The dilemma of conscience in Christian belief: A pastoral perspective

This article describes the crisis of integrity experienced by a trinitarian Christian attempting to take seriously the results of current Jesus scholarship. It explores a number of traditional methods for reconciling the Jesus of history with the Christ of faith, and proposes a different paradigm, based on the structure of kairos time and the psychological dynamics of friendship.     

Encountering non-Christian Chinese international students: cross-cultural adaptive practices of local Christian organisations in the UK

ABSTRACT

This paper explores the cross-cultural organisational adaptation of host religious organisations through their interaction with non-Christian Chinese international students in the UK. Grounded in Kim’s integrative adaptation theory, the research employed the methods of participant observation, interviews and document analysis to examine the interaction of international students with two specific churches (part of the Church of Scotland). The study found that in order to provide international engagement, the churches in question underwent cross-cultural organisational adaptation and transformation with a consideration of the cultural differences and the needs of Chinese students in intercultural communication, including in terms of multicultural team building, the improvement of intercultural competence and adaptive religious practices. These adaptive transformations or ‘customised services’ attracted and engaged large numbers of Chinese students in the intercultural interaction surrounding congregations. The cultural adaptation of host congregations contributes to the quality of social support for international students as well as the intercultural expansion of Christian values and beliefs throughout the trend of student mobility.     

In the world but not of it: managing the conflict between Christian and institution.

Christian physicians, nurses and other health care workers must manage a daily conflict of conscience between their Christian faith and predominantly secular health care institutions. This essay examines various efforts for managing these conflicts: a turn towards social justice or a seeking of holiness. Seeking social justice, however, is theologically empty. Traditionally, the Christian requirement that we be "in this world but not of it" requires a journey along a narrow path to holiness. Christian medical morality must, therefore, be understood within this light. However, just as there cannot be generic health care, but rather health care for a particular person's needs and problems there cannot be generic holiness, but only a holiness grounded in worshiping God rightly. In so worshiping the Christian will be assisted in negotiating the inescapable and perilous vocation of being in the world but not of it.     

The moral psychology of rationing among physicians: the role of harm and fairness intuitions in physician objections to cost-effectiveness and cost-containment

Introduction

Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called “moral foundations.” The objective of this study was to determine if “harm” and “fairness” intuitions can explain physicians’ judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to “purity”, “authority” and “ingroup” in cost-related judgments.

Methods

We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care.

Results

1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values?>?0.05). Agreement with cost-containment was associated with higher mean “harm” (3.6) and “fairness” (3.5) intuitions compared to “in-group” (2.8), “authority” (3.0), and “purity” (2.4) (p?<?0.05). In multivariate models adjusted for age, sex, region, and specialty, both “harm” and “fairness” were significantly associated with judgments about cost-containment (OR?=?1.2 [1.0-1.5]; OR?=?1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR?=?1.2 [1.0-1.4]; OR?=?0.9 [0.7-1.0]).

Conclusions

Moral intuitions shed light on variation in physician judgments about cost issues in health care.

     

On the Christian in Christian bioethics.

What is Christian about Christian bioethics? And is an authentically Christian bioethics a practical possibility in the world in which we find ourselves? In my essay I argue that personhood and the personal are so fundamental to the Christian understanding of our humanity that body, soul, and spirit are probably best understood as the components of a triune (as opposed to dual) aspect theory of personhood. To confess to a Christian bioethics is to admit that Christians cannot pretend fully to understand either cures or their meaning. However effective and "knowledge-based" contemporary medical interventions are, a Christian must humbly and honestly confess a lack of complete knowledge on both levels. At the same time, a Christian bioethicist must express a total personal commitment to Christian Faith.     

The ontology and temporality of conscience

Philosophers have often posited a foundational calling voice, such that hearing its call constitutes subjects as responsive and responsible negotiators of normative claims. I give the name ldquo;transcendental conscience to that which speaks in this founding, constitutive voice. The role of transcendental conscience is not – or not merely – to normatively bind the subject, but to constitute the possibility of the subject's being bound by any particular, contentful normative claims in the first place. I explore the ontological and temporal status of transcendental conscience, using Heidegger's account of conscience in Being and Time as my textual touchstone. I ask what performative structure the call of conscience might have that would enable it to constitute normative responsiveness, and I raise some temporal conundrums surrounding this structure. I argue that it is incoherent to attempt to give a literal, chronological account of the origin of normative grip and response. I suggest that we can best understand the founding calls of conscience, not as literal events occurring in regular time, but as events that can only show up retrospectively, as occurring in an ever-receding, unlocalizable past, and that these calls can only be figured mythically and metaphorically. Appropriating a Derridean term, I claim that the voice of transcendental conscience must be that of a lsquo;ghost, whose call binds us by haunting us – a haunting that is no less transcendentally necessary for its inability to be translated into a literal historical event.     

The conscience and convenience of sentencing reform in Indiana

Over the course of the past decade and a half, enormous energy and talent have been devoted to the issue of determinate sentencing. Yet today we know little about the values underlying this reform, and we know even less about the efficacy of determinate sentencing as a crime control policy. This article considers these issues in Indiana 10 years after the renovation of the state's Penal Code. Through a survey of state legislators, an examination of law, official statistics, and personal interview data, the analysis endeavors to understand the ideologies, pragmatics, and impacts of sentencing reform. It is suggested that the implementation of determinate sentencing represents a corruption of both good intentions (“conscience)” and policy objectives. Parenthetically, the article argues that the constructs known as the crime control model and the justice model both constitute a case of arid scholasticism. That is, sentencing reform can be more fully understood in terms of organizational “convenience”.     

The Cost of Being Christian: The Association between Christian Affiliation and Discrimination Experiences among Asians in the United States

Whether religion contributes to or mitigates social inequality is ongoing. This study provides new evidence by examining the association between Christian affiliation and Asian citizens’ discrimination experiences. Using data from the National Asian American Survey and employing the Inverse Probability Treatment Weighting approach, this study finds that having a Christian affiliation is significantly associated with more interpersonal discrimination experienced by Asians in the United States. Strengthened ethnic identity and intraracial contact largely explain the association. Results from several robustness tests confirm this finding. There is a cost of being Christian for Asians in the United States.     

Harmful dysfunction and the search for value neutrality in the definition of mental disorder: response to Wakefield, part 2

Wakefield's claims to have identified and objective scientific component of mental disorders in the concept of dysfunction are examined in light of previous attempts to state a value free concept of mental disorders. The harmful dysfunction concept of dysfunction is not value free because it confounds cause and purpose in a specious use of evolutionary theory and because evolutionary theory cannot reliably supply standards for when a function is broken. Harmful dysfunction analysis collapses into a value-laden concept of mental disorders and serves the untoward goal of promoting the status quo in the modern DSMs. If the concept of dysfunction were taken seriously and rigorously defined, then it might be possible to separate what is medical from what is not in the domain of mental disorders.