scholarly journals Futility of Medical treatment

Author(s):  
Albar Mohammed Ali ◽  
Chamsi Pasha Hassan

Medical and technological resources allow many patients affected by advanced diseases to receive more aggressive and expensive treatments than ever before. This wide range of available options can frequently lead to complex end-of-life decisions, such as when to start palliative care programs. Medical futility refers to interventions that are unlikely to produce any significant benefit for the patient. Medical futility is a daily problem, with significant ethical implications and concerns about the respect of the main ethics principles: beneficence, non-maleficence, patient’s autonomy, and justice. Proceeding with futile treatment is neither in the best interests of the patient nor of the healthcare system. This paper examines the definition of futility, applications of the concept of medical futility, the complexities of management when care is considered futile.International Journal of Human and Health Sciences Vol. 02 No. 01 Jan’18. Page : 13-17

1993 ◽  
Vol 2 (2) ◽  
pp. 161-170 ◽  
Author(s):  
David H. Johnson

There is little to indicate from, her circumstances that events would propel Helga Wanglie, an 86-year-old Minneapolis woman, into the center of public controversy. We know little of her life prior to the events that removed her from the world of conscious, sentient beings. By the time of her death on 4 July 1991, Mrs. Wanglie had become the focus of a nationwide public and professional debate on the rights of a patient in a persistent vegetative state (PVS) to receive aggressive medical treatment when such treatment is felt by the patient's doctors not to be in the patient's best interests.


2020 ◽  
Vol 10 (1-2) ◽  
pp. 48-58
Author(s):  
Rudolf Novotný ◽  
Zuzana Novotná ◽  
Štefánia Andraščíková

AbstractThe paper discusses inappropriate (futile) treatment by analyzing the casuistics of palliative patients in the terminal stage of illness who are hospitalized at the Department of Internal Medicine and Geriatrics of the Faculty hospital with policlinic (FNsP). Our research applies the principles of palliative care in the context of bioethics. The existing clinical conditions of healthcare in Slovakia are characteristic of making a taboo of the issues of inappropriate treatment of palliative patients. Inductive-deductive and normative clinical bioethics methods of palliative care and ethical strategy are applied for defining issues found in inappropriate hemodialysis treatment. An algorithm of hemodialysis treatment requires the definition of those lege artis criteria which, in the context of a patient’s autonomy and his/her decision, precondition the avoidance of the situation in which hemodialysis treatment is inappropriate (futile). Futile treatment in a terminal condition is ethically inappropriate medical treatment that extends the suffering of patients and their relatives. Its definition is determined by the relevant legislation and the methods of bioethics. An active palliative strategy is aimed at managing the process of incurable diseases in the patient’s bio-psycho-socio-spiritual continuity in the process of special bioethics. The global bioethical objective of general bioethics for palliative care is based on the paradigm of social harmony and solidarity in the context of an authentic modus of the patient’s existence as a constitutive principle for the phenomenon of the patient’s being to finite being (death).


Author(s):  
Mykola Veselov ◽  

Today, the concept of “best interests of the child” is recognized as one of the guiding principles of ensuring the rights of children in all spheres of social relations. The object of this study is social relations in juvenile justice as a specific area of children’s rights. The aim of the article is to clarify the meaning of the concept of “best interests of the child” as well as to define the features of administrative and legal provision of this principle in the field of juvenile justice. To achieve this goal, general scientific and special methods of scientific research are used. The author argues that the definition of “best interests of the child” in the field of juvenile justice should only be generally oriented to guaranteeing child’s vital and social needs as a participant in jurisdictional proceedings, taking into account his or her age, biological and social characteristics. Under any circumstances, the list of such interests cannot be exhaustive. In view of the public-service nature of administrative and legal relations, an important role in the current and future ensure of the best interests of the child in any type of jurisdictional proceedings belongs to the administrative and legal means. The priority of attention to administrative and legal means in ensuring the best interests of the child in the field of juvenile justice is due to the wide range and relative universality of administrative and legal regulation, which allows to meet the procedural needs of children within purely jurisdictional proceedings as well as to facilitate other organizational and legal issues of social protection of children.


2018 ◽  
Vol 143 (08) ◽  
pp. 558-565 ◽  
Author(s):  
Friedemann Nauck ◽  
Maximiliane Jansky

AbstractSince 2007, patients with severe advanced life-limiting illnesses and high, complex symptom burdens have a right to receive specialized outpatient palliative care (SAPV). Multi-professional teams with heterogeneous organizational structures provide care in cooperation with primary care givers, not limited to cancer patients. The aim of SAPV is to foster patient’s autonomy and quality of life. SAPV can be provided as counseling of patient and care givers, coordination of care, additional supportive and full care provision. While the basis of SAPV provision is regulated by a SAPV directive, different contracts between care providers and health care insurances regulate organization, cooperation, definition of care levels, service provision and compensation. Some regions have model contracts that are binding for all SAPV teams in the area; in other regions teams negotiate e. g. compensation, individually with insurances. The article gives an overview of the regulations regarding SAPV.


Author(s):  
Denis Tikhomirov

The purpose of the article is to typologize terminological definitions of security, to find out the general, to identify the originality of their interpretations depending on the subject of legal regulation. The methodological basis of the study is the methods that made it possible to obtain valid conclusions, in particular, the method of comparison, through which it became possible to correlate different interpretations of the term "security"; method of hermeneutics, which allowed to elaborate texts of normative legal acts of Ukraine, method of typologization, which made it possible to create typologization groups of variants of understanding of the term "security". Scientific novelty. The article analyzes the understanding of the term "security" in various regulatory acts in force in Ukraine. Typological groups were understood to understand the term "security". Conclusions. The analysis of the legal material makes it possible to confirm that the issues of security are within the scope of both legislative regulation and various specialized by-laws. However, today there is no single conception on how to interpret security terminology. This is due both to the wide range of social relations that are the subject of legal regulation and to the relativity of the notion of security itself and the lack of coherence of views on its definition in legal acts and in the scientific literature. The multiplicity of definitions is explained by combinations of material and procedural understanding, static - dynamic, and conditioned by the peculiarities of a particular branch of legal regulation, limited ability to use methods of one or another branch, the inter-branch nature of some variations of security, etc. Separation, common and different in the definition of "security" can be used to further standardize, in fact, the regulatory legal understanding of security to more effectively implement the legal regulation of the security direction.


Author(s):  
Tim Rutherford-Johnson

By the start of the 21st century many of the foundations of postwar culture had disappeared: Europe had been rebuilt and, as the EU, had become one of the world’s largest economies; the United States’ claim to global dominance was threatened; and the postwar social democratic consensus was being replaced by market-led neoliberalism. Most importantly of all, the Cold War was over, and the World Wide Web had been born. Music After The Fall considers contemporary musical composition against this changed backdrop, placing it in the context of globalization, digitization, and new media. Drawing on theories from the other arts, in particular art and architecture, it expands the definition of Western art music to include forms of composition, experimental music, sound art, and crossover work from across the spectrum, inside and beyond the concert hall. Each chapter considers a wide range of composers, performers, works, and institutions are considered critically to build up a broad and rich picture of the new music ecosystem, from North American string quartets to Lebanese improvisers, from South American electroacoustic studios to pianos in the Australian outback. A new approach to the study of contemporary music is developed that relies less on taxonomies of style and technique, and more on the comparison of different responses to common themes, among them permission, fluidity, excess, and loss.


2012 ◽  
Vol 6 (1-3) ◽  
pp. 243-259 ◽  
Author(s):  
Yohan Yoo

This article demonstrates the need for the iconic status and function of Buddhist scripture to receive more attention by illuminating how lay Korean Buddhists try to appropriate the power of sutras. The oral and aural aspects of scripture, explained by Wilfred Cantwell Smith, provide only a limited understanding of the characteristics of scripture. It should be noted that, before modern times, most lay people, not only in Buddhist cultures but also in Christian and other traditions, neither had the chance to recite scriptures nor to listen to their recitations regularly. Several clear examples demonstrate contemporary Korean Buddhists’ acceptance of the iconic status of sutras and their attempt to appropriate the power and status of those sacred texts. In contemporary Korea, lay Buddhists try to claim the power of scriptures in their daily lives by repeating and possessing them. Twenty-first century lay believers who cannot read or recite in a traditional style have found new methods of repetition, such as internet programs for copying sacred texts and for playing recordings of their recitations. In addition, many Korean Buddhists consider the act of having sutras in one’s possession to be an effective way of accessing the sacred status and power of these texts. Hence, various ways of possessing them have been developed in a wide range of products, from fancy gilded sutras to sneakers embroidered with mantras.


2018 ◽  
Vol 35 (4) ◽  
pp. 62-64
Author(s):  
Nazar Ul Islam Wani

Pilgrimage in Islam is a religious act wherein Muslims leave their homes and spaces and travel to another place, the nature, geography, and dispositions of which they are unfamiliar. They carry their luggage and belongings and leave their own spaces to receive the blessings of the dead, commemorate past events and places, and venerate the elect. In Pilgrimage in Islam, Sophia Rose Arjana writes that “intimacy with Allah is achievable in certain spaces, which is an important story of Islamic pilgrimage”. The devotional life unfolds in a spatial idiom. The introductory part of the book reflects on how pilgrimage in Islam is far more complex than the annual pilgrimage (ḥajj), which is one of the basic rites and obligations of Islam beside the formal profession of faith (kalima); prayers (ṣalāt); fasting (ṣawm); and almsgiving (zakāt). More pilgrims throng to Karbala, Iraq, on the Arbaeen pilgrimage than to Mecca on the Hajj, for example, but the former has received far less academic attention. The author expands her analytic scope to consider sites like Konya, Samarkand, Fez, and Bosnia, where Muslims travel to visit countless holy sites (mazarāt), graves, tombs, complexes, mosques, shrines, mountaintops, springs, and gardens to receive the blessings (baraka) of saints buried there. She reflects on broader methodological and theoretical questions—how do we define religion?—through the diversity of Islamic traditions about pilgrimage. Arjana writes that in pilgrimage—something which creates spaces and dispositions—Muslim journeys cross sectarian boundaries, incorporate non-Muslim rituals, and involve numerous communities, languages, and traditions (the merging of Shia, Sunni, and Sufi categories) even to “engende[r] a syncretic tradition”. This approach stands against the simplistic scholarship on “pilgrimage in Islam”, which recourses back to the story of the Hajj. Instead, Arjana borrows a notion of ‘replacement hajjs’ from the German orientalist Annemarie Schimmel, to argue that ziyārat is neither a sectarian practice nor antithetical to Hajj. In the first chapter, Arjana presents “pilgrimage in Islam” as an open, demonstrative and communicative category. The extensive nature of the ‘pilgrimage’ genre is presented through documenting spaces and sites, geographies, and imaginations, and is visualized through architectural designs and structures related to ziyārat, like those named qubba, mazār (shrine), qabr (tomb), darih (cenotaph), mashhad (site of martyrdom), and maqām (place of a holy person). In the second chapter, the author continues the theme of visiting sacred pilgrimage sites like “nascent Jerusalem”, Mecca, and Medina. Jerusalem offers dozens of cases of the ‘veneration of the dead’ (historically and archaeologically) which, according to Arjana, characterizes much of Islamic pilgrimage. The third chapter explains rituals, beliefs, and miracles associated with the venerated bodies of the dead, including Karbala (commemorating the death of Hussein in 680 CE), ‘Alawi pilgrimage, and pilgrimage to Hadrat Khidr, which blur sectarian lines of affiliation. Such Islamic pilgrimage is marked by inclusiveness and cohabitation. The fourth chapter engages dreams, miracles, magical occurrences, folk stories, and experiences of clairvoyance (firāsat) and the blessings attached to a particular saint or walī (“friend of God”). This makes the theme of pilgrimage “fluid, dynamic and multi-dimensional,” as shown in Javanese (Indonesian) pilgrimage where tradition is associated with Islam but involves Hindu, Buddhist and animistic elements. This chapter cites numerous sites that offer fluid spaces for the expression of different identities, the practice of distinct rituals, and cohabitation of different religious communities through the idea of “shared pilgrimage”. The fifth and final chapter shows how technologies and economies inflect pilgrimage. Arjana discusses the commodification of “religious personalities, traditions and places” and the mass production of transnational pilgrimage souvenirs, in order to focus on the changing nature of Islamic pilgrimage in the modern world through “capitalism, mobility and tech nology”. The massive changes wrought by technological developments are evident even from the profusion of representations of Hajj, as through pilgrims’ photos, blogs, and other efforts at self documentation. The symbolic representation of the dead through souvenirs makes the theme of pilgrimage more complex. Interestingly, she then notes how “virtual pilgrimage” or “cyber-pilgrimage” forms a part of Islamic pilgrimage in our times, amplifying how pilgrimage itself is a wide range of “active, ongoing, dynamic rituals, traditions and performances that involve material religions and imaginative formations and spaces.” Analyzing religious texts alone will not yield an adequate picture of pilgrimage in Islam, Arjana concludes. Rather one must consider texts alongside beliefs, rituals, bodies, objects, relationships, maps, personalities, and emotions. The book takes no normative position on whether the ziyāratvisitation is in fact a bid‘ah (heretical innovation), as certain Muslim orthodoxies have argued. The author invokes Shahab Ahmad’s account of how aspects of Muslim culture and history are seen as lying outside Islam, even though “not everything Muslims do is Islam, but every Muslim expression of meaning must be constituting in Islam in some way”. The book is a solid contribution to the field of pilgrimage and Islamic studies, and the author’s own travels and visits to the pilgrimage sites make it a practicalcontribution to religious studies. Nazar Ul Islam Wani, PhDAssistant Professor, Department of Higher EducationJammu and Kashmir, India


Author(s):  
Andrea Renda

This chapter assesses Europe’s efforts in developing a full-fledged strategy on the human and ethical implications of artificial intelligence (AI). The strong focus on ethics in the European Union’s AI strategy should be seen in the context of an overall strategy that aims at protecting citizens and civil society from abuses of digital technology but also as part of a competitiveness-oriented strategy aimed at raising the standards for access to Europe’s wealthy Single Market. In this context, one of the most peculiar steps in the European Union’s strategy was the creation of an independent High-Level Expert Group on AI (AI HLEG), accompanied by the launch of an AI Alliance, which quickly attracted several hundred participants. The AI HLEG, a multistakeholder group including fifty-two experts, was tasked with the definition of Ethics Guidelines as well as with the formulation of “Policy and Investment Recommendations.” With the advice of the AI HLEG, the European Commission put forward ethical guidelines for Trustworthy AI—which are now paving the way for a comprehensive, risk-based policy framework.


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