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The rhetoric of transformation in ritual healing.

The problem of reconciling accounts of religious healing from the points of view of comparative religion and medicine suggests the necessity of an interpretive or hermeneutic approach to the analysis of therapeutic process. This paper, in the context of examining psychotherapeutic ritual among Catholic Pentecostals, formulates an interpretive approach in which healing is conceived as a form of discourse that is both religious and psychiatric. This discourse embodies a cultural rhetoric capable of performing three essential persuasive tasks: to create a predisposition to be healed, to create the experience of spiritual empowerment, and to create the concrete perception of personal transformation. It is shown that this threefold process activates and controls healing processes endogenous to the supplicant in healing, and either redirects the supplicant's attention toward new aspects of his actions and experiences, or alters the manner in which he attends to accustomed aspects of those actions and experiences. The result is the creation of both a new phenomenological world, and new self-meaning for the supplicant as a whole and holy person.

Catholicism↗

Anencephaly and the interruption of pregnancy: policy proposals for HECs.

This article is directed to hospital communities where absolute proscriptions exist against abortion. The assumption is that many will be Catholic institutions and therefore Catholic moral teachings are examined carefully. By addressing anti-abortion arguments in the context of anencephaly, I hope to show that within even the most conservative moral traditions, humane exceptions to absolute proscriptions against abortion can be justified. More specifically, the article is directed to HECs which either have unstated or ambiguous policies on abortion. It will attempt to show what a reasonable policy could look like and how it could be defended. For committee members not involved in policy questions about abortion, it may stimulate some ethical discussion.

Abortion, Induced↗

The licitness (according to Roman Catholic premises) of inducing the non-viable anencephalic fetus: reflections on Professor Drane's policy proposals.

James Drane's policy proposals for Roman Catholic hospitals, which would allow induction of a firmly diagnosed anencephalic fetus upon the mother's considered request, are defended. Drane's defense of his proposals, by focussing upon the empirical facts of anencephaly and attempting to abstract from the question of whether or not the anencephalic is a potential person, is held to be untenable. However, examination of the Roman Catholic proscription against abortion shows that it applies to humans who are, or might be, persons or potential persons. And the facts of anencephaly show that the anencephalic does not have the biological substrate to be a potential person. Hence the proscription does not apply to induction of the anencephalic fetus.

Abortion, Induced↗

The ordinary-extraordinary distinction reconsidered: a moral context for the proper calculus of benefits and burdens.

The traditional distinction between ordinary, i.e., obligatory means to preserve life and extraordinary, non-obligatory means is an especially useful tool for HECs in today's secular pluralist health care system, because it gives factors that can override the prima facie good of preserving the patient's life. I first indicate the need for such a tool. I then demonstrate the present misunderstanding of the distinction and give its proper understanding. Finally, I show the applicability of the distinction for HEC deliberations about three important types of cases: the conscious, irreversibly but not terminally ill patient who requests cessation of curative treatment; the provision of artificial nutrition and hydration to permanently vegetative patients; and the allotment of intensive care and other scarce medical resources.

Algorithms↗

Medical abortion: ethics, laws and religious points of view, A study by the 1994-1995 Ethics and Morals Committee of the ISPN.

Central nervous system malformations are now frequently detected prenatally. Unfortunately, the progress in diagnosis having far outstripped that in therapeutics, the only question to answer is usually whether the pregnancy should be continued or terminated. Pediatric neurosurgeons have to deal with such problems more and more often. They are asked to give an opinion on the prognosis. In many cases the law requires their involvement in the decision about the possibility of a "therapeutic", or more correctly a medical, abortion. The final decision is based on the religious attitutes of the family and the neurosurgeon and on the law of the country in which the medical abortion would be performed. This article reviews the points of view of the main religions and also the laws in different countries. This knowledge may be of some help to neurosurgeons, especially when the religious attitudes of those involved are different or when their final decision is not in accordance with the law of the country.

Abortion, Legal↗

The ageing gamete in relation to birth control failures and Down syndrome.

Some indirect relationships between contraception failures and offspring with a pathological condition are reviewed, and a causal connection between them is suggested. This hypothesis is supported by the decreasing incidence of Down syndrome (DS) in general in recent years, and the increase among the younger maternal age categories as well as the effect of birth order. A more than doubled incidence of DS children among young Catholic mothers and the fact that conceptions of children with DS are preceded by unusually long periods of abstinence are emphasised and discussed. These data offer circumstantial evidence that the conceptions that occur despite application of the so called "natural" family planning methods in particular are at high risk. The impact of reproductive biological failures ("nature") and of reproductive behaviour ("nurture") on the human gametes can be disentangled by thorough studies of the epidemiology of major and minor congenital anomalies.

Adult↗

A documented evaluation of primary prevention through consultation.

Mental health consultation was offered to an administrative group that anticipated turmoil in their religious community from introduction of change. Data collected on community members prior to consultation, two years, and four years later to study the spread of effect, showed significant improvement in support and well-being from 1977 to 1979 and from 1977 to 1981. A decreasing trend in the community's anxiety level observed in 1979 was maintained in 1981. Evaluation of consultee satisfaction and ongoing consultee programs also showed positive results from this primary prevention effort.

Anxiety↗

Mexican Americans and mental health: a selected review and recommendations for mental health service delivery.

Eight working assumptions are generated from the literature in three problem areas and evaluated with recently published quantitative data, paying particular attention to variation within the ethnic group. Assumptions that Mexican Americans have few emotional problems, primarily use a folk medical system, do not rely on clergymen for emotional support, and have negative attitudes toward mental health services are rejected. Two assumptions are qualified: Mexican Americans have some emotional problems at different rates than Anglos and some Mexican subgroups are relatively unaware of mental health services. There is confirmation of the Mexican American extended family support system and mental health policies which variously discourage utilization by Mexican Americans. Implications for mental health service delivery are discussed.

Attitude to Health↗

The intellectual basis for Latino AIDS policy: towards the humanities and health policy.

The AIDS epidemic touches upon basic humanities themes: sex, death and social worth, to name just three. AIDS policy in general builds upon society's discourse on these topics. The growing Latino population (25% of California and Texas) needs an AIDS policy that builds upon the Latino humanities tradition. The contours of the Latino intellectual tradition, as focused on issues attendant to health, are presented, with examples from Aztec, colonial and modern times.

Acquired Immunodeficiency Syndrome↗

Religion, medical ethics, and transplants.

This article describes the exclusion of public expressions of religion from the history of bioethics during recent decades. It offers a proposal to include the public church for the purpose of gaining donations of vital organs for transplantation. I also include a brief discussion of theological support and practical suggestions for such a program.

Black or African American↗