Bioethics Education in the Anglo-European context developed since 1970 and was incorporated into the undergraduate and postgraduate education, residency training, and continuous education. In the Asia-Pacific region, bioethics education is less structured and often dependent on contextual constraints. This paper provides a cross-sectional analysis, describing institutional experiences in developing bioethics curriculum at two medical schools in Malaysia and Hong Kong. The medical programmes of the two institutions are distinctive in terms curriculum framework, teaching approach, and topic selection, and common challenges (...) include implementation of bioethics courses, students’ resistance to bioethics, and limited teaching capacity, emerged as they evolve. The reported experiences revealed that there is room for improvement regarding how medical schools integrate bioethics education in regions where curriculum development remains at an early stage. At least, a bioethics education requires both top-down support from the faculty to improve teaching and educational quality, as well as from the bottom-up approach to empower students to raise awareness and concerns toward bioethics, and helps students developing reasoning through challenging issues. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

Background Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. Objective The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. (...) Research design A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. Participants and research context A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. Ethical consideration Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. Findings Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the ‘conflicts’ domain with increased clinical exposure. Conclusion Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings. (shrink)

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

This paper investigates a first-order extension of GL called \. We outline briefly the history that led to \, its key properties and some of its toolbox: the \emph{conservation theorem}, its cut-free Gentzenisation, the ``formulators'' tool. Its semantic completeness is fully stated in the current paper and the proof is retold here. Applying the Solovay technique to those models the present paper establishes its main result, namely, that \ is arithmetically complete. As expanded below, \ is a first-order modal logic (...) that along with its built-in ability to simulate general classical first-order provability―"\" simulating the the informal classical "\"―is also arithmetically complete in the Solovay sense. (shrink)

Background: Moral courage is required at all levels of nursing. However, there is a need for development of instruments to measure nurses’ moral courage. Objectives: The objective of this study is to develop a scale to measure nurses’ self-assessed moral courage, to evaluate the scale’s psychometric properties, and to briefly describe the current level of nurses’ self-assessed moral courage and associated socio-demographic factors. Research design: In this methodological study, non-experimental, cross-sectional exploratory design was applied. The data were collected using Nurses’ (...) Moral Courage Scale and analysed statistically. Participants and research context: The data were collected from a convenience sample of 482 nurses from four different clinical fields in a major university hospital in Finland for the final testing of the scale. The pilot comprised a convenience sample of 129 nurses. Ethical considerations: The study followed good scientific inquiry guidelines. Ethical approval was obtained from the university ethics committee and permission to conduct the study from the participating hospital. Findings: Psychometric evaluation showed that the 4-sub-scale, 21-item Nurses’ Moral Courage Scale demonstrates good reliability and validity at its current state of development showing a good level of internal consistency for a new scale, the internal consistency values ranging from 0.73 to 0.82 for sub-scales and 0.93 for the total scale, thus well exceeding the recommended Cronbach’s alpha value of >0.7. Principal component analysis and confirmatory factor analysis supported the theoretical construct of Nurses’ Moral Courage Scale. Face validity and expert panel assessments markedly contributed to the relevance of items in establishing content validity. Discussion and conclusion: Nurses’ Moral Courage Scale provides a new generic instrument intended for measuring nurses’ self-assessed moral courage. Recognizing the importance of moral courage as a part of nurses’ moral competence and its assessment offers possibilities to develop interventions and educational programs for enhancement of moral courage. Research should focus on further validation measures of Nurses’ Moral Courage Scale in international contexts. (shrink)

This paper examines the meaningfulness of pointing in great apes. We appeal to Hannah Ginsborg’s conception of primitive normativity, which provides an adequate criterion for establishing whether a response is meaningful, and we attempt to make room for a conception according to which there is no fundamental difference between the responses of human infants and those of other great apes to pointing gestures. This conception is an alternative to Tomasello’s view that pointing gestures and reactions to them reveal a fundamental (...) difference between humans and other apes. (shrink)

Social enterprises, as typical hybrid organisations, are embedded in a plural institutional environment in which some stakeholders regard achieving social goals as fundamental, while others see economic profit as the priority. A great challenge for social enterprises is dealing with the conflicts resulting from the diverse expectations of stakeholders. Based on the existing works on organisational legitimacy and the social business model, we propose a legitimacy-based social enterprise model composed of three main phases, namely, legitimacy proposition, legitimacy strategy planning, and (...) legitimacy strategy implementation. Our model is meant to serve as an effective legitimacy-building tool for social enterprises of various kinds. (shrink)

Organizations are increasingly expected by their stakeholders to tackle the “wicked” problems of society. These new pressures have created a highly equivocal corporate social responsibility (CSR) environment whereby firms face competing stakeholder perspectives regarding their CSR strategy. To reduce CSR environmental equivocality and determine a CSR strategy, organizations need to effectively and efficiently identify, evaluate, and exploit CSR initiatives to create financial and social value (i.e., shared value). In this paper, we explain how organizations can optimize their shared value creation (...) and promote the construction of intersubjective agreement, which can reduce CSR environmental equivocality. Theory is put forth that explains how the proper alignment of an organization’s level of CSR environmental equivocality, which is comprised of varying amounts of “unknowingness,” corporate entrepreneurship strategy, which promotes experimentation, and stakeholder engagement process, which facilitates information gathering and dissemination, supports the construction of intersubjective agreement. A typology of organizational shared value creation in equivocal CSR environments with four “ideal types” of organizations—Container, Explorer, Embracer, and Manager—is presented and an organization’s choice among and movement between types discussed. (shrink)

Our collective enthusiasm for empathy reflects a sense that it is deeply valuable. I show that empathy bears a complex and surprisingly problematic relation to another social epistemic phenomenon that we have reason to value, namely testimonial trust. My discussion focuses on empathy with and trust in people who are members of one or more oppressed groups. Empathy for oppressed people can be a powerful tool for engendering a certain form of testimonial trust, because there is a tight connection between (...) empathy and a approval of another's outlook. I then argue that the qualities of empathy that make it such a powerful tool for bridging differences and building trust also have a problematic upshot: they make it the case that reliance on empathy will sometimes have a distorting effect upon the ways we extend testimonial trust. (shrink)

In this article it will be concluded that systematic menstrual tracking in women’s sport has the potential to cause harm to athletes. Since the ruling of Dobbs v. Jackson Women’s Health Organization (2022) in the United States, concerns regarding menstrual health tracking have arisen. Research suggests that the menstrual tracking of female athletes presents potential risks to “women’s autonomy, privacy, and safety in sport” (Casto 2022, 1725). At present, the repercussions of systematic menstrual tracking are particularly under-scrutinized, and this paper (...) seeks to combine novel research in the sport sciences with present ethical debates in the philosophy of sports. Utilizing Beauvoir’s feminist philosophy (2011), this paper argues that systematic menstrual tracking may contribute to the wider system of women’s oppression by exploiting female athletes, as well as enabling the internalization of submissive behaviour in cultures where athletes are expected to comply unquestioningly. Five policy recommendations are made concerning autonomy, informed consent, education, safeguarding and data access. The overall findings of this paper propose that a more in-depth understanding of the links between data, privacy, and the menstrual cycle are required by sports organizations and governing bodies if athletes are to be protected in a future where systematic menstrual tracking is inevitable. (shrink)

Empathy is a form of emotionally charged imaginative perspective‐taking. It is also the unique source of a particular form of understanding, which I will call humane understanding. Humane understanding consists in the direct apprehension of the intelligibility of others’ emotions. This apprehension is an epistemic good whose ethical significance is multifarious. In this paper, I focus on elaborating the sense in which humane understanding of others is non‐instrumentally valuable to its recipients. People have a complex but profound need to be (...) humanely understood. Because we respond to others’ very real need when we pursue this sort of understanding of their emotions, empathy is best understood as itself a way of caring, rather than just a means to promote other caring behavior. (shrink)

Working memory (WM) deficits are pervasive co-morbidities of epilepsy. Although the pathophysiological mechanisms underpinning these impairments remain elusive, it is thought that WM depends on oscillatory interactions within and between nodes of large-scale functional networks. These include the hippocampus and default mode network as well as the prefrontal cortex and frontoparietal central executive network. Here, we review the functional roles of neural oscillations in subserving WM and the putative mechanisms by which epilepsy disrupts normative activity, leading to aberrant oscillatory signatures. (...) We highlight the particular role of interictal epileptic activity, including interictal epileptiform discharges and high frequency oscillations (HFOs) in WM deficits. We also discuss the translational opportunities presented by greater understanding of the oscillatory basis of WM function and dysfunction in epilepsy, including potential targets for neuromodulation. (shrink)

This article aims to make an analysis of the cultural and anthropological issues raised by synthetic biology. The novelty of the field makes it relatively difficult to compose a comprehensive analysis, even for philosophers with experience, but who are not familiar with the specifics of the field. The article will follow the synthesis of the models of ethical decision applicable in the field of ethical evaluation of technologies from a cultural and anthropological perspective, their critical analysis and will highlight the (...) limitations of each model, as well as a possible synthesis of a model of ethical evaluation of technologies. Afterwords, it can be decided whether a particular technology - such as those involved in synthetic biology - poses risks to the environment, to those involved in research, to future generations, to humanity as a whole or to present or future ecosystems. (shrink)

The intrinsic merit of Northoff's model lies primarily in the fact that it integrates data concerned with different levels of organization of the brain. This approach implicitly argues against reductionism, although, apparently, its rather simplistic assumption gives too many degrees of freedom. In considering that a symptom from two different syndromes indicates a common neural alteration, we grossly disregard neural plasticity.

The target article is an elegant synthesis of the developmental and functional data and views on the evolutionary origin of the mammalian isocortex, integrating results from cell and molecular biology, experimental neuroanatomy, and chemoarchitectonic studies. Complementarily, we give here an account of two modes of isocortical evolution (prosomere reshuffling and invention) in terms of costs of radiation and neural tissue.

An argument that draws on empirical findings in psychology to offer a blueprint for cultivating a widespread commitment to public reason. At the core of liberal theory is the idea—found in thinkers from Hobbes to Rawls—that the consent of the governed is key to establishing political legitimacy. But in a diverse liberal polity like the United States, disagreement runs deep, and a segment of the population will simply regard the regime as illegitimate. In Liberalism in Practice, Olivia Newman argues (...) that if citizens were to approach politics in the spirit of public reason, couching arguments in terms that others can reasonably accept, institutional and political legitimacy would be enhanced. Liberal theory has relied on the assumption of a unified self, that individuals are unified around a single set of goals, beliefs, attitudes, and aptitudes. Drawing on empirical findings in psychology, Newman argues instead that we are complex creatures whose dispositions and traits develop differently in different domains; we hold different moral commitments in different parts of our lives. She argues further that this domain differentiation allows us to be good liberal citizens in the public domain while remaining true to private commitments and beliefs in other domains. Newman proposes that educational and institutional arrangements can use this capacity for differentiation to teach public reason without overwhelming conflicting commitments. The psychology and pedagogy of public reason proposed by Newman move beyond John Rawls's strictly political liberalism toward what Newman terms practical liberalism. Although we cannot resolve every philosophical problem bedeviling theories of liberalism, we can enjoy the myriad benefits of liberalism in practice. (shrink)

En este artículo nos proponemos revisar, sobre una base léxica y fraseológica, la traducción publicada al rumano de la novela de Guillermo Arriaga, Un dulce olor a muerte, a partir del análisis de las teorías de la traducción más relevantes en relación con el tratamiento de los elementos culturales. En esencia, mediante el uso de las funciones del lenguaje definido por Nord, respecto a las diferencias culturales en la traducción, nuestro objetivo es explorar las diversas prácticas culturales de transferencia, con (...) el fin de centrarse en los aspectos lingüístico-culturales, dentro de la novela mexicana y su traducción, que ambos constituyen nuestro corpus. Por otra parte, tratamos de identificar los principales métodos de traducción que se han aplicado, con el propósito de establecer su porcentaje de uso y debatir sobre su funcionalidad. (shrink)

This paper examines Hannah Ginsborg's attempt to address the challenge raised by Saul Kripke's meaning sceptic. I start by identifying the two constraints that the sceptic claims must be met by a satisfactory answer. Then I try to show that Ginsborg's proposal faces a dilemma. In the first instance, I argue that it is able to meet the second constraint, but not the first. I then amend the proposal in order to make room for the first constraint. I go on (...) to argue that, under this new interpretation, it cannot meet the second constraint. (shrink)

Background: Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous. Objective: This article is an analysis (...) of the concept of moral courage in nursing. Design: Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis. Data sources: The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis. Ethical considerations: This study was conducted according to good scientific guidelines. Results: Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment. Discussion and conclusion: This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Professional codes of ethics are regarded as elements of nurses' ethical knowledge base and consequently part of their ethics education. However, research focusing on these codes from an educational viewpoint is scarce. This study explored the need and applicability of nursing codes of ethics in modern health care, their importance in the nursing ethics curriculum, and the need for development of their teaching. A total of 183 Finnish nurse educators and 212 nursing students answered three structured questions, with an opportunity (...) to justify their responses, and one open-ended question. Descriptive statistics and content analysis were used to analyse the data. The results suggest that the existence of the codes was seen as important and their applicability mainly as appropriate, despite new challenges posed by modern health care. The codes were regarded as an important part of nurses' ethics education, but current integrated teaching methods require development. (shrink)

Previous research has shown implicit semantic processing of faces or pictures, but whether symbolic carriers such as words can be processed this way remains controversial. Here we examine this issue by adopting the continuous flash suppression paradigm to ensure that the processing undergone is indeed unconscious without the involvement of partial awareness. Negative or neutral words projected into one eye were made invisible due to strong suppression induced by dynamic-noise patterns shown in the other eye through binocular rivalry. Inverted and (...) scrambled words were used as controls to provide baselines at orthographic and feature levels, respectively. Compared to neutral words, emotion-described and emotion-induced negative words required longer time to release from suppression, but only for upright words. These results suggest that words can be processed unconsciously up to semantic level since under interocular suppression completely invisible words can lead to different processing speed due to the emotion information they carry. (shrink)

Chu Hsi (1130-1200) exerted a lasting influence on the thought and life of the Chinese in subsequent cent. The core of his synthesis was moral and social philosophy, but it also included knowledge about the natural world. His doctrine of ke-wu (invest. of things) made him mindful of the specialized knowledged in such "scientific" traditions as astronomy, harmonics, med., etc. This study of Chu Hsi's thought gives a systematic account of the basic concepts of his natural philosophy. Also discusses Chu (...) Hsi's actual knowledge about the natural world. And examines the relation between Chu Hsi and Chinese "scientific" traditions and compares his natural knowledge with that of the Western scientific tradition. (shrink)

Background: Nursing practice takes place in a social framework, in which environmental elements and interpersonal relations interact. Ethical climate of the work unit is an important element affecting nurses’ professional and ethical practice. Nevertheless, whatever the environmental circumstances, nurses are expected to be professionally competent providing high-quality care ethically and clinically. Aim: This study examined newly graduated nurses’ perception of the ethical climate of their work environment and its association with their self-assessed professional competence, turnover intentions and job satisfaction. Method: (...) Descriptive, cross-sectional, correlational research design was applied. Participants consisted of 318 newly graduated nurses. Data were collected electronically and analysed statistically. Ethical considerations: Ethical approval and permissions to use instruments and conduct the study were obtained according to required procedures. Data were rendered anonymous to protect participant confidentiality. Completing the questionnaire was interpreted as consent to participate. Findings: Nurses’ overall perception of the ethical climate was positive. More positive perceptions related to peers, patients and physicians, and less positive to hospitals and managers. Strong associations were found between perceived ethical climate and self-assessed competence, turnover intentions in terms of changing job, and job satisfaction in terms of quality of care. Nurses at a higher competence level with positive views of job satisfaction and low turnover intentions perceived the climate significantly more positively. Conclusion: Nursing management responsible for and having the power to implement changes should understand their contribution in ethical leadership, as well as the multidimensional nature of nurses’ work environment and the interaction between work-related factors in planning developmental measures. Future research should focus on issues in nurse managers’ ethical leadership in creating ethical work environments. There is also a need for knowledge of newly graduated nurses’ views of factors which act as enhancers or barriers to positive ethical climates to develop. Interventions, continuing education courses, and discussions designed to promote positive ethical climates should be developed for managers, nurses, and multi-professional teams. (shrink)

Per the OpenNotes directive of the 21st Century Cures Act implemented in 2021, patients and their legally recognized representatives must be able to access the electronic medical record in real time. This is an opportunity for clinical ethicists and other providers to reflect on their charting practices, particularly how and when they quote patients. Although using direct quotations is common because it seems to avoid misinterpretation, it may not always be appropriate. In this article, we discuss some of the risks (...) and benefits of quoting in the context of OpenNotes and provide suggestions for how clinical ethicists can leverage their unique position to help mitigate some of these risks and promote more reflective charting practices among the teams they work with. (shrink)

Law moves, whether we notice or not. Set amongst a spatial turn in the humanities, and jurisprudence more specifically, this book calls for a greater attention to legal movement, in both its technical and material forms. Despite various ways the spatial turn has been taken up in legal thought, questions of law, movement and its materialities are too often overlooked. This book addresses this oversight, and it does so through an attention to the materialities of legal movement. Paying attention to (...) how law moves across different colonial and contemporary spaces, this book reveals there is a problem with common law's place. Primarily set in the postcolonial context of Australia - although ranging beyond this nationalised topography, both spatially and temporally - this book argues movement is fundamental to the very terms of common law's existence. How, then, might we move well? Explored through examples of walking and burial, this book responds to the challenge of how to live with a contemporary form of colonial legal inheritance by arguing we must take seriously the challenge of living with law, and think more carefully about its spatial productions, and place-making activities. Unsettling place, this book returns the question of movement to jurisprudence. (shrink)

This major essay collection takes a fresh look at how differences among people matter for music and musical thought.

The significance of the discovery of half of Dewey’s most important China lecture series notes, “Social and Political Philosophy,” cannot be overestimated. These newly-discovered lecture notes provide us with a unique opportunity to conduct a translation case study in both directions: first, to check Hu Shi’s translation against Dewey’s lecture notes; and second, to check John Dewey: Lectures in China, 1919-1920, “back translations” in the terminology of translation studies, both against Hu’s translation and against Dewey’s original notes that the back (...) translators tried to reconstruct. More important, by treating translations as re-writes and as products of cultural and ideological manipulations, this case study enables us to analyze how Hu Shi appropriated Dewey’s ideas to advance his own cultural and political agenda while acting as the latter’s interpreter. (shrink)

The life of the political philosopher whose pamphlets Common Sense and The American Crisis greatly influenced colonial opinion during the Revolution.