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Abstract: The modern hospice movement, which is the origin of what is now known as palliative care, derived strong inspiration from Christianity. Given this original Christian inspiration, the global spread of palliative care even to countries where Christianity is only a minority religion may look surprising. In line with the theory of the "secularization of hospice," it could be argued that palliative care has spread globally because its underlying philosophy has become secular, allowing it to become universal. However, given the continuing importance of religion in many areas of palliative care, we could wonder how secular contemporary palliative care really is. This article argues that the universality of palliative care philosophy resides in its susceptibility to contextualization. Palliative care has become a global success story because people all over the world committed to palliative care's principles and ideas have contextualized these and developed models of palliative care delivery and even philosophy that are adapted to the local socio-economic and cultural-religious contexts. This article analyzes palliative care in India to illustrate this point, describing contextualized models of palliative care delivery and showing that palliative care physicians and nurses in India draw inspiration from their local context and religiosity.
Resumen: el movimiento moderno hospitalario, que es el origen de lo que ahora se conoce como cuidados paliativos, obtuvo una fuerte inspiración del cristianismo. Dada esta inspiración cristiana original, la propagación global de los cuidados paliativos incluso a países donde el cristianismo es sólo una religión minoritaria puede parecer sorprendente. En consonancia con la teoría de la "secularización de la hospitalización", se podría argumentar que los cuidados paliativos se han extendido globalmente puesto que su filosofía subyacente se ha vuelto secular, lo que le permite convertirse en universal. Sin embargo, dada la importancia continua de la religión en muchas áreas de los cuidados paliativos, podríamos preguntarnos cuán seculares son realmente los cuidados paliativos contemporáneos. Este artículo argumenta que la universalidad de la filosofía de cuidados paliativos reside en su susceptibilidad a la contextualización. Los cuidados paliativos se han convertido en una historia de éxito mundial, ya que personas de todo el mundo comprometidas con los principios e ideas de los cuidados paliativos los han contextualizado y han desarrollado modelos de prestación de cuidados paliativos e incluso una filosofía que se adapta al contexto socioeconómico y cultural-religioso local. Este artículo analiza los cuidados paliativos en la India para ilustrar este punto a través de modelos contextualizados de prestación de cuidados paliativos, y muestra que los médicos y enfermeras de cuidados paliativos en la India se inspiran en su contexto local y religiosidad.
Resumo: O movimento moderno hospitalar, que é a origem do que agora é conhecido como "cuidados paliativos", derivou de uma forte inspiragao do cristianismo. Tendo em vista essa inspiração cristã original, a propagação global dos cuidados paliativos, inclusive a países onde o cristianismo é somente uma religião minoritária, pode parecer surpreendente. Em consonância com a teoria da secularização da hospitalização, poderia argumentar-se que os cuidados paliativos vêm se estendendo globalmente, visto que sua filosofia subjacente vem se tornado secular, o que lhe permite converter-se em universal. Contudo, considerando a importância contínua da religião em muitas áreas dos cuidados paliativos, poderíamos perguntar-nos quão seculares são realmente os cuidados paliativos contemporáneos. Neste artigo, argumenta-se que a universalidade da filosofía de cuidados paliativos reside em sua suscetibilidade a contextualização. Os cuidados paliativos vêm se tornando uma história de sucesso mundial, já que pessoas de todo o mundo comprometidas com os princípios e as ideias dos cuidados paliativos os têm contextualizado e tem desenvolvido modelos de prestação de cuidados paliativos e inclusive uma filosofía que é adaptada ao contexto socioeconômico e cultural-religioso local. No texto, são analisados os cuidados paliativos na Índia para ilustrar esse ponto por meio de modelos contextualizados de prestação de cuidados paliativos e é mostrado que os médicos e os enfermeiros de cuidados paliativos na Índia se inspiram em seu contexto local e em sua religiosidade.
Subject(s)
Humans , Palliative Care , Religion , Bioethics , Christianity , IndiaABSTRACT
ABSTRACT In 2018 the academy will celebrate the 200th anniversary of the publication of the seminal work of Arthur Schopenhauer (1788-1860): The World as Will and Representation (Idea). Schopenhauer is known as the "philosopher of pessimism" and as the "psychologist of the will". His thinking is formally absent in the psychiatric education curricula, which could be enriched by the philosopher's work. Regarding psychiatry's theoretical foundations, Schopenhauer: a) anticipated several issues of species' origin and evolution, which are used in the contemporary understanding of disease development; b) anticipated some attributes of the psychodynamic and cognitive unconscious when referring to the irrational features of the will; c) foresaw the current concept of the embodied mind, which emphasizes the role of the body's structure and dynamics in cognition instead of that of a transcendental reason; d) proposed a simplified and heuristic model of mind, comprising the senses, understanding and reason; at a pragmatic level, particularly concerning psychotherapy, the philosopher e) stated that all human actions spring from three fundamental sources: egoism, malice and compassion; he also speculated about the role of unconscious repression in the genesis of mental illnesses; and finally, f) emphasized the ubiquity of suffering and the insatiability of desire, which unavoidably leads to egocentrism. In this regard he highly valued contemplation of art and nature as a way of dissociating knowledge from desire, and thus allowing the development of compassion and asceticism. This was considered by the philosopher to be "denial of the will", and a path for individual salvation and well-being. In contemporary psychiatry, this metaphysical proposal may be reformulated in terms of promoting cooperation and healthy austerity as a non-specific component of most psychotherapies and educational models. Schopenhauer's thinking may enrich psychiatric training and personal well-being.
RESUMEN En 2018 la academia celebra el bicentenario de la publicación de la obra capital de Arthur Schopenhauer (1788-1860) El mundo como voluntad y representación (idea). Schopenhauer es conocido como el «filósofo pesimista¼ y el «psicólogo de la voluntad¼. Su obra está formalmente ausente en el currículo de la formación en Psiquiatría, que puede enriquecerse con las siguientes contribuciones del filósofo. Con relación a los fundamentos teóricos de la Psiquiatría, Schopenhauer: a) anticipó diversos aspectos del origen y la evolución de las especies que hoy se utilizan para la comprensión del desarrollo de la enfermedad; b) anticipó algunos atributos del inconsciente dinámico y cognitivo cuando se refirió a los aspectos no racionales de la voluntad; c) predijo el concepto contemporáneo de la mente corporizada, cuando enfatizó con relación a la cognición el papel de la estructura y la dinámica corporales, en lugar de una razón trascendental; d) propuso un modelo simplificado y heurístico de la mente, que comprende los sentidos, el entendimiento y la razón; en un sentido pragmático, referido particularmente a la psicoterapia, el filósofo: e) afirmó que todas las acciones humanas se originan de 3 fuentes fundamentales: egoísmo, maldad y compasión; también especuló acerca del papel de la represión inconsciente en la génesis de las enfermedades mentales, y para terminar, f) enfatizó la ubicuidad del sufrimiento y la insaciabilidad del deseo, lo que inevitablemente lleva al egocentrismo. En este sentido, valoró la contemplación artística y de la naturaleza como una vía para disociar el conocimiento del deseo y así permitir el desarrollo de la compasión y el ascetismo. El filósofo lo consideraba la "negación de la voluntad" y un camino para la salvación y el bienestar individual. En la Psiquiatría contemporánea, esta propuesta metafísica puede reformularse como la promoción de la cooperación y de una austeridad sana, como un componente inespecífico de la mayoría de las psicoterapias y los modelos educativos. El pensamiento de Schopenhauer puede enriquecer la instrucción en Psiquiatría y el bienestar personal.
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Humans , Psychiatry , Work , Knowledge , Psychotherapy , Repression, Psychology , Stress, Psychological , Thinking , Models, Educational , Ethics , Anniversaries and Special EventsABSTRACT
According to Gandhiji there is nothing such “Gandhism”. And it is in fact, that he was neither a systematic philosopher nor a system builder. But it is to be admitted as he was freedom fighter, social reformer and practical man. Not like a social scientist but as a scientist he was an empirical oriented. So his aim was to bring problem like social, political, economic and cultural face to face with the truth.
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It is indispensable for physicians to understand and recognize the fusion of different cultures, to deliver the best possible service to patients with different cultural backgrounds, especially when ethical-medical problems are involved. The Hindu community in Chile differs in significant ways with the western culture. This is especially true for some issues such as the belief in reincarnation or gender inequality, among others. These discrepancies can be relevant for the analysis of several bioethical problems. Therefore, it is necessary to understand the different beliefs, traditions and Hindu visions. We hereby present a review of Hinduism, its relation with medical practice and, as an example, a case of abortion in a Hindu family. Reviewing the traditions, beliefs and methods will help to understand and respect the beliefs of different cultures in contemporary and globalized bioethics.