https://www.um.edu.mt/library/oar/handle/123456789/332 Mon, 20 Apr 2026 00:58:30 GMT 2026-04-20T00:58:30Z https://www.um.edu.mt/library/oar/handle/123456789/145578 Title: A position paper on advance medical directives : ethical safeguards Abstract: This position paper has been prepared by an interdisciplinary group of academics from the University of Malta, bringing together expertise in medicine, ethics, theology, philosophy, law, and jurisprudence, in collaboration with senior clinical staff at Mater Dei Hospital, in response to the proposed Advanced Medical Directives Act (2026). The proposed legislation aims to establish a legal framework governing the drafting, registration, recognition, and implementation of advance medical directives. The authors welcome this initiative as both timely and necessary, particularly in safeguarding patient dignity at the end of life, supporting families faced with difficult decisions, and providing guidance and legal protection to healthcare professionals. Nevertheless, the paper identifies several ethical considerations that must be addressed to ensure that the legislation achieves its intended purpose while protecting vulnerable individuals and maintaining sound clinical judgement.; A central concern of the position paper is the need for a prudent interpretation of advance medical directives. While legal clarity is essential, decisions at the end of life cannot be reduced to a purely legalistic application of written instructions. Rather, advance directives must be interpreted within a broader ethical framework that includes prudence, proportionality of treatment, and respect for human dignity. The paper distinguishes between two commonly recognised forms of advance medical directives: the living will and the durable power of attorney for healthcare. It notes that the Bill provides for living wills but omits provisions for healthcare proxies, which are often considered more flexible and effective in ensuring that patient wishes are respected in complex clinical situations.; Particular attention is given to artificial nutrition and hydration (ANH), which the Bill treats as life-sustaining interventions. The paper identifies three broad clinical scenarios. First, temporary ANH in reversible conditions generally falls outside the scope of advance refusals. Second, long-term ANH in chronic illness may shift over time from supportive care to life-prolonging treatment, requiring prudent reassessment in light of evolving circumstances. Third, in the final stages of dying, ANH may become burdensome and ethically permissible to be withdrawn, particularly where its continuation increases discomfort or prolongs suffering. In these cases, the focus of care shifts from sustaining physiological functions to providing comfort, alleviating suffering, and supporting families.; Throughout the paper, emphasis is placed on maintaining the distinction between proportionate and disproportionate treatment, and between allowing natural death and euthanasia. Advance medical directives should guide clinical decision-making, preferably, in the context of advanced care planning. Additionally, the paper stresses the need to safeguard vulnerable individuals, particularly elderly persons, from coercion or subtle pressure when drafting advance directives.; This paper also acknowledges that, despite the presence of a clear advance directive, the patient’s actual circumstances may not fully align with those anticipated in the directive. For this reason, it proposes the inclusion of a durable power of attorney alongside the advance medical directive.; The paper concludes with several recommendations, including: promoting advance care planning rather than relying solely on written directives; introducing a durable power of attorney for healthcare; establishing clinical ethics consultation services; strengthening palliative care; introducing a conscience clause; reviewing DNR practices; clarifying mental capacity assessment procedures; ensuring safeguards against coercion; providing clinical guidance on ANH; and allowing individuals to express ethical or religious values to guide interpretation of directives.; Ultimately, the paper affirms that advance medical directives can serve as valuable instruments for compassionate and ethically responsible end-of-life care, provided they are embedded within a robust ethical framework that prioritises dignity, prudence, and solidarity. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145578 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145570 Title: L-użu tas-Salmi fir-Raba’ Evanġelju Abstract: Sa mill-ewwel żminijiet, l-Insara interpretaw il-persuna u l-ministeru ta’ Ġesù fid-dawl tal-Iskrittura. San Pawl diġà jikteb lill-Insara ta’ Korintu u jgħidilhom li “Kristu miet minħabba dnubietna, skont l-Iskrittura, difnuh u qam mill-imwiet fit-tielet jum, skont l-Iskrittura.” L-Evanġelisti wkoll bnew in-narrativa rispettiva tagħhom fuq din l-istess linja billi inkludew numru ta’ kwotazzjonijiet mill-Iskrittura sabiex isaħħu dak li kienu qed jiktbu fuq Ġesù. L-Evanġelista San Ġwann mhuwiex eċċezzjoni għal dan, hekk kif huwa jinkludi mas-17-il silta li nistgħu nqisuhom bħala kwotazzjonijiet minn dak li l-Insara jsejħulu t-Testment il-Qadim. Dawn il-kwotazzjonijiet huma pjuttost osra u mxerrda man-narrattiva kollha, għalkemm hemm konċentrazzjoni fuq il-kapitli 12 u 19, jiġifieri fir-rakkonti tal-passjoni u l-mewt ta’ Ġesù. Filwaqt li ngħidu dan, ninnutaw kif ħafna minn dawn il-kwotazzjonijiet ma jaqblux kelma b’kelma mal-verżjonijiet tat-Testment il-Qadim li nafu bihom, jiġifieri mat-test Lhudi (MT), u t-test tas-Setwaġinta (LXX). Mhux biss, imma hemm każi fejn l-istudjużi juru li mhumiex ċerti għal liema test partikulari l-Evanġelista kien qed jirreferi meta jikkwota mill-Iskrittura. F’dan l-istudju ser nippreżentaw xi wħud mir-referenzi għas-Salmi li nsibu fin-narrattiva tar-Raba’ Evanġelju. L-għan tagħna mela mhuwiex wieħed eżawrjenti, imma biss biex naraw kif dan l-Evanġelista fehem dak li sab f’dawn is-Salmi u l-mod kif applikahom għall-persuna u l-ministeru ta’ Ġesù. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145570 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145451 Title: Traditional roots, modern shoots. Maltese family dynamics in a changing world Authors: Berry, John Anthony Abstract: Examining the situation in Malta concerning the family reveals two un deniable facts. Firstly, the family is the most fundamental institution of society. Secondly, families play a vital role in the country’s well-being and growth. A nation’s health is directly linked to the strength of its families, which are the foundation of society. Numerous indicators from various sources demonstrate that individuals with strong family bonds experience greater happiness and improved physical and mental health. In Maltese society, respect (24.5%), communication (17.8%), trust (16.3%), love (15.2%), and understanding (6.6%) are the most highly valued traits in a relationship. In essence, the adage “unity is strength” applies to the concept of family closeness. Strong families and societal prosperity are inherently intertwined, with education and upbringing playing vital roles along with values, tradition, and adaptability to changing times. Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145451 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/145450 Title: Of harlots and holiness : the Church as the 'Casta Meretrix’ in Hans Urs von Balthasar Authors: Berry, John Anthony Abstract: Casta Meretrix articulates the Church’s paradoxical identity as simultaneously holy and sinful, a motif profoundly reconfigured by Hans Urs von Balthasar. Drawing on biblical typology, patristic interpretation, and historical allegory—from Rahab and Hosea to Tamar and the Shulamite—Balthasar constructs a nuanced ecclesiology that honors divine grace while acknowledging human frailty. This essay examines his method, showing how Casta Meretrix offers a critical framework for engaging ecclesial sin, historical failings, and the Church’s redemptive vocation, emphasizing vigilance, penitential self-awareness, and the transformative power of divine love within a flawed yet elect community. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/145450 2026-01-01T00:00:00Z