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We tend to think that “dignity” means that someone is sophisticated and well-mannered or that human dignity points to great achievements. There is, though, a special dignity in those who are vulnerable for they provide a focal point for love and generally respond enthusiastically to that love; they draw love out of others.

It is possible to defend the Church’s teaching that contraception is incompatible with God’s plan for sexuality in many different ways. This essay sketches the fundamental views of reality common to all the defenses and the main lines of the most prominent defenses, some based on natural law (of which there are several versions), on the theology of the body, and on the physical, psychological, and social consequences of the use of contraception. While all the defenses have merit, the argument based on the recognition that sexual intercourse is meant to be a complete self-gift has a special power of its own.

Electronic cigarettes have been marketed as a safer alternative to cigarettes, and their use is expanding exponentially. However, there is a severe lack of scientific data about the ingredients in the liquid used in the device and the health consequences of using electronic cigarettes. As technology has outpaced regulations, the production and sale of electronic cigarettes are, as yet, unregulated and do not fall under the purview of the Food and Drug Administration. This article will review the mechanism of action and what is currently known about the safety of electronic cigarettes. The risk of poisoning for children will also be identified, as well as the implications for home healthcare clinicians. Language: en

Wound ostomy continence (WOC) programs are essential in any healthcare organization, including home care agencies, to provide comprehensive, high-quality care. Advanced practice nurses (APNs) with assessment, diagnostic, and coordination skills are well suited to manage the complex patients being cared for by home care agencies. A number of research studies have assessed the credibility and value of APNs in the home care setting, caring for complex, frail patients. This article describes the role of the APN, and the role of the WOC specialist nurse, comparing similarities and differences. The advanced practice WOC nurse is now essential in the home care setting to manage the care of complex patients.

Prostate cancer is the most frequently diagnosed cancer in men in the United States, often requiring a prostatectomy. Incontinence is an almost inevitable consequence of this surgery, either temporary or ongoing. It is important that this quality-of-life issue be considered preoperatively and that patients considering surgery have information about the potential for incontinence. Teaching about noninvasive management of incontinence can begin before surgery and continue in the postoperative period. Home healthcare clinicians and Wound, Ostomy and Continence (WOC) nurses can play a pivotal role in educating patients on the potential sequela of surgery and ways to prevent or treat these conservatively.

The Church's teachings are often very challenging. Those who are involved in the health-care professions and who conduct their practices in accord with Church teaching can expect misunderstanding and even rejection from their colleagues and patients. One of the most difficult teachings of the Church is its condemnation of contraception. In 1968 Pope Paul VI issued the encyclical Humanae vitae, which hit the world like a bomb. In it he affirmed the Church's long-standing teaching on human sexuality and condemned contraception in particular. Today scientific advances such as in vitro fertilization and embryonic stem-cell research, as well as the challenges in making moral decisions about end-of-life care, make it increasingly difficult for health-care professionals to practice in accord with their deeply held moral convictions. Developing a properly formed conscience, which is the voice of God, is essential in dealing with these contemporary issues and making right choices. This essay outlines the process for properly forming the conscience. It also explains why prescribing contraception is morally wrong.

Sacral nerve stimulation with InterStim is approved in the United States for use in adults. Limited data on the effectiveness of sacral nerve stimulation in children are available. We report our experience with patients who underwent InterStim placement for the treatment of severe dysfunctional elimination syndrome, which is defined as a constellation of functional urinary and gastrointestinal symptoms in patients without anatomical anomalies or obvious neurological disease, in whom intensive medical and behavioral therapies have failed to improve symptoms.A total of 23 patients 6 to 15 years old with presenting symptoms of dysfunctional voiding, enuresis, incontinence, urinary tract infections, bladder pain, urinary retention, urgency, frequency, constipation and/or fecal soiling were followed for a mean of 13.3 months after InterStim placement.Of the 19 patients with urinary incontinence 3 (16%) had complete resolution, 13 (68%) had improvement, 2 (11%) were unchanged and 1 (5%) was worse (sign test, p = 0.002). Among the 16 patients with nocturnal enuresis 2 (13%) had resolution, 9 (56%) improved, 4 (25%) were unchanged and 1 (6%) was worse (sign test, p = 0.0063). Of the 15 patients with urinary retention requiring intervention 9 (60%) had improvement and 1 had worsening symptoms (sign test, p = 0.022), while 2 of 6 patients (33%) on intermittent catheterization were able to stop. One patient had development of new incontinence and enuresis. Bladder pain, urgency, frequency and constipation improved in 67% (8 of 12), 75% (12 of 16), 73% (11 of 15) and 80% (12 of 15) of the patients, respectively. Medications required postoperatively decreased by an average of 3 per patient (p0.001). The overall patient satisfaction rate was 64%, while that of the caregiver was 67%. Two leads were explanted from the 23 patients. Complications encountered included 1 seroma, 1 episode of skin sensitivity, 2 device failures and 1 lead revision.Sacral nerve stimulation in children is an option for carefully selected patients who have failed other therapies. Our results show that sacral nerve stimulation was effective in the majority of patients with the dysfunctional elimination syndrome. However, longer followup is needed.

Veritatis Splendor n'a pas ete ecrit pour reiterer la condamnation ecclesiale de la contraception, mais pour etablir que certains points de vue de l'ecole de theologie morale connue sous le nom de proportionalisme sont en conflit avec l'enseignement moral du magistere catholique. La pretention proportionaliste que la contraception n'est pas une action intrinsequement mauvaise, semble avoir ete l'impulsion pour defier le concept des actions intrinsequement mauvaises dans leur ensemble. Cet article explore la discussion terminologique sur la comprehension du terme mal intrinseque. Il tente de degager le debat de ce theme ou il s'est enlise pour le diriger vers la nature meme des biens que sont la procreation et l'union du mariage ainsi que leur relation.

Cowdin and Tuohey argue for a rethinking of Catholic bioethical principles and the Church's moral authority. Citing the Second Vatican Council for support, they argue that if the Church were to respect the proper autonomy of medicine, it would allow sterilizations. In this essay I argue against Cowdin and Tuohey's understanding that the Church has derived its moral laws independent of consultation with medicine and that it treats medicine simply as a source of technical expertise. I also argue that they misunderstand that nature of autonomy as well as the Church's position regarding the type of autonomy they request for medicine. I will especially argue against their understanding of the principles of totality and double effect as "dispensations" from the moral order. I conclude that they have provided no grounds to cause the Church to reconsider its condemnation of all sterilizations.

The professional discipline of bioethics for some time now has seemed to be concerned primarily with two major questions.1 One is how various ethical theories such as utilitarianism, deontology, natural law ethics, principlism, feminist care ethics or casuistry (and perhaps other systems as well) would assess a certain action, e.g., assisted suicide or cloning.