Patient-reported outcomes are frequently used for medical decision making, at the levels of both individual patient care and healthcare policy. Evidence increasingly shows that PROs may be influenced by patients’ response shifts and dispositions. We identify how response shifts and dispositions may influence medical decisions on both the levels of individual patient care and health policy. We provide examples of these influences and analyse the consequences from the perspectives of ethical principles and theories of just distribution. If influences of response (...) shift and disposition on PROs and consequently medical decision making are not considered, patients may not receive optimal treatment and health insurance packages may include treatments that are not the most effective or cost-effective. We call on healthcare practitioners, researchers, policy makers, health insurers, and other stakeholders to critically reflect on why and how such patient reports are used. (shrink)

While stigmatisation is universal, stigma research in low- and middle-income countries (LMIC) is limited. LMIC stigma research predominantly concerns health-related stigma, primarily regarding HIV/AIDS or mental illness from an adult perspective. While there are commonalities in stigmatisation, there are also contextual differences. The aim of this study in DR Congo (DRC), as a formative part in the development of a common stigma reduction intervention, was to gain insight into the commonalities and differences of stigma drivers (triggers of stigmatisation), facilitators (factors (...) positively or negatively influencing stigmatisation), and manifestations (practices and experiences of stigmatisation) with regard to three populations: unmarried mothers, children formerly associated with armed forces and groups (CAAFAG), and an indigenous population. Group exercises, in which participants reacted to statements and substantiated their reactions, were held with the ‘general population’ (15 exercises, n = 70) and ‘populations experiencing stigma’ (10 exercises, n = 48). Data was transcribed and translated, and coded in Nvivo12. We conducted framework analysis. There were two drivers mentioned across the three populations: perceived danger was the most prominent driver, followed by perceived low value of the population experiencing stigma. There were five shared facilitators, with livelihood and personal benefit the most comparable across the populations. Connection to family or leaders received mixed reactions. If unmarried mothers and CAAFAG were perceived to have taken advice from the general population and changed their stereotyped behaviour this also featured as a facilitator. Stigma manifested itself for the three populations at family, community, leaders and services level, with participation restrictions, differential treatment, anticipated stigma and feelings of scapegoating. Stereotyping was common, with different stereotypes regarding the three populations. Although stigmatisation was persistent, positive interactions between the general population and populations experiencing stigma were shared as well. This study demonstrated utility of a health-related stigma and discrimination framework and a participatory exercise for understanding non-health related stigmatisation. Results are consistent with other studies regarding these populations in other contexts. This study identified commonalities between drivers, facilitators and manifestations—albeit with population-specific factors. Contextual information seems helpful in proposing strategy components for stigma reduction. (shrink)

Dans ses recherches empiriques, philosophiques et métaphysiques la conscience humaine ne sort pas de sa propre sphère. C'est toujours la conscience qui parle. Par sa connaissance l'homme ne peut dépasser la conscience directe. Par sa pensée il tend à dépasser médiatement la conscience. Cette constatation nous est dictée par le fait scientifiquement fondé que tant la conscience humaine que son contenu sont tirés, c.a.d. révélés, des profondeurs cachées où ils sont recélés. C'est ce qui rend évident que l'homme possède un (...) merveilleux "sens sondeur", lui permettant de reconnaître les hauteurs et les profondeurs de notre conscience et aspirant à la transcendance. Le domaine de l'expérience se borne nécessairement aux phénomènes, et tandis que celui de la philosophie s'étend au fondement de ces phénomènes et à leurs rapports réciproques, la métaphysique, la science des principes, se propose de pénétrer l'origine et le sens profond de toute chose, du néant à l'ultime perfection. Après Kant qui a voulu en finir avec la métaphysique dogmatique unilatéralement déductive, la méthode inductive a pris définitivement le dessus. Cette méthode ne s'arroge pas le droit de juger d'une façon apodictique en ce qui touche aux problèmes de l'existence, qui ont donné naissance aux dispositions de la conscience humaine. Elle s'efforce, au contraire, de faire en cette matière une large part à l'inconnu en démontrant que les résultats sont heuristiques, hypothétiques et problématiques. Ainsi la théorie de la connaissance, la philosophie et la théologie s'accordent à dire que les données microcosmiques dans la sphère de la conscience humaine peuvent être les représentants des entités macrocosmiques. Si la conscience humaine poursuit ses recherches philosophiques et métaphysiques, c'est qu'elle doit sa genèse à une relation universelle dont elle est la représentation. (shrink)

Research on unethical leadership has predominantly focused on interpersonal and high-intensity forms of harmful leader behavior such as abusive supervision. Other forms of harmful leader behavior such as excessively pressuring subordinates or acting in self-centered ways have received less attention, despite being harmful and potentially occurring more frequently. We propose a model of four types of harmful leader behavior varying in intensity and orientation : Intimidation, Lack of Care, Self-Centeredness, and Excessive Pressure for Results. We map out how these relate (...) to other constructs in the unethical leader behavior field in order to integrate the existing work on how leaders can cause harm to followers. Next, in five studies, we develop and test a new survey instrument measuring the four proposed types of perceived HLB. We provide initial validity evidence for this new measure, establish its psychometric properties, and examine its nomological network by linking the four types of HLB to related leadership constructs and soft and hard outcome correlates at the individual and team level. We find that HLB is negatively related to constructive forms of leadership and positively to unethical ones. HLB is also related in the expected direction to job satisfaction, engagement, psychological safety, knowledge sharing, knowledge hiding, deviance, and objectively recorded team-level stress-related absenteeism. (shrink)

Most research on ethical leadership to date investigates the consequences of ethical leadership rather than its antecedents. Here, we aim to contribute to this field by studying leader personality as a potential antecedent of ethical leader behavior. In two multisource studies, we investigated the relationships between personality traits and ethical leader behavior. Leader personality was measured through self-ratings using the five-factor personality framework. Two subordinates rated their leaders' ethical behavior. Study 1 used a unidimensional Ethical Leadership Scale (ELS). In study (...) 2 we used this scale as well as an instrument distinguishing three different ethical leader behaviors, namely, fairness, role clarification, and power sharing. Further, in study 2 we controlled for the influence of the relationship between leader and followers (LMX). As expected, conscientiousness and agreeableness were most consistently related to ethical leadership. In study 1, after controlling for the other personality traits, conscientiousness related positively with ethical leadership. In study 2, after controlling for other traits and LMX, conscientiousness related positively with ethical leadership and the behavior role clarification, and agreeableness with power sharing and fairness. Also, emotional stability related positively with ethical leadership and role clarification after controlling for LMX. As expected, openness to experience and extraversion were unrelated to ethical leader behaviors. (shrink)

Burnout has important ramifications for employees and organizations and preventing burnout forms an ethical issue for managers. However, the role of the leader and especially the role of ethical aspects of leadership have received relatively little attention in relation to burnout to date. We conducted a survey among employees (N = 386) of a Dutch retail organization, nested in 122 teams with a leader. Our first contribution is that we empirically show the hypothesized opposing relationships of ethical and passive leadership (...) behavior with follower burnout. Furthermore, we examined two job characteristics as mechanisms that link these forms of leadership and burnout. Lastly, we show that the positive relationship of ethical leadership with burnout via role clarity (but not overload) is dependent on the degree of passive leadership the leader is perceived to display. Our results suggest that organizations should promote ethical leadership behaviors and limit passive leadership behaviors by stimulating leaders to be active in their role and use their social influence to promote ethical conduct. (shrink)

Although narcissists often emerge as leaders, the relationship between leader narcissism and follower performance is ambiguous and often even found to be negative. For women, narcissism seems especially likely to lead to negative evaluations. Since narcissists have the tendency to be impulsive and change their minds on a whim, they may come across as inconsistent. We propose “inconsistent leader behavior” as a new mechanism in the relationship between leader narcissism and follower performance and argue that leader gender plays an important (...) role in whether narcissistic leaders are perceived as inconsistent. Specifically, we expect leader narcissism to have a negative relationship with follower performance through perceived inconsistent leader behavior, especially for female leaders. Thus, we examine leader gender as a personal factor moderating the relationship between narcissism and perceived inconsistent behavior. Also, as perceived inconsistency is likely less problematic when a good relationship exists, we examine leader–member exchange as a contextual condition moderating the relationship between leader behavior and follower performance. We test our moderated mediation model in a multi-source study with 165 unique leader–follower dyads. As expected, leader narcissism was positively related to perceived inconsistent leader behavior, and this relationship was stronger for female leaders. Inconsistent leader behavior was negatively related to follower performance, but only when LMX was low. Our research highlights that perceived behavioral inconsistency can be problematic and—for female leaders—provides an explanation of the negative relation of leader narcissism with follower performance and of the inconsistencies in evaluations of narcissistic leaders’ effectiveness. (shrink)

This is a very high quality book with a slightly misleading title. It is difficult to see how it could serve as an introduction for anyone except the mathematically mature or, at least, a student who has already been introduced to formal logic through the lower predicate calculus. Not that these topics are not covered in the book—they comprise the first 92 pages; but the discussion quickly moves into intellectual high gear with sophisticated treatments of the independence of systems of (...) propositional logic, first-order theories, isomorphism of interpretations, and completeness and decidability. With this caveat, Mendelson's book is one of the best of the "second generation" of books on mathematical logic. It is lucid and rigorous, and contains no "frills." It does, however, contain numerous exercises in which the student will have the pleasure of developing for himself some of the more important theorems in the various subjects treated. Among these are chapters on formal number theory, including Gödel's incompleteness theorem, recursive undecidability, Tarski's theorem; a chapter on axiomatic set theory with Hartog's theorem, the axiom of choice, and the axiom of restriction ; and a truly excellent chapter on effective computability which takes off from the notion of an algorithm, and then uses this as a basis upon which to develop the theories of Markov algorithms, Turing algorithms, the theories of Herbrand and Gödel, recursively enumerable sets and undecidable problems. An appendix contains a version of K. Schütte's consistency proof for formal number theory.—H. P. K. (shrink)

We will prove in Zermelo-Fraenkel set theory without axiom of choice that the transitive hull R* of a relation R is not much “bigger” than R itself. As a measure for the size of a relation we introduce the notion of κ+-narrowness using surjective Hartogs numbers rather than the usul injective Hartogs values. The main theorem of this paper states that the transitive hull of a κ+-narrow relation is κ+-narrow. As an immediate corollary we obtain that, for every infinite cardinal (...) κ, the class HCκ of all κ-hereditary sets is a set with von Neumann rank ϱ(HCκ) ≤ κ+. Moreover, ϱ(HCκ) = κ+ if and only if κ is singular, otherwise ϱ(HCκ) = κ. The statements of the corollary are well known in the presence of the axiom of choice (AC). To prove them without AC - as carried through here - is, however, much harder. A special case of the corollary (κ = ω1, i.e., the class HCω1 of all hereditarily countable sets) has been treated independently by T. JECH. (shrink)

Los convulsos acontecimientos de estos últimos años han demostrado, a escala global, cuán enajenante es nuestra experiencia presente del tiempo. Las tendencias actuales de la teoría crítica y otros enfoques histórico-sociológicos insisten en el ritmo devorador de la aceleración (P. Virilio; H. Rosa) y en la reconfiguración temporal a partir del “presentismo” (Koselleck; F. Hartog). Sin embargo, sabemos que estas cuestiones distan de ser absolutamente nuevas, y que ya preocupaban a los filósofos y a los fenomenólogos en la primera (...) mitad del siglo XX. La publicación reciente de los últimos tratados del Ereignis y de los Cuadernos negros, redactados en los años 1930 y 1940, nos permite acceder a una reflexión original sobre lo que Heidegger nombra la maquinación o fabricación [Machenschaft]. Nos gustaría analizar la manera en la que, a partir de la fabricación, se puede replantear el sentido de nuestra experiencia temporal íntima frente a la situación moderna. Más concretamente, ahondaremos en las formas en las que la primacía de la fabricación funciona como cerrazón de posibilidades, llegando a impedir que pueda ocurrir algo realmente “histórico”. (shrink)

INTRODUCTION TO ASPECTS OF FACE PROCESSING: TEN QUESTIONS IN NEED OF ANSWERS. HD Ellis 1. INTRODUCTION These proceedings of the first international ...

In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that (...) it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism. (shrink)

Humans are neophile, curious, and explorative animals with impressive capabilities for creative problem-solving. I discuss some of the ultimate roots behind human creativity while reviewing two books on creativity and problem-solving. To E. O. Wilson, the driv­ing force behind creativity is our instinctive love of novelty, and creativity’s ultimate goal is “self-understanding.” I elaborate on and question this assumption. The theories of inclu­sive fitness and group selection are discussed, with Wilson in favor of the latter. Finally, the theory of gene-culture (...) coevolution is introduced as fundamental to the unity of science and the humanities and to closing the gap between these two cultures. Eagleman and Brandt’s volume is more of an entertaining history of design and human inventiveness than a study in creativity as such. We hear about the three main operations of creative process: bending, blending, and breaking, and these operations are the primary means by which all ideas evolve, according to the authors. (shrink)

Islamic philosophy; Hanbalites; doctrines; creation (Islam); early works to 1800.

H. Tristram Engelhardt, Jr.; Medicine, Philosophy, and Theology: Christian Bioethics Reconsidered, Christian bioethics: Non-Ecumenical Studies in Medical Morali.

In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the doctor-patient relationship in societies deriving their law from English origins. Despite this, confidentiality remains a value which the physician must strive to preserve. He cannot however do this without considering its (...) effect upon possible innocent third parties. (shrink)

At a meeting of the Physical Society of London in 1925 participants expressed their concerns regarding a recent suggestion by the Australian physicist T. H. Laby for replicating the established value of the mechanical equivalent of heat. This rather controversial discussion about the value of redetermining this numerical fact brings to light different understandings of the moral economy of accuracy in scientific work; it signals a distinctive new stage in the historical understanding of accuracy and precision and the moral integrity (...) in conducting research. (shrink)

The modern corpuscular theory of radiation was born in 1905 when Einstein advanced his light quantum hypothesis; and the steps by which Einstein's hypothesis, after years of profound scepticism, was finally and fully vindicated by Arthur Compton's 1922 scattering experiments constitutes one of the most stimulating chapters in the history of recent physics. To begin to appreciate the complexity of this chapter, however, it is only necessary to emphasize an elementary but very significant point, namely, that while Einstein based his (...) arguments for quanta largely on the behaviour of high-frequency black body radiation or ultra-violet light, Compton experimented with X-rays. A modern physicist accustomed to picturing ultra-violet light and X-radiation as simply two adjacent regions in the electromagnetic spectrum might regard this distinction as hair-splitting. But who in 1905 was sure that X-rays and γ-rays are far more closely related to ultra-violet light than to α-particles, for example? This only became evident after years of painstaking research, so that moving without elaboration from Einstein's hypothesis to Compton's experiments automatically eliminates from consideration an important segment of history—a segment in which a major role was played by William Henry Bragg. (shrink)