本书既深入浅出地阐释了中国古代儒释道三教的基本义理与思想,又史论结合地提示出其中所蕴涵的伦理价值取向与道德教化功能。.

This essay explores the differences and common position, mutual connections and influence between the theory of Buddhist nature as the central problem of Buddhism and the theory of human nature as the central problem of Confucian philosophy it holds that the largest difference between the two theories is that Buddhism emphasizes abstract noumenon, while Confucianism emphasizes man, human nature and ethical relations; and after entered into China, Buddhism has been influenced by Confucian theory of human nature, gradually gone on a (...) humanized and mindized road, and become a much more ethicalized religion. (shrink)

Online learning resources play an important role in teaching and learning in the process of online learning. Teachers will be satisfied with selectable and suitable online learning resources, which can promote their self-efficacy to facilitate online teaching and learning. This study proposed a model to examine the effects of the selectivity of online learning resources and the suitability of online learning resources on teachers’ online teaching satisfaction, and the mediating role of technology self-efficacy and online teaching self-efficacy between them. The (...) results indicated that SE-OLR and SU-OLR positively affected teachers’ online teaching satisfaction; TECHN-SE and OT-SE positively influenced teachers’ online teaching satisfaction, while TECHN-SE and OT-SE played mediating roles between SE-OLR and SU-OLR and teachers’ online teaching satisfaction. The findings have implications for the design and development of online learning resources to improve teachers’ satisfaction and facilitate students’ learning effectiveness and teachers’ online teaching. (shrink)

Morality, in the context of luxury counterfeit goods, has been widely discussed in existing literature as having a strong association with decreased purchase intention. However, drawing on moral disengagement theory, we argue that individuals are motivated to justify their immoral behaviors through guilt avoidance, thus increasing counterfeit purchase intention. This research demonstrates that consumers’ desire to purchase counterfeit luxuries hinges on two types of moral reasoning strategies: moral rationalization and moral decoupling. The empirical results show that each strategy increases purchase (...) intention, but respectively through moral judgment and perceived benefit. Implications for researchers and managers are discussed. (shrink)

Tainted political symbols ought to be confronted, removed, or at least recontextualized. Despite the best efforts to achieve this, however, official actions on tainted symbols often fail to take place. In such cases, I argue that political vandalism—the unauthorized defacement, destruction, or removal of political symbols—may be morally permissible or even obligatory. This is when, and insofar as, political vandalism serves as fitting counter-speech that undermines the authority of tainted symbols in ways that match their publicity, refuses to let them (...) speak in our name, and challenges the derogatory messages expressed through a mechanism I call derogatory pedestalling: the glorification or honoring of certain individuals or ideologies that can only make sense when members of a targeted group are taken to be inferior. (shrink)

Courage is a basic virtue to any heroic society. It is the defining virtue of the aristocratic warrior in the Iliad. It came with a set of other related virtues, all functioning in a social setting unique to that heroic era. However, as society evolved beyond the heroics of war to the civility of settled city–states, courage would be reviewed and redefined. In fact the whole virtue complex would undergo fundamental changes. Still later, when from out of the cities philosophers (...) rose, they would, in their commitment to a higher justice or righteousness than what the city had to offer to date, submit courage to a third critique and transformation. We see this in Greece; we may also see it in China. (shrink)

Many have argued that certain statues or monuments are objectionable, and thus ought to be removed. Even if their arguments are compelling, a major obstacle is the apparent historical value of those commemorations. Preservation in some form seems to be the best way to respect the value of commemorations as connections to the past or opportunities to learn important historical lessons. Against this, I argue that we have exaggerated the historical value of objectionable commemorations. Sometimes commemorations connect to biased or (...) distorted versions of history, if not mere myths. We can also learn historical lessons through what I call repudiatory honouring: the honouring of certain victims or resistors that can only make sense if the oppressor(s) or target(s) of resistance are deemed unjust, where no part of the original objectionable commemorations is preserved. This type of commemorative practice can even help to overcome some of the obstacles objectionable commemorations pose against properly connecting to the past. (shrink)

A prominent way of justifying civil disobedience is to postulate a pro tanto duty to obey the law and to argue that the considerations that ground this duty sometimes justify forms of civil disobedience. However, this view entails that certain kinds of uncivil disobedience are also justified. Thus, either a) civil disobedience is never justified or b) uncivil disobedience is sometimes justified. Since a) is implausible, we should accept b). I respond to the objection that this ignores the fact that (...) civil disobedience enjoys a special normative status on account of instantiating certain special features: nonviolence, publicity, the acceptance of legal consequences, and conscientiousness. I then show that my view is superior to two rivals: the view that we should expand the notion of civility and that civil disobedience, expansively construed, is uniquely appropriate; and the view that uncivil disobedience is justifiable in but only in unfavorable conditions. (shrink)

Social movements often impose nontrivial costs on others against their wills. Civil disobedience is no exception. How can social movements in general, and civil disobedience in particular, be justifiable despite this apparent wrong-making feature? We examine an intuitively plausible account—it is fair that everyone should bear the burdens of tackling injustice. We extend this fairness-based argument for civil disobedience to defend some acts of uncivil disobedience. Focusing on uncivil environmental activism—such as ecotage (sabotage with the aim of protecting the environment)—we (...) argue that some acts of uncivil disobedience can be morally superior to their civil counterparts, when and because such acts target people who are responsible for environmental threats. Indeed, insofar as some acts of uncivil disobedience can more accurately target responsible people, they can better satisfy the demands of fairness compared to their civil counterparts. In some circumstances, our argument may require activists to engage in uncivil disobedienceeven whencivil disobedience is available. (shrink)

Learning from Chinese Philosophies engages Confucian and Daoist philosophies in creative interplay, developing a theory of interdependent selfhood in the two philosophical traditions. Karyn Lai draws on the unique insights of the two philosophies to address contemporary debates on ethics, community and government. Issues discussed include questions on selfhood, attachment, moral development, government, culture and tradition, and feminist queries regarding biases and dualism in ethics. Throughout the book, Lai demonstrates that Chinese philosophies embody novel and insightful ideas for addressing contemporary (...) issues and problems. (shrink)

The Zhuangzi, a 4th century BCE Chinese text, is optimistic about life unrestrained by entrenched values. This paper contributes to existing debates on Zhuangzian freedom in three ways. First, it reflects on how it is possible to enjoy the freedom envisaged in the Zhuangzi. Many discussions welcome the Zhuangzi’s picture of release from life shaped by canonical visions, without also giving thought to life without these driving visions. Consider this scenario: in a world with limitless possibilities, would it not be (...) fraught, not knowing how to interpret situations? I suggest that freedom in the Zhuangzi is possible only if one succeeds in reorienting herself to the new ‘normal’. Second, I introduce and develop the idea of working with constraints. This focuses on an agent's maximizing the fit between relevant conditions, on the one hand, and their capabilities, on the other. Finally, I propose that self-directed practice, an important expression of agency, is required for building capabilities that enable such freedom. I examine the idea of risk involved in these firsthand experiences, articulating an account of agency that sits at the heart of hard-won Zhuangzian freedom. (shrink)

Does ‘remembering that p’ entail ‘knowing that p’? The widely-accepted epistemic theory of memory answers affirmatively. This paper purports to reveal the tension between ETM and the prevailing anti-luck epistemology. Central to my argument is the fact that we often ‘vaguely remember’ a fact, of which one plausible interpretation is that our true memory-based beliefs formed in this way could easily have been false. Drawing on prominent theories of misremembering in philosophy of psychology, I will construct cases where the subject (...) vaguely remembers that p while fails to meet the safety condition, which imply either that ETM is false or that safety is unnecessary for knowledge. The conclusion reached in this paper will be a conditional: if veritic epistemic luck is incompatible with knowledge, then ‘remembering that p’ does not entail ‘knowing that p’. (shrink)

While much has been said about what ought to be done about the statues and monuments of racist, colonial, and oppressive figures, a significantly undertheorised aspect of the debate is the aesthetics of commemorations. I believe that this philosophical oversight is rather unfortunate. I contend that taking the aesthetic value of commemorations seriously can help us a) better understand how and the extent to which objectionable commemorations are objectionable, b) properly formulate responses to aesthetic defences of objectionable commemorations, and c) (...) help us explore aesthetic solutions—for example, artistic interventions as counterspeech—to objectionable commemorations. Here, I propose that the aesthetic value of objectionable commemorations can amplify the force of the objectionable messages conveyed, and the moral disvalue of objectionable commemorations can hinder our appreciation of their aesthetic value. These two considerations shall help us answer the practical question of what to do about objectionable commemorations of apparently good aesthetic value. Both, I shall argue, give us further reason to remove, replace, recontextualise, or even vandalise objectionable commemorations. Sometimes we need to save the art from its own immorality to best respect its aesthetic value. (shrink)

The cicada catcher focuses as much on technique as he does on outcomes. In response to Confucius’ question, he articulates in detail the learning he has undertaken to develop techniques at each level of competence. This chapter explains the connection between the cicada catcher’s development of technique and his orientation toward outcomes. It uses details in this story to contribute to recent discussions in epistemology on the cultivation of technique.

Sit-ins, blockades, and lock-ons are common protest tactics. They work partly because continuing the operation or attempting quickly to remove activists risks injuring or killing them. Injuring or killing the activists is morally wrong, so the targets of the protest must (temporarily) yield to the activists. This appears to be a case of moral blackmail: The blackmailer makes it so that the blackmailed must either do what the blackmailer wants or do something morally wrong. Here, protestors appear to exploit the (...) targets’ tendency to be moral. Can such tactics be justified? I contend that they can insofar as such activists merely add further reason to what their targets already have decisive reason to do. The problem of moral blackmail, however, complicates the morality of primarily communicative civil disobedience. (shrink)

It is proposed here that the Confucian li, norms of appropriate behavior, be understood as part of the dynamic process of moral self-cultivation. Within this framework li are multidimensional, as they have different functions at different stages in the cultivation process. This novel interpretation refocuses the issue regarding the flexibility of li, a topic that is still being debated by scholars. The significance of this proposal is not restricted to a new understanding of li. Key features of the various stages (...) of moral development in Confucian thought are also articulated. This account presents the picture of a Confucian paradigmatic person as critically self-aware and ethically sensitive. (shrink)

This paper purports to disprove an orthodox view in contemporary epistemology that I call ‘the epistemic conception of memory’, which sees remembering as a kind of epistemic success, in particular, a kind of knowing. This conception is embodied in a cluster of platitudes in epistemology, including ‘remembering entails knowing’, ‘remembering is a way of knowing’, and ‘remembering is sufficiently analogous to knowing’. I will argue that this epistemic conception of memory, as a whole, should be rejected insofar as we take (...) into account some putative necessary conditions for knowledge. It will be illustrated that while many maintain that knowing must be (1) anti-luck and (2) an achievement, the two conditions do not apply to remembering. I will provide cases where the subject successfully remembers that p but lacks knowledge that p for failing to meet the two putative conditions for knowledge. Therefore, remembering is not a kind of knowing but a sui generis cognitive activity. (shrink)

Civil disobedience, despite its illegal nature, can sometimes be justified vis-à-vis the duty to obey the law, and, arguably, is thereby not liable to legal punishment. However, adhering to the demands of justice and refraining from punishing justified civil disobedience may lead to a highly problematic theoretical consequence: the debilitation of civil disobedience. This is because, according to the novel analysis I propose, civil disobedience primarily functions as a costly social signal. It is effective by being reliable, reliable by being (...) costly, and costly primarily by being punished. My analysis will highlight a distinctive feature of civil disobedience: civil disobedients leverage the punitive injustice they suffer to amplify their communicative force. This will lead to two paradoxical implications. First, the instability of the moral status of both civil disobedience and its punishment to the extent where the state may be left with no permissible course of action with regard to punishing civil disobedience. Second, by refraining from punishing justified civil disobedience, the state may render uncivil disobedience—illegal political activities that fall short of the standards of civil disobedience—potentially permissible. (shrink)

Mengzi maintained that both benevolence (ren 仁) and rightness (yi 義) are naturally-given in human nature. This view has occupied a dominant place in Confucian intellectual history. In Mencius 6A, Mengzi's interlocutor, Gaozi, contests this view, arguing that rightness is determined by (doing what is fitting, in line with) external circumstances. I discuss here some passages from the excavated Guodian texts, which lend weight to Gaozi's view. The texts reveal nuanced considerations of relational proximity and its limits, setting up requirements (...) for moral action in scenarios where relational ties do not play a motivational role. I set out yi's complexity in these discussions, highlighting its implications for (i) the nei-wai debate; (ii) the notion of yi as "rightness," or doing the right thing; and (iii) how we can understand the connection between virtue and right action in these early Confucian debates. This material from the excavated texts not only provides new perspectives on a longstanding investigation of human nature and morality, it also challenges prevailing views on Warring States Confucian intellectual history. In the well-known debate between Mengzi and Gaozi in Mencius 6A, Mengzi maintained that both ren and yi are naturally-given 1 in human nature. The figure 1 To say that ren and yi are naturally-given is not to say that they are fully-developed from the start. I use the phrase "naturally-given" throughout the paper to indicate where a particular capacity or resource (ren or yi) may be found, rather than its final polished state. (shrink)

In the Lunyu, Confucius remarks on the implausibility—or impossibility—of a life lacking in xin 信, reliability (2.22). In existing discussions of Confucian philosophy, this aspect of life is often eclipsed by greater emphasis on Confucian values such as ren 仁 (benevolence), li 禮 (propriety) and yi 義 (rightness). My discussion addresses this imbalance by focusing on reliability, extending current debates in two ways. First, it proposes that the common translation of xin as denoting coherence between a person’s words and deeds (...) is inadequate. The translation fails to capture the longer-term consistency in a person’s actions and behaviours in different circumstances across time. Second, it explores how the Lunyu passages discuss the processes of learning that prepare a person for reliable action. (shrink)

Since the 1940s, Western epistemology has discussed Gilbert Ryle’s distinction between knowledge-that and knowledge-how. Ryle argued that intelligent actions – manifestations of knowledge-how – are not constituted as intelligent by the guiding intervention of knowledge-that: knowledge-how is not a kind of knowledge-that; we must understand knowledge-how in independent terms. Yet which independent terms are needed? In this chapter, we consider whether an understanding of intelligent action must include talk of knowledge-to. This is the knowledge to do this or that now, (...) not then or in general. Our argument is refined and buttressed by consideration of a text in Chinese philosophy, the Lüshi Chunqiu. This 3rd century BCE text, a compendium on good government, focuses on different types of knowledge that an effective ruler or a capable official should possess. A significant number of those discussions concern examples of knowing-how being manifested in particular situations. The text is explicitly aware of the importance of timeliness and awareness of context in manifesting know-how. Some might say that these are merely manifestations of knowing-how. But we see these examples as revealing characteristics of know-how that Ryle did not anticipate. Might knowing-to be an essential and irreducible aspect of intelligent action? (shrink)

Epistemic absolutism is an orthodox view that propositional knowledge is an ungradable concept. Absolutism is primarily grounded in our ungradable uses of “knows” in ordinary language. This paper advances a thorough objection to the linguistic argument for absolutism. My objection consists of two parts. Firstly, arguments for absolutism provided by Jason Stanley and Julien Dutant will be refuted respectively. After that, two more general refutation-strategies will be proposed: counterevidence against absolutism can be found in both English and non-English languages; the (...) linguistic argument for absolutism is subject to a methodological mistake as the linguistic usages of “knows” cannot accurately reflect its conceptual nature. Therefore, we should give epistemic gradualism, as opposed to absolutism, a more serious consideration. (shrink)

In Daoist philosophy, the self is understood as an individual interdependent with others, and situated within a broader environment. Within this framework, the concept ziran is frequently understood in terms of naturalness or nature while wuwei is explained in terms of non-oppressive government. In many existing accounts, little is done to connect these two key Daoist concepts. Here, I suggest that wuwei and ziran are correlated, ethical, concepts. Together, they provide a unifying ethical framework for understanding the philosophy of the (...) Daodejing. I explore the meaning of ziran as self-so-ness or, in human terms, as pertaining to an individual’s spontaneity. The appropriate response to the spontaneity of individuals is to avoid, insofar as possible, imposing or using restrictive norms and methods, that is, wuwei. According to this view, ziran and wuwei offer an account of ethics that attends to core notions of interdependent selfhood, including mutuality, relationality, interdependence, symbiosis, and responsiveness. (shrink)

In this article, we present an account of ming 明 in the Zhuangzi's Neipian in light of the disagreements among the thinkers of the time. We suggest that ming is associated with the Daoist sage's vision: he sees through the debaters' attempts to win the debates. We propose that ming is primarily a meta-epistemological stance, that is, the sage understands the nature of the debates and does not enter the fray; therefore he does not share the thinkers' anxieties. The sage (...) takes his stance at the pivot of dao (daoshu 道樞) and, from there, responds to the different views limitlessly. (shrink)

The purpose of this paper is to provide a new solution to the radical sceptical paradox. A sceptical paradox purports to indicate the inconsistency within our fundamental epistemological commitments that are all seemingly plausible. Typically, sceptics employ an intuitively appealing epistemic principle (e.g., the closure principle, the underdetermination principle) to derive the sceptical conclusion. This paper will reveal a dilemma intrinsic to the sceptical paradox, which I refer to as the self-hollowing problem of radical scepticism. That is, on the one (...) hand, if the sceptical conclusion turns out to be true, then the epistemic principle employed by sceptics would lose its foundation of plausibility; on the other hand, if the sceptical conclusion does not follow, then the sceptical problem would not arise. In either case, the so-called sceptical paradox cannot be a genuine paradox. This new solution has three theoretical merits: it is undercutting, less theory-laden, and widely applicable. (shrink)

This chapter discusses ren 仁, a major term in the Confucian Analects. It analyzes the range of meanings of ren across different conversations, paying special attention to its associations with other key Confucian terms such as li (禮 behavioural propriety) and zhi (知 understanding). Building on this analysis, the discussion focuses on ren in terms of how it is manifest in a person’s life. In particular, it expresses ren in terms of an exemplary life—a life lived well. The chapter also (...) dwells briefly on how this model of a good life can inform and enrich contemporary debates in ethics. (shrink)

Recently there has been extensive debate over whether “belief is weak”, viz, whether the epistemic standard for belief is lower than for assertion or knowledge. While most current studies focus on notions such as “ordinary belief” and “outright belief”, this paper purports to advance this debate by investigating a specific type of belief; memory belief. It is argued that (outright) beliefs formed on the basis of episodic memories are “weak” due to two forms of “entitlement inequality”. My key argument is (...) thus twofold. First, by rejecting the epistemic theory of memory, I argue that one can be entitled to belief but not to knowledge. Second, by scrutinising a recent defence of the belief norm of assertion, it will be demonstrated that belief is weaker than assertion, as long as we expect one to match words with deeds. (shrink)

Relearning and remembering are usually seen as two distinct cognitive processes in contemporary philosophy of memory. In particular, relearning is sometimes regarded as a kind of memory error. This paper aims to address two questions. First, is relearning a kind of memory error? Second, how to draw a distinction (if any) properly between relearning and remembering? My answer to the first question is a conditional ‘yes’—it depends on whether relearning can be falsidical and whether metacognitive monitoring counts as a part (...) of memory process. My answer to the second question appeals to a gradualist account, according to which the distinction between relearning and remembering is not an absolute yes-or-no affair, but a matter of degrees. (shrink)

Background: In health, ethics is an essential aspect of practice and care and guarantees a better quality of life for patients and their caregivers. Objective: To outline a conceptual analysis of quality of life and ethics, identifying attributes, contexts and magnitudes for health. Method: A qualitative design about quality of life and ethics in health, considering the evolutionary approach in order to analyse the concept. To collect the data, a search was done using the keywords ethic*, quality of life and (...) health. After, in total, 152 studies were found, finalizing seven relevant studies for the proposed concept analysis. Findings and discussion: Of seven studies analysed, their main results were shown by means of antecedents, consequences and attributes of the concepts. The three final attributes that synthesize the concept of quality of life and ethics in health were highlighted: Ethics dilemmas and quality of life; Human ethics and quality of life; and Ethics of care and quality of life. In fact, the attributes and context clearly reveal that ethics and quality of life influence the ability to solve ethical dilemmas, guarantee human ethics in healthcare and impact ethics in healthcare for the production of effective health policies and care that encompasses professional quality of life as well. Conclusion: The magnitude of ethical knowledge in each professional discipline permits cultivating a solidary attitude and developing the willingness to improve healthcare. The right to access, dignity and respect in care delivery are rooted in behaviours and are spontaneously applied in practice to the extent that they play an ethical role. (shrink)

The Zhuangzi, a 4th century BCE Daoist text, is sceptical about the political culture of its time. Those who debated conceptions of a good life were hostile to the views of others. They were intolerant and at times contemptuous of others who did not embody their values. In contrast to such negativity, the Zhuangzi promotes equanimity. The equanimity of the sagely person is grounded in a balance she maintains between engagement and withdrawal. Engaging critically, she problematises the lack of diversity (...) in their options for a good life. By withdrawing, she refuses to be party to the squabbles that perpetuate intolerance. The paper aims to show how equanimity is possible, thereby articulating a new angle on emotions in the Zhuangzi. (shrink)

Many scholars note that the Analects, and Confucian philosophy more generally, hold a conception of knowing that more closely approximates ‘knowing-how’ than ‘knowing-that’. However, I argue that this description is not sufficiently sensitive to the concerns of the early Confucians and their focus on self-cultivation. I propose that a particular conception of knowing—knowing to act in the moment—is better suited to capturing the Analects’ emphasis on exemplary lives in actual contexts. These investigations might also contribute to discussions on know-how in (...) epistemology in western philosophy. (shrink)

How do speakers learn the social meaning of different linguistic variants, and what factors influence how likely a particular social–linguistic association is to be learned? It has been argued that the social meaning of more salient variants should be learned faster, and that learners' pre‐existing experience of a variant will influence its salience. In this paper, we report two artificial‐language‐learning experiments investigating this. Each experiment involved two language‐learning stages followed by a test. The first stage introduced the artificial language and (...) trained participants in it, while the second stage added a simple social context using images of cartoon aliens. The first learning stage was intended to establish participants' experience with the artificial language in general and with the distribution of linguistic variants in particular. The second stage, in which linguistic stimuli were accompanied by images of particular aliens, was intended to simulate the acquisition of linguistic variants in a social context. In our first experiment, we manipulated whether a particular linguistic variant, associated with one species of alien in the second learning phase, had been encountered in the first learning phase. In the second experiment, we manipulated whether the variant had been encountered in the same grammatical context. In both cases we predicted that the unexpectedness of a new variant or a new grammatical context for an old variant would increase the variant's salience and facilitate the learning of its social meaning. This is what we found, although in the second experiment, the effect was driven by better learners. Our results suggest that unexpectedness increases the salience of variants and makes their social distribution easier to learn, deepening our understanding of the role of individual language experience in the acquisition of sociolinguistic meaning. (shrink)

By examining fundamental Confucian concepts -- zhengming, ren, li, xiao, shu and dao -- the essay demonstrates that Confucian ways of thinking do not always fit neatly into categories such as 'moral' or rights'. The author provides a positive interpretation of certain Confucian ideas including: the concept of a person as a self- in- relation; the notion of responsibility as particularistic and dependent upon the kinds of relationships one has and the social positions one occupies; and the view of the (...) moral community as comprised by selves- in- relation who are reciprocally connected and who share similar ideals and forms of life. (shrink)

Exemplarism – the view that exemplary people, whom we admire, are the bearers of our moral concepts – presents considerable challenges to the (widely-assumed) place of moral theory in how we learn to be moral. Exemplarism has been garnered by Amy Olberding to articulate a Confucian approach to moral learning. This paper extends Exemplarism by considering how it may be put into practice, based on a seminal Confucian text, the Analects of Confucius. To date, the majority of discussions on Confucian (...) ethics that have brought Confucian philosophy to the attention of Anglophone scholars tend to focus on conceptually-based matters. There remain questions regarding how these values may be inculcated and embodied in our moral lives. Central to our proposal is the practice of reflective observation (guan 觀), comprised by three integrated components: observation, evaluation, and emulation. Observing, reflectively, is important not only for an individual’s acculturation to existing norms and practices but also for how they may subsequently exercise some latitude over their moral practices. Our reflections offer a practical approach to Confucian moral learning. In doing so, we demystify moral learning in Confucianism and open up avenues for future cross-tradition dialogues on moral education. (shrink)

The standard criticisms of Confucian ethics appear contradictory. On the one hand, Confucian ethics is deemed overly rule-bound: it is obsolete because it advocates adherence to ancient Chinese norms of proper conduct. On the other hand, Confucian ethics is perceived as situational ethics—done on the run—and not properly grounded in fundamental principles or norms. I give reasons for these disparate views of Confucian ethics. I also sketch an account of Confucian morality that focuses on moral development; in this account the (...) place of normative ethics is nominal. (shrink)

PurposeAdolescents develop their decision-making ability as they transition from childhood to adulthood. Participation in their medical care should be encouraged through obtaining assent, as recommended by the American Academy of Pediatrics (AAP). In this research, we aim to define the current knowledge of AAP recommendations and surgeon practices regarding assent for elective reconstructive procedures.MethodsAn anonymous electronic survey was distributed to North American paediatric surgeons and fellows through the American Pediatric Surgical Association (n=1353).ResultsIn total, 220 surgeons and trainees responded (16.3%). Fifty (...) per cent of the surgeons who are familiar with the concept of assent had received formal training; 12% of the respondents had not heard of assent before the survey. Forty-seven per cent were aware of the 2016 AAP policy statement regarding assent in paediatric patients. Eighty-nine per cent always include adolescents as part of the consent discussion. Seventy-seven per cent solicit an expression of willingness to accept the proposed care from the patient. The majority (74%) of the surgeons perceived patient cooperation/understanding as the biggest barrier to obtaining assent. Over half of the respondents would consider proceeding with elective surgery despite the adolescent patient’s refusal. Reasons cited for proceeding with elective surgery include surgeons’ perception of medical necessity, perceptions of disease urgency, and lack of patient maturity.ConclusionPaediatric surgeons largely acknowledge the importance of assent, but variably practice the principles of obtaining assent from adolescent patients undergoing elective reconstructive procedures. Fewer surgeons are explicitly aware of formal policy statements or received formal training. Additional surgeon education and institutional policies are warranted to maximise inclusion of adolescents in their medical care. (shrink)

This essay focuses on the unity of several virtues in pre-Qin Confucians. Confucius maintains the proper application and coherence of such virtues as benevolence, wisdom, trustworthiness, straightforwardness, courage, and firmness. Further, Confucius takes benevolence and nobility as characteristic of human being. Particular attention is paid to the distinction and relationship between virtuous characters and virtuous actions.