Does the philosophy of medicine exist?

There has been a great deal of discussion, in this journal and others, about obstacles hindering the evolution of the philosophy of medicine. Such discussions presuppose that there is widespread agreement about what it is that constitutes the philosophy of medicine.Despite the fact that there is, and has been for decades, a great deal of literature, teaching and professional activity carried out explicitly in the name of the philosophy of medicine, this is not enough to establish that consensus exists as to the definition of the field. And even if consensus can be obtained as to what constitutes the philosophy of medicine, this does not mean that it exists as a field.     

Christian Ethics,Religious Ethics,and Secular Ethics: A Contemporary Reappraisal

In this essay, I argue that Christian ethicists should not think of themselves as religious ethicists. I defend this claim by arguing that the concept of religious ethics, as it has come to be understood as a discipline that is distinct from secular ethics, is incoherent. In part one, I describe the fraught attempts by theologians in the 20th century to identify the distinctiveness of Christian ethics. In part two, I argue that certain accounts of natural law unwittingly reinforce a problematic conception of secular ethics. Part three examines some trends in religious studies and comparative religious ethics to highlight problematic conceptions of religion. Drawing together these strands of inquiry, I contend that that the secular-religious dichotomy in contemporary ethics should be rejected, but by the same token, I suggest that comparative ethics remains a worthwhile enterprise.     

‘Just leave it blank’ non-religious children and their negotiation of prayer in school

ABSTRACT

This article examines how non-religious children experience acts of collective worship and prayer in primary school settings and analyses how they negotiate religion and their non-religious identities in these events. Drawing on ethnographic fieldwork examining non-religious childhoods and collective worship in three English primary schools, the authors explore how non-religious children demonstrate their agency when confronted with particular boundaries and concepts related to religion and non-religion in school contexts. Attending to the experiences, perspectives, and practices of non-religious children adds to our understanding of the varieties of non-religion, which has to date largely focused on elite, adult populations. Focusing on non-religious children’s experiences of prayer reveals how these children did not experience tensions between praying to God and their non-religious identities and articulated their own interpretations of these practices, deepening understanding of the lived realities of non-religious cultures and identities.     

National Context,Parental Socialization,and the Varying Relationship Between Religious Belief and Practice

Parents are crucial agents of religious socialization, but the broader social environment is also influential. A key question is whether parents are more or less influential when their religious beliefs and practices are not shared by people around them. Current thinking on the issue has largely been shaped by Kelley and De Graaf, who argued that parental religious socialization matters most in secular countries. We maintain that that conclusion is mistaken: levels of parental and national religiosity are both important, but their effects are largely independent of each other. Kelley and De Graaf's findings rely on the assumption that religious belief and practice are different expressions of the same underlying phenomenon (religiosity) and vary in the same way across time and space. These measures are not equivalent, however. In relatively religious societies, belief in God is widespread even among those who do not attend services, whereas in societies where religious involvement is low, nonchurchgoers tend to be nonbelievers.     

From agape to organs: religious difference between Japan and America in judging the ethics of transplant

This essay argues that Japan's resistance to the practice of transplanting organs from persons deemed "brain dead" may not be the result, as some claim, of that society's religions being not yet sufficiently expressive of love and altruism. The violence to the body necessary for the excision of transplantable organs seems to have been made acceptable to American Christians at a unique historical "window of opportunity" for acceptance of that new form of medical technology. Traditional reserve about corpse mutilation had weakened and, especially as presented by the theologian Joseph Fletcher, organ donation was touted as both expressive of agape and a way of "updating" Christianity via the ethics of Utilitarianism. Many Japanese, largely Buddhist and Confucian in their orientation, view these changed valorizations as neither necessary nor patently more ethical than those of their own traditions.     

Time trends in the adjustment of Swedish teenage girls: a 26-year comparison of 15-year-olds

The aim of this study was to investigate stability and change over 26 years in self-reported adjustment of Swedish teenage girls. Data were collected with the same questionnaire from two school-cohorts in a middle-sized Swedish community: 522 girls attending Grade 8 (approximately at age 15) in 1970, and 529 girls attending Grade 8 in 1996. The first cohort was part of the longitudinal research programme Individual Development and Adaptation (IDA). In most domains, adjustment problems were approximately as common in 1996 as in 1970, with two exceptions: more girls reported problems with self-esteem and antisocial problems in 1996. In the antisocial domain, a polarization process was indicated, with an increase also in the number of girls without adjustment problems. In the relational domains, especially peer relations, there was an increase in positive adjustment. The results are discussed in relation to earlier findings and to social changes during the period.     

Love and space in the nursing home

Nursing homes and other institutionsdesigned for persons with impairments are not,in fact, designed for persons with impairments.They are typically designed for theimpairments, not the persons, and therebybecome a part of the problem by reinforcingphysical and cultural manifestations of theimpairments. In the essay that follows, Idescribe an architectural design project inwhich students were asked to make changes to anexisting nursing home for the persons who livedthere. This requires not only becoming familiarwith the spaces, but with the personsthemselves and designing space to helparticulate their voices and being. This revised version was published online in June 2006 with corrections to the Cover Date.     

The ‘redefinition of death’ debate: Western concepts and western bioethics

Biomedicine is a global enterprise constructed upon the belief in the universality of scientific truths. However, despite huge scientific advances over recent decades it has not been able to formulate a specific and universal definition of death: In fact, in its attempt to redefine death, the concept of death appears to have become immersed in ever increasing vagueness and ambiguity. Even more worrisome is that bioethics, in the form of principlism, is also endeavouring to become a global enterprise by claiming neutrality. It appears that the discourse within both disciplines have similarly manipulated the boundaries of death to include the “dying”. This paper argues that the redefinition of death debate in biomedicine reveals a concept of personhood which is profoundly western in origin and which is in accordance to the concept adhered to within principlism. Biomedicine and bioethics do not appear to acknowledge the limitations of their own world view and hence lack an understanding of their applicability and appropriateness in diverse social and cultural contexts; a situation which adds credence to claims as to the hegemonic and imperialistic nature of all such global enterprises. Ms. Jones is an intensive care clinical nursing specialist. Dr. Kessel is a public health physician and medical ethicist.