Today’s medical training environment exposes medical trainees to many aspects of what has been called “the hidden curriculum.” In this article, we examine the relationship between two aspects of the hidden curriculum, the performance of emotional labor and the characterization of patients and proxies as “bad,” by analyzing clinical ethics discussions with resident trainees at an academic medical center. We argue that clinicians’ characterization of certain patients and proxies as “bad,” when they are not, can take an unnecessary toll on (...) trainees’ emotions. We conclude with a discussion of how training in ethics may help uncover and examine these aspects of the hidden curriculum. (shrink)

With their comprehensive categorization of “ambivalence-related phenomena,” Moore et al. helpfully clarify and contextualize these decisional states as they arise in patient care. Given the...

Hospital systems commonly face the challenge of determining just ways to allocate scarce drugs during national shortages. There is no standardised approach of how this should be instituted, but principles of distributive justice are commonly used so that patients who are most likely to benefit from the drug receive it. As a result, clinical indications, in which the evidence for the drug is assumed to be established, are often prioritised over research use. In this manuscript, we present a case of (...) a phase II investigational trial of intravenous thiamine for delirium prevention in patients undergoing haematopoietic stem cell transplantation to emphasise several shortcomings in the overarching prioritisation of clinical over research uses of scarce drugs. Specifically, we present the following considerations: clinical use may not have stronger evidence than research use; a strong scientific rationale for research use may outweigh the claim for clinical indications in which there is weak evidence; treatment within the context of a clinical trial may be the standard of care; and research use may not only benefit patients receiving the treatment but also offers the prospect of improving future clinical care. In summary, we argue against allocation schemes that prohibit all research uses of scarce drugs and instead recommend that allocation schemes include a balanced approach that weighs risks and benefits of access to scarce drugs irrespective of the research versus clinical use designation. (shrink)

This research is motivated by the criticism levelled at the academic community for its failure to incorporate sufficient ethics education into the accounting curriculum :53–71, 2004; Madison and Schmidt 2006). The inclusion of ethics decision-making frameworks by professional bodies in their codes of conduct or as a standalone tool and the encouragement of their use as a part of ethics education to help students to identify and think through ethical issues in a business context has been subject to very limited (...) research to date. The aim of this study is to provide evidence of the impact of providing a framework on its own and providing a framework as part of a comprehensive integrated ethics education component of a first-year unit of study, on accounting students’ ethical sensitivity and judgment. Results indicate that providing students with a framework only does not increase students’ ethical sensitivity but does support their ethical judgment. In contrast, the integrated ethics component does increase student’s ethical sensitivity, however, an unexpected finding of this study is that increases in students’ ethical judgement are greater if they have not been previously exposed to the framework. Taken together, our findings suggest that it is the framework that has a significant impact on students’ ethical judgment, while an integrated ethics education can expose students to a range of ethical issues and thereby improve their ethical sensitivity, a critical component which initiates the ethical decision-making process. (shrink)

There is growing recognition that good ethics can have a positive economic impact on the performance of firms. Many statistics support the premise that ethics, values, integrity and responsibility are required in the modern workplace. For consumer groups and society at large, research has shown that good ethics is good business. This study defines and traces the emergence and evolution within the business literature of the concepts of values, business ethics and corporate social responsibility to illustrate the increased emphasis that (...) has been placed on these issues over time. Two organizations that have successfully dealt with these issues were analyzed to identify the links among values, ethics, and corporate social responsibility as they are incorporated into the culture and management of a firm. This study identified the presence and implementation of values, business ethics, and CSR actions within the two organizations studied. (shrink)

In this wide-ranging book the author presents his critique of the contemporary portrayal of cognition, an analysis of the conceptual foundations of cognitive science and a proposal for a new concept of the mind. Shanon argues that the representational account is seriously lacking and that far from serving as a basis of cognitive activity, representations are the products of such activity. He proposes an alternative view of the mind in which the basic capability of the cognitive system is not the (...) manipulation of symbols but rather action in the world. His book offers a different outlook on the phenomenon of consciousness and presents a new conception of psychological theory and explanation. This revised second edition includes a new Postscript. (shrink)

In their critique of connectionist models Fodor and Pylyshyn (1988) dismiss such models as not being cognitive or psychological. Evaluating Fodor and Pylyshyn's critique requires examining what is required in characterizating models as 'cognitive'. The present discussion examines the various senses of this term. It argues the answer to the title question seems to vary with these different senses. Indeed, by one sense of the term, neither representa-tionalism nor connectionism is cognitive. General ramifications of such an appraisal are discussed and (...) alternative avenues for cognitive research are suggested. (shrink)

A pioneering study of the phenomenology of the special state of mind induced by Ayahuasca, a plant-based Amazonian psychotropic brew. The author's research is based both on extensive firsthand experiences with Ayahuasca, and on interviews conducted with a large number of informants coming from different places and backgrounds.

The experience of consciousness is analyzed. First, a pre-theoretical characterization of the term "consciousness" is attempted. Second, the phenomenology of human consciousness is described. Specifically, consciousness is defined in terms of several patterns all of which consist of the coupling of pairs of opposites. Resonance between such opposites may be the key charactereristics of human consciousness. Third, the function of consciousness is considered. It is suggested that consciousness is functional in that it offers a medium in which cognition may be (...) conducted in a manner akin to action in the real world. More general theoretical ramifications having to do with the representational view of mind are also discussed. (shrink)

Henrich et al.'s critical review demonstrating that psychology research is over-reliant on WEIRD samples is an important contribution to the field. Their stronger claim that is less convincing, however. We argue that WEIRD people's apparent distinct weirdness is a methodological side-effect of psychology's over-reliance on WEIRD populations for developing its methods and theoretical constructs.

A significant international literature has shown that political fragmentation the existence of multiple parties in a governing body - affects policy-making. Indeed, an increase in the number of parties increases the number of viewpoints considered, but on the other hand may also lead to a decrease in government flexibility. This paper first of all shows that Flemish municipalities often have fragmented governments as measured by the number of parties represented in the municipal council and the College of Mayor and Alderman. (...) We also show that this fragmentation at the local level affects policy-making, though not necessarily in the same directions found in the international literature. (shrink)

A report suggests that United States’ army officers may engage in dishonest reporting regarding their compliance procedures. Similarly, nurses with espoused high ethical standards sometimes fail to live up to them and may do so while deceiving themselves about such practices. Reasons for lapses are complex. However, multitudinous managerial demands arising within ‘technical and instrumental rationality’ may impact on honest decision‐making. This paper suggests that compliance processes, which operates within the social structural context of the technical and instrumental rationality manifest (...) as ‘managerialism’, contributes to professional ‘dishonesty’ about lapses in care, sometimes through ‘thoughtlessness’. The need to manage risk, measure, account, and control in order to deliver efficiency, effectiveness, and economy (technical rationality) thus has both unintended and dysfunctional consequences. Meeting compliance requirements may be mediated by factors such as the ‘affect heuristic’ and ‘reflexive deliberations’ as part of the ‘structured agency’ of nurses. It is the complexity of ‘structured agency’ which may explain why some nurses fail to respond to such things as sentinel events, a failure to recognize ‘personal troubles’ as ‘public issues’, a failure which to outsiders who expect rational and professional responses may seem inconceivable. There is a need to understand these processes so that nurses can critique the context in which they work and to move beyond either/or explanations of structure or agency for care failures, and professional dishonesty. (shrink)

Mouse embryonic stem cell lines offer an attractive route for introducing rare genetic alternations into the gene pool since the cells can be pre‐screened in culture and the mutations then transmitted into the germline through chimera production. Two applications of this technique seem ideally suited for a genetic analysis of development are enhancer and gene trap screens for loci expressed during gastrulation and production of targeted mutations using homologous recombination. These approaches should greatly increase the number of mouse developmental mutants (...) available and help to elucidate the genetic hierarchy controlling embryogenesis. (shrink)

Amartya Sen introduces the concept of capabilities, i.e. what people are able to do and to be, as a non-economic measure in the development evaluation. This essay seeks to explore how this concept deals with the issues of values and politics, which in many cases determines people’s identity. The main argument is that the concept of capabilities is built around a certain individualistic view of human beings, whereas identity suggests a more complex picture. As such, Sen’s capability approach cannot properly (...) address the issue of identity and risks losing important insights which may contribute to people’s well being. Keywords: Amartya Sen, capability approach, identity, development, justice. Abstrak: Amartya Sen memperkenalkan konsep kapabilitas, yakni apa yang dapat dilakukan oleh seseorang dan bagaimana ia dapat menjadi dirinya, sebagai tolok ukur non-ekonomik dalam evaluasi pembangunan. Artikel ini berupaya mengkaji bagaimana konsep ini dapat diselaraskan dengan nilai-nilai identitas dan politik, yang dalam banyak hal menentukan apa yang dianggap oleh banyak orang sebagai nilai. Argumen yang dikemukakan dalam artikel ini adalah bahwa konsep mengenai kapabilitas dibangun atas sebuah pandangan individualistik mengenai manusia, sementara identitas menyiratkan sebuah gambaran yang lebih kompleks. Dipahami secara demikian, pendekatan kapabilitas Sen tidak dapat menanggapi permasalahan identitas secara memadai dan beresiko kehilangan insight penting yang justru dapat memberi sumbangan bagi kesejahteraan manusia. Kata-kata kunci: Amartya Sen, pendekatan kapabilitas, identitas, perkembangan, keadilan. (shrink)

This paper is a response to Henley who criticizes a previous paper of mine arguing against my claim that computers are devoid of consciousness. While the claim regarding computers and consciousness was not the main theme of my original paper, I do, indeed, subscribe to it. Here, I review the main characteristics of human consciousness presented in the earlier paper and argue that computers cannot exhibit them. Any ascription of these characteristics to computers is superficial and misleading in that it (...) fails to capture essential, intrinsic features of human cognition. More generally, psychological theory couched in terms of semantic representations and the computational operations associated with them is bound to be inadequate. The phenomenology of consciousness is a specific case marking this inadequacy. (shrink)

In recent publications, Fodor points out a basic impasse that the representational-computational view of mind confronts. Mental representations have to serve two functions—to be the substrate of mental computations and to be the carriers of meaning. Fodor points out that these two functions cannot be brought together and concludes that semantics is not part of psychology. On the basis of similar observations, I suggest drawing another conclusion, namely, that the premises of the representational-computational view are wrong, and that psychology is (...) not mentalistic. The discussion presents a fundamental contrast between two notions of the key term semantics. These, in turn, define two different perspectives for cognitive research. A third perspective for the study of meaning and cognition is suggested. With it, it is argued, the Fodorian impasse is avoided. (shrink)

This note presents a typology of reasons for involving the notion of God in theoretical discussions of human consciousness. These reasons have to do with points of connection, commonality, analogy and affinity between the notions of God and of consciousness, with phenomenological patterns manifested in human conscious experience (in particular, ones encountered in non-ordinary states of mind), and with theoretical and meta-theoretical considerations.

Research about the Olympic Games has primarily focused on preparing athletes for competition. Less attention has been paid to the post-Olympic-phase and athlete well-being during this time. This study explored Australian Olympic athletes’ experiences following the conclusion of the 2016 Rio Olympic Games, including the factors that may have contributed to or challenged their well-being during this time. Eighteen athletes participated in semi-structured interviews and thematic analysis revealed that when Olympic performance appraisal met prior expectations, when athletes planned for a (...) return to work or study, and when support from a variety of sources was readily available, this positively influenced athletes’ well-being during the POP. When these factors were not in place, more challenging post-Games experiences were present, and well-being was compromised. The findings contribute to the broader literature on elite athlete well-being and at an applied level, may be used to inform targeted programs that focus on supporting athletes after an Olympic campaign. (shrink)

This study examines the impact of the strength of an accounting firm's ethical environment on the quality of auditor judgment, across different levels of audit expertise. Using a 2 × 2 full factorial 'between subjects' experimental design, with audit managers and audit seniors, the impact of different levels of strength of the ethical environment on auditor judgments was assessed with a realistic audit scenario, requiring participants to make judgments in respect of an inventory writedown. Based on prior research, and as (...) hypothesized, participants possessing greater auditing experience made higher quality technical judgments. While there were no significant differences between the quality of audit judgments made by participants in the stronger ethical environment, over-all results indicate that managers are more sensitive to differences in the strength of the ethical environment than seniors. This is consistent with the hypothesis, and with prior research which suggests that the impact of the code will only be significant if it has been bilaterally internalized by individuals. This has important implications for accounting firms and regulators, given that the International Standard on Quality Control 1, requires the communication and reinforcement of ethical principles as part of firms' quality control processes. It suggests that firms will need to carefully consider the means by which they communicate and reinforce ethical principles, as it is possible to differentially impact auditors of different rank. (shrink)

This paper proposes an answer to the title question on the basis of the analysis of empirical data -- a large corpus of what I call thought sequences, namely, trains of verbal-like expressions that spontaneously pass through people's minds. The analysis reveals several patterns that could not have occurred had thought not been conducted in a conscious manner. The feature that makes these patterns possible is the concreteness resulting from the articulation of thought in a particular medium: such articulation is (...) perforce conscious. In practically all standard models of cognition today the substrate of cognitive activity is abstract, and, indeed, consciousness is usually not accounted for . Here, I show that non-abstractness of mentation provides for three important functional benefits. First, the local de-coupling of medium and content opens the possibility of thought progressing along lines not planned or envisioned by the thinker beforehand, and thus it is a key for the generation of novelty. Second, articulated thought creates a medium for activities carried out in the internal theatre of the mind that are analogous to activities carried out in the real world. Third, articulation provides for the quality of entitihood, hence for compartmentalization and enhanced control as well as for reflection and meta-observation. The discussion is grounded in a general critique of the conceptual foundations of cognition that regards action in the world, not computational operation applied upon abstract underlying symbolic representations, as the basic capability of the human cognitive system. (shrink)

This paper is part of a comprehensive research project whose aim is to study the phenomenology of the special state of mind induced by the psychoactive Amazonian potion ayahuasca. Here, I focus on those aspects of the ayahuasca experience that are related to basic features of the human consciousness. The effects of the potion are discussed in terms of a conceptual framework characterizing consciousness as a cognitive system defined by a set of parameters and the values that they take. In (...) various theoretical contexts, these values have been assumed to be basic, paradigmatic properties of human consciousness. The phenomenological data pertaining to ayahuasca indicate that the features at hand can be modified. Following earlier suggestions by William James and Aldous Huxley, I conclude that any general theory of consciousness should be based not only on the study of so-called ordinary consciousness, but also on that of non-ordinary states. (shrink)

The article on synaesthesia by Ramachandran and Hubbard is comprehensive and intellectually stimulating. In this commentary, I would like to present some empirical data not discussed in R&H and to raise some theoretical questions relating to ideas proposed in this article. My comments will be divided into three sections, or - rather - three stories, which correspond to three, independent and different, occasions in my career in which I found myself dealing with synaesthesia. Each of these stories carries a moral (...) that adds to the picture of synaesthesia drawn in R&H. (shrink)

In this paper, I discuss substance-induced visions and consider their epistemic status, meaning, and modes of proper interpretation. I focus on the visions induced by ayahuasca, a powerful psychoactive plant-made brew that has had a central status and role in the indigenous tribal cultures of the upper Amazonian region. The brew is especially famous for the visions seen with it. These are often coupled with personal psychological insights, mentations concerning topics of special significance to one, intellectual (notably, philosophical and metaphysical) (...) ideations, as well as powerful religious and spiritual sentiments. Thus, under the intoxication, people often feel that they gain significant knowledge and understanding. The present discussion takes a cognitive-phenomenological perspective coupled with a philosophical analysis of the various epistemological questions at hand. (shrink)

Temporality is a fundamental determinant of human cognition. There are, however, states of mind in which people feel that temporality changes radically and perhaps even becomes irrelevant. Here I attempt a typology of the patterns of such non-ordinary temporal experiences. The discussion is based on a phenomenological study of the special state of consciousness induced by Ayahuasca, a powerful Amazonian psychoactive brew.

A new phenomenological framework for the characterization of human consciousness is presented. The theory is introduced in several stages - making distinctions concerning types of consciousness, levels, parameters, functional features and dynamic operations. The phenomenology encompasses both ordinary and non-ordinary states of mind. It appears that in its totality the phenomenology of human consciousness comprises a well- structured system exhibiting coherence and internal structure. In addition, this framework presents a new approach for cognitive research, methodologically as well as theoretically. Observations (...) concerning the intellectual challenge of consciousness are. (shrink)

We explore the entanglement of the vacuum of a relativistic field by letting a pair of causally disconnected probes interact with the field. We find that, even when the probes are initially non-entangled, they can wind up to a final entangled state. This shows that entanglement persists between disconnected regions in the vacuum. However the probe entanglement, unlike correlations, vanishes once the regions become sufficiently separated. The relation between entropy, correlations and entanglement is discussed.

In this essay I share some of the lessons I have learned over the last 25 years studying how the vascular endothelium via nitric oxide contributes to the regulation of the cardiovascular system in humans. My motivation for this effort is that in an era of molecular reductionism in biomedical research I believe that the lessons from the vascular endothelium and NO are instructive in a larger sense. These discoveries might also be among the "last" big biomedical discoveries made by (...) traditional physiology and pharmacology using primarily organ baths, pharmacological blockers, and in... (shrink)

Via megafoons uitgebraakte theorieën zijn zelden duidelijk en over slechts weinig strijdpunten zullen we ooit een consensus bereiken, maar geef toe: er is nooit eerder een jaar geweest als 1968. En een jaar als dat zal er waarschijnlijk nooit meer komen, want nooit eerder vond, zowat overal ter wereld, een vrijwel gelijktijdige en spontane opstand van zich verzettende geesten plaats. Dit boek bundelt een aantal kunstfilosofische en anekdotische (kort)verhalen die met elkaar in verbinding staan in een raamvertelling naar aanleiding van (...) 50 jaar mythevorming rond mei '68. Het vertrekt vanuit een eigenzinnige, niet eenduidige werkelijkheidsopvatting en versmelt vijf vaderlandse kunstenaars met de tijdsgeest. Het is geschreven voor iedereen die in de kantlijn van het schemergebied woont dat zich uitstrekt tussen een lumineus verleden en een steeds moeilijker te begrijpen nu. En voor verlichte geesten die koppig weigeren de poorten naar de feitelijkheid van het heden open te gooien. Wereldverbeteraars die, door roestigheid aangetast, niet langer in staat zijn elastisch te denken. De internationaal gerenommeerde kunstenaar Fred Eerdekens speelt er een hoofdrol in en ontwierp daarnaast, speciaal voor het boek, een kunstwerk: Les murs parlent. Een authentieke, maar hedendaagse ode aan de Parijse muurkranten en de ook hier in Vlaanderen links en rechts gekladde slogans. (shrink)

Koriat & Goldsmith (1996t) present two different programs for memory research. Different though they are on the methodological level, on the substantive level the two programs are based on the same view, according to which memory consists of represented information that is permanently stored in the mind (or brain). This view is, I think, wrong. One can support the methodological pluralism Koriat & Goldsmith advocate, but on the substantive level pluralism is not admissible.

The definition of precision medicine has continued to evolve, partly in response to criticism of the original concept. However, whatever the definition or current state of the brand, it fundamentally relies on a putatively tight linkage between genotype and complex human traits. If such a linkage is truly robust, then it should be possible to predict the occurrence of complex traits, both good and bad. If such prediction is possible, it should also be feasible to intervene to prevent or preempt (...) disease-related traits. There are of course many potential barriers to this sort of genomic medicine two-step. For example, a number of statistical considerations make generating biomarker (including gene... (shrink)

Sustainability, and the related concept of climate change, is an emerging domain within nursing and nurse education. Climate change has been posited as a serious global health threat requiring action by health professionals and action at international level. Anåker & Elf undertook a concept analysis of sustainability in nursing based on Walker and Avant's framework. Their main conclusions seem to be that while defining attributes and cases can be established, there is not enough research into sustainability in the nursing literature. (...) This paper seeks to develop their argument to argue that sustainability in nursing can be better understood by accessing non‐nursing and grey literature and, for example, the literature in the developing web‐based ‘paraversity’. Without this understanding, and application in nursing scholarship, nurses will have a rather narrow understanding of sustainability and its suggested links with social and health inequalities and the dynamics underpinning unsustainable neoliberalist political economy. This understanding is based on the social and political determinants of health approach and the emerging domain of planetary health. However, this is a major challenge as it requires a critical reflection on what counts as nursing knowledge, a reflection which might reject sustainability and political economy as irrelevant to much of nursing practice. (shrink)

Religious moderation has been popular and widely promoted to students as a countermeasure to radicalism. However, it runs across several challenges. Not to mention that radicalism has extended its influence within Islamic universities in Indonesia. Many research organisations have found that Indonesian students tend to be radical. Hence, the discussion around religious moderation among students highlights its urgency. With emphasis on the reception of Islamic university students to religious texts, this study proposed the appropriate approach to religious moderation in the (...) context of plural Indonesian society with the reception of Qur’anic verses and hadiths that promoted moderation. It employed a qualitative approach with a purposive sampling technique involving 81 students of Islamic Religious Education of UIN Maulana Malik Ibrahim Malang as the research subjects. They were students from four semester IV and VI classes. This study revealed several key findings: firstly, the majority of students equate religious moderation with religious tolerance; secondly, students draw from a range of verses and hadiths that emphasise religious moderation, primarily on tolerance promotion; and thirdly, students’ application of religious moderation based on religious texts manifests through verbal, written and practical approaches. This study presents a model for developing religious moderation rooted in students’ comprehension of religious texts advocating moderation. This study implies using religious texts to promote moderate thought to lessen radicalism and intolerance in the world. Contribution: This study introduces a religious text-oriented approach to enhance the development of religious moderation, thereby refining strategies and methods that have predominantly emphasised aspects of social reality. The religious texts that advocate for moderation are accepted and applied by students in their lives. This contribution is crucial to lessening radicalism and intolerance in Indonesia. (shrink)

This paper is part of an ongoing project devoted to the investigation of the psychotropic brew Ayahuasca from a cognitive-psychological perspective. This perspective contrasts with those of practically all investigations of Ayahuasca which pertain either to the natural sciences-notably botany, pharmacology, brain science and clinical medicine-or to anthropology. Here, I discuss the visualizations induced by Ayahuasca from a structural, as opposed to contentual, point of view. A typology of the structural forms in which visualizations may appear is drawn. Also examined (...) are the various types of interaction a person can have with his/her visions and aspects pertaining to the semantics of visions and their narrative structure. The distinctions drawn are readily applicable to hallucinatory and visionary experiences induced by other agents and in other contexts. Thus, the present typology may be regarded as presenting the foundations for the cognitive-psychological study of such experiences at large. (shrink)

The mind-body problem concerns the relationship between mind and body, or nowadays - between mind or consciousness and the brain. As a relationship, this can be viewed from two perspectives: from body to mind and from mind to body. In this note I point out that the two readings of the problem are not symmetrical and that there are categorical differences between them. In particular, whereas the body to mind problem constitutes a mystery (cf. the contemporary hard problem), the mind (...) to body problem may be approached from a psychological (as contrasted with philosophical) orientation that allows for concrete phenomenological investigation. (shrink)