It is commonplace that care should be patient-centered. Nevertheless, no universally agreed-upon definition of patient-centered care exists. By consequence, the relation between patient-centered care as such and ethical principles cannot be investigated. However, some research has been performed on the relation between specific models of patient-centered care and ethical principles such as respect for autonomy and beneficence. In this article, I offer a detailed case study on the relationship between specific measures of patient-centered care and the ethical principle of respect (...) for autonomy. Decision Quality Instruments (DQIs) are patient-centered care measures that were developed by Karen Sepucha and colleagues. The model of patient-centered care that guided the development of these DQIs pays special attention to the ethical principle of respect for autonomy. Using Jonathan Pugh’s theory of rational autonomy, I will investigate how the DQIs relate to patient autonomy. After outlining Pugh’s theory of rational autonomy and framing the DQIs accordingly (Part I), I will investigate whether the methodological choices made while developing these DQIs align with respect for autonomy (Part II). My analysis will indicate several tensions between DQIs and patient autonomy that could result in what I call “structural paternalism.” These tensions offer us sufficient reasons, especially given the importance of the ethical principle of respect for autonomy, to initiate a more encompassing debate on the normative validity of Decision Quality Instruments. The aim of the present paper is to highlight the need for, and to offer a roadmap to, this debate. (shrink)

The novelist is not a theologian or a philosopher, but within the enclosed world of Victorian fiction the matter of theology and the nature of good and evil are examined after the disappearance of God. In the fiction of Dickens, this contention is explored together with the responsibility of the reader as stories are told. While theology may sometimes hamper the reader of fiction, in Victorian novels God may be absent while deeply theological issues remain to be explored and responded (...) to. (shrink)

The Artist and Religion in the Contemporary World Although we begin with the words of the poet Henry Vaughan, it is the visual artists above all who know and see the mystery of the Creation of all things in light, suffering for their art in its blinding, sacrificial illumination. In modern painting this is particularly true of van Gogh and J.M.W. Turner. But God speaks the Creation into being through an unheard word, and so, too, the greatest of musicians, as (...) most tragically in the case of Beethoven, hear their sublime music only in a profound silence. The Church then needs to see and listen in order, in the words of Heidegger, to learn to "dwell poetically on earth" before God. To dwell thus lies at the heart of its life, liturgically and in its pastoral ministry, as illustrated in the poetry of the English priest and poet, David Scott. This can also be seen as a "letting go" before God and an allowing of a space in which there might be a "letting the unsayable be unsaid" and order found even over the abyss. This is what Vladimir Nabokov has called "the marvel of consciousness" which is truly a seeing in the darkness. The poet, artist and musician can bring us close to the brink of the mystery, and thus the artist is always close to the heart of the church's worship and its ministry of care where words meet silence, and light meets darkness. Such, indeed, is the true marvel of consciousness in the ultimate risk which is the final vocation of the poet and artist, as it was of Christ himself, and all his saints. The church must be ever attentive to the deeply Christocentric ministry of art and the creative power of word and image in the letting the unsayable be unsaid. With the artist we may perhaps stand on Pisgah Height with Moses with a new imaginative perception of the divine Creation. The essay concludes on a personal note, drawing upon the author's own experience in retreat in the desert, with a reminder of the thought of Thomas Merton, a solitary in the community of the Church. (shrink)

Although we begin with the words of the poet Henry Vaughan, it is the visual artists above all who know and see the mystery of the Creation of all things in light, suffering for their art in its blinding, sacrificial illumination. In modern painting this is particularly true of van Gogh and J.M.W. Turner. But God speaks the Creation into being through an unheard word, and so, too, the greatest of musicians, as most tragically in the case of Beethoven, hear (...) their sublime music only in a profound silence. The Church then needs to see and listen in order, in the words of Heidegger, to learn to "dwell poetically on earth" before God. To dwell thus lies at the heart of its life, liturgically and in its pastoral ministry, as illustrated in the poetry of the English priest and poet, David Scott. This can also be seen as a "letting go" before God and an allowing of a space in which there might be a "letting the unsayable be unsaid" and order found even over the abyss. This is what Vladimir Nabokov has called "the marvel of consciousness" which is truly a seeing in the darkness. The poet, artist and musician can bring us close to the brink of the mystery, and thus the artist is always close to the heart of the church's worship and its ministry of care where words meet silence, and light meets darkness. Such, indeed, is the true marvel of consciousness in the ultimate risk which is the final vocation of the poet and artist, as it was of Christ himself, and all his saints. The church must be ever attentive to the deeply Christocentric ministry of art and the creative power of word and image in the letting the unsayable be unsaid. With the artist we may perhaps stand on Pisgah Height with Moses with a new imaginative perception of the divine Creation. The essay concludes on a personal note, drawing upon the author's own experience in retreat in the desert, with a reminder of the thought of Thomas Merton, a solitary in the community of the Church. (shrink)

This book addresses the interrelation between theological thinking and the complex and diverse realms of human ideals. What are the ideals appropriate to our moment in human history, and how do these ideals derive from or relate to theological reflection in our time? In Theological Reflection and the Pursuit of Ideals internationally renowned scholars from a range of disciplines engage with these crucial questions with the intention of articulating a new and historically appropriate vision of theological reflection and the pursuit (...) of ideals for our global times. (shrink)

Imaging Otherness explores relationships between film and religion, aesthetics and ethics. The volume examines these relationships by viewing how otherness is imaged in film and how otherness alternately might be imagined. Drawing from a variety of films from differing religious perspectives -- including Chan Buddhism, Hinduism, Native American religions, Christianity, and Judaism -- the essays gathered in this volume examine the particular problems of 'living together' when faced with the tensions brought out through the otherness of differing sexualities, ethnicities, genders, (...) religions, cultures, and families. (shrink)