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Thoughts on the Jewish perspective regarding organ transplantation.

The purpose of this article is to convey some understanding of Orthodox Jewish thought on organ donation and transplantation. This perspective is particularly important as practitioners become more culturally diverse and medical care becomes more globalized. The Jewish ethical position, found in the Compendium on Medical Ethics: Jewish Moral, Ethical and Religious Principles in Medical Practice, is described. Points of view for determining death in Jewish law as well as some halakic (Jewish law) issues for the donor and recipient are also indicated.

Attitude to Health↗

Islamic views on organ donation.

As medical technology continues its advance, the use of organ transplantation for the palliation and cure of chronic diseases is rising. However, many barriers to organ donation exist, including religious ones. It has long been known that Muslims in North America tend not to donate organs. In the past this tendency has been attributed to religious prohibitions even though cultural views may also play a strong role. The purpose of this article is to explore and define the Islamic religious opinion on organ donation and transplantation to enhance healthcare professionals' understanding of Islamic views concerning brain death and organ donation. It is hoped that this knowledge and understanding may benefit both patients and caregivers in the North American healthcare setting.

Attitude to Death↗

Management of the severely anemic patient who refuses transfusion: lessons learned during the care of a Jehovah's Witness.

OBJECTIVE: To present the case of a Jehovah's Witness with severe anemia and to review the religious philosophy of such patients, the ethical and medicolegal aspects of their care, and the therapeutic options available to clinicians. DATA SOURCES: A MEDLINE literature search (1980 to 1992) identified most studies. Other studies were selected from the bibliographies of identified articles. STUDY SELECTION: Selection of articles was limited to the history, philosophy, medicolegal and ethical issues, and clinical management of anemic Jehovah's Witnesses; a recent article on recommendations for red cell transfusion was also reviewed. CONCLUSIONS: A clear understanding of the philosophy of the Jehovah's Witnesses regarding blood transfusion and of the medicolegal and ethical aspects of their care is essential to clinicians who care for such patients. One must also be aware of the many alternative therapeutic options that can maximize oxygen delivery and minimize oxygen consumption. The insights gained from this review are applicable to any severely anemic patient who refuses blood transfusion.

Aged↗

Physicians and patient spirituality: professional boundaries, competency, and ethics.

Clinical studies are beginning to clarify how spirituality and religion can contribute to the coping strategies of many patients with severe, chronic, and terminal conditions. The ethical aspects of physician attention to the spiritual and religious dimensions of patients' experiences of illness require review and discussion. Should the physician discuss spiritual issues with his or her patients? What are the boundaries between the physician and patient regarding these issues? What are the professional boundaries between the physician and the chaplain? This article examines the physician-patient relationship and medical ethics at a time when researchers are beginning to appreciate the spiritual aspects of coping with illness.

Adaptation, Psychological↗

Ethical issues at the start of life.

In this article the fundamentals of a Jewish ethic are set out, through which today's pressing medical ethical questions are then broached. Ethics derive from a basic view of humanity. The Bible teaches that man is created in God's image, and every life is therefore sacrosanct. Second, since life is God-given we are its guarantors, not its owners. Finally, monotheism sees God as above nature and not in it, so nature itself is not holy--man can, and indeed should, try to improve upon it. With reference to specific medical issues, the need to be wary of the erosion of the family unit and of personal identity is stressed. Concerning abortion and stem cell research, the point is made that an embryo is not a person but is a potentiality and therefore not an object to be used. Regarding genetic intervention, a line is drawn between the therapeutic and the eugenic. Every technology carries with it the possibility of diminishing or enhancing human dignity. What matters is how we use it. The way to use it is in a covenant with God, honouring his image that is mankind.

Ethics↗

Cultural differences: practising medicine in an Islamic country.

Islam and Muslims have been in the headlines recently for one reason or another. But the practice of medicine in an Islamic conservative country such as Saudi Arabia has not been adequately reported. Many questions about cultural differences in the practice of medicine have been directed at me by non-Muslim colleagues. Below, I have tried to answer some of them after practising at a university hospital in Saudi Arabia for the last 25 years.

Abortion, Induced↗

Louder than words. A multi-institutional system sets ethical standards for corporate action.

After establishing its Resource Center for Ethical concerns, Wheaton Franciscan Services, Inc. (WFSI), Wheaton, IL, set out to develop corporate ethics standards. The standards were to manifest a vision that acknowledged the mutuality of relationships among providers and those they serve, and among local and global communities. To establish "ownership" of the standards, WFSI wanted to involve as many people as possible in the planning process. Center staff established a 25-member working task force with broad representation of disciplines and system institutions, then prepared a position paper to serve as a basis for the formulation of the standards. The paper examined current issues in corporate ethics, the theoretical basis of corporate ethics, the appropriateness of corporate ethics for Catholic-sponsored institutions, and the role ethics standards play in an institutional setting. Staff then prepared the first draft of corporate standards. At the first workshop in October 1988, task force members critiqued the draft and modified the proposed corporate standards. Staff sent the draft for critique to a total of 157 persons throughout the system and encouraged them to pass it around to get the advice of others. From the feedback, staff compiled a third draft, which was ultimately approved. WFSI's Corporate Ethics Standards addresses provision of services, relationship with employees, social responsibility, confidentiality, and conflict of interest.

Catholicism↗