Quality of service is a major determinant of customer commitment to the organization. Therefore, it is important to understand the importance of service quality for the corporate image as well. In this study, the predicting roles of quality of service and customer experience have been unveiled in customer commitment through the mediating effect of corporate image. The population frame used in this study is the customers of logistic services providers in China. Total data from the 366 customers have been used (...) to analyze the hypotheses formulated. The sample has been selected using convenience sampling and the software used for data analysis is Smart-PLS. The analytical technique used is partial least square structural equation modeling. Results of the study show that service quality and customer experience have a significant role in the customer commitment to the suppliers. In addition, it has also been found that service quality and customer experience have a major contribution to building the corporate image of the services suppliers. Further, corporate image played a significant mediating role in the relationship between service quality and customer commitment. The study has theoretically contributed to the body of literature by finding the importance of service quality for predicting customer commitment to the suppliers. (shrink)

This article uses a research method that combines theoretical research and empirical analysis. It first introduces the relevant theories of energy service city distribution sites in the context of e-commerce and then the types of energy service city distribution sites and the composition of energy service city distribution systems. The network layout of the service city distribution site and the location objectives, principles, and processes of the model is studied to determine the network layout plan of the energy service city (...) distribution system in this paper. This paper fully considers the characteristics of the network operation mode of the energy service city distribution site and establishes an optimization model for the location selection and vehicle routing of the distribution center with the lowest total system cost under the simultaneous delivery service mode; based on the hierarchical solution strategy, a combination of deep learning is designed. Algorithms mainly include two-stage hybrid heuristic algorithm of cluster analysis, maximum coverage and genetic algorithm; simulation analysis is conducted to verify the effectiveness of the model and algorithm by data simulation, finally get the integrated optimization plan of distribution center location and routing, and put forward the operation strategy through the result expansion analysis. This paper studies the planning model based on the network layout planning of the energy service city distribution system under the e-commerce environment, aiming to promote the breakthrough development of urban smart logistics and prove the importance of the energy service city distribution station network layout planning. The purpose and results of the research are to reduce traffic and environmental pressures, achieve joint direct distribution, improve the efficiency of urban logistics and distribution, and solve the problem of the last mile of the city. (shrink)

Purpose The debate about the end-of-life care decision is becoming a serious ethical and legal concern in the Far-Eastern countries of Korea, China and Japan. However, the issues regarding end-of-life care will reflect the cultural background, current medical practices and socioeconomic conditions of the countries, which are different from Western countries and between each other. Understanding the genuine thoughts of patients who are critically ill is the first step in confronting the issues, and a comparative descriptive study of these perspectives (...) was conducted by collaboration between researchers in all three countries. Methods Surveys using self-reporting paper questionnaire forms were conducted from December 2008 to April 2009 in Korea (six hospitals in two regions), China (five hospitals in four regions) and Japan (nine hospitals in one region). The subjects were patients who were critically ill who had been diagnosed as having cancer. A total of 235 participants (Korea, 91; China, 62; Japan, 52) were eventually recruited and statistically analysed. Results Most respondents had sometimes or often thought of their own death, mostly fear of ‘separation from loved ones’. They wanted to hear the news regarding their own condition directly and frankly from the physician. A quarter of them preferred making end-of-life care decisions by themselves, while many respondents favoured a ‘joint decision’ with their family members. The most favoured proxy decision maker was the spouse, followed by the children. Most admitted the necessity of ‘advance directives’ and agreed with artificial ventilation withdrawal in irreversible conditions. The most common reason was ‘artificial prolongation of life is unnecessary’. Most respondents agreed with the concept of active euthanasia; however, significant differences were sometimes observed in the responses according to variables such as patient's country of origin, age, gender and education level. Conclusion Patients in Far-Eastern countries gave various responses regarding end-of-life care decisions. Although familial input is still influential, most patients think of themselves as the major decision maker and accept the necessity of advance directives with Westernization of the society. Artificial ventilation withdrawal and even active euthanasia may be acceptable to them. (shrink)

This paper summarizes the evolution of analytic philosophy in Taiwan, examines its impact within and beyond academia, and discusses the future of the discipline. The roots of modern philosophy in Taiwan can be traced back to the Japanese colonial era, and analytic philosophy was introduced to the country in the late 1940s when many intellectuals in China moved to Taiwan. However, massive curbs were imposed on philosophy during Chiang Kai-shek’s dictatorship, and the discipline began to thrive again only after Taiwan’s (...) democratization in the late 1980s. Nonetheless, since its introduction in the colonial era, modern philosophy has made significant contributions in Taiwan, encouraging interdisciplinary engagements, advancing civic education, and promoting the spirit of democracy and political liberation. Philosophy has played a key role in Taiwan’s remarkable transformation from an island colonized for hundreds of years to a country that recognizes democracy, freedom, and human rights. The themes of anti-colonialism and anti-domination seen in the works of modern Taiwanese philosophers not only reflect the discipline’s political and historical underpinnings but also signal how Taiwanese philosophy can acquire a distinct identity despite being influenced by many other philosophical traditions. While still at a nascent stage, Taiwanese philosophy has the potential to join forces with other philosophical traditions in advancing the vision of decolonizing philosophy. (shrink)

Medical missionaries made a breakthrough in Korean history in healing and caring for many Hansen and tuberculosis patients. There was a missionary who had no less good influence than medical missionaries at this time. The person is missionary Sarah Barry, who inspired and developed one of the most influential student movements in South Korea. The aim of the present study is to examine life of Sarah Barry and her ministry, focusing upon her positive influences on Korean intellectuals. The relevance of (...) the study is conditioned by the fact that there is no professional academic research on her ministry except for one short paper, which discusses the importance of her role in formulating campus evangelism. In order to achieve the aim of the study, the method of analysis and synthesis of biographical and historical data was used. As a result of the study, Sarah Barry’s biography was researched and systematized. It gave ground to a conclusion that her role in South Korea’s gradual resurgence after the Civil War was seminal. (shrink)

This paper investigates whether the pattern of firms’ corporate social responsibility activities affects firm value. If firms do permanently CSR activities for strategic purposes, firms’ value is more likely to increase. Using firms known to do CSR in Korea, we examine the valuation effect by adopting an earnings response coefficient model and document firms with permanent CSR activities, which show higher ERCs than other firms regardless of the level of CSR activities. This result partly explains the inconsistency among the results (...) of previous studies by showing the differential implication for firm value depending on the CSR activity pattern. Also, the results of our paper imply that investors need to consider the pattern of firms’ CSR activities in their economic decision making. (shrink)

This paper reports on the long-term effectiveness of a non-formal co-curricular educational program based on a campus ecogarden at a Hong Kong university in developing pro-sustainability awareness, attitudes and behavior among undergraduate students. This service-based, nature-based experiential learning program, termed the Ecogarden Farmer and Biodiversity Surveyor, has been running at the university since 2015. The program is divided into two consecutive phases: a training phase comprising various learning activities and a successive internship phase consisting of the all-round practical tasks involved (...) in managing the garden. A retrospective evaluation of the program using phenomenographic approach and content analysis was adopted to reveal the diversity of students’ learning experience, as the indicators of the success of the program. Of 112 participants from 4 cohorts, 32 completed online questionnaires, and semi-structured interviews were successfully conducted with twelve participants, three from each of the four cohorts. The results indicated that the program’s outcomes could be categorized into five themes. Most outcomes fit into the theme ‘an increase in knowledge and skill level,’ followed by ‘rise in environmental awareness,’‘facilitation of personal growth,’ and ‘enhancement of career development.’ Many structural experiences revealed may suggest the success of the program. The longer the participants had participated in the program, the more in-depth and diversified reflection of the senior participants relating to personal development were mentioned. This study provides critical insights into the validity of retrospective program evaluation for assessing the long-term impact of EfS programs by introducing a cross-sectional study of different cohorts as a serial time-point sampling strategy. (shrink)

v. 1. Chugŭl ttae kkaji i kŏrŭm ŭro -- v. 2. kyŏul i manil ondamyŏn -- v. 3. pabosae ŭi norae.

이 글은 조선후기 기호성리학파의 「역학계몽」연구가 어떠한 특징을 지니는가를 고찰한 것이다. 자료의 측면에서 기호성리학파의 「역학계몽」연구는 대체로 한원진을 중심으로 그의 동료, 문인들에 의해 연구되었음을 볼 수 있다. 또한 퇴계학파의 「역학계몽」연구가 이황 「계몽전의」이후, 16세기말로부터 19세기에 이르기까지 지속적으로 이어진데 비하여, 기호성리학파의 「역학계몽」연구는 18세기에 집중적으로 논의되고, 그 이전과 이후에는 비중있는 연구저작들이 거의 발견되지 않는다. 기호성리학파의 「역학계몽」연구의 특징을 고찰하기 위해 본고에서 채택한 주제는 3가지로, 그들의 태극론, 하도와 8괘형성에 관한 이론, 「본도서」의 이른바 ‘오위상득설’이 그것이다. 태극론의 경우 기호성리학파는 「역학계몽」의 상수적 태극을 이기지묘의 이기론과 인기질의 인성론을 바탕으로 해명하는 독특성을 (...) 보여준다. 하도와 8괘형성에 관한 이론에 있어서는 기호성리학파내부에서도 논의가 분분하여 명쾌하게 일치하지 않는다. 결국 그들은 종래 주희와 호방평이 하도와 복희팔괘횡도, 복희팔괘원도를 종합하여 하나의 원리로 설명하려던 시도를 유보한다. 한원진은 하도와 원도의 관계를 중심으로 양자의 관계를 보다 명쾌하게 설명해내는 방식을 취하고, 이는 그의 동료문인들에게 지지를 받는다. 이러한 과정은 전통적 진리체계의 보편성에 대한 의식의 균열을 내포하며, 이러한 기류는 홍대용과 같은 기호실학자들에 의해 전통과학과 진리체계가 부정되면서, 19세기 「역학계몽」연구가 지속되지 못하는 한 원인이 되었다는 것이 필자의 가설이다. (shrink)

1. An Tŏng-mun ŭi hangmun chŏngsin kwa ch'ŏse pangsik -- 2. An Tŏng-mun ŭi Samsan Sŏwŏn wisang chŏngnip kwa kŭ ŭimi -- 3. Ha Ik-pŏm ŭi sam kwa munhak -- 4. Pak Ch'i-bok ŭi Nammyŏnghak kyesŭng yangsang -- 5. Kang Pyŏng-ju ŭi hangmun kwa munhak -- 6. Chŏng Chae-gyu ŭi hangmun chŏngsin kwa 'Taehak' haesŏk -- 7. Kim Chin-ho ŭi haksŏl e taehayŏ -- 8. Kwak Chong-sŏk ŭi Myŏngdŏksŏl nonjaeng -- 9. Kim Hwang ŭi Kyŏnghak Sipto e taehayŏ.

日本人はグローバル化の潮流といかに向き合うべきなのか―そのヒントは「国学」にあった。先人たちが葛藤した問いのなかを私たちはいまも生きている。.

Ki Jeong-jin is the one of the most famous Neo-Confucian theorists of the late Joseon Dynasty, and he is well known as a proposer of the theory of statements that there is only one Principle although the phenomena vary. He particularly emphasizes the role and authority of Principle. His arguments related to the theory were mainly raised in the work of Napryangsaeui. He, in this work, explicitly reveals the intention to resolve the issues of the nature of humans and things (...) in the Ho-hak debate. But he has never directly participated in the debate. Instead, after his death, some debates over Napryangsaeui arose between his students and Jeon Woo. This paper aims to analyze Ki Jeong-jin’s theory by comparison with the view of Han Wonjin who represents the theory of nature of humans and things in the Ho-hak school, and with the issues of debate between Ki Jeong-jin’s students and Jeon Woo. Particularly, we focused on the matter of relation between ‘completeness and incompleteness’ and ‘original nature’. Through this analysis, we could expand the understanding of the aspects discussed in the theory on the similarities and differences in nature of humans and things, and the significance of Ki Jeong-jin’s theory. Furthermore, in the history of Neo-Confucianism in the Joseon Dynasty, we could shed light on the reconstruction process of the philosophical statements that there is only one Principle but the phenomena vary. (shrink)

1. Katachi no odissei -- 2. Rinshō no chi -- 3. Aku no tetsugaku nōto 4. Zōho 21-seiki mondaigun ; Jutsugoshū II -- 5. Shūkyō to kagaku; Jinruichi shō -- 6. Shinpen Nihon bunka ni okeru aku to tsumi ; Shōnenba -- 7. Jutsugoteki sekai to seido -- 8. Seishin no fūga -- 9. Shinpen Pasukaru to sono jidai -- 10. Shinpen kindai Nihon ni okeru seido to shisō.

In lieu of an abstract, here is a brief excerpt of the content:THE INCARNATION: MUSLIM OBJECTIONS AND THE CHRISTIAN RESPONSE ROBERT L. FASTIGGI St. Edward's University Austin, Texas Introduction: Christian-Muslim Dialogue and the Incarnation THE TWO largest religions in the world, Christianity and Islam cannot help but encounter each other. In the last two decades, several important steps have been made by Catholics, Protestants and Orthodox Christians to engage in meaningful dialogue with members of the Islamic faith.1 While sincerity, mutual (...) respect and good will are all in evidence in these efforts to dialogue, it also is clear that an authentic theological discussion between Christians and Muslims cannot help but arouse a certain degree of tension over the Christian doctrine of the Incarnation. In my own experience in dialogue with Muslims,2 there seems to emerge a point in which discussion of Jesus the prophet vs. Jesus the Incarnate Word of God will inevitably take place. Such discussions can prove to be stimulating and educational. However, they tend to go best when there is an honest and open acknowledgement of the differences that exist between 1 A good summary of Catholic and Protestant efforts can be found in John Renard, " Christian-Muslim Dialogue: A Review of Six Post-Vatican II, Church-Related Documents," Journal of Ecunmenical Studies 23 :1, Winter, 1986: 69-89. On the Orthodox Christian dialogue with Muslims, see Orthodox Christians and Muslims, ed. N. M. Vaporis (Brookline, Mass.: Holy Cross Orthodox Press, 1986). 2 I have visited Saudi Arabia and Bahrain as a Joseph J. Malone Fellow with the National Council of U.S.-Arab Relations, and I was a member of the Christian-Muslim Dialogue Commission of the Austin Metropolitan Ministries in Austin, Texas. 457 458 ROBERT L. FASTIGGI the two traditions. As Georges Anawati, a Catholic Islamicist; notes : " As a starting point, dialogue requires respect for the identity of the other. It does not ignore obvious differences... for to do so would be of no use for ·either friendship or truth." 3 A Muslim scholar, Professor Mohammed Taibi of the University of Tunis, likewise remarks that " the more one is firm about the classical aspects of divergence, the better the contacts between Christians and Muslims." 4 At issue in the Christian-Muslim discussion of the Incarnation is the unique character of each faith. In Islam, there is the absolute affirmation of divine unity (tawhid) which necessarily condemns any attempt to associate something other than God with God (shirk). Christianity, though, has as one of its central tenets the affirmation that the uncreated Word of God (ho logos) became flesh (sarx) in Jesus (John 1 :14). Islam, therefore, presents a unique challenge to the Christian theologian. Is it possible to formulate a Christology which can affirm the Islamic principle of tawhid and evade the accusation of shirk without compromising the core of the Christian message? This is the question this article hopes to address. One suggestion for Christians in dialogue with Muslims is given by Hans Kiing in his book Christianity and the World Religions.5 Kiing believes that Christians would do best to go back to the mindset of the original Jewish Christians who possessed an understanding of Jesus which is much more compatible with the Qur'anic view of Jesus as the "servant of God." 6 While Kiing's suggestion is helpful for Christians who are looking for an analogy to the Islamic view of Jesus, I find it problematical for several reasons. Kiing seems to suggest that the Jesus of history (as s Georges Anawati, 0.P., "An Assessment of the Christian-Islamic Dialogue," in The Vatican, Islam and the Middle East, ed. Kail Ellis, O.S.A. (Syracuse, N.Y.: Syracuse University Press, 1987), p. 59. 4 Ibid., p. 65. 5 Hans Kung, Christi"anity and the World Religions: Paths of Dialogue with Islam, Hinduism, and Buddhism, trans. Peter Heinegg (New York: Doubleday, 1986), pp. 109-130. a Ibid., p. 122. MUSLIM OBJECTIONS & CHRISTIAN RESPONSE 459 well as the Jesus of the New Testament) is quite separate from the Christ of the ecumenical councils. Such an assertion, though, does not find support from many Christian theologians and biblical scholars (not to mention church authorities).1 Moreover, Kiing appears to have an... (shrink)

Since male CEOs dominate corporate leadership, the literature on top management decision making suffers from an implicit masculine bias. Although research indicates that males and females are biologically and psychologically different, the leadership characteristics of female CEOs are largely unexplored. Two of these characteristics, risk aversion and ethical sensitivity, are tied to key accounting issues, such as conservatism in financial reporting and steadfast opposition to fraud. In this study, we examine the relationship between CEO gender and accounting conservatism, and find (...) a positive association between the two. Consistent with conventional wisdom, this association appears to be stronger in firms with high rather than low litigation and takeover risks. This study contributes to the ethics literature by highlighting the benefits of gender diversity in upholding the integrity of financial reporting. (shrink)

The great academic disputation of Ho-rak had been made for about 200 years since it began in 1709. An argument that the human nature and the nature of things are same or different was one of the main subjects for the great academic disputation. Gan Lee (李柬, 1677-1727) and Wonjin Han (韓元震, 1682-1751) were leading discussants of the argument. After Lee and Han, Neo-Confucian scholars in Joseon dynasty attempted comprehensively to synthesize their two views. But such Scholars as Seong-ju Lim (...) (任聖周, 1711-1788) and Jeongjin Ki (奇正鎭, 1798-1879) criticized a reformulation of One Principle and Many Differentiations. Lim argued that there was not only One Principle but also one vital breath as well as Many Differentiations of vital breath as well as One Principle. His idea of One Principle is relevant for a similarity between the natures of humans and things, and his idea of Many Differentiations is relevant for a difference between the natures of humans and things. Lim grasped that all the natures of things had two aspects of similarity and difference. But Gi criticized that their discussants were too narrowly specific in arguing this issue. He argued that One principle and Many Differences entailed each other. Like Lim's idea, his idea confirmed the sides of both, too. The nature of original substance is equivalent to the nature of existence. It seems to me that such a fruitful result of Korean philosophy, which an argument between the natures of humans and things had been distinctly made, for the future, will be an area of being made a deeper exploration from various aspects. (shrink)

In recent years, the issue of corporate social responsibility has become particularly relevant. Accelerating technological advances and increasing consumption are increasingly causing negative impacts on the environment and society that is why the organizations’ social responsibility is becoming more and more relevant every year. The experience of foreign countries shows that social responsibility is useful not only for business but also for its environment, determines the increasing number of socially responsible organizations in Lithuania and a more favorable attitude of consumers (...) towards the activities of organizations [36]. According to Mauriciene and Pauzuoliene, the priority of socially responsible organizations is the expectations and needs of consumers. Socially responsible organizations emphasize in their activity reports the importance of socially responsible activities to the organization, its employees, society and consumers. Consumers are more likely to appreciate such an organization, prefer to choose its products, encourage others to do the same, and believe more in what it does. Analysis of the literature. The issues of corporate social responsibility are investigated by both Lithuanian and foreign scientists and others). It is noticed that foreign scientists Henderson, 2007; Rodriguez, Cruz, 2007; Grosbois, 2012; Dolores, Vargas-Sanchez, 2014; Joon-Ho, Bong-Ihn, Ki-Tai, Jong-Pil, 2017, Ponnapureddy et al. Robin et al, Mensah, Lee and Heo et al sufficiently widely analyze hotel social responsibility. The aim of the work is to investigate the social responsibility of the organization from the point of view of consumers. The objectives raised in the work: To discuss the concept of corporate social responsibility and the peculiarities of implementing in the activities; To describe the models of corporate social responsibility; To assess the social responsibility of accommodation providers in terms of consumers. The following research methods were used to achieve the aim and objectives: analysis of scientific literature, questionnaire survey and statistical analysis of the obtained data. The result of the study. Taking into account the social responsibility of accommodation companies from the point of view of consumers, as an interested party and one of the most important market participants, according to the ethical, legal and economic responsibility components it is stated that the social responsibility of accommodation companies is of medium level and should be improved according to all criteria. (shrink)

This article offers a critical interpretation of Artificial Intelligence (AI) as a philosophical notion which exemplifies a secular conception of thinking. One way in which AI notably differs from the conventional understanding of “thinking” is that, according to AI, “intelligence” or “thinking” does not necessarily require “life” as a precondition: that it is possible to have “thinking without life.” Building on Charles Taylor’s critical account of secularity as well as Hubert Dreyfus’ influential critique of AI, this article offers a theological (...) analysis of AI’s “lifeless” picture of thinking in relation to the Augustinian conception of God as “Life itself.” Following this critical theological analysis, this article argues that AI’s notion of thinking promotes a societal privilege of certain rationalistic or calculative ways of thought over more existential or spiritual ways of thinking, and thereby fosters a secularization or de-spiritualization of thinking as an ethical human practice. (shrink)

OpenAI’s Chat Generative Pre-training Transformer (ChatGPT), Google’s Bard and other generative artificial intelligence (GenAI) technologies can greatly enhance the capability of healthcare profess...

This article examines some of the recent theological critiques of the movement of technological human enhancement known as ‘transhumanism’. Drawing on the comparisons between grace and technology often found in the theological discourse on transhumanism, this article argues that the Thomistic distinction between healing grace and elevating grace can not only supplement the theological analysis of transhumanism and its ethical implications, but also help Christian theologians and ethicists become more aware of how the phenomenon of technology may have implicitly shaped (...) the contemporary understanding of ‘grace’ as well as the task of theology as a spiritual and indeed ethical practice. (shrink)

While the domestic effect of structural racism and other social vulnerabilities on Covid‐19 mortality in the United States has received some attention, there has been much less discussion (with some notable exceptions) of how structural global inequalities will further exacerbate Covid‐related health disparity across the world. This may be partially due to the delayed availability of accurate and comparable data from overwhelmed systems, particularly in low‐ and middle‐income countries. However, early methods to procure and develop treatments and vaccines by some (...) high‐income countries reflect ongoing protectionist and nationalistic attitudes that can systemically exclude access for people in regions with weaker health systems. What's needed is a global coordinated effort, based on the principle of solidarity, to foster equitable health care access. (shrink)

I present and evaluate the prospects of the biosemantic program, understood as a philosophical attempt to explain the mind’s origins by appealing to something that non-minded organisms and minded organisms have in common: representational capacity. I develop an analogy with ancient attempts to account for the origins of change, clarify the biosemantic program’s aims and methods, and then distinguish two importantly different forms of objection, a priori and a posteriori. I defend the biosemantic program from a priori objections on the (...) grounds that the standard of explanation presupposed by them is inappropriate and leads to absurdities if consistently applied. Once the way is cleared of a priori objections, the success of biosemantics turns on the strength of a posteriori objections, that is, on the program’s empirical adequacy. Here, its prospects are less clear, but I offer reasons, by analogy with chemical combination and other everyday phenomena, to think that minded beings and their representational capacities might well have their origin and explanation in non-minded beings. An evolutionary origin and explanation of mind is plausible, at least as far as naturalistic accounts and explanations go. (shrink)

In this paper, I offer a novel solution to the well-known problem concerning two polarity items in Korean, amu-(N)-to and amu-(N)-rato, that show a complementary distribution within the set of typical NPI-licensing contexts. I present a uniform analysis of the distribution of these NPIs, where the complementary distribution follows from the opposite scope properties of the emphatic particles to and rato contained in the NPIs in question. As the- oretical background, I adopt Karttunen and Peters’s (1979, Syntax and Semantics 11: (...) Presuppositions (pp. 1–56). New York: Academic Press) and Wilkinson’s (1996, Natural Language Semantics, 4, 193–215) scope analysis of even, Lahiri’s (1998, Natural Language Semantics, 6, 57–127) analysis of Hindi NPIs, and Guerzoni’s (2002, Proceedings of NELS 32 (pp. 153–170); GLSA, University of Massachusetts, Amherst, Mass.; 2004, Natural Language Semantics, 12, 319–343) analysis of the negative bias of yes/no-questions containing minimizers. The current analysis also lends further support to Guerzoni’s approach in that it bears out the prediction that in certain environments, a yes/no-question can be positively biased, i.e., only the positive answer is allowed as a legitimate answer in the context; this prediction was left unconfirmed in Guerzoni’s work. (shrink)

In this issue of the Hastings Center Report, Joshua Rager and Peter Schwartz suggest using opioid treatment agreements as public health monitoring tools to inform patients about “the requirements entailed by undergoing opioid therapy,” rather than as contractual agreements to alter patients’ individual behavior or to benefit them directly. Because Rager and Schwartz's argument presents suspected OTA violations as a justification to stop providing opioids yet does not highlight the broader epistemic and systemic context within which clinicians prescribe these medications, (...) their proposal may perpetuate a climate of distrust and stigmatization without correcting systemic factors that may have placed patients and others at risk in the first place. Given the context of epistemic uncertainty regarding opioid safety and efficacy, insufficient training for opioid prescribers, and inadequate patient education, I propose replacing OTAs, which have a narrow focus on patient behaviors, with opioid treatment plans, which would promote mutual, collaborative, and shared decision-making on the most appropriate pain management program. An OTP can be ethically justified as a tool to prevent and treat iatrogenic addiction under a specific paradigm—one that adopts a default position of professional epistemic humility and holds all collaborative parties accountable in chronic pain management. (shrink)

Journal of Chinese Philosophy, EarlyView.