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Religious advance directives: the convergence of law, religion, medicine, and public health.

Because of the deep interpersonal significance of decisions made at the end of life, it is not surprising that religion has played an important role in patient and family decision making. Specific religious concerns about death and dying have led to religious advance directives. Advance directives offer a case study of models of interaction between religious communities and secular institutions. This paper examines why such directives have been created and how they may affect health care decisions. An analysis of their strengths and weaknesses concludes that specific religious instructions are unnecessary in written directives and may undermine both the religious and health care goals of patients.

Advance Directives↗

Hospice and the politics of spirituality.

Within the hospice literature, spirituality and religion are usually defined in opposition to one another, with religion negatively associated with the external, authoritarian doctrines of Christianity and spirituality positively associated with the free search for truth, meaning, and authenticity. According to survey data, however, most Americans integrate spirituality and traditional religious commitments. The hospice literature is promoting spirituality to its own detriment by alienating potential patients and depriving religious patients of the resources that religious traditions and their affiliated religious communities have to offer.

Christianity↗

Intercultural differences in the bioethical assessment of abortion: preliminary results and a proposal for further research.

Descriptor terms related to 37 articles dealing with the moral question of abortion and taken from a printed database specializing in Catholic applied ethics were scanned for clusters with respect to the Anglo-American or European origin of the articles. To identify types within the data Configural Frequency Analysis was used. Application indicated a dominant interest in the process of ethical decision-making in Anglo-American Catholic bioethics. The assumption that European Catholic bioethicists discuss the morality of abortion primarily in terms of an anthropological debate focused on the moral status of prenatal life could not be validated statistically.

Abortion, Legal↗

Suffer the little children: the ancient practice of infanticide as a modern moral dilemma.

Inherent in nursing practice is respect for human life. Traditionally, this respect has been guided by the sanctity-of-life principle as embraced by the Jewish and Christian faiths. However, there appears to be a shift in philosophical thought regarding the inviolability of human life in medical and nursing practice. The very notion of what constitutes human life is the subject of vigorous debate, both within and outside the hospital-institutional setting. The topic of infanticide is examined from traditional Jewish and Christian perspectives and contrasted with current philosophical thinking. Pediatric nurses are challenged to reflect on how this potential shift in values will affect their personal philosophy and professional practice.

Child Advocacy↗

Human experimentation in Judaism.

The supreme value of human life, the sanctity of human life, and the obligation of patients to accept standard efficacious medical therapy are axiomatic Judaic principles. If a seriously and/or terminally ill patient has already received all standard treatments and is asked to consider experimental therapy that may prolong his or her life or may hasten death, he or she is allowed but not required to accept the treatment. Healthy people may volunteer to participate in research studies that involve little or no risk.

Human Experimentation↗

Ethical considerations in modern human experimentation.

The use of properly controlled clinical trials in medical experimentation has been of vital importance to the progress of medical science. At the same time, the new form of experimentation has also generated some of our most difficult and perplexing moral dilemmas. The solutions to the many complicated ethical problems involved in human experimentation are not straightforward, and despite numerous books, articles, codes, guidelines, and declarations, many specific issues of right and wrong in human experimentation have not yet been definitively resolved. Society today has an obligation greater than ever to control, regulate, and enforce properly balanced codes of human experimentation in order to minimize the unacceptable ethical problems and maximize the desired results of modern human experimentation. These, however, are not sufficient. The patient's greatest safeguard in experimentation is a skillful, intelligent, and conscientious physician and investigator. Thus, the investigator bears great responsibility in balancing between the common good and the individual's rights. In this article the relevant secular and Jewish ethical principles and rules concerning human experimentation are specified and methodologically organized. Particular emphasis is placed on the elucidation and evaluation of the ethical controversies surrounding randomized clinical trials.

Beneficence↗

Assisted reproductive medicine: current Islamic bioethical rules.

The advances and wide availability of assisted reproductive techniques represent the dramatic changes that have occurred in infertility treatment and in attitudes towards the different options faced by both physicians and patients. It is a human right that individuals can freely choose reproductive options. Though reproductive choice is basically a personal decision, yet it is not totally so. Islam is a comprehensive system that regulates the spiritual as well as civil aspects of individual and communal life. It aims to develop the unique personality of the individual and a distinct culture for the community based on Islamic ideals and values. The basic concept of Islam is to avoid mixing genes as Islam enjoins the purity of genes and heredity.

Attitude to Health↗

Eugenics, McGill, and the Catholic Church in Montreal and Quebec: 1890-1942.

Tracing the origins of eugenics in Canada and seeking to apply a national model, the article explores the juxtaposition between the movement's origin in Britain and its popularity in the Canadian academic milieu, and its condemnation in Quebecois intellectual circles. The first aspect of the movement is explored through the work of two McGill professors, Carrie Derrick and J.G. Adami. In contrast, there is both apathy and resistance from the Quebecois polity--and the influence of Catholicism in forming a resistant position to the eugenics movement--to consider. The impact of works by Blais, Forest, and others are examined in this respect. The conclusion argues for a bifurcated response to eugenic ideas in Quebec, divided along linguistic-cultural lines.

Canada↗

Ethical perspectives on Jehovah's Witnesses' refusal of blood.

When Jehovah's Witnesses refuse blood, they regularly ask their physicians to explore and provide all other medically and scientifically based alternatives, even when these alternatives may not be as effective and may carry risk of failure that could lead to physical disabilities or death. An awareness of the values at stake and of other cases from personal experience and the literature can help physicians, patients, and their families to move toward ethically responsible decisions and actions.

Adolescent↗

Ethics of genetic counseling--basic concepts and relevance to Islamic communities.

Scientific advances and technical developments in the field of laboratory diagnosis and their practical applications have raised ethical issues linked to religion, beliefs, lifestyle and traditions prevailing in different communities. Some of these are pertinent to genetic screening at various stages of life, prenatal diagnosis and the right of the genetically affected fetus to live--all aspects relevant to inbreeding marriages. Of relevance are medical and ethical principles based on professional responsibility. These ideological and social aspects encounter the challenges of science and its applications in the health field, which are linked, directly or indirectly, to scientific achievements and applications related to human genetics. Analysis of the human genome and identification of its sequence, and chemical components, and theories arising from connection of human genome components in health and disease conditions, have led to global requirements to outline legal aspects and ethical principles in relation to diagnosis, prevention and health care. This paper presents basic aspects of disseminating genetic information, guiding the individual, the couple, or the concerned family through genetically induced ill health and methods of control and prevention. The paper discusses the elements and manner and presents details of the application of genetic counseling in Islamic communities in light of scientific, religious, social and legal aspects in the Islamic arena.

Awareness↗