bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive Leadership and Employee Well-Being
Authors: Kelloway E. Kevin , Weigand Heidi , McKee Margaret C. , Das Hari
Published: November 2012

We report two studies examining the relationship between positive leadership behaviors and employee well-being. In the first, data from 454 nursing home employees showed that (a) a newly developed measure of positive leadership was distinct from transformational leadership and (b) positive leadership behaviors predicted context-specific and context-free well-being after controlling for transformational and abusive leadership. In the second study, data from a daily diary study ( N = 26) showed that (a) positive leadership predicted positive, but not negative, employee affect and (b) positive leadership interacted with transformational leadership to predict employees positive affect.
The Hamilton Rating Scale for Depression: The making of a “gold standard” and the unmaking of a chronic illness, 1960–1980
Authors: Worboys Michael
Published: November 2012

Objectives:

To show why and how the Hamilton Rating Scale for Depression became the ‘Gold Standard’ for assessing therapies from the mid-1960s and how it was used to frame depression as a short-term and curable illness rather than a chronic one.

Methods:

My approach is that of the social construction of knowledge, identifying the interests, institutional contexts and practices that produce knowledge claims and then mapping the social processes of their circulation, validation and acceptance.

Results:

The circulation and validation of Hamilton Rating Scale for Depression was relatively slow and it became a ‘Gold Standard’ ‘from below’, from an emerging consensus amongst psychiatrists undertaking clinical trials for depression, which from the 1960s were principally with psychopharmaceuticals for short-term illness. Hamilton Rating Scale for Depression, drug trials and the construction of depression as non-chronic were mutually constituted.

Discussion:

Hamilton Rating Scale for Depression framed depression and its sufferers in new ways, leading psychiatrists to understand illness as a treatable episode, rather than a life course condition. As such, Hamilton Rating Scale for Depression served the interests of psychiatrists and psychiatry in its new era of drug therapy outside the mental hospital. However, Hamilton Rating Scale for Depression was a strange kind of ‘standard’, being quite non-standard in the widely varying ways it was used and the meanings given to its findings.
Understanding Mentoring In Leadership Development
Authors: Clayton Jennifer K. , Sanzo Karen L. , Myran Steve
Published: November 2012

According to Daresh, collaboration between veteran and new or aspiring leaders can promote an environment that is conducive to high levels of student achievement. This study sought to understand the mentoring relationship between veteran school leaders and aspiring leaders within a district that is in Year 2 of a School Leadership Program grant. Results focused on two main themes: (a) accountability time pressures and (b) development and sustainability of the mentor/mentee relationship. Implications for school district leadership and university leadership preparation programs are discussed.
The Vocation to Heal: Health Care in the Light of Catholic Faith: Scriptural, Theological, and Philosophical Reflections
Authors: Latkovic Mark S.
Published: November 2012

“Better a poor man strong and robust, than a rich man with wasted frame. More precious than gold is health and well-being, contentment of spirit than coral. No treasure greater than a healthy body; no happiness, than a joyful heart! Preferable is death to a bitter life, unending sleep to constant illness. Dainties set before one who cannot eat are like the offerings placed before a tomb. What good is an offering to an idol that can neither taste nor smell? So it is with the afflicted man who groans at the good things his eyes behold!”

(Sirach 30:14–20) 1

“Hold the physician in honor, for he is essential to you, and God it was who established his profession. From God the doctor has his wisdom…His knowledge makes the doctor distinguished…[But God] endows men with the knowledge to glory in His mighty works, through which the doctor eases pain and the druggist prepares his medicines; thus God's creative work continues without cease in its efficacy on the… earth…[The doctor] beseeches God that his diagnosis may be correct and his treatment bring about a cure.”

(Sirach 38:1–3, 6–8, 14)
Palliative Sedation at the End of Life Uses and Abuses
Authors: Pitre Thomas M.
Published: November 2012

Palliative sedation is becoming more widely used in complex end-of-life scenarios. Its use is clearly a significant advance in good medical care in some settings but without the clear ethical guidelines of our Catholic moral tradition its use can lead to euthanasia. The current literature on palliative sedation is reviewed from both the secular and Catholic ethical perspectives. Case scenarios are used to illustrate both perspectives. Particular emphasis is placed on using sound ethical principles in the consideration of using palliative sedation at the end of life. Trends in the use of palliative sedation are reviewed.
Effect of Abortion, in Vitro Fertilization, and Other Causes of Prenatal Death on Life Expectancy in the United States from 1925 to 2005
Authors: Meidl Erik J.
Published: November 2012

The average life expectancy in the United States at the time of birth has increased dramatically over the past century. This paper examines the historical effects of prenatal causes of death on the post-conception life expectancy in the United States from 1925 to 2005. The mortality rates from uterine implantation failure, unrecognized and recognized miscarriage, stillbirth, legal abortion, and embryonic death related to in vitro fertilization were utilized to determine the post-conception life expectancy. The historical changes in the incidence of different causes of prenatal death are presented. The utility of using post-conception life expectancy to evaluate the causes and to plan approaches to improve the chances of survival of human beings in the embryonic and fetal stages of life is discussed.
The Loss of a Physician's Freedom of Conscience Will Result in the Breakdown of Patient Autonomy within the Doctor-Patient Relationship
Authors: Burke Brian J.
Published: November 2012

The development of patient autonomy within health care has created new challenges in the physician-patient relationship. When a patient demands a service that violates the conscience of a physician, it creates conflict within that relationship. This has become particularly problematic when a patient demands abortion or artificial contraception and the physician is morally bound to refuse. This paper argues that the integrity of the physician's conscience must be maintained in order to uphold the integrity of the patient's autonomy. If the physician is forced to violate his conscience, then the guarantee that a patient's desires and wishes will be respected will be lost because a great moral inequality will be created between the physician and the patient. To safeguard both the physician-patient relationship and the patient's autonomy, it is vital that the physician's conscience be protected.
Freedom of Conscience in Ethical Decision Making
Authors: Vélez Juan R.
Published: November 2012

The freedom of conscience of health providers (physicians, pharmacists, and institutions) has been consistently defended by United States law. In the last few years the freedom of these health providers to act in line with their conscience has been challenged by abortion advocates. The current United States administration wishes to weaken this freedom by reversing a recent ruling of the Department of Health and Human Services, which stipulated that institutions receiving federal funds must express their compliance with non-discrimination laws. A person's moral conscience makes practical judgments founded on binding objective moral norms. For this reason each person is bound to obey his conscience and should have the freedom to do so without discrimination. Physicians and other health-care providers should not be deprived of these legitimate rights.
To PEG or Not to PEG A Case of a Hospice Referral for Vitamin B12 Deficiency
Authors: Isajiw George
Published: November 2012

This case history of a 92-year-old patient with pernicious anemia and Alzheimer's dementia is an example of an inappropriate hospice referral as a result of the unfortunately all-too-common practice of making such referrals based on apparent clinical deterioration of elderly patients without proper physician diagnostic involvement to rule out reversible pathology. It further demonstrates the benefit of home tube feedings utilizing percutaneous gastrostomy in dementia patients with malnutrition due to swallowing dysfunction without aspiration and without evidence of malabsorption syndrome. The prevailing “prejudice” against recognizing the benefits of tube feeding of the non-terminal elderly on the part of both families and clinicians is a “hurdle” that can be overcome with gentle, persistent patient advocacy and a touch of “paternalism” in the face of the “modern” medical-moral culture of equating “substituted judgment” with “absolute autonomy.” This case also demonstrates the need to evaluate each patient on a rational, individual, clinical basis as opposed to blindly applying so-called “evidence-based medicine” in an extremely diverse population of patients labeled with the so-called diagnosis of “terminal Alzheimer's dementia.”
Dignitas personae and the Question of Heterologous Embryo Transfer
Authors: Oleson Christopher
Published: November 2012

Contrary to the claims of many Catholic ethicists that the teaching of Dignitas personae leaves the question of human embryo rescue completely open and unresolved, this article argues that the only natural and reasonable reading of what is plainly taught in that document compels one to the conclusion that the Congregation for the Doctrine of the Faith (CDF) has implicitly and de facto committed itself to the rejection of heterologous embryo rescue. In other words, if one accepts the moral premises which the text clearly lays down, sound practical reasoning leaves one no alternative but to conclude that heterologous embryo transfer rescue is ethically unacceptable. Accordingly, if the CDF were now subsequently to say that embryo rescue is morally licit, it would have to reverse itself on certain moral claims that it committed itself to in Dignitas personae.
“Reproductive Health Care,” the “Demographic Imperative,” and the Real Health Needs of Women in the Developing World (Part Two)
Authors: Mosher Steven W.
Published: November 2012

Proponents of “reproductive health care” assert that the 1994 population conference in Cairo marked a watershed between two radically different approaches to reducing the fertility of women in the developing world. They concede that, prior to Cairo, population control programs were driven solely by a narrow demographic imperative. Following Cairo, however, they maintain that a broad approach to improving reproductive health was adopted that not only encouraged smaller families, but did so in the context of providing “client-centered” programs that conferred significant health and welfare benefits to their target population. This two-part article will show that these several claims are misleading, if not altogether false.

In the first article, which was published in the previous issue, the failure of population control programs to address women's health needs was documented, as the women themselves perceive them. The rationalizations used to support an exclusive focus on contraception and sterilization (“latent demand” and “unmet need”) were examined, as well as the harm that has been done to women's health by such drugs and devices.

In this, the second, article the post-Cairo conference rhetorical shift to “reproductive health” is discussed, and the claims that such programs have reduced maternal mortality, infant mortality, and the absolute number of abortions are analyzed. A discussion ensues of how the health needs of women in the developing world could be better met by redirecting existing resources to primary health care, including obstetric care.
Brain Death A Morally Legitimate Criteria for Determining Death?
Authors: Napier Stephen
Published: November 2012

The issue of whether the whole brain death criterion serves as good evidence for death has surfaced within Catholic bioethical circles of late. There apparently is a vocal minority who claim that the Church's acceptance of the brain-death criterion should be overturned. The present paper addresses these arguments, first by clarifying the philosophical anthropology largely accepted by the Catholic intellectual tradition. And second, the paper shows that whole brain death is good evidence for death once one understands the basics of this philosophical anthropology. The paper finishes by criticizing arguments to the effect that whole brain death is either too strong of a criterion or too weak. The “too strong” proponents consider higher-brain (upper-brain) death sufficient, therefore persons in a persistent vegetative state should be considered dead. The “too weak” proponents argue that whole brain death is not sufficient for determining death, consequently the Church should reject it. The paper concludes by rebutting these arguments.
Acceptance, Universal Patient Acceptance, and Access to Care An Update
Authors: Patthoff Donald , Corsino Bruce V.
Published: November 2012

There is an unnoticed step that occurs before a person becomes a patient, that is, every prospective patient must first express his or her need for care to a health professional who responds by describing how the patient might access that care. When the health professional accepts the patient as someone to talk with at the outset, this is termed “acceptance.” Acceptance has been defined as the hidden ethic and core value underlying the applied ethical tool of universal patient acceptance (UPA). Acceptance impacts access to care. Published reactions to acceptance and UPA have so far ranged from thoughtful and constructive, to emotionalized and reactive. As the practical applications of acceptance and UPA are discussed in national forums on access to care, some general trends have emerged. This paper is a status update on UPA and speaks to those proposals and recommendations. The ethical basis of UPA is expanded upon, and the attempt is made to more effectively operationalize the concept and further justify its relevance to the allied-health professions. A clearly articulated notion of acceptance is needed to protect professional conscience from secular interests of patients. It is only after broader multi-disciplinary review and debate, however, that UPA can become less hidden or presupposed, and actually find expression in the ethics codes and training curricula of all the health professions. Once expressed within these professional forums, it will likely gain more relevance in the critical evaluations of acceptance as it is more broadly used in the conversations of economics, politics, and secular (non-professional) society.
Efficacy and Efficiency in Natural Family Planning Services
Authors: Fehring Richard J.
Published: November 2012

Relatively few Catholic couples in the United States use modern methods of natural family planning (NFP). So too, few Catholic physicians and health professionals prescribe the use of NFP methods for their patients. Reasons for low use of NFP methods include their perceived low efficacy; the complexity of learning, using, and teaching these methods; and the prolonged (and often unnecessary) required abstinence. Newer and simplified methods of NFP have been developed by physicians and scientists that are less complex and use modern technologies of detecting fertility and communicating instructions. Catholic physicians and scientists need to continue to answer the call by the Holy Fathers (from Pius XII to Benedict XVI) to develop secure and scientifically sound methods of NFP.
Health-Care Counter-Reform
Authors: Condit Donald P.
Published: November 2012

The debate preceding passage of the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act, of 2010, was divisive amongst United States Catholics. Supporters of this flawed legislation dissented from the United States Conference of Catholic Bishops. Threats to human dignity persist for the most vulnerable, including the unborn, elderly, immigrants, and poor. Third parties will increase intrusion upon the doctor-patient relationship. Unsustainable spending trends portend healthcare rationing. Catholic social teaching offers clear, and universal, principles for citizens of good will to guide amelioration of these fundamental health-care policy concerns.
Natural Family Planning in Education and Practice
Authors: Beeman Patrick C.
Published: November 2012

Natural family planning (NFP), which comprises multiple, variegated methods, is an underutilized form of birth control. This is despite women's interest in it. It is unclear why this is the case. One hypothesis is that nurses and physicians, main sources of information on reproductive health matters, are not adequately trained to provide NFP services to patients. The extant English language literature on the subject of NFP and professional education was examined and analyzed for information on the breadth, content, and depth of NFP teaching in medical and nursing programs. Data on physicians’ and nurses’ practice and attitude toward NFP were also examined. Few articles and limited data exist to indicate what type of training in NFP student doctors and nurses receive, though it is clear that some information about it is obtained through the undergraduate nursing or medical curriculum. The literature suggests that many health-care providers would offer an NFP method to specific patients, but that such opportunities are rarely sought and are in fact limited. These methods would be more widely used if health-care professionals in general had better and more adequate training in NFP and offered it to more of their patients. Catholic professionals in particular have a special responsibility to train users and teachers of NFP.
The Early Human Embryo is Scarred by Terms of Ambiguous Meaning
Authors: Bozzato Gianni
Published: November 2012

The author examines both the so-called “Catholic” and “lay” theses on the identity and status of the early human embryo. He points out that some assumptions shared by both theses are biologically equivocal. Moreover, some authoritative experts validate those assumptions by using linguistic artifices which confound the understanding of this sensitive issue. He disputes the ambiguity of the expressions “human life,” “human being,” and “genetic identity.” He concludes his essay listing some terms, which do not assign univocal meaning, and which are exploited to alter objective data and biological concepts for corroborating the “lay” thesis.
The Approved Miracles of St. Gianna Beretta Molla, Wife, Mother, and Physician
Authors: McKenna Thomas J. , Ruppersberger Lester
Published: November 2012

Saint Gianna Beretta Molla gave up her life to save the life of her child. She was a devout woman and pediatrician who refused a hysterectomy to remove a benign fibroid tumor in her uterus during pregnancy as the procedure would have resulted in the death of her unborn child. Her saintliness was confirmed by two medical cases. The first was a twenty-seven-year-old woman who developed a recto-vaginal fistula approximately two weeks after she gave birth to a stillborn baby by Caesarean section. While she was being prepared for transfer to another facility, a Capuchin religious sister turned to Gianna Beretta Molla asking through her intercession that the patient be healed of the illness and thereby avoid the dangerous trip. About this time the pain disappeared completely and, upon examination, the fistula had completely healed. The second case is a thirty-five-year-old Brazilian woman who, during her pregnancy, suffered through many complications, including a large retroplacental clot and a detached placenta. Later rupture of the amniotic membrane was confirmed. The patient was advised to abort the baby, but with the advice of her bishop she turned instead in prayer to Blessed Gianna Beretta Molla. She was monitored closely, and the baby was delivered by Caesarian section. The mother suffered more complications, but ultimately recovered. The clinical aspects of retrovaginal fistulas, subchorionic hemorrhage, and pre-term premature rupture of the membranes are reviewed.
Is the Psychological Adjustment of Donor-Conceived Children of Lesbians Higher than that of Other Children?
Authors: O'Leary Dale
Published: November 2012

The recent publication of the “US National Longitudinal Lesbian Family Study: Psychological Adjustment of 17-Year-Old Adolescents” suggests that lesbian-headed families are not only as good, but better than father/mother families. However, the study suffers from several methodological flaws. The control group was mismatched for age, ethnicity, and level of education. The questionnaire was completed by one of the mothers, while similar questionnaires filled out by the children or by teachers were not included. Six of the seventy-seven lesbian couples separated prior to conception while forty separated later on (60 percent separation rate). The effect of the redundancy of a lesbian family unit may temper the effect of separation, but this leads to conflicts in the relationship, which impact the children. In a prior study the effect of conception by donor sperm has been shown to be associated with depression, delinquency, and substance abuse, with those born to lesbian couples twice as likely to say they have struggled with substance abuse. Children born to a mother in a lesbian relationship through donor insemination are deprived of something to which every child has a right—a father—and sooner or later the child will ask, “Why me?”
Contraceptives for Victims of Rape and for the Mentally Disabled: A Reply to Stephen Napier
Authors: Tollefsen Christopher
Published: November 2012

In this paper I argue for the following claims. First, contraceptive acts are intrinsically wrong, and not merely always wrong within the marital context. Second, in consequence, the defense of the administration of contraceptives in case of rape must be understood under the rubric of the principle of double effect. Third, the existence or threat of rape is therefore not a sufficient condition for the permissible administration of contraceptives; the intention must be upright. Fourth, in the case as described by Stephen Napier, the intention with which contraceptives would be administered is almost certainly contraceptive; thus this administration would be an instance of an intrinsically evil act. Recognition of why this is so is the key to understanding why, despite a prima facie agreement, as noted by Napier, between his own position and that of Germain Grisez, there is nevertheless a rather deep disagreement. I articulate that disagreement, and indicate why I believe the question has not been fully resolved by Napier's essay.
The Life and Times of John J. Billings: The Mucus Symptom, a Physiologic Marker of Women's Fertility
Authors: Norris Charles W.
Published: November 2012

Dr. John J. Billings died on April 1, 2007, after a long illness. Prior to his death he had been awarded the President's Medal by Georgetown University in recognition of his research in developing the Billings Ovulation Method of natural family planning. However, he was personally unable to accept the award due to his failing health. This paper is a biographic sketch of his long and illustrious career.
Character and Action in the Physician's Vocation
Authors: Mitchell Louise A.
Published: November 2012

The Christian physician cannot both prescribe contraception at the office and believe that contraception is wrong at home. He or she cannot divide personal beliefs from the practice of medicine and still maintain integrity. This is a matter of character on which the Hippocratic Oath is instructive but which much of current medical ethics glosses over. A Christian physician acts out of a Christian metaphysics founded on God as Creator. The Christian anthropology built upon this foundation depicts the human being as made in the image of God and created for excellence. The development of good character through practicing the virtues is the path to excellence. The Christian physician of good character acting on his belief in God avoids prescribing contraception and takes strength from Christ the Good Samaritan and Divine Physician.
Contraception for the Mentally Disabled: A Contraceptive Act?
Authors: Napier Stephen
Published: November 2012

This paper argues that in certain circumstances, a Catholic institution that cares for disabled persons can ensure that some of them conform to a temporary sterilizing intervention. The argument proceeds by observing that the Church permits temporary sterilizing interventions for rape victims, because such interventions are not contraceptive acts, but rather, acts of defense. For similar reasons, some mentally disabled persons cannot consent to sexual intercourse and since rape is defined as unconsensual intercourse, some mentally disabled persons are proper candidates of temporary sterilizing interventions. These interventions do not count as contraceptive acts either. This is the case even if the disabled person in question desires the intercourse. This is so because consent is an intellectual act and desire is a passion. Desire does not entail consent. Although the conclusion reached may look “liberal” or “heretical” the argument shows that it is consistent with firm Church teaching.
Your Conscience, Your Right: A History of Efforts to Violate Pro-Life Medical Conscience, and the Laws that Stand in the Way
Authors: Mattox M. Casey , Bowman Matthew S.
Published: November 2012

Attacks on the conscience rights of health-care professionals are increasing. This stems from the seven stages of liberal legal activism which begins with the assertion that a specific (immoral) activity should not be illegal and ends with the condemnation as criminals of those who disagree with the immoral activity. The history of legal activism in the United States with regard to abortion is traced, including attempts to force Catholic hospitals to perform abortions and sterilizations. These include challenges on the national and state levels with conscience-protection legislation enacted both in Congress and in state legislatures. However, these laws provide no explicit means by which a medical professional or institution may seek redress for a violation of their conscience. This has led to recent failures of conscience protection, such as when Catholic Charities in New York was forced to provide insurance coverage for contraceptives and a Catholic nurse was forced to assist in a twenty-two-week-old dismemberment abortion. The conscience protection regulations issued near the end of President Bush's second term would be helpful in ensuring greater education about and adherence to the laws and respect for conscience rights, but the Obama Administration has proposed rescinding the Bush Administration regulations. Catholic Medical Association members must stand and defend their conscience rights in this time or risk the loss of those rights in the near future. The Alliance Defense Fund and its allies are ready to assist medical students, professionals, and institutions who are willing to stand in this gap and refuse to sacrifice their consciences to the anti-choice agenda being promoted by those who call themselves “pro-choice.”
Perinatal Hospice: Compassionate and Comprehensive Care for Families with Lethal Prenatal Diagnosis
Authors: Calhoun Byron D.
Published: November 2012

When the diagnosis of a lethal anomaly has been established, many patients will choose to continue to their pregnancy. Until recently, there has been a lack of medical literature addressing the specific management of the families who find themselves in this unique situation. Since 1996, we have proposed a model of care that involves the strength of prenatal diagnosis, perinatal grief management, and hospice care to address the needs of these families. This article describes how to identify patients who benefit from this care; the multidisciplinary team approach; and the aspects of antepartum, intrapartum, and postpartum care. The literature to date is discussed, and barriers to implementation described.
Catholic Health Care and Current Ethical Dilemmas in Health-Care Delivery
Authors: Brehany John F.
Published: November 2012

Today there is a growing crisis in politics and economics, as well as health care and more specifically Catholic health care. We have inherited a great legacy in Catholic health care in America; and despite modern challenges to it, we must protect this ministry. Three areas are proposed in which we must respond to the particular medical-ethical challenges we are facing, and these areas are the following: protection of conscience and religious freedom, freedom to develop positive alternatives, and recapturing the vision of Catholic health care. Ultimately love of Christ and fidelity to his teaching and example must undergird our efforts in preserving the delivery of Catholic health care in America.
Organ and Tissue Donation and Transplantation
Authors: Shea John B.
Published: November 2012

Since 1968, vital organs, necessary for life, have been removed from patients for transplantation into patients in whom corresponding organs have ceased to function. Since then this has been morally justified by the claim that the donor is “brain dead” or has suffered “cardiac death.” Brain death is defined as complete and irreversible loss of all brain function, and cardiac death is declared two to five minutes after cessation of the heartbeat.

The moral problem is that the criteria used to declare that brain death or cardiac death has occurred are arbitrary, open to serious world-wide debate, variable in definition and application, and, more seriously, do not necessarily provide moral certainty that real death has occurred and that such organ retrieval does not actually cause the death of the donor.

This problem has been debated over the years at the Pontifical Academy of Sciences and remains a subject of legitimate debate to this day. The declaration of brain death or cardiac death also does not appear to be consistent with the teaching of Pope Benedict XVI that the definition of death receive the consensus of the entire scientific community and does not give everyone certainty that the primary criterion is respect for the life of the donor and that the organs are removed from a dead body, a cadaver.
What is Right About the Contra-Life Argument Against Contraception?
Authors: Anderson Robert D.
Published: November 2012

The contra-life argument against contraception by Germain Grisez, Joseph Boyle, John Finnis, and William May maintains that contraception is always and everywhere morally wrong because it involves a contra-life choice to impede new human life. This article develops four problems that people might have with the contra-life argument and then shows that none of those problems undercut the argument. The most serious problem is that the contra-life argument seems to fail to show adequately what is wrong with impeding new human life, and this article neutralizes that problem by showing that choices to impede new human life are wrong because they involve unreasonable self-preference. Finally, this article shows that the moral character of contraceptive use for non-contraceptive reasons is often difficult to determine.
Condoms and AIDS: Is the Pope Right or Just “Horrifically Ignorant”?
Authors: Wills Susan E.
Published: November 2012

Pope Benedict XVI's assertion that the distribution of condoms cannot overcome the AIDS epidemic in sub-Saharan Africa and that condoms may even worsen the problem was met with widespread ridicule and condemnation. Yet, experts in HIV/AIDS and sexually transmitted diseases (STDs) have published scores of articles documenting condom ineffectiveness in preventing STD transmission. Even with perfect use, condoms fail. The standard of correct and consistent use has always proven to be beyond the capacity of condom users. Numerous studies have shown the tendency of individuals to take greater risks (more partners, less careful partner selection, etc.) when they think they are protected, for example, by condoms or antiretroviral drugs. Repeated exposures to STDs over time produce a cumulative risk that virtually guarantees transmission. Most HIV/AIDS experts today concur that behavioral changes (principally abstinence and monogamy), not condoms, are key to reducing incidence.
Geriatric Case Reports: Issues of Justice and Proportionality
Authors: Burke Greg F.
Published: November 2012

The practice of medicine has become increasingly focused on the care of the elderly due to demographic changes and an increase in human longevity. A number of diseases, most particularly dementia and vasculopathy, are much more common in geriatric patients. Ethical dilemmas related to justice (right patient/right care) and proportionality (benefit/burden analysis) are typical in this population. Two cases from clinical practice are utilized to demonstrate these ethical problems in real-world narratives and provide reasonable moral guidance rooted in the Catholic tradition. The author recognizes that there may be different clinical assessments based on practitioner experience and the medical literature, but asserts that the ethical principles derived are solidly defensible and universal.
Saint Augustine, Freedom of Will, and Pornography
Authors: Harvey John F.
Published: November 2012

In this article, which was originally a talk given at the annual Courage and EnCourage conference in July 2009, at Villanova University, I first discuss the pastoral letter of Bishop Robert W. Finn on the Dignity of the Human Person and the Dangers of Pornography. Then I summarize St. Augustine's theory concerning the necessity of a united will to overcome an addictive habit, specifically, his insights into the freedom of the will and other aspects of the will. I propose that Augustine's insights be used as an important part of the pastoral approach to helping a person addicted to pornography.
Love and Healing
Authors: DeMarco Donald
Published: November 2012

This article develops the theme of healing as removing that which is alien to the human being. This notion of healing is consonant with two aspects of love: affirming the self in its proper or authentic state, and restoring the wounded self to that state. Christianity owes much to the contributions of the ancient Greeks on this subject, but greatly surpasses them in its recognition of the critical importance of the body and the supreme value of love.
Abuse by Priests, Homosexuality, Humanae vitae, and a Crisis of Masculinity in the Church
Authors: van den Aardweg Gerard J.M.
Published: November 2012

Data on the age of the preferred partner of same-sex attracted men show that the abuse of minors by priests and deacons is primarily a question of “ordinary” homosexuality, and secondarily of homosexual pedophilia (not just unspecified “pedophilia”). This points to the substantial over-representation of homosexually inclined men among seminarians and priests, which in turn is related to a process of “homosexualization” (and feminization) in the Church. The general dissent from the moral doctrine on sexuality and marriage (as set forth in the encyclical Humanae vitae) has paved the way for this process. A few suggestions are discussed for the prevention of the abuses of the past decades: (a) improved screening of candidates for the priesthood as well as for the office of bishop on masculine personality maturity, which includes normal heterosexuality and fatherhood qualities; (b) a spiritual regime for seminary students and priests that is demanding on the self and directs the battle for holiness; (c) appointment of bishops and seminary regents who are active apostles of Humanae vitae and Evangelium vitae.
Pope Benedict XVI on the Priesthood and Homosexuality
Authors: Mullady Brian
Published: November 2012

In his recent interview published as the book Light of the World, Pope Benedict XVI noted that the Vatican has repeatedly stated that men with a homosexual orientation should not be admitted to the priesthood even if they performed no homosexual acts. He stated that he did not want celibacy to be an excuse to attract people with a homosexual orientation. There are several reasons for this stance.

The priesthood is not a denial of the spousal meaning of the body which underlies marriage. This spousal meaning entails the fact that since man is a composite of body and spirit, the body is the physical self by which the gift of the soul which characterizes married love is finally ratified. The giving and receiving of sperm and ova expresses physically the prior giving and receiving of soul. This gift of self to another, for those who are called to it, can also be realized by the gift of self to God as is the case with virgins and religious.

Though celibacy is a discipline, because of the all-encompassing concentration of forces necessary for the priesthood, realized especially in the consecration of the Eucharist, it is a fit means for carrying out this spousal meaning of the body. As a result, a priest must have the same ability to give the gift of himself totally as a married man does; only his gift is to the whole Church.

There is an argument as to whether homosexuality is a result of nurture or nature. In either case, as long as this condition remains, the total dedication of self required of the priest would not be possible. If this is the result of nature, this cannot be changed; and the person could not contemplate a priestly vocation. If this results from nurture, then it could be changed; in which case after a person has changed it, he could pursue the priesthood.
Outcomes of Intercessory Prayer for those who are Ill
Authors: Fosarelli Patricia
Published: November 2012

Intercessory prayer for those who are ill is a common religious practice not only by individuals but also by communities of faith. Although such prayer has much religious meaning, is there scientific evidence that it brings about the outcomes for which it asks? The scientific literature investigating the efficacy of intercessory prayer for the ill and the difficulties in putting prayer to scientific scrutiny is explored in this article. Overall, studies have yielded mixed results and have been criticized (on a scientific basis) as having methodological flaws such as small sample size, varied end-points, varied definitions of prayer, and varied expertise of “intercessors.” Such studies have also been critiqued on metaphysical and religious grounds, namely, that God's actions cannot (and should not be) subjected to scientific scrutiny.
Safe Passages
Authors: Mulcaire-Jones George , Scanlon Robert
Published: November 2012

Maternal mortality in Africa remains unacceptably high. The prevailing response to reducing maternal mortality has emphasized “reproductive health” and has failed to clearly focus on those causes responsible for 90 percent of maternal deaths. In contrast, the “Safe Passages” model directs training and resources toward interventions that save the lives of mothers and babies. Within the Safe Passages model, a “premise” and an “equation” offer an ethical and strategic framework for maternal health-care development which respects human life and dignity and prioritizes those interventions most likely to reduce maternal and newborn deaths. The Safe Passages “equation” emphasizes the key components of respect for persons, safe birth, and fertility literacy. Successful training and development programs should work to insure participants and organizations are inspired, educated, equipped, and evaluated.
Fertility Awareness–Based Methods for Family Planning and as an Alternative to Hormonal Contraceptives for Therapeutic Reasons
Authors: Ferris Ronald
Published: November 2012

In current medical practice, many women are prescribed hormonal contraceptives as a method of family planning. Over the years, medical professionals have prescribed hormonal contraceptives to manage numerous health conditions in addition to family planning purposes. A particular question arises in regard to women taking hormonal contraceptives for therapeutic reasons if the drug has a contraceptive effect and abortifacient properties. An important consideration is a definite lack of knowledge among medical professionals and patients about alternatives to hormonal contraceptives. To most lay people and medical professionals, fertility awareness-based methods equate to the outdated calendar rhythm method and therefore tend to be regarded as mostly a matter of chance so that they would have no benefit in helping manage gynecological conditions. In this paper, one will be able to see that modern fertility awareness-based methods are effective as a method of family planning and that there are medical applications that offer an excellent alternative in the treatment of various gynecological conditions, including infertility.
A Critique of the National POLST Paradigm through an Analysis of Colorado's New MOST Legislation
Authors: Brugger E. Christian
Published: November 2012

Colorado recently legalized a new document for use in end-of-life care called a Medical Orders for Scope of Treatment (MOST) form. The legislation exempts from liability to homicide laws caregivers who execute MOST orders for the withdrawing or withholding of life-sustaining procedures. But it drops the requirement that patients be terminally ill before they are free to refuse those procedures. It permits anyone to refuse any medical treatment for any reason; and holds health-care institutions, practitioners, and surrogate decision makers free from liability when they carry out the orders. This essay criticizes the new law together with the view of autonomy implicit within it. The essay proposes six reasons grounded in the requisites of justice and the common good why the new law should be opposed. It recommends that Catholic hospitals refuse to accept MOST-type documents.
Maternal Mortality Causality a Kenyan Experience
Authors: Kagia Jean W.
Published: November 2012

Maternal and neonatal mortality rates are the best indicators of any country's health-care service. In developing countries, women form the backbone of the economy while children provide security against extinction. Global maternal mortality estimates indicate that most of the countries in sub-Saharan Africa have maternal mortality rates that are greater than 550/100,000 live births. In contrast, Kenya's maternal mortality rate is 414/100,000 live births. Analysis of the specific causes of maternal mortality in Kenya indicates a clear need for addressing postpartum hemorrhage, improving access to skilled birth attendance, and promoting antenatal care. The Protecting Life Movement is introducing rescue home centers to address the problem of crisis pregnancies in Kenya.
Saint René Goupil, Surgeon
Authors: McDermott Scott
Published: November 2012

Saint René Goupil is the patron of the American Association of Nurse Anesthetists. Given his training as a surgeon and his efforts to relieve the suffering of others, he makes an excellent patron for physicians also. Goupil worked at the Hôtel Dieu Hospital in Sillery, near Quebec City, which combated the Indians' practice of euthanasia by providing palliative care. There, as well as in his captivity, he epitomized a Catholic medical practice which shows concern for the soul as well as the body. Finally, Goupil bore heroic witness to the dignity of all human persons when he offered medical treatment even to one of his Mohawk torturers.
Perspectives on Directive 58
Authors: Travaline John M. , Berg Thomas V.
Published: November 2012

The United States Conference of Catholic Bishops recently revised directive 58, on the use of artificial nutrition and hydration, in its Ethical and Religious Directives for Catholic Health Care Services. Although the revision clarifies that the use of artificial nutrition and hydration is ordinary, proportionate, and therefore, in principle, morally obligatory, the ethical debate surrounding this issue continues. Furthermore, many clinicians remain confused about the implications of this directive, as well as its application to specific cases. This article seeks to clarify both the implications and the practical application of directive 58, pointing out that providing artificial nutrition and hydration is part of normal care giving, and there are few instances in which such care can be licitly withheld or withdrawn from a patient.
Microstructural evolution in 10Ni3MnCuAl precipitation hardened steel after aging at 510°C
Authors: Luo Y , Wang H B , Zhang W , Min Y A , Wu X C
Published: November 2012

The precipitate hardened plastic mould steel 10Ni3MnCuAl after aging at 510°C is investigated by optical microscopy, X-ray diffractometry, TEM and three-dimensional atom probe. The results show that its microstructure is granular bainite with a certain amount of retained austenite after soluted and cooled in furnace, and its content decreases until close to 0. By TEM observation, the age hardening of the 10Ni3MnCuAl steel is mainly ascribed to the precipitation of a high density, ultrafine and fully coherent NiAl precipitation with the B2 structure at 510°C for 4 h, and a multicomponent precipitate can be found in steel for 100 h aging. The three-dimensional atom probe researches show that its age hardening derives from a spherical multicomponent precipitate containing Fe, Ni, Al, Mn and Cu, and the content of Fe decreases with aging time, while those of Ni, Al, Mn and Cu are opposite, and the ratio between Ni and Al is roughly 1, and the Cu precipitates are surrounded by Ni, Al and Mn clusters for 100 h aging. The hardness variation is related to the size and number density of the precipitates, and it follows the cutting mechanism during early aging while obeys Orowan mechanism during overaging.
Effect of nodule count on austenitising and austempering kinetics of ductile iron castings and mechanical properties of thin walled iron castings
Authors: Fraś E , Górny M , Tyrała E , Lopez H
Published: November 2012

In the present work, the potential for producing thin walled ductile iron castings with an ausferritic matrix is presented. Experimentally, thin walled iron castings of 2 mm in thickness were obtained and characterised by a nodule count of 1992 mm−2. In addition, a reference casting was produced with a 25 mm thick wall and a nodule count of 330 mm−2. Austenitising was carried out at 920°C, whereas austempering was implemented in the 300–400°C temperature range. The austenitising and austempering transformation rates were determined by dilatometry, and the results were confirmed by microstructural analyses. It was found that in thin walled castings, the austenitising and austempering times were reduced by either one-half or one-third of the ones corresponding to the reference casting. The exhibited mechanical properties of the thin walled castings were also determined as a function of austempering time and temperature. It was found that austempering at 300°C for 1200 s leads to thin walled castings with a tensile strength of 1500 MPa. Accordingly, from this work, it is plausible to produce high strength thin walled castings that satisfy all the ASTM 897M grades of ausferritic ductile iron through proper heat treating.