‘There is a Time to be Born and a Time to Die’ (Ecclesiastes 3:2a): Jewish Perspectives on Euthanasia

Reviewing the publications of prominent American rabbis who have (extensively) published on Jewish biomedical ethics, this article highlights Orthodox, Conservative and Reform opinions on a most pressing contemporary bioethical issue: euthanasia. Reviewing their opinions against the background of the halachic character of Jewish (biomedical) ethics, this article shows how from one traditional Jewish textual source diverse, even contradictory, opinions emerge through different interpretations. In this way, in the Jewish debate on euthanasia the specific methodology of Jewish (bio)ethical reasoning comes forward as well as a diversity of opinion within Judaism and its branches

Cancer Biomarker Discovery: The Entropic Hallmark

Background: It is a commonly accepted belief that cancer cells modify their transcriptional state during the progression of the disease. We propose that the progression of cancer cells towards malignant phenotypes can be efficiently tracked using high-throughput technologies that follow the gradual changes observed in the gene expression profiles by employing Shannon's mathematical theory of communication. Methods based on Information Theory can then quantify the divergence of cancer cells' transcriptional profiles from those of normally appearing cells of the originating tissues. The relevance of the proposed methods can be evaluated using microarray datasets available in the public domain but the method is in principle applicable to other high-throughput methods. Methodology/Principal Findings: Using melanoma and prostate cancer datasets we illustrate how it is possible to employ Shannon Entropy and the Jensen-Shannon divergence to trace the transcriptional changes progression of the disease. We establish how the variations of these two measures correlate with established biomarkers of cancer progression. The Information Theory measures allow us to identify novel biomarkers for both progressive and relatively more sudden transcriptional changes leading to malignant phenotypes. At the same time, the methodology was able to validate a large number of genes and processes that seem to be implicated in the progression of melanoma and prostate cancer. Conclusions/Significance: We thus present a quantitative guiding rule, a new unifying hallmark of cancer: the cancer cell's transcriptome changes lead to measurable observed transitions of Normalized Shannon Entropy values (as measured by high-throughput technologies). At the same time, tumor cells increment their divergence from the normal tissue profile increasing their disorder via creation of states that we might not directly measure. This unifying hallmark allows, via the the Jensen-Shannon divergence, to identify the arrow of time of the processes from the gene expression profiles, and helps to map the phenotypical and molecular hallmarks of specific cancer subtypes. The deep mathematical basis of the approach allows us to suggest that this principle is, hopefully, of general applicability for other diseases

Suffering and the work of emancipation through education

It is argued that for those who are not the successful beneficiaries of the system, schooling creates the conditions for lifelong suffering, in both psychological and social terms, without serious recourse to a vital and effective public sphere of debate, decision and action where their voices may be heard and taken into account. The authors develop this argument in terms of three foci: (1) the example of the reduction of professional work to assessable performances in the continuing professional development (CPD) of medical professionals; (2) the experience of self-harm at school; and 3) the role of the private sector in schooling. Their final argument is that the solution is not to reform the lifelong schooling of people but to emancipate through education. They argue that bringing about young people's engagement with adults in the work of education as a democratic activity requires the kind of openness and tolerance, and also the suspension of authority of those in charge, that is antithetical to the forms of organisation found throughout the private, public and military sectors. Their conclusion, therefore, is not optimistic

El fruto de la tecnología: debemos nosotros alimentar un paciente anciano a todo costo? Fruits of technology: should we feed an old patient at all costs?

El próposito de este artículo es analizar las preguntas que rodean un común pero complejo dilema ético, médico y asistencial, llamado la justificación de continuar o suspender la alimentación forzada en pacientes extremadamente ancianos que sufren de aguda demencia progresiva. Tradicionalmente el principio de santidad de la vida apoya la idea que la vida debe ser prolongada a todo costo y la decisión de continuar com la alimentación, no se pone en duda. Sin embargo, últimamente han surgido gran cantidad de ideas revolucionarias hacia las actitudes, las concepciones y los valores del tratamiento, los cuales han guiado hacia una urgente necesidad de discutir el problema en un sentido mas profundo. Hasta qué punto debemos alimentar a la fuerza un paciente demente, el cual se niega a comer (sonda, alimentación intravenosa), atando sus manos o utilizando otras medidas? Esto ocurrío en un instituto geriátrico en Israel, donde una orden médica de un determinado médico consterno a las enfermeras de planta, las cuales decidieron que en este específico caso su punto de vista no era similar al del médico. El resultado fue una conferencia nacional con la participación de médicos, enfermeras, trabajadores sociales y sicólogos.<br>The purpose of this article is to analyze questions on a complex ethic, medical and caring dilemma about reasons to continue or suspend compelled alimentation in really old patients carrying progressive acute dementia. Traditionally, the principle of life holiness supports the idea that life should be extended at all costs and the decision to continue feeding the patients is not questioned. However, revolutionary ideas are arising about attitudes, concepts and value of treatment, conducting an urgent need to discuss this problem deeply. Until when should we compel demented patients to eat, as they do not accept food and have to be fed through a catheter or intraveined alimentation, tying back their hands or using other measures? This discussion occurred in a geriatric institution at Israel, when a doctor's order was not accepted by nurses, as they had a different way of seeing the problem. A national conference on this theme was organized with the attendance of doctors, nurses, social workers and psychologists