Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ ...Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.展开更多
According to Fromm, the life instinct constitutes the primary potentiality in man, while the death instinct a secondary potentiality, and which of the two prevails depending crucially on the living conditions that the...According to Fromm, the life instinct constitutes the primary potentiality in man, while the death instinct a secondary potentiality, and which of the two prevails depending crucially on the living conditions that the subject experiences during his or her childhood. Not limited to the individual level, Fromm＇s observation works on the collective level as well. Different environments foster different potentialities and lead to the formation of different cultures and ethics. A biophilic ethics treasures the value of love, peace, reciprocal altruism and unity of being, while a biophobic ethics is more addicted to hatred, violence, dualistic confrontation, and mutual destruction. Appling Fromm＇s theory to the interpretation of Charles Johnson＇s Middle Passage, readers can get a newly enlightened understanding of this award-winning masterpiece. Based on Fromm＇s hypothesis about human nature, this article analyzes the representation of the confrontations between the biophobic ethics and the biophilic ethics in this novel, the former being embodied by Captain Falcon＇s ＂syndrome of decay＂ which is also Johnson＇s critical metaphor of Western civilization, while the latter embodied by the Allmuseri culture＇s ＂syndrome of growth＂ which represents Johnson＇s idealistic imagination of the sum of non-Western civilization展开更多
Movies have great power to shape the system of values in contemporary culture. In this paper, we deal with theological reflection of suicide and euthanasia and their presentation as free decisions of individuals shown...Movies have great power to shape the system of values in contemporary culture. In this paper, we deal with theological reflection of suicide and euthanasia and their presentation as free decisions of individuals shown in the movies Seven Pounds and The Sea Inside. Also, we shall present theological reflection on culture of life and culture of death aimed to find common ground for dialogue between two opposed points of view. In the first, introductory part, we will present two views of human freedom, and we will point out that just a theological speech about freedom includes the category of responsibility. On the other hand, what happens often is neglecting categories of resposibility and absolutisation or marginalization of free will. Then we will, as an introduction to the interpretation of films, present global statistics that justify global concerns when it comes to suicide and euthanasia. Next, we will show in central part the concept of quality of life, and we will interpret it through the two mentioned films. In the last section, We conclude, despite opposition between culture of life and death, to offer category of altruism as a starting point for dialogue between the two cultures.展开更多
The ＂Tree of Death＂ is a metaphor I use to unlock my Christian assumptions on how the dead attain eternal existence in the afterlife state. The tree＇s unconcealedness, in this life and presumably the next, along wi...The ＂Tree of Death＂ is a metaphor I use to unlock my Christian assumptions on how the dead attain eternal existence in the afterlife state. The tree＇s unconcealedness, in this life and presumably the next, along with the moral habits an agent develops in this life explain the obstinacy of the dead, that is, how the agent＇s irrevocable decision to side with the God of Abraham, or not, is possible. For that to be the case, the existential relationships that generate personal identity in this life must accompany （individuate） the subject in the next life. In Christian philosophy, the person-making process mirrors the relationships of the Blessed Trinity. While Martin Heidegger is not a Christian philosopher, his view on truth and being＇s unconcealedness provides a useful piece of the argument to continue the Thomistic case for personal immortality. Heidegger is not a catholic philosopher, but the focus he places on being＇s unconcealedness is consonant with the focus Thomas Aquinas puts on the intelligibility of being. While Heidegger＇s discussion of being is rooted in Dasein＇s finitude, the Thomistic interpretation of being situates unconcealedness within the perspective of God＇s creative act. His vision resets the possibility of applying Heidegger＇s fundamental ontology beyond temporality. The paper develops through a discussion of the Tree＇s ＂branches, trunk, and roots＂ to conclude that the Christian perspective transforms Heidegger＇s view of death into ＂the ultimate possibility of possibility.＂展开更多
Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently add...Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently addressed in a pilot study.The result seems promising but needs larger multicenter trials.展开更多
文摘Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.
基金Acknowledgement： This research is funded by the National Planning Office of Philosophy and Social Science of China （Reference 14CWW022）, and by the China Postdoctoral Science Foundation （Reference 2014M552063）.
文摘According to Fromm, the life instinct constitutes the primary potentiality in man, while the death instinct a secondary potentiality, and which of the two prevails depending crucially on the living conditions that the subject experiences during his or her childhood. Not limited to the individual level, Fromm＇s observation works on the collective level as well. Different environments foster different potentialities and lead to the formation of different cultures and ethics. A biophilic ethics treasures the value of love, peace, reciprocal altruism and unity of being, while a biophobic ethics is more addicted to hatred, violence, dualistic confrontation, and mutual destruction. Appling Fromm＇s theory to the interpretation of Charles Johnson＇s Middle Passage, readers can get a newly enlightened understanding of this award-winning masterpiece. Based on Fromm＇s hypothesis about human nature, this article analyzes the representation of the confrontations between the biophobic ethics and the biophilic ethics in this novel, the former being embodied by Captain Falcon＇s ＂syndrome of decay＂ which is also Johnson＇s critical metaphor of Western civilization, while the latter embodied by the Allmuseri culture＇s ＂syndrome of growth＂ which represents Johnson＇s idealistic imagination of the sum of non-Western civilization
文摘Movies have great power to shape the system of values in contemporary culture. In this paper, we deal with theological reflection of suicide and euthanasia and their presentation as free decisions of individuals shown in the movies Seven Pounds and The Sea Inside. Also, we shall present theological reflection on culture of life and culture of death aimed to find common ground for dialogue between two opposed points of view. In the first, introductory part, we will present two views of human freedom, and we will point out that just a theological speech about freedom includes the category of responsibility. On the other hand, what happens often is neglecting categories of resposibility and absolutisation or marginalization of free will. Then we will, as an introduction to the interpretation of films, present global statistics that justify global concerns when it comes to suicide and euthanasia. Next, we will show in central part the concept of quality of life, and we will interpret it through the two mentioned films. In the last section, We conclude, despite opposition between culture of life and death, to offer category of altruism as a starting point for dialogue between the two cultures.
文摘The ＂Tree of Death＂ is a metaphor I use to unlock my Christian assumptions on how the dead attain eternal existence in the afterlife state. The tree＇s unconcealedness, in this life and presumably the next, along with the moral habits an agent develops in this life explain the obstinacy of the dead, that is, how the agent＇s irrevocable decision to side with the God of Abraham, or not, is possible. For that to be the case, the existential relationships that generate personal identity in this life must accompany （individuate） the subject in the next life. In Christian philosophy, the person-making process mirrors the relationships of the Blessed Trinity. While Martin Heidegger is not a Christian philosopher, his view on truth and being＇s unconcealedness provides a useful piece of the argument to continue the Thomistic case for personal immortality. Heidegger is not a catholic philosopher, but the focus he places on being＇s unconcealedness is consonant with the focus Thomas Aquinas puts on the intelligibility of being. While Heidegger＇s discussion of being is rooted in Dasein＇s finitude, the Thomistic interpretation of being situates unconcealedness within the perspective of God＇s creative act. His vision resets the possibility of applying Heidegger＇s fundamental ontology beyond temporality. The paper develops through a discussion of the Tree＇s ＂branches, trunk, and roots＂ to conclude that the Christian perspective transforms Heidegger＇s view of death into ＂the ultimate possibility of possibility.＂
文摘Glucocorticosteroids have been used as the only treatment for a long time which significantly reduced the mortality of the patients with severe alcoholic hepatitis.The efficacy of transplantation has been recently addressed in a pilot study.The result seems promising but needs larger multicenter trials.
