Faith, identity, and leukemia: when blood products are not an option.
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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital, founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers and gain insight and support from fellow staff members. When a competent adult patient refuses lifesaving treatment for religious or personal reasons, caregivers have a legal obligation to respect this decision. A patient's refusal of treatment adds particular challenges to the delivery of compassionate care. The case of a 50-year-old Jehovah's Witness with acute myelocytic leukemia who declined blood product support is presented. Respecting her religious beliefs during chemotherapy required balancing risk and benefit, watching her suffer while unable to intervene with what the staff saw as simple treatment, and eventually undertaking a complicated grief process. Jehovah's Witness beliefs regarding blood products are reviewed. Caregiver roles and responsibilities are discussed in the context of psychosocial, legal, familial, and ethical issues. (+info)
Healthy Body/Healthy Spirit: a church-based nutrition and physical activity intervention.
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African-Americans (AAs) are significantly less likely to be physically active than other Americans, and, like all Americans, they consume fewer than the recommended five fruit and vegetable (F & V) servings per day. This study, titled Healthy Body/Healthy Spirit, has two primary aims: (1) to test the effectiveness of a culturally tailored self-help dietary (focusing on F & V intake) and physical activity (PA) intervention compared to standard health education materials, and (2) to test the effectiveness of using Motivational Interviewing (MI), delivered by telephone, to modify PA and dietary habits. The study is a randomized effectiveness trial with three experimental conditions. Group 1 (comparison) will receive standard (existing commercial) nutrition and PA intervention materials, Group 2 (TX1) will receive a culturally tailored self-help nutrition and PA intervention of similar intensity as Group 1, and Group 3 (TX2) will receive the same intervention as Group 2, plus four telephone counseling calls based on MI. Participants will be AA adults recruited through local black churches. Despite the extensive use of MI to modify addictive behaviors, this represents one of the first controlled field trials to employ MI to address diet and PA. Secondly, this is one of the first studies to test the effectiveness of a self-help diet and PA intervention tailored for an African-American church population. (+info)
Gender selection: cultural and religious perspectives.
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OBJECTIVE: To review the current developments in the field of preconceptual sex selection and to discuss the cultural and religious perspectives as that accompany the scientific progress. DESIGN: A survey of the major publications in Judaism, Christianity and Islam regarding the issue of gender selection. Examination of current methods of preconceptual gender selection revealed that in vivo methods such as timing of intercourse, the use of ovulation induction medications, and artificial insemination do not appear to affect the sex ratio to a clinically significant degree. In vitro separation of X- and Y-bearing spermatozoa by gradient techniques have been reported to alter significantly the sex ratio at birth. However, these trials were not controlled, and molecular biological techniques could not validate that these methods indeed change the Y- to X bearing spermatozoa ratio sufficiently for clinical use. Nevertheless recent scientific advances have made highly reliable preconceptual sex selection possible by using preimplantation diagnosis (PGD) or sperm separation by flow cytometry combined with AIH or IVF. At present, these methods have been used to avoid sex-linked disorders. Both involve the invasive procedure of IVF and thus are held by most as inappropriate for nonmedical indications. However, improvement in flow cytometry output of sexed spermatozoa might provide in the near future sufficient sorted gametes for artificial insemination. It may be that in the near future, an improvement in flow cytometry output of sexed spermatozoa will provide sufficient sorted gametes for artificial insemination. In such a case, the medical community will be forced to take a stand, whether this reliable noninvasive method of sexing will be allowed for social purposes and even if the practice of PGD should be allowed for nonmedical indications. CONCLUSION: The requirement for a man to procreate by having a minimum of two children-a boy and a girl-is obligatory according to Jewish law. According to both schools, Beit Shamai and Beit Hillel, in order to fulfill the obligation of procreation at least one son is required. Therefore the application of sex preselection for nonmedical indications may by of practical importance using the method of sperm separation or sex selection of pre-embryo by PGD. According to Christian view, especially the one of the Catholic Church, gender preselection even for medical indications is forbidden. Islamic legal viewpoint is that fetal sex selection is lawful when it is practiced on an individual basis, to fulfill the wish of a married couple to have a boy or a girl through available medical means. (+info)
Psychotherapy services outside the National Health Service.
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With the help of an Upjohn Travelling Fellowship, I visited 15 units providing services for people under stress. There were nine residential units and six non-residential units, all were Christian charitable organisations and in all there was close co-operation with the medical profession.All these organisations accept referrals from general practitioners and deserve to be more widely known. (+info)
Confidentiality and its limits: some contributions from Christianity.
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The issue is whether Christianity, of its nature, would seek to prevent a justifiable breach of confidentiality or could endorse it, under certain circumstances, as the act which is fundamentally more loving or more truthful. The individualistic nature of Western Christianity is noted. The Lutheran theologian Dietrich Bonhoeffer is used to show Christian support for dynamic rather than literal truth telling, and for awareness of the contexts and power relations within which persons stand. (+info)
Surgery and religiosity.
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Variances in religious practices and beliefs require health care providers to find alternative ways of meeting medical standards of care in cases where religious beliefs preclude the use of blood transfusions or blood products. We report a case of head and neck tumor with low hemoglobin in which we utilized temporary arterial ligation to aid in minimal blood loss. (+info)
Effects of Greek Orthodox Christian Church fasting on serum lipids and obesity.
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BACKGROUND: No study to date has focused on the impact of Greek Orthodox Christian fasting on serum lipoproteins and obesity yet. METHODS: 120 Greek adults were followed longitudinally for one year. Sixty fasted regularly in all fasting periods (fasters) and 60 did not fast at all (controls). The three major fasting periods under study were: Christmas (40 days), Lent (48 days) and Assumption (August, 15 days). A total of 6 measurements were made during one year including pre- and end-fasting blood collection, serum lipoprotein analyses and anthropometric measurements. RESULTS: Statistically significant end-fasting total and LDL cholesterol differences were found in fasters. Fasters compared to controls presented 12.5% lower end-total cholesterol (p < 0.001), 15.9% lower end-LDL cholesterol (p < 0.001) and 1.5% lower end-BMI (p < 0.001). The end- LDL/HDL ratio was lower in fasters (6.5%, p < 0.05) while the change in end- HDL cholesterol in fasters (4.6% decline) was not significant. Similar results were found when the pre- and end-fasting values of fasters were compared. No change was found in control subjects. CONCLUSIONS: Adherence to Greek Orthodox fasting periods contributes to a reduction in the blood lipid profile including a non-significant reduction in HDL cholesterol and possible impact on obesity. (+info)
Human organs from prisoners: kidneys for life.
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A proposal to allow prisoners to save their lives or to be eligible for commutation of sentence by donating kidneys for transplantation has been a subject of controversy in the Philippines. Notwithstanding the vulnerabilities associated with imprisonment, there are good reasons for allowing organ donations by prisoners. Under certain conditions, such donations can be very beneficial not only to the recipients but to the prisoners themselves. While protection needs to be given to avoid coercion and exploitation, overprotection has to be avoided. The prohibition on the involvement of prisoners in organ transplantation constitutes unjustified overprotection. Under certain conditions, prisoners can make genuinely independent decisions. When it can be reasonably ascertained that they are able to decide freely, society should recognise an obligation to help them implement their decisions, such as when they intend to donate an organ as a way of asserting their religious faith and performing a sacrifice in atonement for their sins. (+info)