Beyond barbarity and concealment: animal sacrifice and religious slaughter in Islamic responses to postdomesticity

In a society where animals to be consumed as food are produced using modern industrial animal farming system (described as postdomestic in Bulliet [2005 Bulliet, R. W. 2005. Hunters, Herders, and Hamburgers: The past and Future of Human–Animal Relationships. New York: Columbia University Press. [Google Scholar]]), most people who consume animals are very much removed from the production process. Most consumers do not participate actively or have intimate knowledge of the rearing and slaughtering of animals for food. In this article, I critically analyse existing Islamic responses to problems arising from the postdomestic condition with regard to consuming animal as food. In this article, my analysis focuses on making explicit the connection between the assumption of barbarity in the civilising discourse surrounding religious requirement for animal slaughter and the problem of postdomestic concealment of animals we consume. Furthermore, I analyse the role that the Islamic requirement for animal slaughter (zabiha) and the tradition of Festival of Sacrifice (eid al-adha) can have potential solutions that religion can offer to the problems of postdomesticity.     

Researching stigma as an outsider: considerations for qualitative outsider research

In this article, we discuss a number of important considerations that we have encountered in the process of researching health stigma topics as “outsiders”: researchers (personally) unfamiliar with the experience or topic under study. In particular, we discuss the importance of the following: a reflective stance, challenging negative representations, flexible and sensitive recruitment strategies, validating experiences of stigma, and participant control and power. We see these points as particularly important in the context of researching stigma as outsiders, where our privilege may contribute to unhelpful, narrow, de-politicized or overly simplistic representations of particular “groups” or experiences. We share these considerations in hope of assisting other researchers to reflect on, and articulate, how they negotiate their positionings within their research and the ways in which they shape and construct the research agenda and, by implication, the people or topics under examination.     

A Pilot Evaluation of Portfolios for Quality Attestation of Clinical Ethics Consultants

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step on the pathway to an eventual certification process for clinical ethics consultants.     

An Ethical Exploration of Barriers to Research on Controlled Drugs

We examine the ethical, social, and regulatory barriers that may hinder research on therapeutic potential of certain controversial controlled substances like marijuana, heroin, or ketamine. Hazards for individuals and society and potential adverse effects on communities may be good reasons for limiting access and justify careful monitoring of these substances. Overly strict regulations, fear of legal consequences, stigma associated with abuse and populations using illicit drugs, and lack of funding may, however, limit research on their considerable therapeutic potential. We review the surprisingly sparse literature and address the particular ethical concerns pertinent to research with illicit and addictive substances, such as undue inducement, informed consent, therapeutic misconception, and risk to participants, researchers, and institutions. We consider the perspectives of key research stakeholders and explore whether they may be infected with bias. We conclude by proposing an empirical research agenda to provide an evidentiary basis for ethical reasoning.     

Ethics Consultation Quality Assessment Tool: A Novel Method for Assessing the Quality of Ethics Case Consultations Based on Written Records

Although ethics consultation is offered as a clinical service in most hospitals in the United States, few valid and practical tools are available to evaluate, ensure, and improve ethics consultation quality. The quality of ethics consultation is important because poor quality ethics consultation can result in ethically inappropriate outcomes for patients, other stakeholders, or the health care system. To promote accountability for the quality of ethics consultation, we developed the Ethics Consultation Quality Assessment Tool (ECQAT). ECQAT enables raters to assess the quality of ethics consultations based on the written record. Through rigorous development and preliminary testing, we identified key elements of a quality ethics consultation (ethics question, consultation-specific information, ethical analysis, and conclusions and/or recommendations), established scoring criteria, developed training guidelines, and designed a holistic assessment process. This article describes the development of the ECQAT, the resulting product, and recommended future testing and potential uses for the tool.     

Exposure-based Interventions for the management of individuals with high levels of needle fear across the lifespan: a clinical practice guideline and call for further research

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle fear in children and adults. The AGREE-II, GRADE, and Cochrane methodologies were used. Exposure-based interventions were included. The included evidence was very low quality on average. Strong recommendations include the following. In vivo (live/in person) exposure-based therapy is recommended (vs. no treatment) for children seven years and older and adults with high levels of needle fear. Non-in vivo (imaginal, computer-based) exposure (vs. no treatment) is recommended for individuals (over seven years of age) who are unwilling to undergo in vivo exposure. Although there were no included trials which examined children < 7 years, exposure-based interventions are discussed as good clinical practice. Implementation considerations are discussed and clinical tools are provided. Utilization of these recommended practices may lead to improved health outcomes due to better health care compliance. Research on the understanding and treatment of high levels of needle fear is urgently needed; specific recommendations are provided.     

Changes in disengagement coping mediate changes in affect following mindfulness‐based cognitive therapy in a non‐clinical sample

Past research has shown that mindfulness‐based interventions increase positive affect in non‐clinical populations. However, the mechanisms underlying this increase are poorly understood. On the basis of previous empirical and theoretical accounts, we hypothesized that a decreased use of disengagement coping strategies in daily life would explain the benefits of a mindfulness‐based intervention in terms of increased positive affect. We analysed the data of 75 healthy adult participants (58 women; 17 men) of different ages (M = 49 years old; SD = 13; age range 19–81) who had been randomly allocated to 8‐week Mindfulness‐Based Cognitive Therapy (MBCT) or to a waitlist control group. The results confirmed our hypothesis: Participants in the MBCT group showed significant improvements in positive affect compared to the control group, with decreased use of disengagement coping styles mediating these improvements. The implications of this study are discussed.     

A Postcolonial Framework for Justification and Eco‐Justice

This work proposes a relationship between eco‐justice and justification by grace rooted in a phenomenological approach. The reality of structural sin experienced by persons living in economic poverty on the African continent is interpreted through the lens of Lutheran catechetical ethics. Lives of repentance will lead to incarnational interventions striving for concrete social transformation.     

Is This Relevant? Physician Perceptions,Clinical Relevance,and Religious Content in Clinical Interactions

Despite wide support among physicians for practicing patient‐centered care, clinical interactions are primarily driven by physicians’ perception of relevance. While some will perceive a connection between religion and patient health, this relevance will be less apparent for others. I argue that physician responses when religious/spiritual topics come up during clinical interactions will depend on their own religious/spiritual background. The more central religion is for the physician, the greater his or her perception of religion's impact on health outcomes and his or her inclusion of religion/spirituality within clinical interactions. Using a nationally representative sample of physicians in the United States and mediated path models, I estimate models for five different physician actions to evaluate these relationships. I find that a physician's religious background is strongly associated with whether or not he or she thinks religion impacts health outcomes, which is strongly predictive of inclusion. I also find that not all of the association between inclusion and physicians’ religious background is mediated by thinking religion impacts health outcomes. Issues of religion's relevance for medicine are important to the degree that religious beliefs are an important dimension of patients’ lives.