Conscientious objection has spurred impassioned debate in many Western countries. Some Norwegian general practitioners (GPs) refuse to refer for abortion. Little is know about how the GPs carry out their refusals in practice, how they perceive their refusal to fit with their role as professionals, and how refusals impact patients. Empirical data can inform subsequent normative analysis.

ZusammenfassungDie rechtliche Regelung der Fortpflanzungsmedizin ist dringend reformbedürftig. Das Embryonenschutzgesetz von 1990 erfasst die neuesten technischen Entwicklungen nicht, ist in manchen Bereichen unstimmig und lückenhaft, setzt die betroffenen Frauen, Paare und Kinder unnötigen gesundheitlichen Risiken aus, erschwert paradoxerweise die Durchsetzung von Kinderrechten und erzeugt Gerechtigkeitsprobleme und Rechtsunsicherheit für die betroffenen Paare und die behandelnden Ärztinnen und Ärzte.Das Embryonenschutzgesetz enthält zudem nur strafrechtliche Verbote. Diese erlauben keine angemessene Reaktion auf die medizinische Entwicklung und den gesellschaftlichen Wandel und werden der Komplexität der (...) Materie nicht gerecht.Diese Probleme müssen gelöst werden. Der Bundesgesetzgeber verfügt seit mehr als 20 Jahren über die Kompetenz zur Regelung der Fortpflanzungsmedizin. Er sollte in der kommenden Legislaturperiode ein umfassendes Fortpflanzungsmedizingesetz schaffen. (shrink)

Monetary intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the dark side of monetary Intelligence and behavioral economics—dishonesty. Dishonesty, a risky prospect, involves cost–benefit analysis of self-interest. We frame good or bad barrels in the environmental context as a proxy of high or low probability of getting caught for dishonesty, respectively. We theorize: The magnitude and intensity of (...) the relationship between love of money and dishonest prospect may reveal how individuals frame dishonesty in the context of two levels of subjective norm—perceived corporate ethical values at the micro-level and Corruption Perceptions Index at the macro-level, collected from multiple sources. Based on 6382 managers in 31 geopolitical entities across six continents, our cross-level three-way interaction effect illustrates: As expected, managers in good barrels, mixed barrels, and bad barrels display low, medium, and high magnitude of dishonesty, respectively. With high CEV, the intensity is the same across cultures. With low CEV, the intensity of dishonesty is the highest in high CPI entities —the Enron Effect, but the lowest in low CPI entities. CPI has a strong impact on the magnitude of dishonesty, whereas CEV has a strong impact on the intensity of dishonesty. We demonstrate dishonesty in light of monetary values and two frames of social norm, revealing critical implications to the field of behavioral economics and business ethics. (shrink)

Corruption involves greed, money, and risky decision-making. We explore the love of money, pay satisfaction, probability of risk, and dishonesty across cultures. Avaricious monetary aspiration breeds unethicality. Prospect theory frames decisions in the gains-losses domain and high-low probability. Pay dissatisfaction (in the losses domain) incites dishonesty in the name of justice at the individual level. The Corruption Perceptions Index, CPI, signals a high-low probability of getting caught for dishonesty at the country level. We theorize that decision-makers adopt avaricious love-of-money aspiration (...) as a lens and frame dishonesty in the gains-losses domain (pay satisfaction-dissatisfaction, Level 1) and high-low probability (CPI, Level 2) to maximize expected utility and ultimate serenity. We challenge the myth: Pay satisfaction mitigates dishonesty across nations consistently. Based on 6500 managers in 32 countries, our cross-level three-dimensional visualization offers the following discoveries. Under high aspiration conditions, pay dissatisfaction excites the highest- (third-highest) avaricious justice-seeking dishonesty in high (medium) CPI nations, supporting the certainty effect. However, pay satisfaction provokes the second-highest avaricious opportunity-seizing dishonesty in low CPI entities, sustaining the possibility effect—maximizing expected utility. Under low aspiration conditions, high pay satisfaction consistently leads to low dishonesty, demonstrating risk aversion—achieving ultimate serenity. We expand prospect theory from a micro and individual-level theory to a cross-level theory of monetary wisdom across 32 nations. We enhance the S-shaped Curve to three 3-D corruption surfaces across three levels of the global economic pyramid, providing novel insights into behavioral economics, business ethics, the environment, and responsibility. (shrink)

In this paper, we consider reducts of p-adically closed fields. We introduce a notion of shadows: sets Mf={∈K2∣|y|=|f|}\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${M_f = \{ \in K^2 \mid |y| = |f|\}}$$\end{document}, where f is a semi-algebraic function. Adding symbols for such sets to a reduct of the ring language, we obtain expansions of the semi-affine language where multiplication is nowhere definable, thus giving a negative answer to a question posed by Marker, Peterzil and Pillay. The second (...) main result of this paper is the fact that in p-adic fields, full multiplication becomes definable if we add a rational function to the semi-affine language. (shrink)

We introduce a very weak language L M on p-adic fields K, which is just rich enough to have exactly the same definable subsets of the line K that one has using the ring language. (In our context, definable always means definable with parameters.) We prove that the only definable functions in the language L M are trivial functions. We also give a definitional expansion $L\begin{array}{*{20}{c}} ' \\ M \\ \end{array} $ of L M in which K has quantifier elimination, (...) and we obtain a cell decomposition result for L M -definable sets. Our language L M can serve as a p-adic analogue of the very weak language (<) on the real numbers, to define a notion of minimality on the field of p-adic numbers and on related valued fields. These fields are not necessarily Henselian and may have positive characteristic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Literature 26.1 (2002) 143-156 [Access article in PDF] The Vicious Habits of Entirely Fictitious People: Hume on the Moral Evaluation of Art Eva M. Dadlez DAVID HUME'S ESSAY, "Of the Standard of Taste," identifies aesthetic merits and defects of narrative works of art. 1 There is a passage toward the end of this essay that has aroused considerable interest among philosophers. In it, Hume writes of cases (...) in which "vicious manners are described, without being marked with the proper characters of blame and disapprobation" ("ST," p. 246). He maintains that works which include such descriptions are aesthetically flawed, adding that we neither can nor should enter into their writers' sentiments or "bear an affection to characters, which we plainly discover to be blameable" ("ST," p. 246).There is no reason to ascribe to Hume a Platonic moralism that condemns art's disinhibition of emotion. Neither does Hume advocate some extravagant form of political correctness that evaluates art by looking to the propriety of its subject matter. As later examples in the quoted essay make clear, Hume is speaking of cases in which fiction not only depicts vicious manners, but endorses them. I will argue that such endorsements are stigmatized neither because a low estimation of depicted behavior infects the estimation of a work's merit nor because we take the endorsement to be mistaken or unwarranted. Fictional endorsements of conduct otherwise regarded as vicious constitute defects because they curtail the aesthetic experience. Hume's claim, then, is as much about human psychology as it is about morality. We cannot divorce morality from narrative art because, for Hume, morality finds its basis in the very sentiments such art is intended to arouse. The content of the works under fire is objectionable because it prompts the [End Page 143] imaginative disengagement of the reader or viewer just when engagement and emotional participation are necessary for full appreciation. As Noël Carroll maintains in his objection to autonomism, a moral defect "will count as an aesthetic defect when it actually deters a response to which a work aspires." 2 This is a view for which I will endeavor to offer an explanation based on Hume's philosophy, and that I will attempt to defend against typical objections. I It would be a mistake to associate the position ventured above with some of those appearing in the recent critical literature. There, a work is sometimes taken to endorse any character's behavior which is not explicitly condemned or which is accompanied by some depiction of positive traits. Thus Nabokov's Lolita is suspected of subtle endorsement of Humbert's behavior mainly because Humbert is described as urbane and intelligent. There is a clear mistake here about what it is that can be taken to constitute an endorsement on the part of a work of fiction. To suggest that Lolita endorses child molesting because we are occasionally allowed to glimpse a sympathetic side of the molester is on a par with claiming that Shakespeare's Macbeth endorses killing for personal gain because we are allowed to glimpse a sympathetic side of the title character. Our reactions to complex characters can be, and usually are, correspondingly complex. We can admire one trait and deplore another without being forced into the kind of all-or-nothing evaluation that writers of serious fiction seldom want to elicit. In any case, it seems clear that the endorsement of a character in toto would probably involve a good deal more than the depiction of a few attractive traits. The grim undoing of the two characters under consideration, coupled with their misery and hopelessness, hardly suggests endorsement. Similarly, an aesthetically pleasing depiction of an event we consider tragic should not be taken as an endorsement of that event. Aesthetic and distressed responses are not mutually exclusive. They can constitute distinct responses to distinct aspects of the same state of affairs. The graceful arrangement of the bodies of Romeo and Juliet is surely not an endorsement of their tragic death or their suicide... (shrink)

Sophisticated senator and legislative onion. Whether or not you have ever heard of these things, we all have some intuition that one of them makes much less sense than the other. In this paper, we introduce a large dataset of human judgments about novel adjective-noun phrases. We use these data to test an approach to semantic deviance based on phrase representations derived with compositional distributional semantic methods, that is, methods that derive word meanings from contextual information, and approximate phrase meanings (...) by combining word meanings. We present several simple measures extracted from distributional representations of words and phrases, and we show that they have a significant impact on predicting the acceptability of novel adjective-noun phrases even when a number of alternative measures classically employed in studies of compound processing and bigram plausibility are taken into account. Our results show that the extent to which an attributive adjective alters the distributional representation of the noun is the most significant factor in modeling the distinction between acceptable and deviant phrases. Our study extends current applications of compositional distributional semantic methods to linguistically and cognitively interesting problems, and it offers a new, quantitatively precise approach to the challenge of predicting when humans will find novel linguistic expressions acceptable and when they will not. (shrink)

The goal of this dissertation is to demonstrate that construals of our emotional responses to fictions as irrational or merely pseudo-emotional are not the only explanations available to us, and that necessary and sufficient conditions for an emotional response to a fiction can be established without abandoning either its intentionality or the assignment of a causal role to our beliefs. ;Colin Radford's claim that our emotional responses to fictions are irrational and inconsistent is challenged in two ways. First, distinctions can (...) be drawn between our reactions to fiction and indisputably irrational emotional reactions which preclude arriving at Radford's conclusion via an argument from analogy. Further, the conditions for rationality put forward in several analyses of emotion, ranging from that of David Hume to that of Ronald de Sousa, are not violated by our emotional responses to fictions. ;Kendall Walton's contention that such affective reactions are merely quasi-emotions is contested on the ground that the absence of the existentially committed beliefs which Walton allies with all genuine emotional responses does not demonstrate an absence of cognitive content. Existentially uncommitted evaluative beliefs, thoughts, and even beliefs about the world can be linked to our emotional experience of fictions, and can serve a function necessary to the identification of the emotion, a function which Walton assigns to the existentially committed belief. ;In our experience of fictions, the objects of our emotion are various. However, a direct response to a fictional entity or event is characterized in terms of Peter Lamarque's account: as a response to the content of a thought, a response to what has been thought or imagined rather than to the thought itself. The roles played both by evaluative beliefs and beliefs about what can occur in the world are investigated and found to constitute necessary conditions for an emotional response to a fiction. An account of the role of the imagination, which borrows from Boruah, David Novitz, and Susan Feagin, provides another condition which, together with the two preceding, appears sufficient for such a response. (shrink)

Are values and social priorities universal, or do they vary across geography, culture, and time? This question is very relevant to Asia’s emerging economies that are increasingly looking at Western models for answers to their own outmoded health care systems that are in dire need of reform. But is it safe for them to do so without sufficient regard to their own social, political, and philosophical moorings? This article argues that historical and cultural legacies influence prevailing social values with regard (...) to health care financing and resource allocation, and that the Confucian dimension provides a helpful entry point for a deeper understanding of ongoing health care reforms in East Asia – as exemplified by the unique case of Singapore. (shrink)

Judgment aggregation theory, which concerns the translation of individual judgments on logical propositions into consistent group judgments, has shown that group consistency generally cannot be guaranteed if each proposition is treated independently from the others. Developing the right method of abandoning independence is thus a high-priority goal. However, little work has been done in this area outside of a few simple approaches. To fill the gap, we compare four methods based on distance metrics between judgment sets. The methods generalize the (...) premise-based and sequential priority approaches to judgment aggregation, as well as distance-based preference aggregation. They each guarantee group consistency and implement a range of distinct functions with different properties, broadening the available tools for social choice. A central result is that only one of these methods (not previously considered in the literature) satisfies three attractive properties for all reasonable metrics. (shrink)

Antimicrobial resistance (AMR) describes the evolution of treatment‐resistant pathogens, with potentially catastrophic consequences for human medicine. AMR is driven by the over‐prescription of antibiotics, and could be reduced through consideration of the ethical dimensions of the dilemma faced by doctors. This dilemma involves balancing apparently opposed interests of current and future patients, and unique contextual factors in different countries, which may modify the core dilemma. We describe three example countries with different economic backgrounds and cultures—South Africa, Sri Lanka and the (...) United Kingdom. Then we discuss how country‐specific factors impact on the prominence of various ethical dimensions of the dilemma (visibility and moral equality of future generations; Rule of Rescue; prescribing autonomy and conflicts of interest; consensus on collective action). We conclude that a nuanced understanding of national prescribing dilemmas is critical to inform the design of effective stewardship approaches. (shrink)

BackgroundVarious forms of Clinical Ethics Support (CES) have been developed in health care organizations. Over the past years, increasing attention has been paid to the question of how to foster the quality of ethics support. In the Netherlands, a CES quality assessment project based on a responsive evaluation design has been implemented. CES practitioners themselves reflected upon the quality of ethics support within each other’s health care organizations. This study presents a qualitative evaluation of this Responsive Quality Assessment (RQA) project.MethodsCES (...) practitioners’ experiences with and perspectives on the RQA project were collected by means of ten semi-structured interviews. Both the data collection and the qualitative data analysis followed a stepwise approach, including continuous peer review and careful documentation of the decisions.ResultsThe main findings illustrate the relevance of the RQA with regard to fostering the quality of CES by connecting to context specific issues, such as gaining support from upper management and to solidify CES services within health care organizations. Based on their participation in the RQA, CES practitioners perceived a number of changes regarding CES in Dutch health care organizations after the RQA: acknowledgement of the relevance of CES for the quality of care; CES practices being more formalized; inspiration for developing new CES-related activities and more self-reflection on existing CES practices.ConclusionsThe evaluation of the RQA shows that this method facilitates an open learning process by actively involving CES practitioners and their concrete practices. Lessons learned include that “servant leadership” and more intensive guidance of RQA participants may help to further enhance both the critical dimension and the learning process within RQA. (shrink)

Background One of the objectives of medicine is to relieve patients' suffering. As a consequence, it is important to understand patients' perspectives of suffering and their ability to cope. However, there is poor insight into what determines their suffering and their ability to bear it. Purpose To explore the constituent elements of suffering of patients who explicitly request euthanasia or physician-assisted suicide (EAS) and to better understand unbearable suffering from the patients' perspective. Patients and methods A qualitative study using in-depth (...) face-to-face interviews was conducted with 31 patients who had requested EAS. The grounded theory approach was used to analyse the data. Results Medical, psycho-emotional, socio-environmental and existential themes contributed to suffering. Especially fatigue, pain, decline, negative feelings, loss of self, fear of future suffering, dependency, loss of autonomy, being worn out, being a burden, loneliness, loss of all that makes life worth living, hopelessness, pointlessness and being tired of living were constituent elements of unbearable suffering. Only patients with a psychiatric (co)diagnosis suffered unbearably all the time. Conclusions Unbearable suffering is the outcome of an intensive process that originates in the symptoms of illness and/or ageing. According to patients, hopelessness is an essential element of unbearable suffering. Medical and social elements may cause suffering, but especially when accompanied by psycho-emotional and existential problems suffering will become ‘unbearable’. Personality characteristics and biographical aspects greatly influence the burden of suffering. Unbearable suffering can only be understood in the continuum of the patients' perspectives of the past, the present and expectations of the future. (shrink)

Background: Hospital nurses are frequently the first care givers to receive a patient’s request for euthanasia or physician-assisted suicide (PAS). In France, there is no consensus over which medical practices should be considered euthanasia, and this lack of consensus blurred the debate about euthanasia and PAS legalisation. This study aimed to investigate French hospital nurses’ opinions towards both legalisations, including personal conceptions of euthanasia and working conditions and organisation. Methods: A phone survey conducted among a random national sample of 1502 (...) French hospital nurses. We studied factors associated with opinions towards euthanasia and PAS, including contextual factors related to hospital units with random-effects logistic models. Results: Overall, 48% of nurses supported legalisation of euthanasia and 29%, of PAS. Religiosity, training in pallative care/pain management and feeling competent in end-of-life care were negatively correlated with support for legalisation of both euthanasia and PAS, while nurses working at night were more prone to support legalisation of both. The support for legalisation of euthanasia and PAS was also weaker in pain treatment/palliative care and intensive care units, and it was stronger in units not benefiting from interventions of charity/religious workers and in units with more nurses. Conclusions: Many French hospital nurses uphold the legalisation of euthanasia and PAS, but these nurses may be the least likely to perform what proponents of legalisation call “good” euthanasia. Improving professional knowledge of palliative care could improve the management of end-of-life situations and help to clarify the debate over euthanasia. (shrink)

The paper deals with the question of religious tolerance in Europe’s past and present. Tolerance within Christianity (and within the other so called “Abrahamitic” or “Biblical” Religions) is one of the main points. However, the reader is also invited to take a brief look at Europe’s pre-christian past. To some extent, the religious situation of the Roman Empire in particular rather seems to resemble our own experiences with pluralistic societies in today’s Europe than medieval and early modern circumstances would do. (...) Even the ancient problems with “religious freedom” can be linked with modern counterparts. So this paper will avoid long retrospectives at the well known facts of Europe’s Christian past such as inquisition and European religious wars in order to deal with some more hidden perspectives of European religious his- tory, which were often obscured by the main historiographical narrative. (shrink)

Merab Konstantinovich [Mamardashvili] met with me immediately, as soon as I requested it, although he forewarned me that he could only dimly remember much of that distant past in which I was most interested. But evidently that past still perturbed him as well, since he agreed to speak with me even though he had not yet completely recovered from his illness, and hence his voice was feeble, at times subsiding to a whisper; he would pronounce his words indistinctly, constantly sticking (...) one onto another; on top of that, for technical reasons the dictaphone was situated a bit away from him. It was therefore very difficult to transcribe the text, and I raised many questions with the idea of asking Merab Konstantinovich about them at our next meeting and clearing up some things. But alas, there was no next meeting … Hence I am permitting myself now to publish only some of the most clearly enunciated fragments of my conversation with him, one of the four "forefathers" of the Moscow Methodological Circle, whose name for us, today's participants (and hence neophytes) in the methodological movement, is enveloped by legends handed down by word of mouth. I kept my questions to a minimum. Mamardashvili's reminiscences, arguments, and reflections will seem contentious to many. But no matter, one can dispute points of substance even with those who have passed on. (shrink)

The notion of a Sasaki projectionon an orthomodular lattice is generalized to a mapping Φ: E × E → E, where E is an effect algebra. If E is lattice ordered and Φ is symmetric, then E is called a Φ-symmetric effect algebra.This paper launches a study of such effect algebras. In particular, it is shown that every interval effect algebra with a lattice-ordered ambient group is Φ-symmetric, and its group is the one constructed by Ravindran in his proof that (...) every effect algebra that has the Riesz decomposition property is an interval algebra. It is shown that the doubling construction introduced in the paper is connected to the conditional event algebrasof Goodman, Nguyen, and Walker. (shrink)

Illuminates childrens experiences of embodiment, inter-subjectivity, place, thing, time, and language through a dialogue between developmental research and ...

Rapidly changing estimates on the Soviet régime''s ability to survive show how difficult it is for American Sovietologists to grasp what is going on.

Causal understanding is a defining characteristic of human cognition. Like many animals, human children learn to control their bodily movements and act effectively in the environment. Like a smaller subset of animals, children intervene: they learn to change the environment in targeted ways. Unlike other animals, children grow into adults with the causal reasoning skills to develop abstract theories, invent sophisticated technologies and imagine alternate pasts, distant futures and fictional worlds. In this Review, we explore the development of human-unique causal (...) learning and reasoning from evolutionary and ontogenetic perspectives. We frame our discussion using an ‘interventionist’ approach. First, we situate causal understanding in relation to cognitive abilities shared with non-human animals. We argue that human causal understanding is distinguished by its depersonalized (objective) and decontextualized (general) representations. Using this framework, we next review empirical findings on early human causal learning and reasoning and consider the naturalistic contexts that support its development. Then we explore connections to related abilities. We conclude with suggestions for ongoing collaboration between developmental, cross-cultural, computational, neural and evolutionary approaches to causal understanding. (shrink)