Thesis (Ph. D.)--Ohio State University, 2001. / Includes vita. Includes bibliographical references (leaves 588-604). Available online via OhioLINK's ETD Center.

Diss. (sammanfattning) Umeå : Univ., 2008. / Härtill 5 uppsatser.

This thesis is an ethnographic study of a little documented indigenous group, the Warekena people, who live on the Xié River in north-western Amazonia. Examining the mythic histories of the animate riverscape, my work offers an overview of the emergence of riverside dwelling: starting with a macro view of Xié river lifestyles, I explain how seasonal and distinguishing historic-mythic narratives tie in to wider idioms, and to experiences of social reproduction. I focus on reproductive processes and the perinatal period, highlighting methods used by Xié dwellers to nurture healthy, quality-conscious lifestyles, and I examine Xié aetiologies and pathologies. Mindfulness, or awareness, is viewed as a key component of good health. In this context, healthy childbirth is for the birthing mother an art form, a practice for which her total life experience has prepared her. Childbirth is ranked with such other painful experiences as snakebite, and both childbirth and snakebite are opportunities for personal growth. Infant care is seen through the lens of specific, hands-on techniques that promote mindful states in both the carer and the cared for. Mindfulness emerges as a heuristic device that allows us to scrutinize the Amerindian soul and body, also elucidating soul-loss in the ‘animist’ lived world. I argue that mindfulness is a core characteristic of the ‘cool’ hydrocentric and status-conscious lifestyles of Xié river dwellers, and that it defines what it means to be a person, the Xié way.

Zugl.: Würzburg, Univ., Diss., 2006

The question of whether there might be a moral obligation to select against disability in our offspring has received considerable attention and attracted great controversy within both the philosophical community and beyond over the last couple of decades. Within this thesis I examine this question, taking as a basis for discussion the view that prospective parents should be formally free to choose whether or not to select against disability in their offspring in the absence of adequate justifying reasons to the contrary. I then move on to examine and outline arguments that suggest variously and for a plethora of different reasons that selection against disability should be condemned morally or required. After this is done and it is noted that the sheer volume of different positions and arguments requires a more specific focus I, in my thesis articles take what I view to be the strongest of moral reasons, person-affecting reasons, and look to the question of whether it is possible ground a moral obligation to select against disability in our offspring in the person affecting harms that our reproductive choices might produce. In the first paper I ask whether the non- identity problem really poses such an insurmountable obstacle to the claim that to select against disability may harm those that are created as a result of our selection choices. This leads to the conclusion that on certain accounts of personal identity over time and trans-world identity it is possible to determine harm in a number of previously non-identity cases of which the selection against disability case is one. In the second paper I broaden my focus slightly by looking to the possible harms that our procreative choices might impose on others than the children we may create: ourselves, our existing dependents and existing members of society. In doing this it is shown that our reproductive choices do, at least in societies with advanced social and medical welfare systems, have the potential to impose significant burdens on others. However, whilst this is so, it is also demonstrated that this is not necessarily a decisive reason to condemn a reproductive choice to select for or to fail to select against disability in our offspring. In my final paper I take a slightly different approach, focusing less on the question of whether there should be a moral obligation to select against disability in our offspring and more on the question of whether there should exist a legal imperative to do so. Taking as a basis a liberal approach to the moral limits of law I suggest that impingements on individual liberty may only be justified when it can be shown that our reproductive choices cause significant harms or offence to others, I ask whether the recent insertion into English and Welsh Law of a prohibition on selection for disability can be justified. In line with the findings of the previous two papers which are far from conclusive and by examining the reasons given in legal and policy documents in England and Wales relating to this prohibition I suggest that as it stands such a prohibition cannot be justified. This ultimately leads to a rather unsatisfying – but perhaps inevitable, in light of the messy nature of reproduction – conclusion: It is possible to discuss the ethics of selection against and for disability on person-affecting accounts of morality and to discuss the matter in this way offers sensitive and sensible prescriptions. However, such discussions turn out to be, in virtue of the many competing claims of those affected by reproductive decisions and policy, far more complex than might be assumed and do not fit neatly with the commonly held moral intuition that it is always morally preferable to select against disability in our offspring.

This study aimed at getting acquainted with the opinions of physicians and nurses regarding the teaching of Ethics as a response to the needs of professional practice, indentifying ethical conflicts within these professional's practice and getting to know both unfavorable and favorable conditions to the maintenance of ethical affairs within the workplace. The survey was carried out in the city of Aracaju, State of Sergipe and the units of observation were health institutions of the same city. The study sample was simple-random and had nurses and physicians of these health institutions as its respondents. The results showed that the teaching of Ethics in medical and nursing schools is not consistent with the reality experienced by these professionals and the interconnections between theory and practice, as well as the restrictive approach to a particular term or subject and not as a fix element throughout the entire course, is inexistent. Therefore, the respondents which have been experiencing different kinds of ethical conflicts in their workplace routine such as: Inappropriate behaviors towards patients, negligence, inaccuracy, troubled multiprofessional affairs, have been enduring the task of assisting the patients under inappropriate working conditions. They have trouble in making proper decisions since their training process lacked support. Besides ethical conflicts, the workers also reported some unfavorable conditions for the maintenance of ethical relationships in the workplace, such as inappropriate workplace condition and remuneration, hierarchical conflicts, both inappropriate personal and professional practices, the lack of technical ability combined with the ignorance on the ethic code and their careers legislation, among other matters. Therefore, in the light of the demands experienced by physicians and nurses in their working routine, it is reiterated the need for boosting the teaching of Ethics through more dynamic methodologies, interconnected to professional practice situations, as well as becoming a theme for debate throughout the entire undergraduate course. Through this perspective, the training critical, reflexive, ethical and social responsible professionals is definitely a possibility to be believed. / O presente estudo pretendeu conhecer a percepção de médicos e enfermeiros sobre o ensino da ética como resposta às necessidades da prática, identificar situações de conflitos éticos na prática destes profissionais e conhecer as condições desfavoráveis e favoráveis para a manutenção das relações éticas no ambiente de trabalho. A pesquisa foi realizada na cidade de Aracaju-SE, sendo as unidades de observação as instituições de saúde desta. A amostra foi casual simples e foi composta por médicos e enfermeiros lotados nas respectivas instituições de saúde. Através dos resultados obtidos, percebeu-se que o ensino da ética nos cursos de graduação em medicina e enfermagem não é condizente com a realidade vivida por esses profissionais, faltando a correlação entre a teoria e a prática, com abordagem restrita a um período ou a uma disciplina específica, sem permear por todo o curso. Com isto, os respondentes que vivenciam diversos conflitos éticos em seu cotidiano de trabalho tais como: a atitude profissional inadequada com o paciente, a negligência, a imperícia, as relações multiprofissionais conflituosas, submetem a prestar assistência em condições inadequadas de trabalho, entre outros, têm dificuldade em tomar decisões adequadas, visto que não tiveram o devido respaldo no processo de formação. Além dos conflitos éticos, os profissionais também referiram algumas condições desfavoráveis para a manutenção das relações éticas no ambiente de trabalho, entre elas foram destacadas as condições de trabalho e remuneração inadequadas, os conflitos hierárquicos, a prática profissional e pessoal inadequada, o despreparo e a inabilidade técnica associados ao desconhecimento do código de ética e da legislação das respectivas profissões, dentre outros. Assim sendo, diante das demandas vivenciadas no cotidiano dos médicos e enfermeiros, reafirma-se a necessidade de valorizar o ensino da ética através de metodologias mais dinâmicas, correlacionadas com as situações da prática profissional, sendo discutida durante todo o curso de graduação. Através disto, acredita-se na possibilidade de formar profissionais críticos, reflexivos, com maior responsabilidade ética e social.

Neste trabalho foram analisados trinta processos judiciais, que tramitam pelos Fóruns Regionais Cíveis de São Paulo, capital e interior e Instituições Periciais da Capital. Fez-se as extrações individualizadas de cada processo, objetivando definir as principais causas e documentos juntados ao mesmo e conseqüências de cada condição. Iniciou-se pela importância prática do tema para efeito de evolução médico-social. Buscou-se estudar a visão da relação médico-paciente, mesmo durante a demanda, a informação ao paciente e seus familiares dos procedimentos e limitadores do ato médico; o documental técnico jurídico juntado ao processo; o preparo técnico-jurídico do médico e, se, a propositura de ação depende da formação e especialização do profissional. Foram analisados processos judiciais de primeira instância no período de 1996 a 2002 correlacionados à cirurgias do aparelho digestivo. Usou-se como parâmetro de análise exclusivamente os documentos juntados aos autos onde buscou-se a existência clara da quebra da relação médico-paciente, a existência de consentimento informado, a verificação do documental juntado à defesa pelas partes ou solicitação judicial e a qualificação do profissional envolvido nas ações. Finalmente, analisados os resultados, chegamos a conclusão que a melhor forma para profilaxia da ação cível indenizatória por erro médico é: a boa relação médico-paciente; a manutenção de prontuário médico preenchido, legível, com carimbo e assinatura; o consentimento informado, que, deve ser elaborado, porém, por si só não é suficiente; e a condição técnico curricular do profissional não é fator atenuante para propositura da ação. / Thirty legal proceedings, which are in progress before the Regional Civil Courts both the Capital and the countryside of the State of Sao Paulo, Brazil, besides Examination Institutions in the Capital city of Sao Paulo, have been analyzed in this work Individual excerpts of each case were taken with the purpose of defining the main causes and documentation attached to them as well the consequences of each condition. The practical importance of the subject for the medical-social evolution has been addressed in the first place. The physician/patient relationship view was sought to be studied, even during the claim, as well as the information of the medical procedures and limitations to the patient and his or her family; the technical/legal documentation attached to the case; the physician technical/legal preparation and whether the filing of the action depends on the professional education and specialization. Trial court cases from 1996 to 2002 related to digestive system surgery have been analyzed. The analysis subject hereof has been based exclusively on the documents attached to the case record, where attempts have been made to evidence the clear existence of the breach of the physician/patient relationship, the existence of informed consent, the examination of the documentation attached to the defense by the parties or court request, and the qualification of the professional involved in the actions. Finally, after the results have been analyzed, a conclusion was reached that the best way of avoiding a civil action for damages due to medical malpractice includes: a good relationship between doctors and patients; keeping the patient record completed, legible, stamped, and signed; informed consent, which must be prepared but it is not sufficient on its own; and the professional technical experience and background do not constitute a mitigating circumstance for filing the action.

Law, Wai Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 83-92). / Abstracts in English and Chinese. / ABSTRACT --- p.I / 論文摘要 --- p.II / TABLE OF CONTENTS --- p.III / Chapter CHAPTER 1 --- INTRODUCTION --- p.1 / Chapter CHAPTER 2 --- LISA SOWLE CAHILL´ةS THEOLOGICAL BACKGROUND --- p.5 / Chapter 2.1 --- Introduction --- p.5 / Chapter 2.2 --- Cahill´ةs theological approach to Christian Ethics --- p.5 / Chapter 2.2.1 --- Catholicism --- p.6 / Chapter 2.2.2 --- Feminism --- p.9 / Chapter 2.2.3 --- Theological Anthropology --- p.16 / Chapter 2.3 --- Moral Methodology --- p.21 / Chapter 2.3.1 --- The Bible --- p.21 / Chapter 2.3.2 --- Tradition --- p.22 / Chapter 2.3.3 --- Normative Accounts of the Human --- p.24 / Chapter 2.3.4 --- Descriptive Accounts of the Human --- p.25 / Chapter 2.4 --- Conclusion --- p.26 / Chapter CHAPTER 3 --- LISA SOWLE CAHILL´ةS PARTICIPATORY THEOLOGICAL BIOETHICS --- p.28 / Chapter 3.1 --- Introduction --- p.28 / Chapter 3.2 --- Cahill´ةs Participatory Theological Bioethics --- p.28 / Chapter 3.2.1 --- Principle of Analysis --- p.29 / Chapter 3.2.1.1 --- Ordinary and Extraordinary means of life support --- p.30 / Chapter 3.2.1.2 --- Principle of double effect --- p.31 / Chapter 3.2.2 --- The common good and bioethics --- p.34 / Chapter 3.2.3 --- Theological bioethics and Social Transformation --- p.38 / Chapter 3.2.4 --- Summary --- p.40 / Chapter 3.3 --- Evaluation and Dialogue with Cahill´ةs Participatory Theological Bioethics --- p.41 / Chapter 3.3.1 --- Catholicism --- p.41 / Chapter 3.3.2 --- Feminism --- p.42 / Chapter 3.3.3 --- Common Good --- p.44 / Chapter 3.4 --- Conclusion --- p.46 / Chapter CHAPTER 4 --- END-OF-LIFE CARE IN HONG KONG --- p.47 / Chapter 4.1 --- Introduction --- p.47 / Chapter 4.2 --- End-of-life care in Hong Kong --- p.48 / Chapter 4.2.1 --- Decline and dying in Hong Kong --- p.48 / Chapter 4.2.2 --- Ethical judgments by the health care professions --- p.50 / Chapter 4.2.3 --- Advance directive --- p.54 / Chapter 4.2.4 --- Patients or family´ةs participation --- p.54 / Chapter 4.2.5 --- Chinese culture and Bioethics --- p.56 / Chapter 4.3 --- Christianity engagement in the end-of-life care in Hong Kong --- p.59 / Chapter 4.3.1 --- Christian communities --- p.59 / Chapter 4.3.2 --- Theology bioethics --- p.60 / Chapter 4.4 --- Conclusion --- p.61 / Chapter CHAPTER 5 --- PARTICIPATORY THEOLOGICAL BIOETHICS IN HONG KONG --- p.63 / Chapter 5.1 --- Introduction --- p.63 / Chapter 5.2 --- The significance and relevance of Participatory Theological Bioethics --- p.63 / Chapter 5.2.1 --- Both individual and social ethics --- p.64 / Chapter 5.2.1.1 --- Who is/are the poor? --- p.64 / Chapter 5.2.1.2 --- Inequalities in access to end-of-life care --- p.66 / Chapter 5.2.1.3 --- Medical paternalism --- p.71 / Chapter 5.2.2 --- Transcendent meanings of life --- p.73 / Chapter 5.3 --- INTERCULTURAL DIALOGUE OF PARTICIPATORY THEOLOGICAL BIOETHICS --- p.74 / Chapter 5.3.1 --- Familial relationship as a starting point --- p.75 / Chapter 5.3.2 --- Interpretation of ´بParticipatory´ة --- p.76 / Chapter 5.4 --- Conclusion --- p.80 / Chapter CHAPTER 6 --- CONCLUSION --- p.81 / BIBLIOGRAPHY --- p.83

Neste trabalho foram analisados trinta processos judiciais, que tramitam pelos Fóruns Regionais Cíveis de São Paulo, capital e interior e Instituições Periciais da Capital. Fez-se as extrações individualizadas de cada processo, objetivando definir as principais causas e documentos juntados ao mesmo e conseqüências de cada condição. Iniciou-se pela importância prática do tema para efeito de evolução médico-social. Buscou-se estudar a visão da relação médico-paciente, mesmo durante a demanda, a informação ao paciente e seus familiares dos procedimentos e limitadores do ato médico; o documental técnico jurídico juntado ao processo; o preparo técnico-jurídico do médico e, se, a propositura de ação depende da formação e especialização do profissional. Foram analisados processos judiciais de primeira instância no período de 1996 a 2002 correlacionados à cirurgias do aparelho digestivo. Usou-se como parâmetro de análise exclusivamente os documentos juntados aos autos onde buscou-se a existência clara da quebra da relação médico-paciente, a existência de consentimento informado, a verificação do documental juntado à defesa pelas partes ou solicitação judicial e a qualificação do profissional envolvido nas ações. Finalmente, analisados os resultados, chegamos a conclusão que a melhor forma para profilaxia da ação cível indenizatória por erro médico é: a boa relação médico-paciente; a manutenção de prontuário médico preenchido, legível, com carimbo e assinatura; o consentimento informado, que, deve ser elaborado, porém, por si só não é suficiente; e a condição técnico curricular do profissional não é fator atenuante para propositura da ação. / Thirty legal proceedings, which are in progress before the Regional Civil Courts both the Capital and the countryside of the State of Sao Paulo, Brazil, besides Examination Institutions in the Capital city of Sao Paulo, have been analyzed in this work Individual excerpts of each case were taken with the purpose of defining the main causes and documentation attached to them as well the consequences of each condition. The practical importance of the subject for the medical-social evolution has been addressed in the first place. The physician/patient relationship view was sought to be studied, even during the claim, as well as the information of the medical procedures and limitations to the patient and his or her family; the technical/legal documentation attached to the case; the physician technical/legal preparation and whether the filing of the action depends on the professional education and specialization. Trial court cases from 1996 to 2002 related to digestive system surgery have been analyzed. The analysis subject hereof has been based exclusively on the documents attached to the case record, where attempts have been made to evidence the clear existence of the breach of the physician/patient relationship, the existence of informed consent, the examination of the documentation attached to the defense by the parties or court request, and the qualification of the professional involved in the actions. Finally, after the results have been analyzed, a conclusion was reached that the best way of avoiding a civil action for damages due to medical malpractice includes: a good relationship between doctors and patients; keeping the patient record completed, legible, stamped, and signed; informed consent, which must be prepared but it is not sufficient on its own; and the professional technical experience and background do not constitute a mitigating circumstance for filing the action.

Para avaliar a efetividade do processo de obtenção do termo de consentimento livre e esclarecido (TCLE) no contexto da pesquisa clínica em seres humanos, foram realizadas análises sistematizadas sobre os principais elementos de sustentação do TCLE (bioética na pesquisa em seres humanos, direitos humanos do sujeito da pesquisa, história da obtenção do TCLE, e regulamentações brasileiras na pesquisa em seres humanos), assim como também análises sistematizadas sobre a efetividade dos principais processos envolvidos na obtenção do TCLE (comunicação médico-paciente, tomada de decisão pelo sujeito da pesquisa, e interpretação das expressões de probabilidade no TCLE pelo sujeito da pesquisa). Ainda que estes três processos envolvidos na obtenção do TCLE apresentem, individualmente, alguns procedimentos efetivos, verificou-se que a obtenção de um TCLE verdadeiramente autônomo é utópica e, portanto, o processo de obtenção do TCLE é considerado não-efetivo / In order to evaluate the effectiveness of the process for obtaining the informed consent (IC) within the context of clinical research in human beings, systematic-like analysis were performed on the key elements supporting the IC (bioethics within the research in human beings, human rights for the research subject, history of the obtainment for the IC, and Brazilian regulation within research in human beings), as well as systematic-like analysis on the effectiveness of the major processes involved in the obtainment for the IC (physician-patient communication, decision-making for the research subject, and interpretation of the probability expressions in the IC by the research subject). Eventhough these three processes involved in the obtainment for the IC present, individually, a few effective procedures, the obtainment of a truly autonomous IC is utopia and thus the process for obtaining the IC is considered non-effective