The construction industry consistently ranks amongst the highest contributors to global gross domestic product, as well as, amongst the most corrupt. Corruption therefore inflicts significant risk on construction activities, and overall economic development. These facts are widely known, but the various sources and nature of corruption risks endemic to the Iranian construction industry, along with the degree to which such risks manifest, and the strength of their impact, remain undescribed. To address the gap, a mixed methods approach is used; with (...) a questionnaire, 103 responses were received, and these were followed up with semi-structured interviews. Results were processed using social network analysis. Four major corruption risks were identified: procedural violations in awarding contracts, misuse of contractual arrangements, neglect of project management principles, and, irrational decision making. While corruption risks in Iran align with those found in other countries, with funds being misappropriated for financial gain, Iran also shows a strong inclination to champion projects that serve the government’s political agenda. Root cause identification of corruption risks, namely, the noticeable impact of authoritarianism on project selection in Iran, over criterion of economic benefit or social good, is a significant outcome of this study. (shrink)

Duties to future persons are central to numerous key ethical issues including contraception, abortion, genetic selection, treatment of the environment, and population control. Nevertheless, we still seem to be lacking Parfit's 'Theory X', a general theory of beneficence whose appropriateness extends to future generations. Starting from the Golden Rule, R. M. Hare purportedly derived counterintuitive duties to potential people and 'the potentiality principle'. However, I argue that Hare's derivation involves a hidden and unjustifiable extension from TGR, and show how the (...) most plausible form of TGR is compatible with multiple contradictory principles for the treatment of future persons. I appeal to our own preferences to argue that one extension of TGR follows the spirit of TGR, while the other is deeply implausible. Using the plausible extension, I derive a Contingent Interests Principle that offers much promise as Parfit's elusive Theory X. In contrast to Hare's interpretation of TGR, this application provides solid justification for rejecting the potentiality principle. (shrink)

The study examines the ontological similarity between the concept of competitor orientation and questionable intelligence-gathering efforts. Respondents from the hotel industry were surveyed with self-administered questionnaires. Exploratory factor analysis was carried out to identify the structure underlying variables of market orientation and ethical judgment on questionable intelligence-gathering efforts. The results suggest that the surveyed hotel managers are unable to distinguish the legitimate tactics of competitor orientation from the questionable practice of industrial espionage.

This book provides much new thinking on the phenomenon of whole person education, a phenomenon which features strongly in East Asian universities, and which aims to develop students intellectually, spiritually, and ethically, to master critical thinking skills, to explore ethical challenges in the surrounding community and to acquire a broad based foundation of knowledge in humanities, society and nature. The book considers different approaches to whole person education, including Confucian, Buddhist, and Chinese perspectives, Western philosophy and religion and interdisciplinary approaches. (...) Overall, the book provides a comprehensive overview of whole person education, why it matters and how to implement it. Moreover, although the examples in the book are from East Asia, the discussion and the values involved are universal, important for the whole world. (shrink)

Duties to future persons contribute critically to many important contemporaneous ethical dilemmas, such as environmental protection, contraception, abortion, and population policy. Yet this area of ethics is mired in paradoxes. It appeared that any principle for dealing with future persons encountered Kavka's paradox of future individuals, Parfit's repugnant conclusion, or an indefensible asymmetry. In 1976, Singer proposed a utilitarian solution that seemed to avoid the above trio of obstacles, but Parfit so successfully demonstrated the unacceptability of this position that Singer (...) abandoned it. Indeed, the apparently intransitivity of Singer's solution contributed to Temkin's argument that the notion of "all things considered better than" may be intransitive. In this paper, I demonstrate that a time-extended view of Singer's solution avoids the intransitivity that allows Parfit's mere addition paradox to lead to the repugnant conclusion. However, the heart of the mere addition paradox remains: the time-extended view still yields intransitive judgments. I discuss a general theory for dealing with intransitivity that was inspired by Temkin's sports analogy, and demonstrate that such a solution is more palatable than Temkin suspected. When a pair-wise comparison also requires consideration of a small number of relevant external alternatives, we can avoid intransitivity and the mere addition paradox without infinite comparisons or rejecting the Independence of Irrelevant Alternatives Principle. (shrink)

Children with autism spectrum disorder show marked difficulties in reading comprehension, a complex cognitive skill fundamental to successful daily functioning that is associated with core executive functions. However, the neurophysiological mechanisms underlying reading comprehension deficits in these children remain elusive. Twenty-one right-handed males with high-functioning ASD and 23 age-, IQ-, educational level-, sex- and handedness-matched typically developing individuals underwent a reading comprehension test and the semantic verbal fluency test that tapped core executive functions underlying reading comprehension during concurrent prefrontal functional (...) near-infrared spectroscopy measurement. Participants’ information processing efficiency was also assessed. High-functioning ASD children exhibited general reading comprehension [main effect of group: F = 7.58, p = 0.009], selective verbal fluency deficits [Group × category interaction: F = 4.90, p = 0.032] and slower processing speed. Regarding the hemodynamics of the prefrontal cortex, although ASD individuals showed comparable patterns of PFC brain activation to their healthy counterparts, lower PFC intrahemispheric [main effect of group: F = 11.36, p = 0.002] and interhemispheric [main effect of group: F = 7.79, p = 0.008] functional connectivity were evident during the semantic verbal fluency test. At the whole-group level, poorer reading comprehension performance was associated with poorer performance in the semantic verbal fluency test. Moreover, poorer semantic verbal fluency test performance was associated with slower information processing speed, which is associated with reduced left medial PFC functional connectivity. Abnormal intrahemispheric and interhemispheric prefrontal hypoconnectivity is associated with deficits in executive processes essential for reading comprehension in ASD. Our study has provided important implications for the neuropsychological and neurophysiological mechanisms underlying reading comprehension deficits in ASD. (shrink)

Whole-genome analysis and whole-exome analysis generate many more clinically actionable findings than traditional targeted genetic analysis. These findings may be relevant to research participants themselves as well as for members of their families. Though researchers performing genomic analyses are likely to find medically significant genetic variations for nearly every research participant, what they will find for any given participant is unpredictable. The ubiquity and diversity of these findings complicate questions about disclosing individual genetic test results. We outline an approach for (...) disclosing a select range of genetic results to the relatives of research participants who have died, developed in response to relatives? requests during a pilot study of large-scale medical genetic sequencing. We also argue that studies that disclose individual research results to participants should, at a minimum, passively disclose individual results to deceased participants? relatives. (shrink)

Background Fifteen years have passed since the outbreak of severe acute respiratory syndrome in Hong Kong. At that time, there were reports of heroic acts among professionals who cared for these patients, whose bravery and professionalism were highly praised. However, there are concerns about changes in new generation of nursing professionals. Objective We aimed to examine the attitude of nursing students, should they be faced with severe acute respiratory syndrome patients during their future work. Research design A questionnaire survey was (...) carried out to examine the attitude among final-year nursing students to three ethical areas, namely, duty of care, resource allocation, and collateral damage. Ethical considerations This study was carried out in accordance with the requirements and recommendations of the Central Research and Ethics Committee, School of Health Sciences at Caritas Institute of Higher Education. Findings Complete responses from 102 subjects were analyzed. The overwhelming majority (96.1%) did not agree to participate in the intubation of severe acute respiratory syndrome patients if protective measures, that is, N95 mask and gown, were not available. If there were insufficient N95 masks for all the medical, nursing, and allied health workers in the hospital (resource allocation), 37.3% felt that the distribution of N95 masks should be by casting lot, while the rest disagreed. When asked about collateral damage, more than three-quarters (77.5%) said that severe acute respiratory syndrome patients should be admitted to intensive care unit. There was sex difference in nursing students’ attitude toward severe acute respiratory syndrome care during pregnancy and influence of age in understanding intensive care unit care for these patients. Interestingly, 94.1% felt that there should be a separate intensive care unit for severe acute respiratory syndrome patients. Conclusion As infection control practice and isolation facilities improved over the years, relevant knowledge and nursing ethical issues related to infectious diseases should become part of nursing education and training programs, especially in preparation for outbreaks of infectious diseases or distress. (shrink)

Ethical extensionism generally involves drawing one or more lines of moral standing. I argue for all living organisms, there is a non- zero probability of sentience and consciousness, and we cannot justify excluding beings from consideration on the basis of uncertainty of their sentience, etc., and rather we should incorporate this uncertainty into the strength of our moral responsibilities. This use of probabilities differs critically from multi-criteria theories of moral standing and those that assign benefit of the doubt, which involve (...) unjustified exclusions and dilutions of duties. From uncertainty rises certainty : we have duties to non-human organisms, although they may often be minor. This modification of extensionist ethics provides foundation for an environmental ethic that parallels interpersonal and animal welfare ethics, and it suggests that we owe much greater concern to 'lower' organisms than they are typically given. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Few moral arguments have been made against vegetarian diets. One exception is the “Logic of the Larder:” We do animals a favor by purchasing their meat, eggs, and milk, for if we did not purchase these products, fewer animals would exist. This argument fails because many farm animals have lives that are probably not worth living, while others prevent a significant number of wild animals from existing. Even if this were not so, the purchase of animal products uses resources that (...) could otherwise be used to bring a much greater number of animals into existence. (shrink)

The essays in this volume apply philosophical analysis to address three kinds of questions: What are the implications of genetic science for our understanding of nature? What might it influence in our conception of human nature? What challenges does genetic science pose for specific issues of private conduct or public policy?

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)