Auswahl der wissenschaftlichen Literatur zum Thema „Medico-spiritual practice“

Conversion therapy is a set of practices that aim to change or alter an individual’s sexual orientation or gender identity. It is premised on a belief that an individual’s sexual orientation or gender identity can be changed and that doing so is a desirable outcome for the individual, family, or community. Other terms used to describe this practice include sexual orientation change effort (SOCE), reparative therapy, reintegrative therapy, reorientation therapy, ex-gay therapy, and gay cure. Conversion therapy is practiced in every region of the world. We have identified sources confirming or indicating that conversion therapy is performed in over 60 countries.1 In those countries where it is performed, a wide and variable range of practices are believed to create change in an individual’s sexual orientation or gender identity. Some examples of these include: talk therapy or psychotherapy (e.g., exploring life events to identify the cause); group therapy; medication (including anti-psychotics, anti- depressants, anti-anxiety, and psychoactive drugs, and hormone injections); Eye Movement Desensitization and Reprocessing (where an individual focuses on a traumatic memory while simultaneously experiencing bilateral stimulation); electroshock or electroconvulsive therapy (ECT) (where electrodes are attached to the head and electric current is passed between them to induce seizure); aversive treatments (including electric shock to the hands and/or genitals or nausea-inducing medication administered with presentation of homoerotic stimuli); exorcism or ritual cleansing (e.g., beating the individual with a broomstick while reading holy verses or burning the individual’s head, back, and palms); force-feeding or food deprivation; forced nudity; behavioural conditioning (e.g., being forced to dress or walk in a particular way); isolation (sometimes for long periods of time, which may include solitary confinement or being kept from interacting with the outside world); verbal abuse; humiliation; hypnosis; hospital confinement; beatings; and “corrective” rape. Conversion therapy appears to be performed widely by health professionals, including medical doctors, psychiatrists, psychologists, sexologists, and therapists. It is also conducted by spiritual leaders, religious practitioners, traditional healers, and community or family members. Conversion therapy is undertaken both in contexts under state control, e.g., hospitals, schools, and juvenile detention facilities, as well as in private settings like homes, religious institutions, or youth camps and retreats. In some countries, conversion therapy is imposed by the order or instructions of public officials, judges, or the police. The practice is undertaken with both adults and minors who may be lesbian, gay, bisexual, trans, or gender diverse. Parents are also known to send their children back to their country of origin to receive it. The practice supports the belief that non-heterosexual orientations are deviations from the norm, reflecting a disease, disorder, or sin. The practitioner conveys the message that heterosexuality is the normal and healthy sexual orientation and gender identity. The purpose of this medico-legal statement is to provide legal experts, adjudicators, health care professionals, and policy makers, among others, with an understanding of: 1) the lack of medical and scientific validity of conversion therapy; 2) the likely physical and psychological consequences of undergoing conversion therapy; and 3) whether, based on these effects, conversion therapy constitutes cruel, inhuman, or degrading treatment or torture when individuals are subjected to it forcibly2 or without their consent. This medico-legal statement also addresses the responsibility of states in regulating this practice, the ethical implications of offering or performing it, and the role that health professionals and medical and mental health organisations should play with regards to this practice. Definitions of conversion therapy vary. Some include any attempt to change, suppress, or divert an individual’s sexual orientation, gender identity, or gender expression. This medico-legal statement only addresses those practices that practitioners believe can effect a genuine change in an individual’s sexual orientation or gender identity. Acts of physical and psychological violence or discrimination that aim solely to inflict pain and suffering or punish individuals due to their sexual orientation or gender identity, are not addressed, but are wholly condemned. This medico-legal statement follows along the lines of our previous publications on Anal Examinations in Cases of Alleged Homosexuality1 and on Forced Virginity Testing.2 In those statements, we opposed attempts to minimise the severity of physical and psychological pain and suffering caused by these examinations by qualifying them as medical in nature. There is no medical justification for inflicting on individuals torture or other cruel, inhuman, or degrading treatment or punishment. In addition, these statements reaffirmed that health professionals should take no role in attempting to control sexuality and knowingly or unknowingly supporting state-sponsored policing and punishing of individuals based on their sexual orientation or gender identity.

Abstract Based on archival research and supplemented by ethnographic observations, this article critically revisits the history of La Divina Pastora, the Madonna of Spanish origin, in colonial Trinidad, focusing on how the spirituality and materiality of two statues of this Marian image intersected, competed, and reinforced each other: a fair-complexioned La Divina Pastora in northern Trinidad, created and patronized by the Catholic central authorities; and a dark-skinned, miracle-working La Divin/Sipari Mai in Siparia, formerly a peripheral Spanish mission in southern Trinidad. Tracing the trajectory of their lives and relations reveals the complexities of the ecclesiastical history of Trinidad, unearthing the contradictions and tensions between the patriarchal making and remaking of religious orthodoxy and the popular praxis of faith for day-to-day substantive issues needing medico-spiritual solutions. Unlike extant studies, addressing the two distinct statues representing the same Marian image, this article utilizes a holistic approach in order to appreciate why and how the Madonna at Siparia emerged, survived, and thrived as a shared empowering object, despite the colonial obsession with racial-cultural purity and regimes of the boundaries of belonging. The conflicts among the Christian communities were intertwined and thwarted the Catholic central authority’s attempts to exploit La Divin/Sipari Mai’s transgressive power to attract Hindus to the Church. The tangled conflicts also created conditions in which Hindu supplications for miraculous cures persisted and thrived, despite discrimination and repression by the Catholic authorities. The incessant interactions between Catholics and Hindu devotees in Siparia led to the combination of their originally divergent practices and worldviews and the transformation of the dark-colored Madonna from La Divina Pastora to La Divin/Sipari Mai, an alternative spiritual construction that represented various maternal/female bodies, each conforming to distinct religious traditions.

AbstractBackgroundDementia is the seventh leading cause of death worldwide. The notion of Medical‐assistance in Dying (MAiD) among dementia and Alzheimer’s patients has been legalized in Canada and Netherlands. However, there has been little research dedicated to clinical intervention and clinical ethics in MAiD as well as policy, legal, ethical barriers and challenges, and research gaps for physicians, dementia care specialists, healthcare providers, and carers. In Canada, MAiD accounts for 2.5% of all deaths, including dementia.MethodA comprehensive search in Google Scholar, PubMed, and the National Library of Medicine was conducted to discover evidence‐based MAiD practice, legislation, and ethical protocols among dementia and Alzheimer’s patients worldwide through peer‐reviewed research articles published between 2012 and 2022 that focused on quantitative, qualitative, and mixed methods. This includes MAiD education, clinical practices, legislation, attitudes and experiences of physicians, geriatricians, dementia care specialists and health care providers and barriers in MAiD in dementia for patients and their decision‐making capacity in the early or late stages of dementia.ResultThree Canadian studies demonstrate knowledge and experiences of dementia care specialists for advanced requests for MAiD in British Columbia; capture physicians' characteristics and attitudes toward MAiD for non‐competent dementia patients in Quebec; and reflect insight into the current practises of MAiD among dementia patients focused on their autonomy and mental capacity of consent in Canada. Studies in the Netherlands reveal physicians' experiences and workload, pressure and expectations of relatives and societies to access end‐of‐life options and care for MAiD; and argue on early vs. late stages in Dutch practices and decision‐making and consent among incompetent dementia patients.ConclusionThe roles of Alzheimer’s societies, stakeholders, MAiD assessors and providers, and social support systems are critical in educating, advocating for, and empowering dementia patients and carers to MAiD in the early and late stages. More research is needed to inform policymakers and legislators in developing a roadmap for educational interventions to MAiD assessors and providers, health care providers, medico‐legal practitioners, stakeholders, and family carers on ethical, cultural, spiritual, and legal issues, as well as legislative process related to MAiD any changes to the law in societies.

In the 1970s, scientists combined spiritual meditation methods with scientific knowledge to access the curative potential of belief-based practices. Mindfulness was one of several meditation methods scientists claimed could deliver health benefits. In 1979, Jon Kabat-Zinn redefined traditional mindfulness meditation for clinical use, later rebranding the training as mindfulness-based stress reduction (MBSR). Mindfulness eventually became the dominant object of meditation research, spawning a family of mindfulness-based interventions (MBIs). Today MBIs are embedded within UK health and social policy. However, despite the widespread acceptance of mindfulness, scientists have identified limitations in the evidence supporting its proliferation. Notwithstanding these concerns, little is known about how meditation converged with science during the 1970s and 1980s. Transdisciplinary investigation of the history of meditation has shed new light on mindfulness’s migration to medico-scientific domains. From this perspective, MBSR appears as part of a wider movement to relocate spiritual meditation within science. By analysing peer-reviewed scientific and humanities studies, this paper will outline how mindfulness became scientifically validated through a process I describe as medicalisation. I will also briefly discuss a possible relationship between medicalisation and current concerns in mindfulness research. Keywords: mindfulness, meditation, transdisciplinary, belief, medicalisation

La Bioetica ci insegna quanto sia importante che la Medicina sia disposta a guardare e a trattare l’uomo che soffre nella sua interezza spirituale e corporea, opponendosi a quella cultura scientifica che ha perso il senso della unità dell’individuo, curando la patologia e non il malato. La prospettiva olistica è quella che meglio comprende il concetto di salute, in quanto definisce la salute come abilità di conseguire gli scopi vitali riferendosi all’uomo nella sua interezza. In questa modalità di affrontare l’uomo nella sua globalità, entra in gioco la corporeità, base necessaria per la relazione con i propri simili. La Medicina estetica si basa sull’intuizione che individua come il malessere del corpo possa andare ben oltre il corpo; ricorrervi deve significare rispettare l’umanità che è in ognuno di noi nella ricerca di un equilibrio psico-fisico che richiama ad una duplice moralità: quella del medico che deve prestare la sua opera senza tradire gli scopi dell’arte medica e quella dell’utente che deve rispettare la sacralità della sua persona. Affrontare una diagnosi di malattia è difficile; il malato vaga in una condizione di incredulità e sgomento che possono far dimenticare che c’è un viso che “chiede” e un corpo che “parla”; l’attenzione alla componente estetica della nostra persona nei percorsi di malattia può aiutare a riportare l’attenzione e assumere la corporeità al centro dell’interesse del paziente. Ciò non comporta alcun riduzionismo soggettivista, tutt’altro: permette di non mistificare l’esperienza soggettiva mettendo in luce il ruolo della dimensione della malattia nella definizione delle nostre più intime esperienze. In questa particolare situazione, in un contesto condiviso e supportato dall’intero staff sanitario, la Medicina estetica può portare un contributo per interagire con un corpo che può desiderare di essere riscoperto: il suo apporto, in un approccio integrato al paziente, tende a far sì che la cura del paziente possa operare su tutte le quattro dimensioni della salute, organica, psichica, socio-ambientale, etico-spirituale, ognuna delle quali investe tutta la sua persona: per far sì che, se esistono malattie inguaribili, non debbano mai esistere malattie incurabili. ---------- Bioethics teaches us the importance of Medicine being open to consider and treat suffering people in their spiritual and corporeal wholeness, thus opposing a scientific culture which has lost the sense of unity of the individual, as it deals with the treatment of organs or pathologies rather than of patients. The holistic perspective interprets the concept of health in the best way, in that it defines health as the ability of achieving vital goals, and refers to the human being as a whole. This way of dealing with the total human being implies a role for corporeity, intended as a necessary basis for inter-individual relationships. Aesthetic Medicine is based on the intuition according to which it is possible to identify how physical discomfort may extend well beyond the body itself; therefore, resort to it must mean respect for the human beings we all are, and continuous search for psychic and physical equilibrium, which implies two aspects of morality, i.e., ethical practice by physicians, who must dispense their services without failing in the aims of the art of medicine, and ethical behaviour by users, who must respect the holiness of their own persons. It is difficult to face a diagnosis of disease; sick persons fall a prey to feelings of disbelief and dismay such that they may be induced to neglect their own “asking” faces, and their own “talking” bodies. So, the attention to the aesthetic component of our persons during the course of the illness may help to focus again both the attention and the interest of patients on corporeity. This does not imply any sort of subjectivist reductionism, quite the contrary. Rather, it allows to not mystify the subjective experience, by emphasizing the role played by the importance of the disease within the definition of our most intimate experiences. Then, in the particular situation herein referred to, that is, within a context which is shared and supported by all the health staff, Aesthetic Medicine can make its contribution to interact with a body which it is really possible to rediscover. The contribution of Aesthetic Medicine – within a patient- focused approach – is intended to allow that patients’ care may act for all four aspects of health, i.e., organic, psychical, socio-environmental, and ethical-spiritual ones, each of which concerns their whole persons. And this, so that – even if non-healing diseases exist – “not curable” diseases shall never exist.

With growing life expectancy, age-related mental health issues are rising in the elderly. Whether normal aging or pathological senility, mindfulness practices are useful, economic, and accessible. The elderly experience many forms of anxiety with varying severity. There can be stress, anxiety, depression, and negative emotions. Quality of life and sleep, cognitive impairments, chronic pain, decreased social contacts are common concerns of the elderly. There is growing evidence that mindfulness practices mitigate their suffering. This chapter covers details on mindfulness-based tools for the elderly, their practices, exercises, and techniques. The recommended techniques are group-based, participatory, age-appropriate, and reflective. Given the vulnerability of the elderly, the chapter cautions about latent medico-legal and ethical issues in using mindfulness for the elderly. They must be blended with cultural, religious, moral, and spiritual elements to derive optimum benefits for the individual or small groups of such persons. A future road map is given.