BackgroundThis research explores how the COVID-19 pandemic has changed the ways doctors make end-of-life decisions, particularly around Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR), treatment escalation and doctors’ views on the legalisation of euthanasia and physician-assisted suicide.MethodsThe research was conducted between May and August 2021, during which COVID-19 hospital cases were relatively low and pressures on NHS resources were near normal levels. Data were collected via online survey sent to doctors of all levels and specialties, who have worked in the (...) NHS during the pandemic.Results231 participants completed the survey. The research found that over half of participants reported making more patients DNACPR than prepandemic, and this was due, at least in part, to an increased focus on factors including patient age, Clinical Frailty Scores and resource limitations. In addition, a sizeable minority of participants reported that they now had a higher threshold for escalating patients to ITU and a lower threshold for palliating patients, with many attributing these changes to formative experiences gained during the pandemic. Finally, our study found that there has not been a statistically significant change in the views of clinicians on the legalisation of euthanasia or physician-assisted suicide since the start of the pandemic.ConclusionThe COVID-19 pandemic appears to have altered several aspects of end-of-life decision making, and many of these changes have remained even as COVID-19 hospital cases have declined. (shrink)

Wittgenstein mentions “forms of life” only on a limited number of occasions in his writings; however, this concept is at the core of his approach to language, as the vast literature on the subject shows. My aim in this paper is neither to adjudicate which of the many competing interpretations of “forms of life” is correct nor to propose a new one. I start with a methodological take on this notion and test it by applying it to a (...) specific case. In my view, the notion of forms of life is a methodological tool that Wittgenstein uses to draw attention to the embeddedness of language in our lives and practices. This reading, I suggest, allows us to oppose those who want to see in Wittgenstein a conservative thinker, based on his remark on forms of life as “the given” that must be accepted. In particular, it becomes possible to put his notion to use in the study of linguistic and social change. Hence, I propose as an example the case of innovative language games in trans communities. In this context, the notion of forms of life enables us to see with more clarity how linguistic change occurs, which also helps us better understand phenomena such as disagreement, conflict, and hermeneutical injustice. (shrink)

Over the last four decades, Vilhjálmur Árnason professor emeritus in philosophy, has been at the forefront in the academic fields of moral and political philosophy, and medical – and bioethics in Iceland. His research and in-depth understanding of the ethical aspects of medicine and life sciences in Icelandic society are demonstrated by his extensive written work on these issues. In 1993, the first edition of his book _Ethics of life and death_ was published in Iceland, a comprehensive book (...) on ethical issues related to healthcare, research, and public health. A second and improved edition of the book was published in 2003, and a German version in 2004. The third and latest edition was published in August 2023, which takes into account developments in the aforementioned fields in recent years, and as before with a particular focus on Iceland. The contents of this influential book will be discussed in this article, with special emphasis on comparing current subjects with previous editions. Moreover, it will be addressed if and how Árnason‘s thinking and perspective have changed over the years. (shrink)

ABSTRACT Early modern alchemy studied both matter and life, much like today's life sciences. What material life is and how it comes about intrigued alchemists. Many found the answer by assuming a vital principle that served as the source and cause of life. Recent literature has presented important cases in which vitalist formulations incorporated corpuscular or mechanical elements that were characteristic of the New Science and other cases in which vitalist thinking influenced important figures of the (...) Scientific Revolution. Not merely speculative, vitalist ideas also motivated chymical practice. The unity of life science and material science that is found in many formulations of Renaissance alchemy disintegrated in Georg Ernst Stahl's version of post-Cartesian vitalism. (shrink)

Countless academic books have been written about how to interpret literary texts. From reader response criticism to Marxist hermeneutics and beyond, the scholarship on interpretive methods is vast. Yet all these books fail to address a more fundamental question: Why should we read in the first place? Or, to put it another way, why is reading an important thing to do? In order to answer these questions, Thomas J. Millay turns to the wisdom of Danish philosopher-theologian Søren Kierkegaard. In this (...) the first book to be written on Kierkegaard's philosophy of reading, Millay finds that reading does have a specific purpose: it is supposed to change your life. With lucid, nontechnical prose, Millay both establishes the definitive interpretation of Kierkegaard's philosophy of reading and explores the various concrete practices Kierkegaard recommended for its implementation"--Publisher's description. (shrink)

Objective The establishment of patient-centered measures capable of empirically determining meaningful cognitive change after surgery can significantly improve the medical care of epilepsy patients. Thus, this study aimed to develop reliable change indices (RCIs) and standardized regression-based (SRB) change norms for a comprehensive neuropsychological test battery in the German language. Methods Forty-seven consecutive patients with temporal lobe epilepsy underwent neuropsychological assessments, both before and 12 months after surgery. Practice-effect-adjusted RCIs and SRB change norms for each test (...) score were computed. To assess their usefulness, the presented methods were applied to a clinical sample, and binary logistic regression analyses were conducted to model the odds of achieving improvement in quality of life (QOL) after surgery. Results The determined RCIs at 90% confidence intervals and the SRB equations for each test score included in the test battery are provided. Cohen’s kappa analyses revealed a moderate mean agreement between the two measures, varying from slight to almost perfect agreement across test scores. Using these measures, a negative association between improvement in QOL and decline in verbal memory functions after surgery was detected (adjusted odds ratio = 0.09, p = 0.006). Significance To the best of our knowledge, this study is the first to develop RCIs and SRB change norms necessary for the objective determination of neuropsychological change in a comprehensive test battery in the German language, facilitating the individual monitoring of improvement and decline in each patients’ cognitive functioning and psychosocial situations after epilepsy surgery. The application of the described measures revealed a strong negative association between improvement in QOL and decline in verbal memory functions after surgery. (shrink)

In his last writings, Wittgenstein repeatedly addresses the question of how our concepts relate to general facts of nature or human nature and how they are embedded in our lives. In doing so, he uses the term “pattern of life”, characterizing the complicated relationship between concepts and our lives and how our concepts “are connected with what interests us, with what matters to us” (LWPP II, 46). But who is this “us”, and whose interests manifest in the concepts we (...) use to designate patterns of life? What if certain concepts—or their absence—are exclusionary, discriminatory, or otherwise unjust to those who are not “us”? In this paper, I want to discuss Wittgenstein’s notion of “pattern of life” in its interweaving with facts, human life, and concepts, as well as its political implications. To this end, I will first outline the relationship between facts and concept formation as Wittgenstein drew it in his last writings. Based on this, I will argue that he uses the concept of pattern of life to capture the complicated relationship between concepts and human nature or “social facts”. Going beyond Wittgenstein and drawing on recent feminist epistemology, I will raise the question of the political implications of our patterns of life and concomitant social “conceptual injustices”. Finally, I will show how imagining facts otherwise and other conceptual worlds can help us to reveal the prejudices and injustices of our concepts and can lead to conceptual change and new patterns of life that may ultimately even change “things”, i.e., our thinking, judging and acting in the world. (shrink)

BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals (...) retrospectively from January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.

In this book, inspired by Martin Heidegger--who found in poetry the most fundamental insights into the human condition--John Lysaker develops a concept of ur-poetry to explore philosophically how poetic language creates fresh meaning in our ...

John Dupr explores recent revolutionary developments in biology and considers their relevance for our understanding of human nature and society. He reveals how the advance of genetic science is changing our view of the constituents of life, and shows how an understanding of microbiology will overturn standard assumptions about the living world.

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate (...) and logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:The Politics of Practical Reason: Why Theological Ethics Must Change Your Life by Mark RyanDavid ElliotThe Politics of Practical Reason: Why Theological Ethics Must Change Your Life Mark Ryan eugene, or: cascade books, 2011. 229 pp. $20.80If the spirited debate between Stanley Hauerwas and Jeffrey Stout remains front-page news in theological ethics, then Mark Ryan’s subtle and penetrating The Politics of Practical Reason will (...) help keep it there. Ryan argues that practical reason is the hinge of ethical thinking and that it is “political” in the sense of shaping the community or polis. Given this hinge, the pressing question is of course, “Whose practical reason?” To answer this, Ryan probes major contemporary ethicists from Charles Taylor to Alasdair MacIntyre, but the book always circles back to Hauerwas and Stout. Their debate is ultimately decided by proxy, through a mediating philosopher whose work on practical reason Ryan sees both as the gold standard and as the indispensable background for understanding Hauerwas. Expecting this to be MacIntyre, the reader may be surprised—and perhaps even convinced—that the philosopher who best explains and possibly vindicates Hauerwas is in fact Elizabeth Anscombe, Ludwig Wittgenstein’s protégé, close friend, and translator.The book opens with Anscombe’s Intention (1957), which Donald Davidson called “the most important treatment of action since Aristotle.” In it, Anscombe argued that intention presupposes desire and is declared in public language within a context of social practices presupposed for agency to be intelligible. The implication is that we form intentions as members of a community with a particular form of life sustained by social practices. With human desire as its motivating nisus, Ryan insists that intention “is part of the very form of practical reasoning, then, to be political” (144).Having retrieved Anscombe’s model of practical reason, Ryan examines the field of contemporary ethics to see who measures up. Charles Taylor fails to place agents in a particular community, locating us instead in that bloated abstraction called “modernity.” Ryan therefore concludes that Taylor’s is an “ethics for anybody,” which leaves the self finally disembodied (94–98). Stout fares little better due to his refrain that Hauerwas went astray when he abandoned justice talk. Ryan counters that Stout’s sort of justice should be abandoned; lacking a substantive vision of the good and a teleology of freedom, Stout’s justice is reckoned a blind guide who cannot see or say why the polis should pursue one end and not another. Hauerwas, on the other hand, specifies a particular polis within which practical reason can intelligibly function: the church. It has [End Page 218] a substantive vision of the good (i.e., the peaceable kingdom) located in a scriptural narrative displayed by social practices requiring formation in the virtues (119–21). Ryan therefore endorses Hauerwas’s politics of practical reason, indebted to MacIntyre and made possible by Anscombe.I see one lacuna in this otherwise excellent book. Ryan seemingly advocates a pragmatic model of practical reason that is wholly internal to the polis rather than grounded in “truths of human nature as such” (101). This makes Anscombe an uneasy ally. Her “Modern Moral Philosophy” famously proposed a retrieval of virtue that required an overhauled “account of human nature … and above all of human flourishing” (41). This move opened the door for ethical naturalism, perhaps even natural law—both of which Anscombe and the later MacIntyre endorse. But these look suspiciously like what Ryan calls an “ethics for anybody.” So in the end are Anscombe and MacIntyre turncoats, or do Hauerwas and Ryan not follow them far enough? This crucial question remains unanswered.Despite this wrinkle, Ryan’s book is the best intervention in the Hauerwas–Stout debate that we now have. It throws light on Hauerwas, challenges Stout, shows why Anscombe matters, and gives practical reason its generous due. Philosophically deft and charitable in tone, it deserves to be read and studied as a major contribution to the field.David ElliotUniversity of Notre DameCopyright © 2015 Society of Christian Ethics... (shrink)

As cultural evolutionists interested in how culture changes over the long term, we've thought and written a lot about migration, but only recently tumbled to an obvious idea: migration has a profound effect on how societies evolve culturally because it is selective. People move to societies that provide a more attractive way of life, and all other things being equal, this process spreads ideas and institutions that lead to economic efficiency, social order and equality.

In Foucault’s writing throughout the 1960s, in which he foregrounds the critical function of language and signification, works of art and literature – and works of avant-garde art and literature in particular – appear prominently and are the objects of sustained theoretical investment. In the 1970s, however, as Foucault moves away from his earlier concern with language’s capacity to dissolve “man” and begins to concentrate instead on the ways in which man is governed, works of art and literature no longer (...) possess the same political promise for him and drop out almost completely from his writing. Yet the question of aesthetics does not disappear for him entirely, and, in his final years, he returns to it, though with his analysis now directed at what he calls an “art” or “aesthetics of life.” In this paper, I examine these developments with the aim of drawing out the connections between Foucault’s changing view of aesthetics and the larger transformations that take shape within his overall project. Against this background, I argue that Foucault’s call for an art of life, in which the individual develops techniques for continually reinventing his or her existence, does not necessitate abandoning the avant-garde aesthetic practices that he had previously advocated. Rather, I assert, his conception of an art of life – when read in conjunction with his theorization of critique as a “permanent” questioning of the limits imposed on us – offers a new framework for reimagining both the function of those practices and their legacies in culture today. (shrink)

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of (...) 191 older adults living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care. (shrink)

In this article I critically discuss English-speaking philosophical literature addressing the question of what it essentially means to speak of 'life’s meaning'. Instead of considering what might in fact confer meaning on life, I make two claims about the more abstract, meta-ethical question of how to understand what by definition is involved in making that sort enquiry. One of my claims is that over the past five years there has been a noticeable trend among philosophers to try to (...) change our understanding of what talk of 'life’s meaning' connotes. For example, whereas most philosophers for a long while had held that such talk is about a kind of value possible in the life of human beings, recently some have argued that certain non-human parts of nature can exhibit meaningfulness, which, furthermore, is not necessarily something valuable. The second claim I advance is that there is strong reason to reject this trend, and instead for philosophers to retain the long-standing approach. (shrink)

Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents anonymously completed questionnaires to assess the study variables. The present study demonstrated (...) that stressful life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI. (shrink)

A positive attitude toward later life is crucial for wellbeing among older adults. Maintaining a healthy relationship with adult children can help reduce older parents’ sense of loneliness and nurture a positive life attitude. This study aimed to investigate the associations between multidimensional intergenerational relationship quality and attitudes toward later life among aging Chinese adults in Hong Kong and examine the mediating effects of a sense of loneliness. Representative survey data were collected from 801 participants with at (...) least one adult child. Multiple linear regression was employed to investigate the associations between overall intergenerational relationship quality with a sense of loneliness as well as the attitude toward later life. To examine the mediating effects of a sense of loneliness, causal mediational analyses were performed. Results demonstrated that overall intergenerational relationship quality was positively associated with aging parents’ attitude toward later life, and this relationship could be partially mediated by a sense of loneliness. Among the four subdomains of intergenerational relationship quality, the influences of structural-associational solidarity and intergenerational conflict on attitude toward later life were almost fully mediated by a sense of loneliness, whereas the influences of consensual-normative solidarity and affectual closeness were partially mediated. These findings contributed to an improved understanding of the relationship between intergenerational relationship quality, sense of loneliness, and attitude toward later life, and could inform future policies and service programs that promote aging adults’ social integration and positive aging. (shrink)

This study investigated the relationship between death anxiety and experienced meaning in life. Six hundred and forty-eight Chinese college students were surveyed using the Death Anxiety Scale, the Prosocial Behavior Scale, and the Meaning in Life Scale. The results showed that death anxiety predicted experienced meaning through three pathways: the first one was through search for meaning singly; the second one was through prosocial behavior singly; and the third one was through search for meaning and prosocial behavior serially, (...) which accounted for the highest proportion of the total effect. This study highlights the positive side of death anxiety. (shrink)

Media use is always embedded in real everyday contexts, which would suggest that a profound change in everyday structure also brings about a change in the media repertoire. To explore the relationship between everyday structure and media use we present selected empirical findings from a qualitative panel study with couples on how they change their media repertoire in the wake of separation, new partnership, children leaving the parental home, and relocation. For analyzing the effects of these periods (...) of upheaval we differentiate the mediatized ways of life into various dimensions: temporal, spatial, content-related, social, meaning-related, material, emotional, and physical. The findings tell us which changes in everyday structure bring about dynamics in the media repertoire, for example, more or less control over time (temporal), distance from family and friends (spatial), or emotional crises (emotional), and which factors are relevant for people when they renegotiate their media use within the new life situation. (shrink)

The metaphor of parasites or parasitism has dominated literary critical discourse since the 1970s, prominent examples being Michel Serres in France and J. Hillis Miller in America. In their writings the relationship between text and paratext, literature and criticism, is often likened to that between host and parasite, and can be therefore deconstructed. Their writings, along with those by Derrida, Barthes, and Thom, seem to be suggesting the possibility of a semiotics of parasitism. Unfortunately, none of these writers has drawn (...) enough on the biological foundation of parasitism. Curiously, even in biology, parasitism is already a metaphor through which the signified of an ecological phenomenon involving two organisms is expressed by the signifier of “[eating] food at another’s [side] table”. This paper will make some preliminary remarks on semiotics of parasitism, based on the notions of Umwelt (Jakob von Uexküll) and structural coupling (Maturana and Varela). It will look into the phenomenon of co-evolutionary process in community ecology. With reference to empirical history, the project will briefly surveythe literary and medical praxis of the 17th century England where large number of creative writings referred to the phenomenon of parasitism, which was deeply embedded in religious practice (e.g., the Eucharist) and political life (e.g., the courtier ecology in monarchy) of the times. Finally, it will touch upon the possible ‘parasitic’ relationship between language and biology. (shrink)

The paper offers an analysis of the interview data collected in the project "Politics and everyday life: Three years later" in terms of three main topics: attitudes to the political sphere, change of social system, and the democratic public sphere. The analysis focuses on ambivalences expressed in the responses which, under the surface of overall disappointment and discontent, may contain preserved results of the previously achieved "social learning" and their positive potentials. The main objective was to examine to (...) what extent the processes of political maturation of citizens, identified in the 2002 study, have continued. After pointing to a number of shifts in people?s views of politics which generally do not contradict the tendencies outlined in 2002, it is argued that the process of rationalization of political culture has not stopped, but it manifests itself differently in changed circumstances. The republican euphoria of 2002 has been replaced by resignation, with a stronger individualist orientation and a commitment to professional achievement. Clanak analizira gradju dobijenu intervjuima u okviru istrazivanja "Politika i svakodnevni zivot - tri godine posle" u pogledu tri krupne teme: odnos prema politici, promena drustvenog poretka i demokratska javnost. Analiza se usredsredjuje na ambivalencije izrazene u iskazima ispitanika koje, ispod opste atmosfere razocaranosti i nezadovoljstva, mogu kriti ocuvane rezultate prethodnog "socijalnog ucenja" i njihove pozitivne potencijale. Osnovni cilj je ispitati u kojoj meri su procesi politickog sazrevanja gradjana, uoceni u istrazivanju iz 2002, nastavljeni i u kasnijem razdoblju. Posle izdvajanja jednog broja pomaka u odnosu na stavove prema politickoj sferi iz 2002, koji u osnovi ne protivrece tada ocrtanim tendencijama, zakljucuje se da proces racionalizovanja politicke kulture nije prekinut, ali se u novim uslovima ocituje na drugaciji nacin. Republikansku euforiju iz neposredno postpetooktobarskog razdoblja zamenila je rezignacija, uz narastanje individualizma i okretanje profesionalnom postignucu. (shrink)

Philosophy has been always received or bypassed for its resonance or aloofness with the spirit of the time. Should not philosophy/phenomenology of life be expected to do more to ascertain its validity? Should it not pass the pragmatic test, that is to respond directly to the life-concerns of its time? What is the role of the philosopher and philosophy today? Due to the ever-advancing scientific, technological, social and cultural changes that are shaping human life and the (...) class='Hi'>life-world-in-transformation, we are desperately seeking a measure to estimate life's unfolding, a compass to stir the course between Scylla and Charibda to maintain human-hood and creative insight for laying the cornerstones for the unforeseeable unfolding of life dynamisms. It is this challenge which philosophy/phenomenology of life meets with underlying ontopoietic unraveling of the hidden logoic concatenations of beingness-in-becoming. The present collection of essays offers contributions to answer this challenge by focusing upon measure, sharing-in-life, intersubjectivity and communication, societal equilibrium, education, and more. It will be of great interest to those working in the fields of Phenomenology, Philosophy, History of Philosophy, and Contemporary Philosophy. (shrink)

According to agency theory, agents base their economic decisions on self-interests when adverse selection conditions exist. However, cognitive moral development theory predicts that ethics/morals may influence decision-makers not to behave egoistically. Rutledge and Karim, 173-184) find both the moral reasoning level of the managers and an adverse selection condition affect a manager's project evaluation decisions significantly. Since prior studies have shown that national culture might influence the application of agency theory in project evaluation, this current study uses a different moral (...) development measurement to reexamine Rutledge and Karim's hypotheses in another culture. A total of 73 Taiwanese executive MBA students with an average of 12.17 years work experience participated in this study. We found that both moral development level and adverse selection conditions significantly affect managers' project continuance decisions. The interaction effect of these two factors indicates that, when adverse selection conditions exist, participants with a high level of moral development exhibit less of a tendency to continue an unprofitable project than those with a low level of moral development. With subjects from a different culture, our results confirm the findings of Rutldege and Karim. That is, the effects of moral development and adverse selection conditions on managers' project continuance decisions are robust and can be generalized to different cultures. Implications of the findings of this study to multinational firms are also discussed. (shrink)

In this innovative book, Hasok Chang constructs a philosophy of science for 'realistic people' interested in understanding and promoting the actual practices of inquiry in science and other knowledge-focused areas of life. Inspired by pragmatist philosophy, he reconceives the very notions of reality and truth on the basis of his concept of the 'operational coherence' of epistemic activities, and offers new pragmatist conceptions of truth and reality as operational ideals achievable in actual scientific practice. Rejecting the version of scientific (...) realism that is concerned with claiming that our theories correspond to an ultimate reality, he proposes instead an 'activist realism': a commitment to do all that we can actually do to improve our knowledge of realities. His book will appeal to scholars and students in philosophy, science and the history of science, and all who are concerned about the place of science and empirical truth in society. (shrink)

Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japanese-speaking Japanese Americans and 28 Japanese living in Japan.Negative feelings toward living in adverse health states and receiving life-sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or (...) financial caregiving burden on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group-oriented decision-making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end-of-life care and decision-making process are largely preserved. (shrink)

The main idea of this article is to present various perspectives in order to analyze the recent crisis concerning the agriculture-based rural societies in the developed capitalist communities. In all of these countries there is a production crisis, resulting in too much food. But this is also an ideological crisis, because the consumer thinks that the food is produced at too high a price. And it is a political crisis as well because a major part of the voters think subsidies (...) and trade barriers are too high. The paper argues that beneath the present agricultural and rural policy crisis lies the failure of three great projects of our time: 1) The project of natural science; 2) The project of liberal capitalism; and 3) The project of scientific socialism. The failure of these three projects has to do with the breakdown of the positivist idea of modernization. Modernization theory was partly wrong because it overlooked the persistence of locally based life modes. Those life modes must be understood before a sustainable rural development is found. The article reviews some contemporary social science perspectives that have recently been developed to grasp the fundamental changes of today's rural societies. Based on those perspectives and primarily the life mode perspective, five key elements that are essential to analyze if we want to understand future development are isolated: food production, resources, space, social diversity, and culture. (shrink)

Ethics and Qualities of Life looks at what enters into ethical judgment and choice. Interpretation of a case and of what the options are is always a factor, as is a sense of the possible values at stake. Intuitions also enter in, but often are unreliable. For a long time it seemed only fair that oldest sons inherited, and struck few people as unfair that women were not allowed to attend universities. A moral judgment is putatively part of a (...) moral order in a society that any reasonable person would accept. But what counts as "reasonable" is generally contestable. The unreliability of intuitions leads naturally to ethical theory. Kantian, contractualist, and consequentialist theories all have some important truth in them, but not the whole truth. Contractualism lacks the resources required for a fully determinate account of what counts as "reasonable". Broad general rules are important to Kant and are at the center of everyday morality. But can Kantian ethics explain why they have to have this central role? Our evolving social contract now contains elements that once would have seemed counter-intuitive to most people. But could consequentialists have predicted with entire confidence the consequences of social changes that we now think were desirable? The last part of this book contains a double argument. One is that ethical theory is employed by humans in a state of semi-ignorance of relevant factors, grasping at likely truths and evolved intuitions. The other is that consequentialist considerations have a major role at the fundamental level, but much more in justification or criticism than in ethical discovery. (shrink)

The demand for organ transplants, both globally and in South Korea, substantially exceeds the supply, a situation that might have been aggravated by the enactment of the Life-Sustaining Treatment Decision Act (LSTDA) in February 2018. This legislation may influence emergency medical procedures and the availability of organs from brain-dead donors. This study aimed to assess LSTDA’s impact, introduced in February 2018, on organ donation status in out-of-hospital cardiac arrest (OHCA) patients in a metropolitan city and identified related factors. We (...) conducted a retrospective analysis of a regional cardiac arrest registry. This study included patients aged 16 or older with cardiac arrest and a cerebral performance category (CPC) score of 5 from January 2015 to December 2022. The exclusion criteria were CPC scores of 1–4, patients under 16 years, and patients declared dead or transferred from emergency departments. Logistic regression analysis was used to analyse factors affecting organ donation. Of the 751 patients included in this study, 47 were organ donors, with a median age of 47 years. Before the LSTDA, there were 30 organ donations, which declined to 17 after its implementation. In the organ donation group, the causes of cardiac arrest included medical (34%), hanging (46.8%), and trauma (19.2%). The adjusted odds ratio for organ donation before the LSTDA implementation was 6.12 (95% CI 3.09–12.12), with non-medical aetiology as associated factors. The enactment of the LSTDA in 2018 in South Korea may be linked to reduced organ donations among patients with OHCA, underscoring the need to re-evaluate the medical and legal aspects of organ donation, especially considering end-of-life care decisions. (shrink)

A book for nurses, doctors and all who provide end of life care, this essential volume guides readers through the ethical complexities of such care, including current policy initiatives, and encourages debate and discussion on their controversial aspects. dived into two parts, it introduces and explains clinical decision making-processes about which there is broad consensus, in line with guidance documents issued by WHO, BMA, GMC, and similar bodies. The changing political and social context where 'patient choice' has become a (...) central idea, and the broadened scope of potients' best interests, have added to the complexity of decision-making in end of life care. The authors discuss issues widely encountered by GPs, nurses, and hospital clinicians. These include patient choice, consent, life-prolonging treatment, and symptom relief including sedation. Part rwo explores the more controversial current end of life care initiatives, such as advance care planning preferred place of care and death, euthanais and assited suicide, extended ideas of 'best interests', and the view that there are therapeutic duties to the relatives of Throughout their discussion the authors draw attention to loose ends and contradictions in some of the proposals. Examining the current policy of comsumerist choice, they reject its place in the health service, proposing a a realistic, fair, humane and widely adoptable system of end of life care. As knowledge of ethical theories is required in training courses, and the vocabulary of ethical theory is widespread in current discussions a substantial appendix on ethical theories and terms is available online. Written by the same authors as The Philosophy of Palliative Care: Critique and Reconstruction, which won the Medical Journalists' Association Specialits Book Award 2007, this new book for non-specialists is essential reading for all health care professionals involved in providing end of life care. (shrink)

It is commonly held that there are both cases in which there is a strong moral reason not to cause the existence of a disabled person and cases in which, although it would be permissible to cause a disabled person to exist, it would be better not to. Yet many disabled people are affronted by the idea that it is sometimes better to prevent people like themselves from existing, precisely because these people would be disabled. One of their grounds for (...) concern, which will be my particular focus in this paper, is that claiming that there are reasons to prevent the existence of disabled people may be expressive of a demeaning and hurtful view of the status of existing disabled people, a view that may encourage discriminatory attitudes towards and treatment of the disabled. I will contend that there can indeed be moral and prudential reasons for preventing the existence of a disabled person. But I will argue that it is less obvious than many people assume what, if anything, the recognition of these reasons expresses about disabled people. And I will contend that, even if the recognition of these reasons does express a perception of disabled people that is potentially hurtful, this effect could be offset by the social expression of a contrary view that I will claim is in fact compatible with and equally valid as the potentially hurtful view. Whether it may be morally objectionable to cause a disabled person to exist depends, in part, on whether the person’s life would be worth living. If it is ever objectionable to cause a disabled person to exist, the objections are surely strongest when the person’s life would be “worth not living” – that is, would have aspects or features that would be bad for the person and that would decisively outweigh those, if any, that would be good. Such cases are, however, quite rare. Indeed, some people question whether there are any disabilities so severe as to cause life to be worth not living. It can be argued that disability involves only the absence of certain abilities and that mere deficits.... (shrink)

ObjectiveThe impact of the mindfulness-based stress reduction program on psychological outcomes and quality of life in lung cancer patients remains unclear. This meta-analysis aimed to evaluate the effectiveness of the MBSR program on psychological states and QoL in lung cancer patients.MethodsEligible studies published before November 2021 were systematically searched from PubMed, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases. The risk of bias in eligible studies was assessed using the Cochrane tool. Psychological variables and QoL were (...) evaluated as outcomes. We used the Grading of Recommendations Assessment, Development and Evaluation system to grade the levels of evidence. Statistical analysis was conducted using RevMan 5.4 and STATA 14.0.ResultsA total of 17 studies involving 1,680 patients were included for meta-analysis eventually. MBSR program significantly relieved cancer-related fatigue and negative psychological states, enhanced positive psychological states, and improved quality of sleep. Evidence on MBSR programs' overall treatment effect for QoL revealed a trend toward statistical significance.ConclusionBased on our findings, the MBSR program shows positive effects on psychological states in lung cancer patients. This approach should be recommended as a part of the rehabilitation program for lung cancer patients.Systematic Review Registrationhttps://archive.org/details/osf-registrations-mwvbq-v1, identifier: 10.17605/OSF.IO/MWVBQ. (shrink)

This book attempts to articulate a contemporary philosophy of life drawing upon Buddhist resources from the Vimalakīrti Sūtra. Among the major themes in this Mahayana Buddhist scripture is the "skillful means" required to live a healthy and undeluded life. The book adopts that theme as a means of developing a practical approach to contemporary Buddhist life. Following many of the brilliant stories in the sutra, this book attempts to provide clear explanations for the primary Buddhist teachings and (...) the relationships that bind them all together into an inspiring way of living. Among the questions addressed are: who is the Buddha, how is a worldview of change and contingency applicable to current life, what does it mean to claim that there is no permanent self, what are the primary characteristics of an admirable Buddhist life, how is freedom conceived in Buddhism, and how do all of these themes help us address contemporary issues such as global warming, gender identities, political dichotomies, the global economy, and more. Although historical questions do arise in the book, its primary purpose if contemporary and practical, an effort to say clearly how this text helps us stake out a way of living for contemporary, global citizens. (shrink)