The Abuse of Power: A View of Sexual Misconduct in a Systemic Approach to Pastoral Care

The article explores the dynamics of transference and countertransference in hierarchical relationships which exist between clergy and lay persons, both in the parish setting, as well as in the pastoral counseling relationship. It is of utmost importance that the power differential be consciously acknowledged by pastoral caregivers so that appropriate boundaries can be exercised. All too often it is the negligent, careless, or unconscious disregard for this power dynamic by individuals providing pastoral care that has led to the sexual violations recently surfaced within our religious institutions. Acknowledgement of the imbalance of power, and its consequences for both clergy and parishioner, is essential in a systemic model of pastoral care.     

The bioethics of care: widows, monastics, and a Christian presence in health care.

At the beginning of the twenty-first century, with vocations to the Christian religious orders of the West in marked decline, an authentic Christian presence in health care is threatened. There are no longer large numbers of women willing to offer their life labors bound in vows of poverty, chastity, and obedience, so as to provide a real preferential option for the poor through supporting an authentic Christian mission in health care. At the same time, the frequent earlier death of men leaves a large number of widows, some in need of care and some able to provide care. Drawing on the role of widows sketched in 1 Timothy 2, one can envision Christian widows entering a life of prayer and service in health care settings. As female monastics, such widows could reintroduce a salient Christian presence in health care. How one ties this response to the message of 1 Timothy 2 will depend on one's understanding of the status of Scripture, the significance of tradition, the nature of theological epistemology, the meaning of theology, the nature of the Church, and the ontology of gender. The position taken on these issues will define the character of a Christian bioethics of care.     

关注焦点:女性主义伦理学、发展理论与人权

从两个方面探讨--强调全球性的关注和女性主义伦理学的交叉:人权及发展理论.首先,对以权利为基础的理论进行批评.其次,在人权运动中,努力考虑全球的健康问题.尔后,采纳可选择的范例是,寻求结合发展和人权理论形成一个全球伦理.最后,对于全球女性主义伦理学提出一个可选择的框架,对于实践有更充分的应答,以加强所有人享受健康及生育的能力.     

论当代生命伦理学与人权

生命伦理学面临诸多的伦理问题,其中最为凸显的是人权困境,生命伦理学与人权有着内在的本质联系和契合点,人权是生命伦理的核心和生长点,人权的基本理论和原则使生命伦理学的存在与发展成为可能,并且成为活生生的伦理现实。生命伦理学饱含丰富的人权意蕴,成为人权理论合理性的印证。要科学审视当代生命伦理学和人权关系,化解人权困境,推动生命伦理学的发展。     

GLOBAL BIOETHICS: TRANSNATIONAL EXPERIENCES AND ISLAMIC BIOETHICS

In the 1970s “bioethics” emerged as a new interdisciplinary discourse on medicine, health care, and medical technologies, primarily in Western, developed countries. The main focus was on how individual patients could be empowered to cope with the challenges of science and technology. Since the 1990s, the main source of bioethical problems is the process of globalization, particularly neo‐liberal market ideology. Faced with new challenges such as poverty, inequality, environmental degradation, hunger, pandemics, and organ trafficking the bioethical discourse of empowering individuals is no longer sufficient. Global bioethics nowadays is concerned with applying and implementing a universal ethical framework. Islamic bioethics has contributed to creating such framework (exemplified in the UNESCO Universal Declaration on Bioethics and Human Rights) while at the same time it is continuously articulating and interpreting this framework in specific settings and contexts.     

当代医学伦理学的四种研究进路及其反思

当代中国医学伦理学尚未形成统一的学科范式,但主要有四种研究进路：应用伦理学进路、经验主义进路、道德教育进路和生命伦理学进路。这四种进路在学术界占据着主导地位,构成了医学伦理学的基本知识图景。但是任何未经反思的知识前提都是不可靠的,需要从本体论、知识论和价值论的层面对它们进行认真的反思,以构建更加科学和系统的理论体系。在本体论上,需要考虑伦理学概念的本质属性及其与医学实践的联系。在知识论上,需要质疑伦理理论和具体应用之间的适用性和相关性。在价值论上,需要考虑伦理学研究和实践中所涉及的价值取向。

     

欧美生命伦理委员会的机构建设与咨询服务

在当今国际世界,生命伦理学已经发展成一种国际性的“社会运动”,成为学术界和公众关注的热点领域。在欧美国家健全和完善现代医疗保健制度过程中,“生命伦理委员会”起到至关重要的作用,它不仅促使人们从伦理学角度探索“我/我们应当如何决定和行为”的问题,也推动社会从制度建构和文化塑造层面回答“政府应当如何行为”、“如何增进公民的生命伦理意识”等问题,并从哲学领域深入探索如何应对生命伦理学理论与实践中的复杂问题与困境,论证相关伦理选择及其实践的合理性。20世纪60年代以来,欧美社会生命伦理学在机构建设、咨询服务和思维方式等方面的经验可以为中国生命伦理学学科发展及生命伦理委员会建设提供有益的参考。     

REVEREND ROBOT: AUTOMATION AND CLERGY

Digital technology, including artificial intelligence, is having a dramatic impact on the professions of medicine, law, journalism, finance, and others. Some suggest that clergy will also be affected. We describe recent progress in designing artificially intelligent systems, suggesting that this is possible, perhaps even likely. We investigate ways in which technology currently is affecting ministry and outline some plausible scenarios in which digital systems could supplement or supplant clergy in some areas, specifically preaching and pastoral care. We also raise some theological issues raised by the use of digital systems in ministry.     

Perspectives from the Edge: Chaplains in Greater Boston, 1945–2015

We follow Bender et al.’s (Religion on the Edge: De‐Centering and Recentering the Sociology of Religion) call to study religion “on the edge” by looking at the work of chaplains, religious professionals who work outside of congregations. Rather than studying chaplains within a single type of institution—the military, healthcare, or other sectors—we shift the unit of analysis to geography, asking where chaplains in Greater Boston worked between 1945 and the present. Based on coverage in the Boston Globe, we find that chaplains, mostly men, worked across Greater Boston between 1945 and 2015. The majority were Catholic with frequent minorities of Protestants and Jews, and—after 1995—a few Buddhists, Muslims, and Humanists. Most worked in higher education, healthcare, and prisons. While much of the chaplains’ work seems improvisational and varied, we identify services related to ceremonies, bearing witness, and working around death as common occurrences across the venues where chaplains worked. To the extent that these patterns are evident in other cities, they suggest that chaplains have regularly been a quiet part of the religious landscape, that they are a consistent part of the institutional field, and that their work has more commonalities across sectors than previous studies suggest.     

Pragmatism as a research program--a reply to Arras

This paper is a reaction to an article by John Arras published earlier in this journal. In this article Arras argues that freestanding pragmatism has little new to offer to bioethics. We respond to some of Arras' arguments and conclude that, although he overstates his case at certain points, his critique is, broadly speaking, correct. We then introduce and discuss an alternative approach to pragmatist ethics, one which puts to work the ideas and insights of pragmatism conceived as a broad philosophical movement, without lapsing into a canon dependent approach. The approach we propose exhibits a number of characteristics that differ from Arras'saccount of freestanding pragmatism and offers something new to bioethics.     

Protestant Clergy and the Culture Wars: An Empirical Test of Hunter's Thesis

Examinations of culture wars typically assess the attitudes of the American public. This study instead focuses on culture wars among religious elites—clergy—and tests three aspects of the culture wars thesis: (1) whether religious elites are engaged in culture wars, (2) whether clergy attitudes are polarized on these issues, and (3) whether religious authority or religious affiliation is more salient in creating culture wars cleavages. Using data from a large random sample of Protestant clergy, we find a substantial amount of engagement in culture wars by all types of Protestant clergy. The amount of polarization is more attributable to views of religious authority (i.e., biblical inerrancy) than to religious tradition. Moreover, polarization among clergy is somewhat more evident on culture wars issues than on other social and political issues. These findings are generally supportive of the culture wars thesis and should help return examinations of culture wars back to where they were originally theorized to be waged: among elites.     

Saints and Sinners: Training Papua New Guinean (PNG) Christian Clergy to Respond to HIV and AIDS Using a Model of Care

Papua New Guinea has experienced a growing HIV/AIDS epidemic. The Christian Churches have played a vital role in responding to HIV, through community support, encouragement and social change. Strong, effective Church leadership can help create safe environments of care and support for those infected and for prevention of HIV. Method A series of trainings in capacity development for clergy were undertaken by the National AIDS Council Secretariat (NACS)/National HIV/AIDS Support Project (NHASP). Results A model “Church’s Response to HIV and AIDS in a Care Continuum” was developed to assist the training. This paper discusses the model and the lessons learned.

Widows, women, and the bioethics of care.

Widows, women, and the bioethics of care must be understood within an authentic Christian ontology of gender. Men are men and women are women, and their being is ontologically marked in difference. There is an ontology of gender with important implications for the role of women in the family and the Church. The Christian Church has traditionally recognized a role for widows, deaconesses, and female monastics, which is not that of the liturgical priesthood, but one with a special relationship to care and therefore with particular implications for health care and a Christian bioethics of care in the twenty-first century. In the shadow of early male mortality, women as wives should turn to support their husbands and as widows to support those in need. Widows, in becoming authentic Christian monastics, can bring into the world an icon of rightly ordered women providing rightly ordered Christian care for those in need. They can enter the moral vacuum created by misunderstandings of the place of women and the service vacuum created by a disappearance of religious nuns in Western health care facilities with a presence that is at one with the Church of the Fathers.     

Publicly Accessible Intuitions: "Neutral Reasons" and Bioethics

This article examines Leon Kass's contention that a choice forphysician-assisted suicide is "undignified." Although Kass isJewish rather than Christian, he argues for positions that mostChristians share, and he argues for these positions withoutpresupposing the truth of specific religious claims. I arguethat although Kass has some important intuitions, he too readilyassumes that these intuitions will be shared by his audience,and that this assumption diminishes the force of his argument.An examination of the limitations of Kass's argument is helpfulinsofar as it illustrates the real challenge faced by religiousbelievers who wish to defend their beliefs in the "public forum."For it illustrates that what needs to be made "accessible" isthe Judeo-Christian understanding of man and his place in theworld. While I do not wish to claim that this task is impossible,I do think that it is far more difficult than most realize.Like all important tasks, however, unless we wrestle with thedifficulties it raises, our arguments will strike many as unconvincing.     

Bioethics' Gender

I argue that the field of bioethics is gendered feminine, but that the methods it uses to resist this gender identity pose real harm to actual women. Starting with an explanation of what I take ‘gender’ to be, I enumerate four drawbacks to being gendered feminine. I then argue that bioethics suffers from three of the same four drawbacks. I show how the field escapes the fourth disadvantage by adopting a masculine persona that inflicts damage on women, and conclude by urging bioethicists to reflect on their complicity in abusive power systems such as gender, race and class.     

AGREEING TO DISAGREE: Indigenous Pluralism from Human Rights to Bioethics

David Hollenbach, working within the context of human rights theory, has developed the notion of "indigenous pluralism" as a means of coping with the problems that arise when different religious traditions hold distinct or incompatible interpretations of human rights. It will be argued that indigenous pluralism is a theoretically and practically useful concept for bioethics as well and hence should be incorporated into bioethical methodology and processes of bioethical policy formation. Subsequently, the notion of indigenous pluralism will be discussed in relation to determinations of death as a means of illustrating this concept's applicability to bioethical inquiry.     

A Trauma-Informed Call to Action: Culturally-Informed,Multidisciplinary Theoretical and Applied Approaches to Prevention and Healing

ABSTRACT

The prevalence of trauma and its negative impact on humankind has created a burgeoning awareness of the need for systems that are trauma-informed across the lifespan. A collaborative project with the National Partnership to End Interpersonal Violence (NPEIV) sought out research as a call-to-action to mitigate the impact of trauma. The following is an introduction to a special double-issue focused on theoretical and applied approaches to using trauma-informed care in multi-disciplinary, mental and physical health, criminal justice, school-based, and community settings. Consideration is given to essential issues such as resilience, self-care, and cultural awareness.     

Ethics in Long-Term Care: Are the Principles Different?

It has become common in medical ethics to discuss difficult cases in terms of the principles of respect for autonomy, beneficence, nonmaleficence, and justice. These moral concepts or principles serve as maxims that are suggestive of appropriate clinical behavior. Because this language evolved primarily in the acute care setting, I consider whether it is in need of supplementation in order to be useful in the long-term care setting. Through analysis of two typical cases involving residents of long-term care facilities, I argue for the additional principles of candor and responsibility for narrative integrity.