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.     

The Dream of Consensus: Finding Common Ground in a Bioethical Context

Consensus is the holy grail of bioethics, the lynch pin of the assumption that well informed, well intentioned people may reach generally acceptable positions on ethically contentious issues. It has been especially important in bioethics, where advancing technology has assured an increasing field of complex medical dilemmas. This paper results on the use of a multicriterion decision making system (MCDM) analyzing group process in an attempt to better define hospital policy. In a pilot program at The Hospital for Sick Children, Toronto, a series of small scale focus groups was constituted to examine criteria defining organ transplant eligibility. Criteria were organized hierarchically using the Analytic Hierarchy Process, an MCDM approach, and the resulting data was analyzed using Expert Choice 9.0, software designed to facilitate AHP analysis. Qualitative and quantitative analysis map barriers to practical consensus in a way not previously possible.     

Medical ethics in Poland

The work related to medical ethics written by Polish authors are reviewed and some topics concerning teaching and various other activities in this field are presented. The attention is centered on the opinions and attitudes concerning the essence of medical profession and the personal model of the physician, doctor-patient relationship (including duties of the doctor), medical research on humans, abortion and other problems. The role of medico-ethical tradition in Poland is described. Main trends in polish ethical thought in relation to medicine are taken into consideration. General aspects of medical ethics in present-day Poland are tentatively characterized.     

Are Christian politics possible? A Kierkegaardian perspective

This paper provides a rereading of Søren Kierkegaard's attack upon Christendom in light of his theory of spheres of existence to examine whether Christian politics are possible after Kierkegaard. Talking of Christian politics makes sense only in the esthetic and the religious spheres of existence. However, Kierkegaard argues that politics worthy of the title Christian are impossible. Either such politics are simply Christendom far removed from New Testament Christianity, or Christian politics are faced with the paradox of existing before God and cannot proceed.     

Report of the Acting General Secretary to the 11th Assembly of the World Council of Churches,Karlsruhe, 2022

This is the text of the report on 31 August 2022 of the acting general secretary of the World Council of Churches (WCC) to the WCC's 11th Assembly, which took place in Karlsruhe, Germany, from 31 August to 8 September 2022.     

The Religious Right and Russia: Christian Nationalism and Americans’ Views on Russia and Vladimir Putin Before and After the Ukrainian Invasion

Since 2016, Americans’ attitudes toward Russia and Vladimir Putin have shifted, with Republicans becoming far more supportive of both. And though condemnation of Russia's invasion of Ukraine in 2022 remains bipartisan, many Christian-right leaders still support Putin and Russia. What undergirds this support? Drawing on three national data sets, we theorize Americans’ warmth toward Putin and Russia is reinforced by an ideology that seeks to institutionalize America's mythical Anglo Protestant ethno-culture—Christian nationalism. Though we propose Christian nationalism's relationship with Russia is more contingent on Russia's geopolitical activity vis-à-vis the United States, we theorize that Christian nationalism consistently predicts Putin support due to his authoritarian ethno-nationalism. April 2018 data show those who affirm America's Christian heritage in the past and/or present are more likely to view Putin and Russia favorably and Russia as our ally. March 2021 data also reveal a linear positive association between Christian nationalism and favorability toward Putin. And March 2022 data reveal a linear positive association between Christian nationalism and admiring Putin's leadership. They also show a U-shaped curvilinear relationship with viewing Russia as a threat. Paradoxically, Christian nationalism may warm Americans toward foreign authoritarians like Putin even when it compels Americans to perceive their nations as threats.     

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.     

Physician-assisted suicide reconsidered: dying as a Christian in a post-Christian age.

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society.     

There is no moral authority in medicine: response to Cowdin and Tuohey.

Central to the Cowdin-Tuohey paper is the concept of a moral authority proper to medical practitioners. Much as I agree with the authors in refusing to degrade doctors to the status of mere technicians, I argue that one does not succeed in retrieving the moral dimension of medical practice by investing doctors with moral authority. I show that none of the cases brought forth by Cowdin-Tuohey really amounts to a case of moral authority. Then I try to explain why no such cases can be found. Developing an insight that is common to all the major moral thinkers in the philosophia perennis, I show that doctors are professionally competent with respect only to a part of the human good; morally wise persons are competent with respect to that which makes man good as man. I try to show why it follows that a) professional expertise has no natural tendency to pass over into moral understanding, and that b) doctor and non-doctor alike start from the same point in developing their understanding of medical morality. It follows that the authors fail in their attempt to de-center the moral magisterium of the Church by setting up centers of moral authority outside of the Church.