Ethical decision making in medicine has recently seen calls to move towards less prescriptive- based approaches that consider the particularities of each case. The main alternative call from the literature is for better understanding of phronesis concepts applied to decision making. A well-cited phronesis-based approach is Kaldjian’s five-stage theoretical framework: goals, concrete circumstances, virtues, deliberation and motivation to act. We build on Kaldjian’s theory after using his framework to analyse data collected from a three-year empirical study of phronesis and the (...) medical community. The data are a set of narratives collected in response to asking a medical community what making ethically wise decisions means to them. We found that Kaldjian’s five concepts are present in the accounts to some extent but that one of the elements, motivation, is constructed as playing a different, though still crucial role. Rather than being an end-stage of the process as Kaldjian’s framework suggests, motivation was constructed as initiating the process and maintaining the momentum of taking a phronesis-based approach. The implications for medical ethics decision-making education are significant as motivation itself is a highly complex concept. We therefore theorise that motivation is required for leading in, continuing and completing the actions of the ethical decision taken. Appreciating the central importance of motivation through the whole of Kaldjian’s framework has implications for cultivating the virtues of phronesis and courage to take the right course of action. (shrink)

Contemporary clinical ethics was founded on principlism, and the four principles: respect for autonomy, nonmaleficence, beneficence and justice, remain dominant in medical ethics discourse and practice. These principles are held to be expansive enough to provide the basis for the ethical practice of medicine across cultures. Although principlism remains subject to critique and revision, the four-principle model continues to be taught and applied across the world. As the practice of medicine globalizes, it remains critical to examine the extent to which (...) both the four-principle framework, and individual principles among the four, suffice patients and practitioners in different social and cultural contexts. Using the four-principle model we analyze two accounts of surrogate decision making – one from the developed and one from the developing world – in which the clinician undertakes medical decision-making with apparently little input from the patient and/or family. The purpose of this analysis is to highlight challenges in assessing ethical behaviour according to the principlist model. We next describe cultural expectations and mores that inform both patient and clinician behaviors in these scenarios in order to argue that the principle of respect for persons informed by culture-specific ideas of personhood may offer an improved ethical construct for analyzing and guiding medical practice in a globalized and plural world. (shrink)

Volume 20, Issue 3, March 2020, Page 73-74.

Multinational companies commonly and increasingly undertake their research in low and middle-income countries through commercial clinical research organizations (CROs). The involvement of these scientific middle men complicates the application of the theories of justice. We examine those complexities, and conclude that while the difficulties are not immune to analysis in terms of these theories, the theories have to be deployed in new ways in order to be useful in the new commercial world.

BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any (...) given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. (shrink)

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent (...) willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor. (shrink)

This paper argues that, although no resistance or revolution is permitted in the Kantian state, very tyrannical regimes must not be obeyed because they do not qualify as states. The essay shows how a state ceases to be a state, argues that persons have a moral responsibility to judge about it and defends the compatibility of this with Kantian authority. The reconstructed Kantian view has implications for how we conceive authority and obligation. It calls for a morally demanding definition of (...) the state and asserts that the primary personal responsibility is not to evaluate the morality of every single law but to evaluate the moral standing of the polity.Send article to KindleTo send this article to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle. Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service.Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Your Kindle email address Please provide your Kindle [email protected]@kindle.com Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Dropbox To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Send article to Google Drive To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive. Kant, the State, and RevolutionVolume 18, Issue 1Reidar Maliks DOI: https://doi.org/10.1017/S1369415412000271Available formats PDF Please select a format to send. By using this service, you agree that you will only keep articles for personal use, and will not openly distribute them via Dropbox, Google Drive or other file sharing services. Please confirm that you accept the terms of use. Cancel Send ×Export citation. (shrink)

This paper presents a cross-sectional study that demonstrates how King Abdulaziz University has responded to the lockdown imposed by the Ministry of Education in Saudi Arabia due to the Covid-19 pandemic. The purpose of this study was to examine the perceptions of students and faculty towards assessment that had to take place online due to physical or social distancing rules and lockdowns. A descriptive mixed-method study was conducted with two different self-administered questionnaires that were developed for students and faculty, respectively. (...) A total of 547 responses were received from undergraduate students and 213 from faculty. The main finding suggests the need for a multilevel approach to the problems of cheating and plagiarism, including raising student awareness and ethics, training teachers to detect cheating methods, and institutions activating their code of practice and applying severe sanctions on those who engage in such practices. (shrink)

This paper examines the problematisation of sex-selective abortion (SSA) in UK parliamentary debates on Fiona Bruce's Abortion (Sex-Selection) Bill 2014–15 and on the subsequent proposed amendment to the Serious Crime Bill 2014–15. On the basis of close textual analysis, we argue that a discursive framing of SSA as a form of cultural oppression of minority women in need of protection underpinned Bruce's Bill; in contrast, by highlighting issues more commonly articulated in defence of women's reproductive rights, the second set of (...) debates displaced this framing in favour of a broader understanding, drawing on postcolonial feminist critiques, of how socio-economic factors constrain all women in this regard. We argue that the problematisation of SSA explains the original cross-party support for, and subsequent defeat of, the policies proposed to restrict SSA. Our analysis also highlights the central role of ideology in the policy process, thus making politics visible in policymaking. (shrink)

In fact, it can be easily said that during the Prophet's time and in the early periods after him, women were visibly active in the fields of science, commerce, and politics. Because at the time of the revelation of the Qur'an, not only men but also women were making great efforts to learn and teach the Prophet's message as in many other fields. In the first period, many female Companions, especially Prophet 'A'isha and other Ummah-i Believers, made serious efforts to (...) learn the hadiths and pass them on to future generations. The woman, like the man, is Allah's caliph on earth. There is no difference between men and women in terms of honor, dignity and value in the sight of Allah. Both have separate rights and duties. During the Jahiliyyah period, girls were buried alive after birth, but the birth of Islam and the Age of Bliss (the Age of the Prophet) marked the beginning of a happy era for women. Muslim women companions actively participated in education, religious discussions, trade and warfare. In conclusion, Islam aimed to liberate women from the violence of the age of ignorance. It emphasized women's freedom of property, work, learning knowledge and family happiness. (shrink)

Prince of philosophers -- The emergence of Islam -- Boy genius -- Court physician -- A traveling philosopher -- Death of an intellectual -- A lasting legacy.

Communication between road users is a major key to coordinate movement and increase roadway safety. The aim of this work was to grasp how pedestrians (Experiment A), cyclists (Experiment B), and kick scooter users (Experiment C) sought to visually communicate with drivengers when they would face autonomous vehicles (AVs). In each experiment, participants (n= 462,n= 279, andn= 202, respectively) were asked to imagine themselves in described situations of encounters between a specific type of vulnerable road user (e.g., pedestrian) and a (...) human driver in an approaching car. The human driver state and the communicative means of the approaching car through an external Human-Machine Interface (eHMI) were manipulated between the scenarios. The participants were prompted to rate from “never” to “always” (6-point Likert scale) the frequency with which they would seek eye contact with the human driver either in order to express their willingness to cross or to make their effective decision to cross. Our findings revealed that a passive human driver in an AV with no visual checking on the road triggered a decline in vulnerable road users’ desire to communicate by eye contact (Experiments A–C). Moreover, the results of Experiment C demonstrated that the speed screen, the text message screen, and the vibrating mobile app eHMI signals diminished kick scooter users’ desire to communicate visually with the human driver, with some age-based differences. This suggested a better comprehension of the approaching car’s intentions by the kick scooter users, driven by the features of the eHMI. (shrink)

The ‘right not to know’ (RNTK) can be used by patients as a safeguard against the effects that certain medical information can have on their well-being. At first glance, one might reason it suitable for a patient to enact their RNTK. However, although Davies states that RNTK gives people the ability to both protect themselves from self-perceived harm and exercise their autonomy, I will argue that ‘not knowing’ hinders patients’ ability to exercise their existential freedom and represents what Sartre calls (...) an instance of ‘bad faith’. Davies argues that the RNTK takes precedence over many related issues and objections associated with a patient’s decision to implement such a resolution.1 Fundamentally, the RNTK gives patients power to protect themselves from subjective harm and to exercise their autonomy. In most cases, objectors of RNTK cite the negative impact on the patient’s state of health, which affects not only the patient but also those persons who would also be negatively affected by patient health outcomes. For the majority of objectors, patients have moral obligations to lessen the degree of burden on others, which refusal can initiate. However, Davies concludes, ‘…the burden placed on others is not sufficiently significant …. (shrink)

Abstract: Retama raetam (RR) is a traditional medicinal plant belongs to fabaceae family which grows in North Africa and East Mediterranean region. Locally, RR is used in several diseases including diabetes mellitus and hypertension. Thus, this study aims to investigate certain behavioral and central effects of methanolic extract of RR seeds in experimental animals (male Albino adult mice of 20 – 35 gm). Three exploratory behavioral models are used in this study, open field, elevated plus maze and light-dark box models, (...) in addition, picrotoxin induced seizure model in mice. In elevated plus-maze test of anxiety, a dose of 25 mg/kg of RR induced a significant increase in number of open arms entries and time spent on open arms of the maze compared to the control. In light-dark model, time spent on light area and number of light-dark transitions are significantly increased after treatment with 25 mg/kg RR extract of seeds. Open field model also revealed a significant increase in general motor activity of the mouse after 25 mg/kg of RR. On the other hand, a dose of 50 mg/kg of RR significantly induced a profound central and peripheral analgesic responses. In summary, this study concludes that RR seeds have a profound anxiolytic-like effect and analgesic response with delay in latency time of seizure induced by picrotoxin in mice. (shrink)

Research on interpersonal trauma tends to focus on the effects of traumatic encounters on those one who directly undergo the experience. In this paper, I seek to understand the experiences of the friends and family of the one who has undergone trauma, a paradigmatic case being the relatives of veterans (O’Nell, 1999). I argue that one way we can understand the experiences of friends and relatives is through Pauline Boss’ concept of _ambiguous loss_ (Boss, 1986, 2007). The kind of ambiguous (...) loss relevant for our purposes is when a family member is physically present but psychologically absent, for example, in the case of a relative with advanced dementia. This is what I purport happens in some instances of traumatic experience. I argue that third-person traumatic encounter can be experienced as a loss due to the changes in the person who has undergone the traumatic encounter and that this, in turn, causes changes in the person experiencing the loss and their relationship with their traumatised family member. I argue that first-person traumatic encounter is a transformative experience (Paul, 2014), i.e., an experience which causes personal and epistemic changes in the subject undergoing it, and that third-person traumatic encounter can also be a transformative experience. (shrink)

To Kant, the French revolution's central events were the transfer of sovereignty to the people in 1789 and the trial and execution of the monarch in 1792-1793. Through a contextual study, this Element argues that while both events manifested the principle of popular sovereignty, the first did so in lawful ways, whereas the latter was a perversion of the principle. Kant was convinced that historical examples can help us understand political philosophy, and this Element seeks to show this in practice.

Papers presented at the Seminar on Ethics and Aesthetics in Indian Literary Practices, held at Udaipur in Rajasthan, India in 2009; organized by Department of English, Mohanlal Sukhadia University, Udaipur, India.

The article deals with the breakdown of the co called „grand narratives“ and with processes that preceded it. The author focuses on the degradation of the traditional meaningful forms, such as myth and grand narrative, and their becoming a „story“. He offers a detailed examination of the essential characteristics of a story. He sees the particular forms of the codification of the world as related to following developments: the rise of grand narratives as related to the transition to linear alphabetical (...) codes, while their transformation into a story as connected with the rise of technological images. He sees this transition as a negative phenomenon, since this shift of the focus of human activities on images resulted in a significant reduction of our freedom. (shrink)

This article argues against the depiction of Ibn Khaldūn as someone whose preoccupation and credulity regarding mysticism or the occult diminish the rationalism and reformism of his thought, rendering it irrelevant to our concerns today. Instead, it argues that he consistently tries to steer his readers away from such pursuits by exposing them as fake when possible, or—in cases where their reality is attested to by unimpeachable religious sources—by highlighting the dangers they pose to both religion and state.

On the outside wall and in the vestibule of the ‘House of Publius Paquius Proculus’ in Pompeii (building I.7.1) three graffiti containing the name Cucuta can be found. The first simply readsCucuta(CIL4.8065 [outside wall]). The second tells us that Cucuta was an attendant of the Emperor Nero (CIL4.8066 [outside wall]):Cu(cuta) | Cucuta Ner(onis).From the third we learn that Cucuta was a financial secretary (a rationibus) of Nero (CIL4.8075 [vestibule]):Cucuta ab ra[t]ioni[b]us | Neronis Augusti. While the meaning and significance of these (...) graffiti may seem apparent—that one of Nero's attendants scratched his name on the wall and vestibule pillar as he waited for the emperor to return from a meeting—the closeness betweenCucuta(an otherwise unattested name) andcicuta(hemlock) raises a key question: should we readCucutaasCicutaand therefore understand the third graffito in particular as a joke about Nero's rumoured fondness for killing family, friends and his senatorial enemies with poison? In other words, is it Poison, and not a person, that keeps Nero's finances in order? And, if so, can theCucutagraffiti give us an alternative insight into the plethora of wall inscriptions found outside building I.7.1 greeting Publius Paquius Proculus and recommending him for office? (shrink)

In this work, Kenan Malik explores the history of moral thought as it has developed over three millennia, from Homer's Greece to Mao's China, from ancient India to modern America. It tells the stories of the great philosophers, and breathes life into their ideas, while also challenging many of our most cherished moral beliefs.

This article intends to review William Dembski's recent monograph entitledBeing as Communion: A Metaphysics of Information, in which he establishes an entire information-centric metaphysics. This viewpoint is compared with al-Ghazālī’s perspective, a Muslim philosophical theologian from the Medieval period. It is concluded that what Dembski defines as information, which for him is the ontological basis of the natural world, seems remarkably close to al-Ghazālī’s notion of God's will and omnipotence. This article is an explorative comparison of their metaphysical frameworks that (...) are discussed in light of modern scientific developments, highlighting their differences and similarities. (shrink)

Objective: There is lack of information on the presentation of eating disorders (EDs) in Saudi Arabia using gold standard clinical tools. The present study aimed to provide data on the presentation of EDs in Saudi Arabia using clinically validated measures.Method: Hundred and thirty-three individuals (33 male) with a mean age of 22 years (2.63) completed three measures: the Eating Disorder Examination (EDE), a semi-structured interview, the Eating Disorder Examination Questionnaire (EDE-Q), a self-report measure, and the Depression Anxiety and Stress Scale (...) (DASS-21) to measure comorbid symptoms.Results: Individuals in Saudi Arabia reported higher levels of restraint, eating concern and shape concern and a higher global score, but lower levels of weight concern on the EDE-Q compared to the EDE. Female participants reported a higher global score, alongside significantly higher scores on the restraint, shape concern and weight concern subscales than males. The most common ED subtype was other specific feeding or ED. Compared with Western community samples, symptom severity in this purposive sample obtained from community settings was significantly higher in this sample.Discussion: Individuals with eating, weight and shape concerns in Saudi Arabia may feel more comfortable expressing their symptoms on a self-report tool compared with a face to face interview. However, it is possible that a self-report measure may over-estimate the severity of symptoms. The data suggest that clinicians in Saudi Arabia should regularly screen for EDs in all genders. It is also important to note that ED symptoms are a cause for concern in young people in Saudi Arabia. (shrink)

Desde la aparición y divulgación del término autoficción hace casi cuarenta años, mucho se ha reflexionado acerca de sus características, sus dimensiones ontológicas, formales y pragmáticas. Esa forma autobiográfica “bajo sospecha” se extendió de la narrativa a la poesía con gran naturalidad, hecho que ha sido ya analizado...

In post-modern times, there has been much empirical evidence to indicate that religions and faiths play a pro-active role in the field of civil society but more importantly in the development of societies, which is a major factor in political and economic development of a country, as well as its governance. Accordingly, the contemporary reality of plurality demands a fresh look into the narratives of different civilisations, cultures and ideologies, rather than imposed meta-narratives of modernity. Hence, explorations of religion and (...) faith to develop an alternative notion of “good governance” from “other’s” worldview are also necessary. Much could be learned from cultures, religions and faiths in the realm of governance studies from the phenomenological perspective. This paper is an attempt to explore how religion could play its functional role to create a sustainable governance concept based on values and ethics. It will look into the situation of religion at present, and how it fits into the framework of governance, and the arguments will be supported by examples and evidence of the viability of the relation between religion and governance. (shrink)

ABSTRACTCan there be a legal or a moral right to resist the government? Scholarly interest in the right of resistance has rarely focused on German philosophy, which has often been considered unusually committed to authority. Yet, during the Enlightenment German philosophers regularly attempted to justify not just conscientious refusal but also revolution. This essay explores the two dominant justifications, which were based in Wolffian perfectionism and Kantian relational theory. It argues that we can best understand the complexity of these theories (...) of resistance by exploring their contrasting views on the state’s purpose: providing material and spiritual welfare, or establishing freedom as independence. (shrink)

The role of testimony in the transmission and generation of knowledge has been debated vigorously in contemporary epistemology. More recently, types other than propositional knowledge are also being discussed, among them know-how. No special attention, however, has been paid so far to tacit forms of know-how. In this article, I am arguing for the thesis that testimony, if understood in an inclusive way, can play a central role in the transmission and generation of tacit know-how. This thesis is embedded in (...) a virtue-theoretic framework: next to testimony, successful acquisition of tacit know-how crucially depends on the relationship between teacher and student and the virtues they both display. (shrink)

This study reviews and synthesizes the contemporary business literature that focuses on the role of corporate social responsibility to enhance firm value. The main objective of this review is to proffer a precise understanding of what has already been investigated and the findings of those investigations regarding the value-enhancing capabilities of CSR for public firms. In addition, this review identifies gaps in the existing literature, evaluates inconsistent findings, discusses possible data sources for empirical researchers, and provides direction for exploring other (...) promising avenues in future studies. The thrust of the CSR literature largely acknowledges the value-enhancing capabilities of firms’ social and environmental activities. However, the predominance of inconsistent theoretical grounds in major CSR-benefits-related areas suggests that there is ample room for future research to contribute to the extant literature. Anecdotal evidence, the prevalence of theoretical arguments, and the availability of large cross-sectional firm-level data suggest that future research will enrich the literature by investigating the real insights behind several unanswered questions, by establishing implicit understandings regarding recognized findings, and by developing new theories in this emerging field. (shrink)