Bu makale, Mâtürîdî’nin ahlak düşüncesinde ahlaki mükellefiyetin kaynağını tespit etmeyi hedeflemektedir. Bu amaçla, ilk olarak onun yazılarında bulunan ahlaka ilişkin kavram türlerinin bir sınıflaması sunulmuştur. Bu noktada üç temel kavram tespit edilmiştir: Fayda, Erdem ve Hak. Ancak bunlardan hak kavramı, ahlaki mükellefiyetin nihai temsilcisi olarak görülmektedir, çünkü ahlakın nesnel olması için bize temel olan kategorik emir kavramını tek başına sunmaktadır. Ardından ahlaki mükellefiyetin iki ana kaynağına yer verilmiştir. Biri vahiy, diğeri ise akıldır. Vahiy emir ve nehiylerle beraber ilahi rubûbiyet ve (...) hakimiyet mefhumlarını sunarken, akıl aynı zamanda ahlâk anlayışımızı objektif mebdelerle belirlemekte ve vahiy öğretilerini desteklemektedir. Bu, ahlak alanında aklın bulgularının genellikle vahiy ile uyumlu olduğu anlamına gelir; farklılık gösterdikleri yerlerde, çoğunlukla insanlığın bilgiye erişiminin olmaması, onların doğru sonuçlara ulaşmasını imkansız kılmaktadır. Bu bağlamda Mâtürîdî, ayrıca vahyin özellikle karanlık ve tartışmalı ahlak alanlarında gerekli olduğunu, çünkü vahyin, yokluğu halinde insanların kesin olarak bilemeyeceği yanıtlar sunduğuna dikkat çeker. Aynı zamanda tabiî hukuk teorisi doğrultusunda aklın bir mükellefiyet kaynağı olduğu ve dolayısıyla bu teorinin Mâtürîdî düşüncesinin kategorize edilmesinde temel bir yol olduğu anlaşılmaktadır. Buna göre doğal dünya akla rehberlik eder ve o, insanın temel ihtiyaçları ve arzuları doğrultusunda ahlaki sonuçların çıkarılabileceği bir bilgi kaynağıdır. Özellikle Mâtürîdî, barış ve refahın insanlığın temel amacı olduğunu ve bunun ancak bir esasla sağlanabileceğini belirtmektedir. Bununla birlikte, Tanrı dünyanın yaratıcısı ve tasarımcısı olduğundan, Tanrı’nın bilgeliğini merkeze alan bir teoloji içinde, müteâl olan ve ahlakı belirleyen temel prensip ilahi hikmettir. Makalenin üçüncü bölümünde ahlaki motivasyon konusuna değinilmektedir. Ahlaki motivasyon ise insanların neye göre ahlaklı davranabileceklerini anlamanın anahtarıdır. Diğer yandan çalışmada Mâtürîdî’nin, yalnızca eylemlerin sonuçlarını dikkate alarak değil aynı zamanda objektif sebeplerle harekete geçebileceğimizi ve eylemleri ahlaki olarak yargılayabileceğimizi gösterdiği sonucuna varılmıştır. Bunun sebebi aklın, eylemleri sadece gerçekliğin tesadüfi ve sübjektif yönlerine değil, aynı zamanda kategorik mebde ve emirlere dayanan kriterlere göre yargılamaya izin vermesidir. Bu çalışmanın son kısmında ise Mâtürîdî’nin, David Hume’un ortaya koyduğu olan-olması gereken uçurumunu aşma bağlamında aklın, ahlaki mükellefiyetler getirdiği ileri sürülmektedir. Böylece Mâtürîdî’ye göre ahlaki mükellefiyetin kaynağının sadece vahiy emirlerine dayanmadığı, aynı zamanda akıl prensiplerinden de kaynaklandığı anlaşılmaktadır. Bu ilkeler önemli ölçüde insan doğası ve doğal dünya üzerine yapılan gözlemlerden elde edilen sonuçların ürünüdür. (shrink)

Some of the most difficult consultations for an ethics consultant to resolve are those in which the patient is ready to leave the acute-care setting, but the patient or family refuses the plan, or the plan is impeded by deficiencies in the healthcare system. Either way, the patient is “stuck” in the hospital and the ethics consultant is called to help get the patient “unstuck.” These encounters, which we call “complex discharges,” are beset with tensions between the interests of the (...) institution and the interests of the patient as well as tensions within the ethics consultant whose commitments are shaped both by the values of the organization and the values of their own profession. The clinical ethics literature on this topic is limited and provides little guidance. What is needed is guidance for consultants operating at the bedside and for those participating at a higher organizational level. To fill this gap, we offer guidance for facilitating a fair process designed to resolve the conflict without resorting to coercive legal measures. We reflect on three cases to argue that the approach of the consultant is generally one of mediation in these types of disputes. For patients who lack decision making capacity and lack a surrogate decision maker, we recommend the creation of a complex discharge committee within the organization so that ethics consultants can properly discharge their duties to assist patients who are unable to advocate for themselves through a fair and transparent process. (shrink)

In this paper, we will consider the role of oaths and codes of ethics in undergraduate medical education. Studies of ethics syllabi suggest that ethics educators typically use well-known bioethics texts such as Beauchamp and Childress. Yet, many issues that medical students will face are addressed by codes of ethics and oaths. We will first provide a historical survey of oaths and codes and then address how these sources of ethical guidance can be effectively used in ethics education of medical (...) students. Oaths and codes can be engagingly taught using a range of techniques including visual narrative. Excerpts from television and film can be used to highlight challenging ethical dilemmas in a variety of settings, taking the learning from the theoretical to the more applied while offering context. (shrink)

This article mitigates the challenges of previously reported literature by reducing the operating cost and improving the performance of network. A genetic algorithm-based tabu search methodology is proposed to solve the link capacity and traffic allocation problem in a computer communication network. An efficient modern super-heuristic search method is used to influence the fixed cost, delay cost, and variable cost of a link on the total operating cost in the computer communication network are discussed. The article analyses a large number (...) of computer simulation results to verify the effectiveness of the tabu search algorithm for CFA problems and also improves the quality of solutions significantly compared with traditional Lagrange relaxation and subgradient optimization algorithms. The experimental results show that with the increase of the weighted coefficient of variable cost, the proportion of variable cost in the total cost increases from 10 to 35%. The growth is relatively slow, and the fixed cost is still the main component. In addition, due to the increase in the variable cost, the tabu search algorithm will also choose the link with large luxury to reduce the variable cost, which makes the fixed cost slightly increase, while the network delay cost and average delay slightly decrease. The proposed method, when compared with the genetic algorithm, has more advantages for large-scale or heavy-load networks. (shrink)

The topology optimization of computer communication network is studied based on improved genetic algorithm, a network optimization design model based on the establishment of network reliability maximization under given cost constraints, and the corresponding improved GA is proposed. In this method, the corresponding computer communication network cost model and computer communication network reliability model are established through a specific project, and the genetic intelligence algorithm is used to solve the cost model and computer communication network reliability model, respectively. It has (...) been proved that GA can solve the complex problems of computer working environment better, which is 80% higher than the general algorithm, and can select the optimal scheme pertinently. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Growing Up With Autism: Challenges and Opportunities of Parenting Young Adult Children with Autism Spectrum DisordersKayhan Parsi and Nanette ElsterAs the parent and stepparent of a child with autism, we witness a world that is quite different from parents with only neurotypical children. Tantrums don’t vanish after the age of three. Aggression is a way of life. Simple communication is a constant challenge. And dreams of a child’s future (...) have to be altered and adapted. In the narratives that accompany this commentary, we see that the challenges of raising a child with autism do not necessarily diminish with age; they may, however, change because children with autism become adults with autism and this presents a new set of both challenges and opportunities.The current epidemic of young children with autism is giving rise to yet another epidemic—the rising number of young adults who are autistic. As one of the authors here mentioned, “the system is in for a tsunami of new individuals needing medical care of all types, needing continued supports for housing and vocational training, communication, occupational and physical therapy” (Cornell). According to a recent study published in Pediatrics, “[y]outh with an ASD have poor postsecondary employment and education outcomes, especially in the first 2 years after high school” (Shattuck, 2012). With the rising number of children being diagnosed with autism, this employment disparity is likely to be exacerbated until or unless the workforce adapts to and accommodates the needs and skills of persons with autism.The needs of young adults with autism are only recently beginning to receive more attention from the media. But for these children’s parents, this issue has always been personal. The emotions on display in these narratives are heartfelt—even raw at times—and seem to swell like the wave of a tsunami itself as parents are now confronting what should be the independence of adulthood. With barriers to employment, health care and housing, young adults with autism remain largely dependent upon their parents. While the topic of transition to adulthood for those with autism is a vast one, implicating the need for wide scale policy change, certain themes emerge in these personal narratives that we wish to focus on here, which may well serve as a guide for that change.The Advocate MotherThe Advocate Mother is a common theme in many narratives of autism and the ones presented here are not different. In fact, nearly all of the narratives presented are written by mothers. Mothers in these narratives exemplify sacrifice, dashed hopes, and even heartbreak. Although there is steely determination in many of these narratives, there is also [End Page 207] self–doubt, anxiety and guilt. As Laura Shumaker recounts the story of taking her adult son to Washington, DC, she experiences great anxiety when her son is mocked. She speaks of “the heavy feeling in [her] chest that mothers get when people laugh at their children.”The advocate mother can easily become the overly consumed mother. Take, for example, the powerful narrative of Nancy Coughlin. She confesses that her daughter’s autism took over her life and the life of her family: “my own mental health was disintegrating, as was my marriage, and in our family’s last–ditch effort to ease the burden we bought a second home; a cheap little place just a few blocks down the road from where we lived. We called it our ‘respite house’.”Others confess that raising a child with autism becomes a “full time job.” (Van der Poel). And the demands of this job do not diminish simply because the child reaches adulthood; it may, in fact, become not only a personal job for some parents but their vocation as well. For instance, Anonymous Four states, “I felt so strongly that parents and young adults needed to know about CIP [College Internship Program], that I applied for a part time job there where I could utilize my background in marketing to help parents like me find the services their son or daughter may desperately need.”While the inability to express appropriate emotions is a hallmark feature of autism, it seems that mothers in particular compensate by... (shrink)

With the many changes occurring in today's healthcare organizations, patients are increasingly equipped with a vast quantity of health care data and being more included in the healthcare decision-making process. The new approach we propose incorporates a new patient-organization framework that examines relevant historical, legal and ethical elements within the doctrine of informed consent in addition to examining the role of new healthcare organizations' obligations to include data to support addressing issues such as population health, health outcomes and health disparities (...) within the informed consent. There is a growing consensus among healthcare professionals that using an evidencebased organizational informed consent framework to improve the informed consent process can lead to better comprehension, health outcomes, transparency and improved patient trust and retention overall. (shrink)

Public intellectuals have long played a role in American culture, filling the gap between the academic elite and the educated public. According to some commentators, the role of the public intellectual has undergone a steady decline for the past several decades, being replaced by the academic expert. The most notable cause of this decline has been both the growth of the academy in the twentieth century,which has served to concentrate intellectual activity within its confines, and the changing nature of the (...) media, which has framed the way in which information is conveyed to the public. We argue that although bioethics has developed primarily within the academic tradition and utilized the role of expert when dealing with the public, bioethicists are well suited to don the mantle of the public intellectual. Indeed, because they address issues in medicine and science of great relevance for the general public, bioethicists have a duty to revitalize the tradition of public intellectuals as a necessary complement to the important, but narrower role of expert. (shrink)

The triumvirate of HIV/AIDS, tuberculosis, and malaria have dominated our public health focus in the developing world. Having claimed millions of lives, these infectious diseases have prompted a large-scale response. Concomitant with these efforts has been a burgeoning bioethics literature examining global health and distributive justice. A scholarly waste-land only a decade ago, there is now a growing and rich literature that aims to unpack our moral obligations when it comes to diseases that affect the majority of the world (many (...) living in absolute poverty). Now, added to the persistent challenges posed by infectious diseases is the growing burden of diseases such as cancer, which disproportionately affect .. (shrink)

The American Society for Bioethics and Humanities has created a quality attestation process for clinical ethics consultants; the pilot phase of reviewing portfolios has begun. One aspect of the QA process which is particularly challenging is assessing the interpersonal skills of individual clinical ethics consultants. We propose that using case simulation to evaluate clinical ethics consultants is an approach that can meet this need provided clear standards for assessment are identified. To this end, we developed the Assessing Clinical Ethics Skills (...) tool, which identifies and specifies specific behaviors that a clinical ethics consultant should demonstrate in an ethics case simulation. The aim is for the clinical ethics consultant or student to use a videotaped case simulation, along with the ACES tool scored by a trained rater, to demonstrate their competence as part of their QA portfolio. The development and piloting of the tool is described. (shrink)

As the field of clinical ethics consultation sets standards and moves forward with the Quality Attestation process, questions should be raised about what ethical issues really do arise in practice. There is limited data on the type and number of ethics consultations conducted across different settings. At Loyola University Medical Center, we conducted a retrospective review of our ethics consultations from 2008 through 2013. One hundred fifty-six cases met the eligibility criteria. We analyzed demographic data on these patients and conducted (...) a content analysis of the ethics consultation write-ups coding both the frequency of ethical issues and most significant, or key, ethical issue per case. Patients for whom ethics consultation was requested were typically male, white, between 50 and 69 years old, of non-Hispanic origin, and of Roman Catholic faith. Nearly half were in the intensive care unit and 44.2 % died in the hospital. The most frequent broad ethical categories were decision-making, goals of care/treatment, and end-of-life. More specifically, capacity, patient’s wishes/autonomy, and surrogate decision maker were the most frequent particular ethical issues. The most common key ethical issues were withdrawing/withholding treatment, patient wishes/autonomy, and capacity. Our findings provide additional data to inform the training of clinical ethics consultants regarding the ethical issues that arise in practice. A wider research agenda should be formed to collect and compare data across institutions to improve education and training in our field. (shrink)

Oral health is a critical part of overall health. The current COVID-19 pandemic has highlighted the importance of oral health. In this article, we describe how dental practice has been impacted by COVID-19, identify the public health response to COVID-19, and explain the gradual resumption of dental care after the initial disruption due to the pandemic. Finally, we discuss how long-standing health disparities in oral health have been exacerbated by the current pandemic.

Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching (...) and evaluating a videotaped CEC performance. We report how we set a criterion cut score (i.e., minimally acceptable score) for judging the ability of users of the ACES tool to evaluate simulated CEC performances.Methods: A modified Angoff standard-setting procedure was used to establish the cut score for an end-of-life case included on the ACES training website. The standard-setting committee viewed the Futility Case and estimated the probability that a minimally competent CEC would correctly answer each item on the ACES tool. The committee further adjusted these estimates by reviewing data from 31 pilot users of the Futility Case before determining the cut score.Results: Averaging over all 31 items, the proposed proportion correct score for minimal competency was 80%, corresponding to a cut score that is between 24 and 25 points out of 31 possible points. The standard-setting committee subsequently set the minimal competency cut score to 24 points.Conclusions: The cut score for the ACES tool identifies the number of correct responses a user of the ACES tool training website must attain to “pass” and reach minimal competency in recognizing competent and incompetent skills of the CECs in the simulated ethics consultation videos. The application of the cut score to live training of CECs and other areas of practice requires further investigation. (shrink)

Federal regulations require that the level of risk posed by pediatric research be classified as “minimal,” “greater than minimal,” or “a minor increase over minimal.” Interpretation of the meaning of the levels has produced a significant literature exploring the ethical basis for making these determinations. This article examines the ethical basis of a variety of approaches proposed in the literature for classifying pediatric research risk. These approaches strive to take into account how society decides which risks are routinely accepted for (...) children outside of research. It is concluded that ways of classifying risk should compare research risks to normal risks for children without special disability and take into account the concerns of the research subject’s community. (shrink)

Based on a general review of international, representative tissue banking policies that were described in the medical, ethics, and legal literature, this paper reviews the range of standards, both conceptually and in existing regulations, relevant to four main factors:(1) commercialization, (2) confidentiality, (3) informed consent, and (4) quality of research. These four factors were selected as reflective of some of the major ethical considerations that arise in the conduct of tissue banking research. The authors emphasize that any policy or ethical (...) guidelines designed to regulate tissue bank research should address all four factors. Whenever this sort of research is conducted between several institutions or several countries, the paper suggests that the relevant entities work collaboratively to harmonize their standards. (shrink)

In light of this empirical study of who bioethicists are and what their values are and then answering the question “What is the future of bioethics?,” we think it’s important to place this question...

_Telling Stories to Change the World_ is a powerful collection of essays about community-based and interest-based projects where storytelling is used as a strategy for speaking out for justice. Contributors from locations across the globe—including Uganda, Darfur, China, Afghanistan, South Africa, New Orleans, and Chicago—describe grassroots projects in which communities use narrative as a way of exploring what a more just society might look like and what civic engagement means. These compelling accounts of resistance, hope, and vision showcase the power (...) of the storytelling form to generate critique and collective action. Together, these projects demonstrate the contemporary power of stories to stimulate engagement, active citizenship, the pride of identity, and the humility of human connectedness. (shrink)

Ethical attitudes and behaviour are complex. This complexity extends to the influencers operating at different levels both outside and within the organisation, and in different combinations for different individuals. There is hence a growing need to understand the proximal and distal influencers of ethical attitudes, and how these operate in concert at the individual, organisational, and societal levels. Few studies have attempted to combine these main research streams and systematically examine their combined impact. The minority of studies that have taken (...) a combined approach have often done so using conventional statistical and analytical techniques which imply linearity between variables—a situation that rarely exists in business settings and is likely to lead to simplistic or even erroneous conclusions. Applying a fuzzy-set qualitative comparative analysis approach, this paper reports on the mutual and simultaneous influence of individual demographic factors, as well as proximal and distal factors stemming from within and outside the work environment to understand individuals’ ethical views within the workplace. The multiple configurations that emerged reveal the complex nature of influencers of ethical attitudes, and reinforce the view that “one size does not fit all”. We discuss these implications together with managerial recommendations and future research directions. (shrink)

This paper explores the psychological foundations of the 'Willingness to Pay/Willingness to Accept' discrepancy. Using a qualitative approach we find that the two response modes appear to invoke different strategies for completion. An examination of the heuristics used by respondents to answer questions concerning the buying and selling of the chance to play a straightforward lottery shows that only some could be taken as supporting current theories which aim to explain the discrepancy.

Svoeobrazie nravstvennykh vozreniĭ K.N. Leontʹeva. Istoki ėticheskikh vzgli︠a︡dov K.N. Leontʹeva ; Fenomen "ėsteticheskogo amoralizma" -- Fenomen ėskhatologicheskoĭ ėtiki. Vizantizm kak nravstvennyĭ ideal ; Pravovoĭ ideal K.N. Leontʹeva v kontekste ėskhatologicheskoĭ ėtiki.

ABSTRACT This study examined how lifestyle factors and gender affect kidney allocation to transplant patients by 99 British and Singaporean participants. Thirty hypothetical patients were generated from a combination of six factors and randomly paired four times. Participants saw 60 patient pairings and, in each pair, chose which patient would receive treatment priority. A Bradley-Terry model was used to derive coefficients for each factor per participant. A mean factor score was then calculated across all participants for each factor. Participants gave (...) lower priority to patients who drank more, were overweight, smoked more and exercised less. A patient’s diet and gender had no significant effect on allocation. There were no significant cross-cultural differences. There were moderate correlations between participants’ self-reported pre- and post-experiment ordering of decision criteria, and these measures and factor coefficients, suggesting a modest level of decision-making consistency. Between participants, moderate levels of concordance with respect to factor importance were observed for self-reported orderings of factors, and weaker agreement for model-derived coefficients. Very similar results were obtained for both British and Singaporean participants, and the implications of the findings are discussed. (shrink)

This essay some first steps toward the naturalization of what I call rational intentionality or alternatively type II intentionality. By rational or type II intentionality, I mean that full combination of rational powers and content-bearing states that is paradigmatically enjoyed by mature intact human beings. The problem I set myself is to determine the extent to which the only currently extant approach to the naturalization of the intentional that has the singular virtue of not being a non-starter can be aggregated (...) up into an account of rational intentionality. I have in mind a broadly defined family of accounts whose main members are the indicator/information-theoretic approach of Dretske (1988), the asymmetric dependence theory of Jerry Fodor (1987, 1990, 1994) and the teleo-semantics of Ruth Millikan (1984, 1993). Somewhat inaccurately, I will call this family of approaches the information-theoretic family. To be sure, there is only a rough family resemblance among the members of the information-theoretic family. Indeed, several intense quarrels divide the members of that family one from another, but the precise outcome of those internecine struggles is not directly relevant to the aims of this essay. ² Taken collectively, the information-theoretic family yields a compelling picture of the place of at least a crude form of intentionality -- what I call frog-like or type I intentionality -- in the natural order. Though frog-like or type I intentionality is, I think, a genuine species of intentionality, it may subsist in the absence of rational powers. It is that species of intentionality enjoyed by irritable creatures who, following Brandom (1994). (shrink)