Objectives—To evaluate a departmental computer system.Design—a. Direct comparison of the time taken to use a manual system with the time taken to use a computer system for lung function evaluation, loan of equipment and production of correspondence. b. Analysis of the accuracy of data capture before and after the introduction of the computer system. c. Analysis of the comparative running costs of the manual and computer systems.Setting—Within a department of respiratory medicine serving a hospital of 1323 beds.Main Outcome Measures—a. Time (...) taken to perform functions with the assistance of computerised methods, in comparison to the manual method used alone. b. Accuracy of data capture. c. Relative running costs.Results—a. The computer system was significantly faster than the manual system for lung function evaluation, loan of equipment, and checking for overdue equipment. The production of correspondence was slightly slower with the computer. b. All outpatient episodes, but only 43 of 65 of inpatient episodes, were captured. Lung function and managerial report data were accurate using both manual and computerised methods. The manual system for equipment loans was inefficient, and use of the computer resulted in the recovery of 221 nebulisers. c. Development costs for 1988–1990 were high. Only £1200 to £1845 per year was recovered directly from staff time saved by the computer but larger savings resulted from changes in work practice. After 10 years the projected deficit is £10 000 per annum in running costs.Conclusions—In comparison with the manual methods, the computer system has shown significant advantages which provide accurate information, with significant favourable effects on working practices. In evaluating computer systems used in clinical practice it is essential to ensure that the projected work practice benefits are achieved without unacceptable costs in staff time, inaccurate data and high financial outlay. (shrink)

This article identifies the moral premises of contemporary business ethics. After analyzing thirty business ethics texts, the article shows that many business ethicists hold the conventional view that being moral is altruistic. This altruistic perspective logically implies a negative evaluation of self-interest and the profit motive, and business. As a result, the prevailing attitude in mainstream business ethics is that without altruistic restraints businesspeople are inclined to lie, steal, and cheat, not create and earn wealth through honest production and voluntary (...) trade. Therefore, the central concern in current business ethics is to curb businesspeople morally, not to empower them in their self-interested desire to make money. In the final analysis, the article shows how the anti-egoist assumptions manifest themselves in a moral prejudice against business, leading to a biased, unfair, and misleading account of the business world. (shrink)

Are there any business decisions that do not have an ethical dimension? Who decides that a decision is unethical? What impact does ethics have in today’s business environment? The case focuses on the development of Hawaii’s first public-private venture capital fund by three very different entities: the State of Hawaii economic development corporation; a US mainland-based private equity investment firm; and a partnership of two serial entrepreneurs. The case uses a progressive disclosure format so students only read and analyze the (...) actions and ethical issues that occur at a specific point in time: creation of the venture capital fund; selection of startups to be included in the fund’s investment portfolio; and public reaction to decisions and actions by the fund. The case frames the issues confronted at each point as ethical dilemmas. Analysis includes answering questions and formulating recommendations or solutions to each dilemma. (shrink)

This book is a philosophical commentary on Schopenhauer's "Fourfold Root of the Principle of Sufficient Reason," dealing with each of Schopenhauer's principal ...

Narrative analysis is well established as a means of examining the subjective experience of those who suffer chronic illness and cancer. In a study of perceptions of the outcomes of treatment of cancer of the colon, we have been struck by the consistency with which patients record three particular observations of their subjective experience: the immediate impact of the cancer diagnosis and a persisting identification as a cancer patient, regardless of the time since treatment and of the presence or absence (...) of persistent or recurrent disease; a state of variable alienation from social familiars, expressed as an inability to communicate the nature of the experience of the illness, its diagnosis and treatment; and a persistent sense of boundedness, an awareness of limits to space, empowerment and available time. These subjectivities were experienced in varying degree by all patients in our study. Individual responses to these experiences were complex and variable. The experiences are best understood under the rubric of a category we call “liminality”. We believe that all cancer patients enter and experience liminality as a process which begins with the first manifestations of their malignancy. An initial acute phase of liminality is marked by disorientation, a sense of loss and of loss of control, and a sense of uncertainty. An adaptive, enduring phase of suspended liminality supervenes, in which each patient constructs and reconstructs meaning for their experience by means of narrative. This phase persists, probably for the rest of the cancer patient’s life. The experience of liminality is firmly grounded in the changing and experiencing body that houses both the disease and the self. Insights into the nature of the experience can be gained from the Existentialist philosophers and from the history of attitudes to death. Understanding liminality helps us to understand what it is that patients with cancer seek from the system to which they turn for help. Its explication should therefore be important for those who provide health care, those who educate health care workers and those concerned to study and use outcomes as administrative and policy making instruments. (shrink)