophysiological and imaging studies. The bases of functional anatomy and pathophysiology of consciousness, its cognitive aspects and its major disorders, their causes and functional substrates with reference to sleep and both spontaneous and iatrogenic disorders of consciousness are critically summarized.

Probability for Weather and Climate

NASA Astrophysics Data System (ADS)

Smith, L. A.

2013-12-01

Over the last 60 years, the availability of large-scale electronic computers has stimulated rapid and significant advances both in meteorology and in our understanding of the Earth System as a whole. The speed of these advances was due, in large part, to the sudden ability to explore nonlinear systems of equations. The computer allows the meteorologist to carry a physical argument to its conclusion; the time scales of weather phenomena then allow the refinement of physical theory, numerical approximation or both in light of new observations. Prior to this extension, as Charney noted, the practicing meteorologist could ignore the results of theory with good conscience. Today, neither the practicing meteorologist nor the practicing climatologist can do so, but to what extent, and in what contexts, should they place the insights of theory above quantitative simulation? And in what circumstances can one confidently estimate the probability of events in the world from model-based simulations? Despite solid advances of theory and insight made possible by the computer, the fidelity of our models of climate differs in kind from the fidelity of models of weather. While all prediction is extrapolation in time, weather resembles interpolation in state space, while climate change is fundamentally an extrapolation. The trichotomy of simulation, observation and theory which has proven essential in meteorology will remain incomplete in climate science. Operationally, the roles of probability, indeed the kinds of probability one has access too, are different in operational weather forecasting and climate services. Significant barriers to forming probability forecasts (which can be used rationally as probabilities) are identified. Monte Carlo ensembles can explore sensitivity, diversity, and (sometimes) the likely impact of measurement uncertainty and structural model error. The aims of different ensemble strategies, and fundamental differences in ensemble design to support of decision making versus advance science, are noted. It is argued that, just as no point forecast is complete without an estimate of its accuracy, no model-based probability forecast is complete without an estimate of its own irrelevance. The same nonlinearities that made the electronic computer so valuable links the selection and assimilation of observations, the formation of ensembles, the evolution of models, the casting of model simulations back into observables, and the presentation of this information to those who use it to take action or to advance science. Timescales of interest exceed the lifetime of a climate model and the career of a climate scientist, disarming the trichotomy that lead to swift advances in weather forecasting. Providing credible, informative climate services is a more difficult task. In this context, the value of comparing the forecasts of simulation models not only with each other but also with the performance of simple empirical models, whenever possible, is stressed. The credibility of meteorology is based on its ability to forecast and explain the weather. The credibility of climatology will always be based on flimsier stuff. Solid insights of climate science may be obscured if the severe limits on our ability to see the details of the future even probabilistically are not communicated clearly.

Rewind, review, reflect and fast forward: from Ethics to GeoEthics.

NASA Astrophysics Data System (ADS)

Marone, Eduardo

2017-04-01

Philosophy has as many definitions as philosophers but, at the end of the day, it is no more and no less than the science of thinking using the reason. It gives us tools for rationalizing, following logical paths and with a critical eye, to understand the material and immaterial substance of the universe. It has many branches, and a couple of them, Ethics and Epistemology, are central for the evolution of the human knowledge, among many others. Today, at the XXI Century, it seems that the lack of formal and adequate education on such important matters is making the act of "thinking" not so important when compared with the accumulation of "information", right or wrong, pasteurized or in disconnected pieces, with no much room/time for critical and logical analysis (Philosophy). If the tools to build the knowledge (Epistemology) are not usually familiar to the scientists and, worst, the need of taking the right actions with the generated new and existing knowledge (Ethics) is not a priority; the outputs cannot be the best ones. There have been several academic works and meetings looking into the causes of the scholarly illiteracy on Ethics and Epistemology in Earth Sciences. Among them, our sessions at EGU have endured showing important aspects that need to be tackled and, particularly, insisting in the fact that it is a continuous effort. However, we still need to go back (Rewind) to the main principles of Philosophy, Epistemology and Ethics, looking at them with care (Review), and think (Reflecting) returning to the present (Fast Forward) to make the world better for future generations. Geoethics consists of research and reflection on the values that underpin appropriate behaviours and practices, wherever human activities interact with the Earth system. Although more general ethical issues, which affect other/all sciences practices and behaviours, are included among the Geoethic concerns (as plagiarism, harassment, gender equity, etc.), the focus remains at the Human-Earth interactions. That implies in a lot of logical thinking, the use of the reason and the critical eye, founded on the philosophical and scientific knowledge humanity has developed along thousands of years. In the education process, the "training" to think, with logic and reason based, should be given since childhood, respecting all the learning ages and constructing a better human being, truly aware of her/his ethical duties. An ethical behaviour is constructed systematically, not created in one semester course or so, and it is not enough if reduced to following consensual rules (deontology), but it is only true when a mandate of our conscience is the reason that move us, fully convinced by the reason, to walk the right behaviour. Learning to think logically, with the reason and based in the best Earth Sciences knowledge, after arriving at the university will not be, probably, enough. Otherwise, when confronted with ethical dilemmas in the practice of our profession, we will not be truthfully prepared to offer reliable scientific support to society, in a proper ethical way, wherever human activities interact with the Earth system.

Administrative and research policies required to bring cellular therapies from the research laboratory to the patient's bedside.

PubMed

Yim, Robyn

2005-10-01

The research process is a balance between the inherent risks of new discoveries and the risks of research participant safety. Conflicts of interest, inherent to the research process, as well as those introduced by emerging cellular therapies, have the potential to compromise safety. The relationship of trust between the researcher and the clinical trial participant facilitates objective decision making, in the best interest of both parties. In the setup of each clinical trial, investigators incorporate ethical, political, legal, financial, and regulatory considerations as protocols are established. Responsibility to abide by these decisions ensures a systematic process and safeguards participants in this process. The integrity of the research process is strengthened by identifying potential conflicting issues with the guiding principles established in the protocols, which may threaten the objectivity of involved parties and jeopardize safety of the participants. The rapid pace and changing paradigms of new discoveries in cellular therapies exaggerate existing conflicts and introduce new ones. Ethical issues raised by emerging cellular therapies include the division of opinions regarding the use of embryonic and fetal tissue to develop stem cell lines for research, the individual versus professional conscience of a researcher, overselling of outcomes as a result of the researcher's desire to be the first to discover a cellular therapy, and therapeutic misconception resulting from a participant's desire for a miracle cure. The basic ethical issue of whether stem cells should be utilized as a cellular therapy raises heated debates because some believe that it is not acceptable to use fetal material as a source of research material for future cures and others feel equally as strong that inaction is unethical because it results in needless suffering and death owing to the absence of this research. Political issues include the divergent position statements of presidential administrations on cellular therapy, variations in individual state laws, and states becoming involved in research funding, such as California's Proposition 71. Legal concerns include expanding private litigation with diversity of lawsuits, expanding lists of defendants, and the use of class-action lawsuits in research cases. Ownership issues also arise in terms of intellectual property, patents, and ownership of stem cells collected from minors, as in umbilical cord blood donations. Situations that challenge the regulatory processes established to ensure participant safety include differences in reporting requirements for private- and public-funded research and the lack of adequate funding and resources to implement and support the institutional review board (IRB) process. Financial considerations influence the development of clinical protocols, because funding is often limited. Financial incentives, personal investment in companies funding research activities, and fundraising pressures may present potential conflicts. In addition, the increasing role of emerging biotechnology start-up companies and pharmaceutical companies in clinical research introduces additional financial considerations. Administrative policies are needed to address these possible conflicts and ensure research participant safety as cellular therapies progress from the research laboratories to the patient's bedside. Administrative policies to ensure minimum standards of quality for emerging products before human clinical trials, policies to enforce consistent reporting requirements for private and public cellular research, policies to minimize financial conflicts of interest, policies to strengthen implementation of the existing IRB process and to structure into the process a consistent, systematic review of these identified conflicts, and policies to limit private litigation will help to preserve the objectivity of the review process and ultimately increase participant safety.

The Correspondence of Bruno Bettelheim and Rudolf Ekstein.

PubMed

Fisher, David James

2006-01-01

This paper provides the historical, cultural, and clinical context for the relationship between Bruno Bettelheim (1903-1990) and Rudolf Ekstein (1912-2005). Both were Viennese-born and trained intellectuals who received doctorates in the human sciences from the University of Vienna in 1937. Both were deeply identified with lay analysis, emphasizing that for psychoanalysis to perpetuate itself it needed to promote serious and rigorous forms of research. Because Bettelheim was the better known of the two, this introduction focuses on Ekstein's family history, with special emphasis on his experience of loss and trauma and his capacity to recover from personal and educational obstacles. It argues that Ekstein was a representative product of Austro-Marxism in the period between the wars, embracing the ethical brand of democratic socialism and group solidarity that was integral to the theory and practice of Austrian Social Democracy. It discusses Ekstein's training with Moritz Schlick in philosophy and his immersion in the Vienna Circle of logical positivism. From Schlick, Ekstein evolved into a philosophical thinker who learned how to think his own thoughts. Ekstein joined the circle of psychoanalytic pedagogues who clustered around the Vienna Psychoanalytic Society, under the tutelage of Willi Hoffer, August Aichhorn and, above all, Anna Freud. The clinical component of psychoanalysis emanated from his commitment to understanding the inner world of the child. Bettelheim and Ekstein first became aware of each other from reading the analytic literature and finally met in America in the 1950s. They shared a professional interest in conducting research and doing clinical work on severely disturbed children and adolescents, including those with psychotic, borderline and autistic diagnoses. They debated the value of milieu therapy versus psychoanalytically oriented psychotherapy on such children. As their relationship evolved, the two collaborated and began a fascinating correspondence that gradually evolved into an intimate friendship. They both engaged in a polemic with Bernard Rimland, who was massively critical of their clinical work and a hostile critic of psychoanalytic approaches to the treatment of disturbed children. Rimland was an advocate of a neurological approach to mental illness, with an emphasis on biology and psychopharmacology. The 22 letters that constitute the Bettelheim-Ekstein exchange began with clinical concerns, including the varieties of solitude, isolation and countertransference disruptions that may trouble the psychoanalytic researcher and clinician in dealing with primitively disordered children. It moves to other issues, including mutual support during the Rimland Affair. As the two became more friendly, a pattern of good-natured competition and envy appeared. The two engaged in a heated exchange on the question of whether contemporary Vienna remained as anti-Semitic as it had been in their respective youths: Bettelheim, the concentration camp survivor, argued that nothing had changed and that most Austrians remained viscerally anti-Semitic; Ekstein, the Austro-Marxist, contended that one could not blame a generation born after World War II, holding that in his experience many Austrians had examined their consciences and held distinctly different options from their parents or grandparents. Toward the end of their correspondence, we encounter Ekstein's tender sensitivity to Bettelheim's descent into depression as a result of the death of his wife, Trude, leading eventually to recurrent episodes of suicidal ideation and plans for his own suicide. The letters testify to a unique friendship with a somewhat old-world quality.

[Patients in pre-dialysis: decision taking and free choice of treatment].

PubMed

Sarrias Lorenz, X; Bardón Otero, E; Vila Paz, M L

2008-01-01

Predialysis is a clinical situation in which the patient has significant impairment of kidney function that will ultimately lead to either death or inclusion in kidney replacement therapy (dialysis and/or transplantation). Since a practical and effective dialysis technique was introduced, the length and quality of survival of patients with end-stage renal failure has constantly increased. Contraindications for dialysis are almost never of a renal origin. The obstacles are the concomitant diseases of the patient. The age of the patient may be one of these obstacles. The average age at initiation of dialysis in our country is currently 67 years and over 50% of patients are 60 years old or older. Decision making: From an ethical viewpoint, there is a consensus in stating that anything that can technically be done, should be done. The principle of nonmaleficence and respect for the autonomy of the patients are "prima facie" principles when the physician has doubts as to whether dialysis provides a benefit to the patient. The principle of autonomy, which makes the patient a competent subject of treatment, allows a framework of shared decisions to be created in which the physician uses his knowledge and experiences in assessing the risk and benefits of dialysis including the alternative of no dialysis. The competent patient, duly informed, will chose the option that is best for him and take the decision. Principle of treatment proportionality: This principle states that there is a moral obligation to implement all therapeutic measures that show a relationship of due proportion between the resources used and the expected result. Dialysis is in principle a proportional treatment for end-stage renal failure. However, it may become a disproportional treatment because of the physical and mental conditions of the elderly patient. The good that is sought with institution of treatment can cause a harm to the patient that justifies noninclusion of the patient in dialysis treatment. Because of the impossibility of establishing universal rules of proportionality, it is necessary to make a personal judgment of conscience in each specific case. Recommendations for initiation or not of dialysis: Taking shared decisions between the patient (or relatives and/or advisors) and the physician. These shared decisions will be documented with signing of the proposed informed consent or rejection of the treatment. The medical team should always be sure that the patients has fully understood the consequences of the decision taken. Explanation of the modalities should include: - Types of dialysis treatment available. - Not to initiate dialysis and continue with conservative treatment until death. This situation may cause many problems if we do not have the help of the palliative care service. - Try dialysis for a limited time. - Stop dialysis and receive medical care until death. - Evaluate the prognosis of renal disease and concomitant diseases, life expectancy and family support. Resolution of conflicts: Conflicts may occur: - Between nephrologist and patient/family. - Between members of the nephrological team. - Between nephrologist and other physicians. When conflicts persist and the need for initiation of dialysis is urgent, it is necessary to initiate treatment and continue it until the resolution of these conflicts, making a record of this decision. In such cases, the Hospital Ethics Care Committee can help with appropriate advice to solve the discrepancies. Decisions taken in advance may be useful in this type of patients. Patients with advanced chronic kidney disease with criteria for Noninclusion or withdrawal of dialysis. - Severe or irreversible dementia. - conditions of permanent unconsciousness. - advanced tumors with metastasis. - terminal disease of another nontransplantable organ. - severe physical and/or mental disabilities. (Strength of Recommendation C)

[Malaise in psychiatry and its history].

PubMed

Chebili, S

2016-04-01

The main hypothesis of this paper is the presence of malaise in psychiatry. The malaise has two sides: on one hand, the end of psychiatry hegemony that dominated the theoretical field of psychiatry until the 1990s. The loss of influence of psychoanalysis is due to its inability to be submitted to any kind of assessment. On the other hand, the supremacy of neurosciences. The idea is not to underestimate the importance of neurosciences but rather to affirm that they occupy the whole theoretical field of psychiatry. This is an unusual situation that is specific to our time. Indeed, this monism has succeeded to an epistemological dualism that has existed throughout the history of psychiatry. In this article, we'll try to draw a history of dualism in psychiatry. Firstly, with Pinel, we find a tension between a metaphysical philosophical pole and a physiological one. Pinel's philosophy has something to do with Condillac's ideology as Pinel applies the analytical method to mental diseases. Under Cabanis's influence, the author of the famous Rapports du physique et du moral de l'homme, this ideology is under pressure with physiologism. As a materialist, he gives an essential part to the brain that distributes pieces of information throughout the body because he thinks that mind influences body. Secondly, dualism lies between the doctrine of localizations defended by Gall and the theory of degeneration elaborated by Magnan. Gall, in Anatomie et physiologie du système nerveux en général, seeks to know how bumps or hollows that are found on the skull are shaped. Gall is for the theory of delocalizations. He is the counterpart of Magnan who wrote a work about Les Dégénérés, that takes its part in the physiological trend with the famous theory of degeneration. For him, degeneration means the imperfect state of a subject whose cerebral functions are in a noticeably imperfect state. Thirdly, with Henry Ey, dualism starts to be less important. Indeed, he tends a monist synthesis with its organodynamic model described in Des idées de Jackson à un modèle organodynamique en psychiatrie. Indeed, he is inspired by the English neurologist Jackson to assert that there are levels of conscience structuring where negative symptomatology appears through its dissolution. Current monism with neuroscience domination sets fundamental epistemological issues. Perhaps neurosciences were setting an impossible task to achieve while following Changeux's intuition. In L'homme neuronal, this latter was developing the idea that to each psychic function, one could associate a neuron. This is a way to go back to Gall who doesn't seem to us to be heuristic. Indeed, let's first introduce the fact that there is no specific cortical area just as the most recent works have shown. Therefore, saying that a cerebral area is correlated to a symptom or a function is no more than relying on parallelism theory. Thus, Bergson, from whom we took the analysis, showed the futility of such a concept and the apporias to which it leads. The research of precise cerebral areas implied in mental diseases, as important as it is, leaves open the question of meaning. The meaning of the disease raises many economic, cultural, psychological and social factors. Thus, we can formulate the hypothesis that psychiatry should be between two complementary poles. First, the pole of neurosciences whose researches are fundamental for research in disease etiology and the development of a new medicine. Second, there is a pole which is more polymorphous and that would deal with the question of meaning. We think that each of these poles should have their own investigation field and their specific methods. We defend the idea that creating subjects such as neuropsychoanalysis is an illusion. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

[Recommendations for early identification of damage to the skeleton by malignant processes, and for early diagnosis of multiple myeloma].

PubMed

Adam, Z; Bednarík, J; Neubauer, J; Chaloupka, R; Fojtík, Z; Vanícek, J; Pour, L; Cermákova, Z; Scudla, V; Maisnar, V; Straub, J; Schützová, M; Gregora, E; Weinreb, M; Stuchlíková, K; Stanícek, J; Hájek, R; Krejcí, M; Vorlícek, J

2006-11-01

The number of newly diagnosed cases of multiple myeloma in the Czech Republic is about 3-4 per 100 000 persons per year. In the higher age groups, the incidence increases. Multiple myeloma is an illness that reacts well to treatment which can result in periods of remission lasting for years. Some of the patients are even able to return to work. A pre-requisite for successful treatment is early diagnosis and this is usually in the hands of first line physicians. This is the reason why the Czech Myeloma Group, in conjunction with neurologists, orthopedicians and radio diagnosticians has issued the following recommendations for first line physicians containing a more detailed description of the symptoms and the diagnostic pitfalls of the disease. This disease reminds a chameleon for the variety of its symptoms. For the sake of clarification, we shall divide multiple myeloma symptoms into five points, each of which is reason enough to warrant an examination to confirm or rule out a malignant cause of health problems (a negative result does not automatically mean exclusion). If any of the recommended examinations results positive, the diagnostic process must be continued, in which case a general practitioner refers the patient to a specialist health centre. Observing these recommendations should minimize the number of cases of late diagnosis. 1. Bone destruction symptoms. - Unexplained backache for more than one month in any part of spine even without nerve root irritability or without pain in other part of skeleton (ribs, hips, or long bones). - Pain at the beginning of myeloma disease is very similar to benigne common discopathy, however the intensity of backache is decreasing within one months in benigne disease. In the case of malignant process the intensity of bone pain is steadily increasing. - Immediate imaging and laboratory investigation are indicated by resting and night pain in spinal column or in any part of skeleton. - Backache with the sign of spinal cord or nerve compression should be sent for immediate X Ray, and focussed CT/MRI followed by acute surgery if needed. - Osteoporosis especially in men and premenopausal women. 2. Features of changed immunity or bone marrow function. Persistent and recurrent infection, typical is normochromic anaemia, with leucopenia and trombocytopenia. 3. Raised erythrocyte sedimentation rate even increase concentration of total plasma protein. 4. Impaired renal function. Increased level of creatinin or proteinuria, nephrotic syndrome with bilateral legs oedema. 5. Hypercalcemia with typical clinical symptoms (polyuria with dehydratation, constipation, nausea, low level conscience, coma). Every one from these points has to be reason for general medical doctor to start battery of tests: -X-ray of bones focused to painful area (mandatory before physiotherapy, local anaesthesia or other empiric therapy). If plain X-ray does not elucidate pain and symptoms are lasting more than one month, please consider all circumstances and results from laboratory investigation. This patient needs referral to the centre with MRI/CT facilities (CT or MRI is necessary investigation in case of nerve root or spine compression). -Investigation of erythrocyte sedimantion rate (high level of sedimentation of erythrocyte can indicate multiple myeloma). -Full blood count. -Basic biochemical investigation serum and urine: serum urea, creatinin, ionts including calcium, total protein, and albumin CRP (high concentration of total protein indicates myeloma, low level of albumin indicates general pathological process, similary increased concentration of fibrinogen, impaired renal function indicates myeloma kidney, however hypercalcemia is typical for highly aggressive myeloma). -Quantitative screening for IgG, IgM and IgA in serum (isolated raised level one of immunoglobulin with decreased level of the others indicates myeloma). -Common electrophoresis of serum is able to detect monoclonal immunoglobulin level at few gramm concentration. If all the laboratory investigation are in normal level the possibility that the current problems are multiple myeloma origine is smaller, but it does not exclude one of rare variant--non secretory myeloma (undifferentiated plasmocyt lost characteristic feature to produce monoclonal immunoglobulin). If any of tests indicate the possibility of myeloma, patient require urgent specialist referral to department with possibility to make diagnosis of malignant myeloma.

Sustainable groundwater resources, Heretaunga Plains, Hawke's Bay, New Zealand

NASA Astrophysics Data System (ADS)

Brown, L. J.; Dravid, P. N.; Hudson, N. A.; Taylor, C. B.

The Heretaunga Plains, Hawke's Bay, New Zealand, is underlain by Quaternary fluvial, estuarine-lagoonal, and marine deposits infilling a subsiding syncline. Within the depositional sequence, river-channel gravels form one of the most important aquifer systems in New Zealand. An interconnected unconfined-confined aquifer system contains groundwater recharged from the Ngaruroro River bed at the inland margin of the plain, 20km from the coast. At the coast, gravel aquifers extend to a depth of 250m. In 1994-95, 66Mm3 of high quality groundwater was ed for city and rural water supply, agriculture, industry, and horticulture. Use of groundwater, particularly for irrigation, has increased in the last 5years. Concern as to the sustainability of the groundwater resource led to a research programme (1991-96). This paper presents the results and recommends specific monitoring and research work to refine the groundwater balance, and define and maintain the sustainable yield of the aquifer system. Three critical management factors are identified. These are (1) to ensure maintenance of consistent, unimpeded groundwater recharge from the Ngaruroro River; (2) to specifically monitor groundwater levels and quality at the margins of the aquifer system, where transmissivity is <5000m2/d and summer groundwater levels indicate that ion exceeds recharge; (3) to review groundwater-quality programs to ensure that areas where contamination vulnerability is identified as being highest are covered by regular monitoring. Résumé Les plaines d'Heretaunga, dans la baie d'Hawke (Nouvelle-Zélande), sont occupées par des dépôts quaternaires fluviaux, estuariens lagunaires et marins remplissant un synclinal subsident. Dans cette séquence de dépôts, des graviers de chenaux fluviatiles forment l'un des plus importants systèmes aquifères de Nouvelle-Zélande. Un système aquifère interconnecté libre et captif contient de l'eau souterraine dont la recharge est assurée à partir du lit de la rivière Ngaruroro sur la marge intérieure de la plaine, à 20km de la côte. Sur la côte, les aquifères des graviers existent à 250m de profondeur. En 1994-95, 66hm3 d'eau souterraine d'excellente qualité ont été extraits pour l'eau potable de villes et de villages, pour l'agriculture, pour l'industrie et pour l'horticulture. L'utilisation de l'eau souterraine, en particulier pour l'irrigation, s'est accrue au cours des 5 dernières années. La prise de conscience du développement durable de la ressource en eau souterraine a conduit à un programme de recherche (1991-96). Cet article présente les résultats de ce programme et recommande les contrôles spécifiques et les travaux de recherche pour affiner le bilan d'eau souterraine, et pour définir et maintenir un rendement durable du système aquifère. Trois facteurs de gestion critique ont été identifiés. Ce sont (1) l'assurance de maintenir une recharge de la nappe conséquente et sans entrave à partir de la rivière Ngaruroro, (2) le suivi spécifique des niveaux de la nappe et de la qualité aux marges du système aquifère, où la transmissivité est inférieure à 5000 m2/j et où les niveaux de la nappe en été indiquent que les prélèvements sont supérieurs à la recharge; et (3) le ré-examen des programmes de qualité de l'eau souterraine pour s'assurer que les zones où la vulnérabilité aux contaminations est identifiée comme étant la plus élevée sont couvertes par une surveillance régulière.

Acceptabilité du test VIH proposé aux nourrissons dans les services pédiatriques, en Côte d'Ivoire, Significations pour la couverture du diagnostic pédiatrique

PubMed Central

Oga, Maxime; Brou, Hermann; Dago-Akribi, Hortense; Coffie, Patrick; Amani-Bossé, Clarisse; Ékouévi, Didier; Yapo, Vincent; Menan, Hervé; Ndondoki, Camille; Timité-Konan, M.; Leroy, Valériane

2014-01-01

Résumé Problème: Le dépistage VIH chez les enfants a rarement été au centre des préoccupations des chercheurs. Quand le dépistage pédiatrique a retenu l'attention, cela a été pour éclairer seulement sur les performances diagnostiques en ignorant même que le test pédiatrique comme bien d'autres peut s'accepter ou se refuser. Cet article met au cœur de son analyse les raisons qui peuvent expliquer qu'on accepte ou qu'on refuse de faire dépister son enfant. Objectif: Etudier chez les parents, les mères, les facteurs explicatifs de l'acceptabilité du test VIH des nourrissons de moins de six mois. Méthodes: Entretien semi-directif à passages répétés avec les parents de nourrissons de moins de six mois dans les formations sanitaires pour la pesée/vaccination et les consultations pédiatriques avec proposition systématique d'un test VIH pour leur nourrisson. Résultats: Nous retenons que la réalisation effective du test pédiatrique du VIH chez le nourrisson repose sur trois éléments. Primo, le personnel de santé par son discours (qui dénote de ses connaissances et perceptions même sur l'infection) orienté vers les mères influence leur acceptation ou non du test. Secundo, la mère qui par ses connaissances et perceptions même sur le VIH, dont le statut particulier, l'impression de bien-être chez elle et son enfant influence toute réalisation du test pédiatrique VIH. Tertio, l'environnement conjugal de la mère, particulièrement caractérisé par les rapports au sein du couple, sur la facilité de parler du test VIH et sa réalisation chez les deux parents ou chez la mère seulement sont autant de facteurs qui influencent la réalisation effective du dépistage du VIH chez l'enfant. Le principe préventif du VIH, et le désir de faire tester l'enfant ne suffisent pas à eux seuls pour aboutir à sa réalisation effective, selon certaines mères confrontées au refus du conjoint. A l'opposé, les autres mères refusant la réalisation du test pédiatrique disent s'y opposer ; bien entendu, même dans le cas où le conjoint l'accepterait. Discussion: Les mères sont les principales mises en cause et craignent les réprimandes et la stigmatisation. Le père, le conjoint peut être un obstacle, quand il s'oppose au test VIH du nourrisson, ou devenir le facilitateur de sa réalisation s'il est convaincu. Le positionnement du père demeure donc essentiel dans la question de l'acceptabilité du VIH pédiatrique. Les mères en ont conscience et présagent des difficultés à faire dépister ou non les enfants sans avis préalable du conjoint à la fois père, et chef de famille. Conclusion: La question du dépistage pédiatrique du VIH, au terme de notre analyse, met en face trois éléments qui exigent une gestion globale pour assurer une couverture effective. Ces trois éléments n'existeraient pas sans s'influencer, donc ils sont constamment en interaction et empêchent ou favorisent la réalisation ou non du test pédiatrique. Aussi, dans une intention d'aboutir à une couverture effective du dépistage VIH des nourrissons, faut-il tenir compte d'une gestion harmonieuse de ces trois éléments: La première, la mère seule (avec ses connaissances, ses perceptions), son environnement conjugal (de proposition du test intégrant 1- l’époux et / ou père de l'enfant avec ses perceptions et connaissances sur l'infection 2- la facilité de parler du test et sa réalisation chez les deux ou un des parents, la mère) et les connaissances, attitudes et pratiques du personnel de l’établissement sanitaire sur l'infection du VIH. Recommandations: Nos recommandations proposent une redéfinition de l'approche du VIH/sida vers des familles exposées au VIH et une intégration plus accentuée du père facilitant leur propre acceptation du test VIH et celle de leur enfant. PMID:25088574

Particle Physics on the Eve of Lhc

NASA Astrophysics Data System (ADS)

Studenikin, Alexander I.

2009-01-01

Fundamentals of particle physics. The quantum number of color, colored quarks and dynamic models of Hadrons composed of quasifree quarks / V. Matveev, A. Tavkhelidze. Discovery of the color degree of freedom in particle physics: a personal perspective / O. W. Greenberg. The evolution of the concepts of energy, momentum, and mass from Newton and Lomonosov to Einstein and Feynman / L. Okun -- Physics at accelerators and studies in SM and beyond. Search for new physics at LHC (CMS) / N. Krasnikov. Measuring the Higgs Boson(s) at ATLAS / C. Kourkoumelis. Beyond the standard model physics reach of the ATLAS experiment / G. Unel. The status of the International Linear Collider / B. Foster. Review of results of the electron-proton collider HERA / V. Chekelian. Recent results from the Tevatron on CKM matrix elements from Bs oscillations and single top production, and studies of CP violation in Bs Decays / J. P. Fernández. Direct observation of the strange b Barion [symbol] / L. Vertogradov. Search for new physics in rare B Decays at LHCb / V. Egorychev. CKM angle measurements at LHCb / S. Barsuk. Collider searches for extra spatial dimensions and black holes / G. Landsberg -- Neutrino Physics. Results of the MiniBooNE neutrino oscillation experiment / Z. Djurcic. MINOS results and prospects / J. P. Ochoa-Ricoux. The new result of the neutrino magnetic moment measurement in the GEMMA experiment / A. G. Beda ... [et al.]. The Baikal neutrino experiment: status, selected physics results, and perspectives / V. Aynutdinov ... [et al.]. Neutrino telescopes in the deep sea / V. Flaminio. Double beta decay: present status / A. S. Barabash. Beta-beams / C. Volpe. T2K experiment / K. Sakashita. Non-standard neutrino physics probed by Tokai-to-Kamioka-Korea two-detector complex / N. Cipriano Ribeiro ... [et al.]. Sterile neutrinos: from cosmology to the LHC / F. Vannucci. From Cuoricino to Cuore towards the inverted hierarchy region / C. Nones. The MARE experiment: calorimetric approach to the direct measurement of the neutrino mass / E. Andreotti. Electron angular correlation in neutrinoless double beta decay and new physics / A. Ali, A. Borisov, D. Zhuridov. Neutrino energy quantization in rotating medium / A. Grigoriev, A. Studenikin. Neutrino propagation in dense magnetized matter / E. V. Arbuzova, A. E. Lobanov, E. M. Murchikova. Plasma induced neutrino spin flip via the neutrino magnetic moment / A. Kuznetsov, N. Mikheev -- Astroparticle physics and cosmology. International Russian-Italian mission "RIM-PAMELA" / A. M. Galper .. [et al.]. Dark Matter searches with AMS-02 experiment / A. Malinin. Investigating the dark halo / R. Bernabei ... [et al.]. Search for rare processes at Gran Sasso / P. Belli ... [et al.]. Anisotropy of Dark Matter annihilation and remnants of Dark Matter clumps in the galaxy / V. Berezinsky, V. Dokuchaev, Yu. Eroshenko. Current observational constraints on inflationary models / E. Mikheeva. Phase transitions in dense quark matter in a constant curvature gravitational field / D. Ebert, V. Ch. Zhukovsky, A. V. Tyukov. Construction of exact solutions in two-fields models / S. Yu. Vernov. Quantum systems bound by gravity / M. L. Fil'chenkov, S. V. Kopylov, Y. P. Laptev -- CP violation and rare decays. Some puzzles of rare B-Decays / A. B. Kaidalov. Measurements of CP violation in b decays and CKM parameters / J. Chauveau. Evidence for D[symbol] mixing at BaBar / M. V. Purohit. Search for direct CP violation in charged kaon decays from NA48/2 experiment / S. Balev. [symbol] scattering lengths from measurements of K[symbol] and K± -> [symbol] decays at NA48/2 / D. Madigozhin. Rare kaon and hyperon decays in NA48 experiment / N. Molokanova. THE K+ -> [symbol]+vv¯ experiment at CERN / Yu. Potrebenikov. Recent KLOE results / B. Di Micco.Decay constants and masses of heavy-light mesons in field correlator method / A. M. Badalian. Bilinear R-parity violation in rare meson decays / A. Ali, A. V. Borisov, M. V. Sidorova. Final state interaction in K -> 2[symbol] decay / E. Shabalin -- Hadron physics. Collective effects in central heavy-ion collisions / G. I. Lykasov ... [et al.]. Stringy phenomena in Yang-Mills plasma / V. I. Zakharov. Lattice results on gluon and ghost propagators in Landau gauge / I. L. Bogolubsky ... [et al.]. [symbol] and [symbol] excited states in field correlator method / I. Narodetskii, A. Veselov. Theory of quark-gluon plasma and phase transition / E. V. Komarov, Yu. A. Simonov. Chiral symmetry breaking and the Lorentz nature of confinement / A. V. Nefediev. Structure function moments of proton and neutron / M. Osipenko. Higgs decay to bb: different approaches to resummation of QCD effects / A. L. Kataev, V. T. Kim. A novel integral representation for the Adler function and its behavior at low energies / A. V. Nesterenko. QCD test of z-scaling for [symbol]-meson production in pp collisions at high energies / M. Tokarev, T. Dedovich. Quark mixing in the standard model and the space rotations / G. Dattoli, K. Zhukovsky. Analytic approach to constructing effective theory of strong interactions and its application to pion-nucleon scattering / A. N. Safronov -- New developments in quantum field theory. On the origin of families and their mass matrices with the approach unifying spin and charges, prediction for new families / N. S. Mankoc Borstnik. Z[symbol] electric strings and center vortices in SU(2) lattice gauge theory / M. I. Polikarpov, P. V. Buividovich. Upper bound on the lightest neutralino mass in the minimal non-minimal supersymmetric standard model / S. Hesselbach ... [et al.]. Application of higher derivative regularization to calculation of quantum corrections in N=l supersymmetric theories / K. Stepanyantz. Nonperturbative quantum relativistic effects in the confinement mechanism for particles in a deep potential well / K. A. Sveshnikov, M. V. Ulybyshev. Khalfin's theorem and neutral mesons subsystem / K. Urbanowski. Effective lagrangians and field theory on a lattice / O. V. Pavlovsky. String-like electrostatic interaction from QED with infinite magnetic field / A. E. Shabad, V. V. Usov. QFT systems with 2D spatial defects / I. V. Fialkovsky, V. N. Markov, Yu. M. Pismak. Bound state problems and radiative effects in extended electrodynamics with Lorentz violation / I. E. Frolov, O. G. Kharlanov, V. Ch. Zhukovsky. Particles with low binding energy in a strong stationary magnetic field / E. V. Arbuzova, G. A. Kravtsova, V. N. Rodionov. Triangle anomaly and radiatively induced Lorentz and CPT violation in electrodynamics / A. E. Lobanov, A. P. Venediktov. The comparative analysis of the angular distribution of synchrotron radiation for a spinless particle in classic and quantum theories / V. G. Bagrov, A. N. Burimova, A. A. Gusev. Problem of the spin light identification / V. A. Bordovitsyn, V. V. Telushkin. Simulation the nuclear interaction / T. F. Kamalov. Unstable leptons and (u - e - [symbol])-universality / O. Kosmachev. Generalized Dirac equation describing the quark structure of nucleons / A. Rabinowitch. Unique geometrization of material and electromagnetic wave fields / O. Olkhov -- Problems of intelligentsia. The conscience of the intelligentsia / J. K. Bleimaier.

Prevalence and correlates of treatment failure among Kenyan children hospitalised with severe community-acquired pneumonia: a prospective study of the clinical effectiveness of WHO pneumonia case management guidelines

PubMed Central

Agweyu, Ambrose; Kibore, Minnie; Digolo, Lina; Kosgei, Caroline; Maina, Virginia; Mugane, Samson; Muma, Sarah; Wachira, John; Waiyego, Mary; Maleche-Obimbo, Elizabeth

2014-01-01

Objective To determine the extent and pattern of treatment failure (TF) among children hospitalised with community-acquired pneumonia at a large tertiary hospital in Kenya. Methods We followed up children aged 2–59 months with WHO-defined severe pneumonia (SP) and very severe pneumonia (VSP) for up to 5 days for TF using two definitions: (i) documentation of pre-defined clinical signs resulting in change of treatment (ii) primary clinician's decision to change treatment with or without documentation of the same pre-defined clinical signs. Results We enrolled 385 children. The risk of TF varied between 1.8% (95% CI 0.4–5.1) and 12.4% (95% CI 7.9–18.4) for SP and 21.4% (95% CI 15.9–27) and 39.3% (95% CI 32.5–46.4) for VSP depending on the definition applied. Higher rates were associated with early changes in therapy by clinician in the absence of an obvious clinical rationale. Non-adherence to treatment guidelines was observed for 70/169 (41.4%) and 67/201 (33.3%) of children with SP and VSP, respectively. Among children with SP, adherence to treatment guidelines was associated with the presence of wheeze on initial assessment (P = 0.02), while clinician non-adherence to guideline-recommended treatments for VSP tended to occur in children with altered consciousness (P < 0.001). Using propensity score matching to account for imbalance in the distribution of baseline clinical characteristics among children with VSP revealed no difference in TF between those treated with the guideline-recommended regimen vs. more costly broad-spectrum alternatives [risk difference 0.37 (95% CI −0.84 to 0.51)]. Conclusion Before revising current pneumonia case management guidelines, standardised definitions of TF and appropriate studies of treatment effectiveness of alternative regimens are required. Objectif Déterminer l'ampleur et les caractéristiques de l’échec du traitement (ET) chez les enfants hospitalisés avec une pneumonie acquise dans la communauté dans un grand hôpital tertiaire du Kenya. Méthodes Nous avons suivi des enfants âgés de 2 à 59 mois avec une pneumonie sévère (PS) et une pneumonie très sévère (PTS) telles que définies par l’OMS, sur un maximum de cinq jours pour l’ET, en utilisant deux définitions: (a) documentation des signes cliniques prédéfinis ayant entraîné un changement du traitement, (b) décision primaire du clinicien de changer de traitement avec ou sans documentation des mêmes signes cliniques prédéfinis. Résultats Nous avons recruté 385 enfants. Le risque d’ET variait de 1,8% (IC95%: 0,4 à 5,1) à 12,4% (IC95%: 7,9 à 18,4) pour la PS et de 21,4% (IC95%: 15,9 à 27) à 39,3% (IC95%: 32,5 à 46,4) pour la PTS selon la définition appliquée. Des taux plus élevés étaient associés à des changements précoces du traitement par le clinicien en l'absence d'une justification clinique évidente. Le non-respect des directives de traitement a été observé pour 70/169 (41,4%) et 67/201 (33,3%) enfants avec une PS et une PTS respectivement. Chez les enfants avec une PS, le respect des directives de traitement était associé avec la présence d'une respiration sifflante au cours l’évaluation initiale (P = 0,02) tandis que le non respect par les cliniciens des traitements recommandés pour la PTS tendait à se produire chez les enfants avec une altération de la conscience (P <0,001). L'utilisation du score de propension correspondant pour tenir compte du déséquilibre dans la répartition des caractéristiques cliniques de base chez les enfants avec une PTS n'a révélé aucune différence dans l’ET entre ceux traités avec le régime recommandé par les directives et ceux traités par des alternatives plus coûteuses à large spectre (différence de risque: 0,37 (IC95%: -0,84 à 0,51). Conclusion Avant la révision des directives actuelles de prise en charge des cas de pneumonie, des définitions standard d’ET et des études appropriées de l'efficacité des traitements alternatifs sont nécessaires. Objetivo Determinar la extensión y el patrón del fallo en el tratamiento (FT) en niños hospitalizados con una neumonía adquirida en la comunidad, ingresados en un gran hospital terciario de Kenia. Métodos Hemos seguido a niños con edades entre los 2-59 meses con una neumonía severa (NS) y neumonía muy severa (NMS) según definición de la OMS de hasta cinco días para FT utilizando dos definiciones: (a) documentación de signos clínicos pre-definidos que resultaron en un cambio de tratamiento (b) decisión del clínico principal de cambiar el tratamiento con o sin documentación de los mismos signos clínicos pre-definidos. Resultados Incluimos a 385 niños. El riesgo de FT varió entre un 1.8% (IC 95% 0.4 a 5.1) y 12.4% (IC 95% 7.9 a 18.4) para NS y 21.4% (IC 95% 15.9 a 27) y 39.3% (IC 95% 32.5 a 46.4) para NMS dependiendo de la definición que se aplicase. Unas mayores tasas estaban asociadas con cambios tempranos en la terapia por el clínico y en ausencia de un razonamiento clínico obvio. Se observaba una no adherencia a las guías de tratamiento en 70/169 (41.4%) y 67/201 (33.3%) de los niños con NS y NMS respectivamente. Entre los niños con SP, la adherencia a las guías de tratamiento estaba asociada con la presencia de sibilancias en la evaluación inicial (P=0.02) mientras que la no adherencia del clínico a los tratamientos recomendados por las guías para NMS tendían a ocurrir en niños con un estado alterado de consciencia (P<0.001). Utilizando el pareamiento por puntaje de propensión para equilibrar los grupos en la distribución de las características clínicas de base de los niños con NMS, se observó que no existían diferencias en FT entre aquellos tratados con el régimen recomendado por las guías versus alternativas más costosas de amplio espectro (diferencias de riesgo 0.37 (IC 95% -0.84 a 0.51). Conclusión Antes de revisar las actuales guías de manejo de casos de neumonía, se requieren definiciones estandarizadas de FT y estudios apropiados de la efectividad del tratamiento de regímenes alternativos. PMID:25130866

[Study on psychiatric disorders and defensive process assessed by the "defense style questionnaire" in sterile males SAMPLE consulting in andrology].

PubMed

Bellone, M; Cottencin, O; Rigot, J M; Goudemand, M

2005-01-01

The literature about artificial insemination and the associated psychological, psychiatric and sexual disorders is relatively rich. But the majority of these studies is made in gynaecology, with a feminine approach of the disorder. There are very few works led in andrology. This justified the investigation of new trails in order to understand better the clinical context of the sterile man. We undertake a study about the psychiatric disorders among sterile men and about the defense styles. These are a clinical entity recently introduced in the quantitative psychopathology research. The defense style questionnaire (DSQ) is a psychometric scale used in common practice in order to measure the defense styles. We made this study in order to examine the psychiatric state of a sterile males sample consulting in andrology; to assess the defense style by means of the Bond and al DSQ-88 ; to look into a difference between the defensive process according to their clinical situation of azoospermic males or as the oligoazoospermic males and finally, to reveal a correlation between the psychiatric disorders developed in this sample of sterile males and the defensive process they used. There were 42 people (22 azoospermic males and 20 oligoazoospermic males) aged between 23 and 49 years old in the analysed sample. These have been selected at the surgery of andrology at the RUHC of Lille, depending on their arrival order for 6 months. There was no significant difference between the two groups as far as the age and the education standard are concerned. The selection criteria were medical and somatic. Our sample population were divided into two groups: azoospermia (no spermatozoon found in the semen analysis) and oligoasthenospermia (decrease of the number and the mobility of the spermatozoa and an increase of the percentage of atypical forms). The method first consisted in the DSQ, followed by the analysis of the psychiatric state according to the DSM IV, a hetero questionnaire to collect some general information about infertility and a self questionnaire about the sexual, conjugal and social effects of infertility. The DSQ and the interviews took place in the andrology department with the same investigator trained for this job. We found in our sample 26.2% of psychiatric disorders according to the DSM IV with a significant over-representation of generalized anxious disorder and somatization disorder. The comparison between azoospermic males and oligoazoospermic males patients showed the absence of significative difference as far as psychiatric morbidity rate and the use of defense styles are concerned. Our sample defended himself in accordance with modalities similar to the general population and used defense mechanisms preferentially belonging to the mature defense style, such as humor, repression and anticipation. The psychiatric pathology was significantly correlated to the preferential use of withdrawal, consumption, reaction formation and lack of humor use. We also confirm in our study the fact that the subjects using especially neurotic defense styles are more likely to develop a psychiatric disorder than the others. Our male sample is a waiting population and threatened by failure. The situation of wait creates anxiety. We also know that infertility is one of the most stressful situations a couple might face. However, our study did not enable us to know the precise relations between generalized anxious disorder and infertility, especially whether the generalized anxious disorder preceded this pathology or not. The over-representation of a somatization disorder only allows us to acknowledge its existence. We can also deduce from that a possible link between infertility and psychic disorder, even if no research permitted to affirm to date the existence of interrelations linking infertility and psychic life. On the whole, this population was suffering despite 73.8% of the patients had no confirmed psychiatric disorder. It is the reason why a liaison psychiatry more inserted into highly specialized teams is interesting, especially because it includes a medical and psychological approach of such disorders. The defense mechanisms preferentially used by this population were humor, repression and anticipation. Humor can only be considered as a defense mechanism when it is applied to oneself. The population who has no psychiatric disorder more uses humor. Does humor protect against the development of a psychiatric pathology, as certain authors proved it ? On the other hand, is repression really protective? It didn't interfere in our study about the development of a psychiatric pathology. So we can suppose that repression was protective for our whole sample, but we can not prove it. However, we wonder if this mechanism works after the failure of an artificial insemination is announced. In which measure such a stress can be repressed out of the conscience field? As for anticipation, it is used by our population who is for the most part in good health. But the question is to know if our sample really envisaged all the different possible solutions or only the success of artificial insemination. As some other works, we confirm that the, psychiatric, people significantly use the neurotic style. Our psychiatric patients used less humor and more consumption, withdrawal and reaction formation than the sane people. Consumption is rarely considered as a defense mechanism by some other authors. And yet, consumption and the existence of psychiatric disorders were very closely linked. This association is found again with anxiety in other studies. The correlation between psychiatric disorder and withdrawal was veryimportant too. The DSM lV defines withdrawal as an apathetic withdrawal. It is not an apathetic withdrawal in our population because the average scores for the ,, activity >, defense mechanism remained high. In our sample, the use of this defense mechanism would encourage the expression of psychiatric troubles. The reaction formation quoted by Freud and Bergeret are both valorised in our society. What kinds of reaction formations use these men ? Are they pathological ? Our study can not answer to these questions. However, the DSQ items examining the reaction formation present its "socially promoted" aspect and forget the pathological one. It has been showed that the evaluation of the defense modalities in a certain type of population can allow the emergence of specific defense mechanisms. This can be considered as predictive factors of development of a mental pathology. The evaluation of specific mental defenses could permit to define vulnerability and affinity for given affections instead of simple personality traits or profiles. Most part of the works shows results in favour of the capacity of DSQ to assess the different defense mechanisms according to the diagnosis groups. But the insufficient numbers of studies moderate on the whole the hypothesis of the existence of specific defense mechanisms--protective factors and factors of vulnerability--linked to a given psychiatric disorder. There is not a difference of psychological effect in terms of degree of sterility. On the other hand, the existence of over-represented psychiatric disorders with sterile males compared with a control group force Consultation-Liaison psychiatrists and andrologists would be able to understand the pain beyond the need of acting by the artificial insemination. In our opinion, this justifies the fact that the patients should have the opportunity of expressing, in the department where they are treated, all the feelings inherent to their personal and conjugal drama as part of a specialized treatment. Our study confirms the difficulty to know whether some defense mechanisms are vulnerability factors for a certain psychiatric disorder or whether the defense mechanisms are an epiphenomenon of a particular psychiatric disorder. This is the reason why a lot of authors having worked with DSQ agree to conclude that additional prospective studies, which would permit to make a link between the defense mechanisms anda certain psychiatric pathology, are necessary. In the case we study, it is important to explore the defensive modalities before the infertility diagnosis and after the birth of a child, with a more important sample population. A better knowledge of the defensive modalities of such a population, used in a psychotherapeutic context could help to prevent the appearance of psychiatric disorders or, if not, to anticipate them.