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PubMed2001

The kindness of strangers: organ transplantation in a capitalist age.

The topic of organ transplantation is examined from the perspective of three authors: Robert Bellah, Jeremy Rifkin, and Margaret Jane Radin. Introduced by reflections on the development of the justification of organ transplantation within the Roman Catholic community and the various themes raised by the historical study in Richard Titmuss's The Gift Relationship, the paper examines how and in what ways the possible commodification of organs will affect our society and the impacts this may have on the supply of organs.

Altruism↗
PubMed2002

Reasonable magic and the nature of alchemy: Jewish reflections on human embryonic stem cell research.

The controversy about research on human embryonic stem cells both divides and defines us, raising fundamental ethical and religious questions about the nature of the self and the limits of science. This article uses Jewish sources to articulate fundamental concerns about the forbiddenness of knowledge in general and of knowledge thought of as magical creation. Alchemy, and the turning of elements into gold and into substances for longevity, and magic used for the creation of living beings was at stake in various Talmudic texts. Since contemporary discourse calls regenerative science magical, and makes claims about its restorative power, careful reflection on when magic is forbidden and when it is responsible allows a novel understanding of ethical questions in stem cell research.

Alchemy↗
PubMed2002

Revisiting the definition of homo sapiens.

Research in genomics, human cloning, and transgenic technology has challenged bioethicists and scientists to rethink the definition of human beings as a species. For example, should the definition incorporate a genetic criterion and how does the capacity to genetically engineer human beings affect the definition of our species? In considering these contemporary bioethical dilemmas, we revisit an ancient source, the Talmud, and highlight how it provides specific biological, cultural, and genetic criteria to define the human species.

Animals↗
PubMed2003

Revisiting the problem of Jewish bioethics: the case of terminal care.

This paper examines the main Jewish sources relevant to end-of-life ethics, two Talmudic stories, the early modern code of law (Shulhan Aruch), and contemporary Halakhaic (religious law) responsa. Some Orthodox rabbis object to the use of artificial life support that prolongs the life of a dying patient and permit its active discontinuation when the patient is suffering. Other rabbis believe that every medical measure must be taken in order to prolong life. The context of the discussion is the most recent release of the "Steinberg Report," which proposes a law regulating end-of-life issues in Israel. It is argued that the Orthodox rabbis base their views on a strongly positivist concept of religious law. The rabbis deliberate the law as a manifestation of the will of God and try to stretch the law as much as possible in order to benefit the patient, even when it is good for the patient to die. Direct and active actions that kill are prohibited; certain forms of passive euthanasia and contrivances that terminate life support without needing direct human action are accepted.

Advisory Committees↗
PubMed2003

A Jewish argument for socialized medicine.

An analysis of traditional Jewish texts yields neither the capitalist notion of medicine nor the socialist one. Neither alternative is sufficient to ground the respect for the sanctity of the human person as a being created in the image of God that is so rationally appealing. That is why the Jewish ethical tradition, which is based on this respect for the sanctity of human personhood, both individual and collective, is so attractive--if only for its insights, rather than its authority; its guidance, rather than its governance.

Cultural Diversity↗
PubMed2004

Andre Hellegers and Carroll House: architect and blueprint for the Kennedy Institute of Ethics.

The Newman programs established at secular colleges and universities provided an opportunity for intellectual, spiritual, and social growth among the Catholic student population. As a young physician and junior medical faculty member, Andre Hellegers took part in the early organization and ongoing work of Carroll House, the Newman Center at the Johns Hopkins Medical Institutions. Helleger's experience at Carroll House enabled him to develop a clear blueprint of an academic center of excellence for the scientific, theological, and philosophical exploration of the many problems that he had seen and foresaw in medicine. That center would become Georgetown's Kennedy Institute of Ethics.

Academies and Institutes↗
PubMed2006

Stem cell research in a Catholic institution: yes or no?

Catholic teaching has no moral difficulties with research on stem cells derived from adult stem cells or fetal cord blood. The ethical problem comes with embryonic stem cells since their genesis involves the destruction of a human embryo. However, there seems to be significant promise of health benefits from such research. Although Catholic teaching does not permit any destruction of human embryos, the question remains whether researchers in a Catholic institution, or any researchers opposed to destruction of human embryos, could participate in research on cultured embryonic stem cells, or whether a Catholic institution could use any therapy that ultimately results from such research. This position paper examines how such research could be conducted legitimately in a Catholic institution by using an ethical analysis involving a narrative context, the nature of the moral act, and the principle of material cooperation, along with references to significant ethical assessments. It also offers tentative guidelines that could be used by a Catholic institution in implementing such research.

Aborted Fetus↗
PubMed1996

The Catholic church and U.S. health care reform.

The Catholic Church is the largest (and arguably the best organized) single denomination in the United States, and it has extensive holdings in the health care field. It therefore has a material stake in the current debate over health care reform, as well as a moral interest in a question touching on the ethics of resource distribution. The position of the church on health care is analyzed as a case study of how organized religion interacts with and attempts to influence social policy in a pluralistic society.

Capitalism↗
PubMed2001

Catholic social policy and U.S. health care reform: a relationship revisited.

The Roman Catholic Church is the single largest denomination in the United States and the one with the most extensive provider stake in health (and related social service) care. As a follow-up to an earlier analysis of the Catholic role in the thwarted health care reform effort of 1993-94, this article looks at the revival of interest in reform and at the rationale behind and strategy of the Catholic Church's current agenda-setting initiative. The emphasis in this article is on the delicate relationship between organized religion and social policy in a society with an officially secular culture.

Catholicism↗
PubMed2001

Issues in Islamic biomedical ethics: a primer for the pediatrician.

The United States is becoming increasingly pluralistic. Pediatricians must become familiar with the factors that affect the emotional, physical, and spiritual health of their patients that are outside the kin of the traditionally dominant value system. Although many articles have addressed the cultural and ethnic factors, very few have considered the impact of religion. Islam, as the largest and fastest-growing religion in the world, has adherent throughout the world, including the United States, with 50% of US Muslims being indigenous converts. Islam presents a complete moral, ethical, and medical framework that, while it sometimes concurs, at times diverges or even conflicts with the US secular ethical framework. This article introduces the pediatrician to the Islamic principles of ethics within the field of pediatric care and child-rearing. It demonstrates how these principles may impact outpatient and inpatient care. Special attention is also given to adolescent and end-of-life issues.

Adolescent↗
PubMed2002

Faith, identity, and leukemia: when blood products are not an option.

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers and gain insight and support from fellow staff members. When a competent adult patient refuses lifesaving treatment for religious or personal reasons, caregivers have a legal obligation to respect this decision. A patient's refusal of treatment adds particular challenges to the delivery of compassionate care. The case of a 50-year-old Jehovah's Witness with acute myelocytic leukemia who declined blood product support is presented. Respecting her religious beliefs during chemotherapy required balancing risk and benefit, watching her suffer while unable to intervene with what the staff saw as simple treatment, and eventually undertaking a complicated grief process. Jehovah's Witness beliefs regarding blood products are reviewed. Caregiver roles and responsibilities are discussed in the context of psychosocial, legal, familial, and ethical issues.

Blood Transfusion↗
PubMed1992

Attitudes toward genetic testing of Amish, Mennonite, and Hutterite families with cystic fibrosis.

BACKGROUND: We had the unique opportunity to study families with cystic fibrosis (CF) from an interrelated Amish-Mennonite kindred and from an isolated Hutterite kindred. METHODS: While obtaining blood for DNA linkage analysis to help find the CF gene, we asked family members to answer a questionnaire about attitudes and feelings toward genetic testing. The questionnaire was also administered to families receiving care at the University of Rochester. After DNA-based CF carrier testing was developed, we asked the families whether they wanted to know the results. RESULTS: Each cultural group felt differently about many issues. Between 31% and 78% approved of CF-carrier testing and 14% to 78% approved of prenatal diagnosis. The majority (59%) of Hutterite parents and siblings were opposed to carriers marrying carriers and most (82%) of the CF families wanted to know the results of carrier testing. CONCLUSIONS: Cultural differences need to be understood before genetic services are offered. Also, most CF mutations and their clinical correlates (phenotypes) will need to be defined. There are as few as three CF mutations in the Hutterite population. It will be possible to offer them the option to choose accurate genetic counseling. It will be difficult to offer genetic services to other populations with more heterogeneous attitudes and many more identified and yet-to-be-identified CF mutations.

Abortion, Therapeutic↗