Pubblichiamo un contributo intitolato "Una risposta scientifica alle disinformazioni sul Covid", ... more Pubblichiamo un contributo intitolato "Una risposta scientifica alle disinformazioni sul Covid", della dottoressa Doyen Nguyen, che rappresenta un importante documento di chiarificazione su molteplici aspetti legati alla pandemia, alla sua gestione da parte delle autorità sanitarie, con particolare riferimento allo sviluppo di vaccini con tecnologia a mRNA, che sono stati utilizzati come principale mezzo di contrasto della diffusione del virus.
Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain... more Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues' revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust. Summary: This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.
understanding of the strengths and limitations of the various sepsis criteria, while urging prosp... more understanding of the strengths and limitations of the various sepsis criteria, while urging prospective comparative studies of the impact of qSOFA vs SIRS and other screening systems on patient outcomes. References 1. Anand V, Zhang Z, Kadri SS, Klompas M, Rhee C; CDC Prevention Epicenters Program. Epidemiology of quick Sequential Organ Failure Assessment criteria in undifferentiated patients and association with suspected infection and sepsis. Chest. 2019;156(2):289-297. 2. Churpek MM, Snyder A, Han X, et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. Am J Respir Crit Care Med. 2017;195(7):906-911. 3. Serafim R, Gomes JA, Salluh J, Povoa P. A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest. 2018;153(3):646-655. 4. Simpson SQ. New sepsis criteria: a change we should not make. Chest. 2016;149(5):1117-1118. 5. Cortes-Puch I, Hartog CS. Opening the debate on the new sepsis definition change is not necessarily progress: revision of the sepsis definition should be based on new scientific insights. Am J Respir Crit Care Med. 2016;194(1):16-18.
"Brain death" (understood in the sense of "whole brain death" and not in the sense of "brainstem ... more "Brain death" (understood in the sense of "whole brain death" and not in the sense of "brainstem death") was introduced into clinical practice in 1968 when the Harvard Ad Hoc Committee defined irreversible coma as a new criterion for death (understood in the full sense of the word). According to the Uniform Determination of Death Act (UDDA), promulgated in 1981 by the President's Commission (which also formally advanced the first conceptual rationale for brain death), the legal declaration of death using the brain death standard requires the irreversible cessation of all functions of the entire brain, including the brain stem. The brain death standard has since evolved, however, to include significant modifications even though, on a literal reading, its clinical test criteria have remained unchanged. This article gives an account of why and how the brain death standard has been updated, leading to the currently practiced guidelines for the determination of brain death put forth by the American Academy of Neurology. According to the updated standard, the presence of certain brain or spinal cord functions does not invalidate the diagnosis of brain death. By analyzing these guidelines critically on the basis of scientific realism and Thomistic hylomorphism, this article demonstrates that the updated brain death standard contradicts both the UDDA and the tenets of sound anthropology held by the Catholic Church.
This discussion note aims to address the two points which Lizza raises regarding my critique of h... more This discussion note aims to address the two points which Lizza raises regarding my critique of his paper "Defi ning Death: Beyond Biology," namely that I mistakenly attribute a Lockean view to his 'higher brain death' position and that, with respect to the 'brain death' controversy, both the notions of the organism as a whole and somatic integration are unclear and vague. First, it is known from the writings of constitutionalist scholars that the constitution view of human persons, a theory which Lizza also holds, has its roots in John Locke's thought. Second, contrary to Lizza's claims, the notions of the organism as a whole and somatic integration are both more than adequately described in the biomedical and biophilosophical literature. In response to the critiques of his paper "Defi ning Death: Beyond Biology," 1 Lizza wrote a long rebuttal, "In Defense of Brain Death: Replies to Don Marquis, Michael Nair-Col-lins, Doyen Nguyen and Laura Specker Sullivan." 2 With respect to my article, "A Holistic Understanding of Death: Ontological and Medical Considerations," 3 Lizza's rebuttal consists of two main points: (i) he argues again that the concept of 'human organism as a whole' is vague, 4 and (ii) from his perspective, I "mistakenly attribute a Lockean view" to his consciousness-related or 'higher brain' formulation of death. 5 In particular, Lizza states explicitly that he holds the constitutive view of human persons. 6 I appreciate Lizza's efforts and wish to address both of these points.
In the ongoing 'brain death' controversy, there has been a constant push for the use of the 'high... more In the ongoing 'brain death' controversy, there has been a constant push for the use of the 'higher brain' formulation as the criterion for the determination of death on the grounds that brain-dead individuals are no longer human beings because of their irreversible loss of consciousness and mental functions. This essay demonstrates that such a position flows from a Lockean view of human persons. Compared to the 'consciousness-related definition of death,' the substance view is superior, especially because it provides a holistic vision of the human person, and coheres with the perennial axiom about the 'whole and parts.'
The "brain death" standard as a criterion of death is closely associated with the need for transp... more The "brain death" standard as a criterion of death is closely associated with the need for transplantable organs from heart-beating donors. Are all of these potential donors really dead, or does the documented evidence of patients destined for organ harvesting who improve, or even recover to live normal lives, call into question the premise underlying "brain death"? The aim of this paper is to reexamine the notion of "brain death," especially its clinical test-criteria, in light of a broad framework, including medical knowledge in the field of neuro-intensive care and the traditional ethics of the medical profession. I will argue that both the empirical medical evidence and the ethics of the doctor-patient relationship point to an alternative approach toward the severely comatose patient (potential brain-dead donor). Lay Summary: Though legally accepted and widely practiced, the "brain death" standard for the determination of death has remained a controversial issue, especially in view of the occurrence of "chronic brain death" survivors. This paper critically re-evaluates the clinical test-criteria for "brain death," taking into account what is known about the neuro-critical care of severe brain injury. The medical evidence, together with the understanding of the moral role of the physician toward the patient present before him or her, indicate that an alternative approach should be offered to the deeply comatose patient.
In this paper, the moral teaching of the first chapter of the en(.yc/ical Veritatis splendor, acc... more In this paper, the moral teaching of the first chapter of the en(.yc/ical Veritatis splendor, according to which Christian morality is both teleological and Christocentric, is applied to the realm of conjugal love in order to shed light onto the issue of Catholic divorce-re-marriage and Holy Communion. First, the paper shows that this moral teaching is grounded in Scriptures and in continuity with the sound moral theology developed by the Doctors of the Church. Second, using this moral teaching as a framework, this paper examines conjugal love from a perspective which integrates three schools of thought: the Aristotelian-Thomistic tradition, Hildebrand :S phenomenological study on love, and Wojtyla/John Paul II's teaching on spousal love. The three main characteristics oflove, unio, concordia, and benovolentia are analyzed in two settings: first, as they are realized in a well-lived Christian marriage and second, in the phenomenon of Catholic divorce-remaniage. The analysis leads to the conclusion that, in man·iage, the key to attaining the true joy of love-properly understood as love and communion with the Triune God, and with the beloved person in God-entails that conjugal love be understood and lived in terms of Christian discipleship. This year (2018) marks the 25th anniversary of St. John Paul IT's encyclical Veritatis splendor (The Splendor of Truth), the first magisterial document on the foundations of Catholic moral theology, promulgated on the Feast of the Transfiguration in 1993. The Holy Father's intention for this encyclical was first made explicit in his 1987 apostolic letter Spiritus Domini on the bicentenary of the death of St. Alphonsus Ligori. 1 There, he promised to 1 See lOANNES PAULUS PP 11, Litt. Apost. Spiritus Domini. l-Vlll-1987, in AAS 79 (1987) 1365-1375, §3; IOANNES PA ULUS PP II, Litt. Encycl. Veritatis splendor, de quibus-dam quaestionibus fundamentalibus doctrinae moralis Ecclesiae. 6
Computer Methods and Programs in Biomedicine, 1997
The Coulter FACULTY knowledge-based systems, Professor Petrushka for peripheral blood interpretat... more The Coulter FACULTY knowledge-based systems, Professor Petrushka for peripheral blood interpretation, Professor Fidelio for flow cytometry immunophenotyping and Professor Belmonte for bone marrow reporting, have been installed in several hospitals in Spain, Portugal and the United Kingdom. In Spain and Portugal, the systems are part of the IZASA-Coulter CITOTECA workstation, which includes a video camera for capturing microscopic images and a networkable laboratory information system supporting color reports. At the Royal Hospitals Trust (St. Bartholomew's Hospital and The Royal London Hospital, London, UK), networked workstations are available and the system is used daily to generate bone marrow reports in the hematology laboratories. There have been considerable benefits from adopting Coulter FACULTY for bone marrow reporting, including faster turnaround time, improved quality of the reports and cost savings.
Pubblichiamo un contributo intitolato "Una risposta scientifica alle disinformazioni sul Covid", ... more Pubblichiamo un contributo intitolato "Una risposta scientifica alle disinformazioni sul Covid", della dottoressa Doyen Nguyen, che rappresenta un importante documento di chiarificazione su molteplici aspetti legati alla pandemia, alla sua gestione da parte delle autorità sanitarie, con particolare riferimento allo sviluppo di vaccini con tecnologia a mRNA, che sono stati utilizzati come principale mezzo di contrasto della diffusione del virus.
Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain... more Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues' revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust. Summary: This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.
understanding of the strengths and limitations of the various sepsis criteria, while urging prosp... more understanding of the strengths and limitations of the various sepsis criteria, while urging prospective comparative studies of the impact of qSOFA vs SIRS and other screening systems on patient outcomes. References 1. Anand V, Zhang Z, Kadri SS, Klompas M, Rhee C; CDC Prevention Epicenters Program. Epidemiology of quick Sequential Organ Failure Assessment criteria in undifferentiated patients and association with suspected infection and sepsis. Chest. 2019;156(2):289-297. 2. Churpek MM, Snyder A, Han X, et al. Quick sepsis-related organ failure assessment, systemic inflammatory response syndrome, and early warning scores for detecting clinical deterioration in infected patients outside the intensive care unit. Am J Respir Crit Care Med. 2017;195(7):906-911. 3. Serafim R, Gomes JA, Salluh J, Povoa P. A comparison of the quick-SOFA and systemic inflammatory response syndrome criteria for the diagnosis of sepsis and prediction of mortality: a systematic review and meta-analysis. Chest. 2018;153(3):646-655. 4. Simpson SQ. New sepsis criteria: a change we should not make. Chest. 2016;149(5):1117-1118. 5. Cortes-Puch I, Hartog CS. Opening the debate on the new sepsis definition change is not necessarily progress: revision of the sepsis definition should be based on new scientific insights. Am J Respir Crit Care Med. 2016;194(1):16-18.
"Brain death" (understood in the sense of "whole brain death" and not in the sense of "brainstem ... more "Brain death" (understood in the sense of "whole brain death" and not in the sense of "brainstem death") was introduced into clinical practice in 1968 when the Harvard Ad Hoc Committee defined irreversible coma as a new criterion for death (understood in the full sense of the word). According to the Uniform Determination of Death Act (UDDA), promulgated in 1981 by the President's Commission (which also formally advanced the first conceptual rationale for brain death), the legal declaration of death using the brain death standard requires the irreversible cessation of all functions of the entire brain, including the brain stem. The brain death standard has since evolved, however, to include significant modifications even though, on a literal reading, its clinical test criteria have remained unchanged. This article gives an account of why and how the brain death standard has been updated, leading to the currently practiced guidelines for the determination of brain death put forth by the American Academy of Neurology. According to the updated standard, the presence of certain brain or spinal cord functions does not invalidate the diagnosis of brain death. By analyzing these guidelines critically on the basis of scientific realism and Thomistic hylomorphism, this article demonstrates that the updated brain death standard contradicts both the UDDA and the tenets of sound anthropology held by the Catholic Church.
This discussion note aims to address the two points which Lizza raises regarding my critique of h... more This discussion note aims to address the two points which Lizza raises regarding my critique of his paper "Defi ning Death: Beyond Biology," namely that I mistakenly attribute a Lockean view to his 'higher brain death' position and that, with respect to the 'brain death' controversy, both the notions of the organism as a whole and somatic integration are unclear and vague. First, it is known from the writings of constitutionalist scholars that the constitution view of human persons, a theory which Lizza also holds, has its roots in John Locke's thought. Second, contrary to Lizza's claims, the notions of the organism as a whole and somatic integration are both more than adequately described in the biomedical and biophilosophical literature. In response to the critiques of his paper "Defi ning Death: Beyond Biology," 1 Lizza wrote a long rebuttal, "In Defense of Brain Death: Replies to Don Marquis, Michael Nair-Col-lins, Doyen Nguyen and Laura Specker Sullivan." 2 With respect to my article, "A Holistic Understanding of Death: Ontological and Medical Considerations," 3 Lizza's rebuttal consists of two main points: (i) he argues again that the concept of 'human organism as a whole' is vague, 4 and (ii) from his perspective, I "mistakenly attribute a Lockean view" to his consciousness-related or 'higher brain' formulation of death. 5 In particular, Lizza states explicitly that he holds the constitutive view of human persons. 6 I appreciate Lizza's efforts and wish to address both of these points.
In the ongoing 'brain death' controversy, there has been a constant push for the use of the 'high... more In the ongoing 'brain death' controversy, there has been a constant push for the use of the 'higher brain' formulation as the criterion for the determination of death on the grounds that brain-dead individuals are no longer human beings because of their irreversible loss of consciousness and mental functions. This essay demonstrates that such a position flows from a Lockean view of human persons. Compared to the 'consciousness-related definition of death,' the substance view is superior, especially because it provides a holistic vision of the human person, and coheres with the perennial axiom about the 'whole and parts.'
The "brain death" standard as a criterion of death is closely associated with the need for transp... more The "brain death" standard as a criterion of death is closely associated with the need for transplantable organs from heart-beating donors. Are all of these potential donors really dead, or does the documented evidence of patients destined for organ harvesting who improve, or even recover to live normal lives, call into question the premise underlying "brain death"? The aim of this paper is to reexamine the notion of "brain death," especially its clinical test-criteria, in light of a broad framework, including medical knowledge in the field of neuro-intensive care and the traditional ethics of the medical profession. I will argue that both the empirical medical evidence and the ethics of the doctor-patient relationship point to an alternative approach toward the severely comatose patient (potential brain-dead donor). Lay Summary: Though legally accepted and widely practiced, the "brain death" standard for the determination of death has remained a controversial issue, especially in view of the occurrence of "chronic brain death" survivors. This paper critically re-evaluates the clinical test-criteria for "brain death," taking into account what is known about the neuro-critical care of severe brain injury. The medical evidence, together with the understanding of the moral role of the physician toward the patient present before him or her, indicate that an alternative approach should be offered to the deeply comatose patient.
In this paper, the moral teaching of the first chapter of the en(.yc/ical Veritatis splendor, acc... more In this paper, the moral teaching of the first chapter of the en(.yc/ical Veritatis splendor, according to which Christian morality is both teleological and Christocentric, is applied to the realm of conjugal love in order to shed light onto the issue of Catholic divorce-re-marriage and Holy Communion. First, the paper shows that this moral teaching is grounded in Scriptures and in continuity with the sound moral theology developed by the Doctors of the Church. Second, using this moral teaching as a framework, this paper examines conjugal love from a perspective which integrates three schools of thought: the Aristotelian-Thomistic tradition, Hildebrand :S phenomenological study on love, and Wojtyla/John Paul II's teaching on spousal love. The three main characteristics oflove, unio, concordia, and benovolentia are analyzed in two settings: first, as they are realized in a well-lived Christian marriage and second, in the phenomenon of Catholic divorce-remaniage. The analysis leads to the conclusion that, in man·iage, the key to attaining the true joy of love-properly understood as love and communion with the Triune God, and with the beloved person in God-entails that conjugal love be understood and lived in terms of Christian discipleship. This year (2018) marks the 25th anniversary of St. John Paul IT's encyclical Veritatis splendor (The Splendor of Truth), the first magisterial document on the foundations of Catholic moral theology, promulgated on the Feast of the Transfiguration in 1993. The Holy Father's intention for this encyclical was first made explicit in his 1987 apostolic letter Spiritus Domini on the bicentenary of the death of St. Alphonsus Ligori. 1 There, he promised to 1 See lOANNES PAULUS PP 11, Litt. Apost. Spiritus Domini. l-Vlll-1987, in AAS 79 (1987) 1365-1375, §3; IOANNES PA ULUS PP II, Litt. Encycl. Veritatis splendor, de quibus-dam quaestionibus fundamentalibus doctrinae moralis Ecclesiae. 6
Computer Methods and Programs in Biomedicine, 1997
The Coulter FACULTY knowledge-based systems, Professor Petrushka for peripheral blood interpretat... more The Coulter FACULTY knowledge-based systems, Professor Petrushka for peripheral blood interpretation, Professor Fidelio for flow cytometry immunophenotyping and Professor Belmonte for bone marrow reporting, have been installed in several hospitals in Spain, Portugal and the United Kingdom. In Spain and Portugal, the systems are part of the IZASA-Coulter CITOTECA workstation, which includes a video camera for capturing microscopic images and a networkable laboratory information system supporting color reports. At the Royal Hospitals Trust (St. Bartholomew's Hospital and The Royal London Hospital, London, UK), networked workstations are available and the system is used daily to generate bone marrow reports in the hematology laboratories. There have been considerable benefits from adopting Coulter FACULTY for bone marrow reporting, including faster turnaround time, improved quality of the reports and cost savings.
Uploads
Papers by Doyen Nguyen