Managers with different cultural backgrounds and under different circumstances have different views on what is acceptable ethical behaviour. This study attempts to determine whether major companies in Hong Kong share the same views as North American academics on what management ethical standards ought to be, and if so, whether any control mechanisms have been established to instill ethical behaviour within their organizations. Notable differences between the practice in these companies and those from a similar survey conducted in North America are (...) identified and explained. The management accountant''s role in the development and implementation of such mechanisms is investigated. (shrink)

Objectives: To investigate the current situation of completing the informed consent for do-not-resuscitate (DNR) orders among the competent patients with terminal illness and the ethical dilemmas related to it. Participants: This study enrolled 152 competent patients with terminal cancer, who were involved in the initial consultations for hospice care. Analysis: Comparisons of means, analyses of variance, Student’s t test, χ2 test and multiple logistic regression models. Results: After the consultations, 117 (77.0%) of the 152 patients provided informed consent for hospice (...) care and DNR orders. These included 21 patients (17.9%) who signed the consent by themselves, and 96 (82.1%) whose consent sheet was signed only by family members. The reasons why patients were not involved in the discussions toward the consent (n = 82) included poor physical or psychological condition (44.9%), concerns of the consultant hospice team (37.2%), and the family’s refusal (28.2%). On a multivariate analysis, patients’ awareness of their poor prognosis (odds ratio = 4.07, 95% confidence interval = 2.05 to 8.07) and their understanding of hospice care (2.27, 1.33 to 3.89) were two independent factors (p<0.01) that influenced their participation in the discussions or their personal signature in the informed consent. Conclusion: The family-oriented culture in Asian countries may violate the principles of the Patient Self-Determination Act and the requirements of the Hospice Care Law in Taiwan, which inevitably poses an ethical dilemma. Earlier truth-telling and continuing education of the public by hospice care workers will be helpful in solving such ethical dilemmas. (shrink)

The apolipoprotein E gene plays an important role in the pathogenesis of Alzheimer's disease , and amyloid plaque comprised mostly of the amyloid-beta peptide ) is one of the major hallmarks of AD. However, the relationship between these two important molecules is poorly understood. We examined how A treatment affects APOE expression in cultured cells and tested the role of the transcription factor NF-B in APOE gene regulation. To delineate NF-B's role, we have characterized a 1098 nucleotide segment containing the (...) 5'-flanking region of the human APOE gene . Sequence analysis of this region suggests the presence of two potential NF-B elements. To demonstrate promoter activity, the region was cloned upstream of a promoterless luciferase gene. This segment was able to drive expression of luciferase in transient transfections of human fetal glial cells. Promoter activity was stimulated twofold by A treatment. Pretreatment with double-stranded DNA decoy oligonucleotides against NF-B reduced A stimulation. Deletion and mutagenetic analyses demonstrated that the distal NF-B element was functional and showed a strong DNA-protein complex band in gel shift analysis, similar to that from control NF-B consensus element. An anti-inflammatory and anti-NF-B drug, sodium salicylate, significantly blocked A-induced APOE promoter function. Our data provide evidence that upregulation of APOE by A in astroglial cells is mediated by an NF-B-element present in the 5'-flanking region of the APOE gene. (shrink)

Die hier vorgelegten Untersuchungen nehmen ihren Aus­ gang von einem Problem, dem ich bereits in dem Vortrag "Berufsstudium und Allgemeinbildung" (1920) und dem Buche "Erkenntnis und Leben" (1923) nachgegangen bin: dem Pro­ blem nämlich, ob, inwieweit und in welchen Formen die Ar­ beit an und in der Wissenschaft der "Bildung" des ganzen Menschen dienen könne. Sie überschreiten den dort gezogenen Rahmen, indem sie sich vornehmlich mit dem Kreis von m e t a p y s h i s c h (...) e Fragestellungen n beschäftigen, der in den genannten Schriften gestreift, aber nicht als solcher in An­ griff genommen war. Insbesondere jene letzten Seinszusam­ menhänge, welche, nicht ohne Verschulden der beteiligten Fachwissenschaften, durch die vielerörterten und -beklagten Irrgänge des "Natur a 1 i s m s" u wie des sogenannten "H i­ s t o r i s m s" u verdunkelt worden sind und immer noch ver­ dunkelt werden, sollen hier in der grundsätzlichen, d. i. w i s­ s e n s c h a ich- f t 1 philosophischen Form behandelt werden, der sich die einschlägigen Erörterungen nur allzu oft zum Schaden der Sache entzogen haben. Ungesucht ergab sich in diesem Zusammenhange die Möglichkeit, einige der in meiner.. Kulturphilosophie (Individuum und Gemeinschafts, 1926) e- wickelten Gedankengänge fortzuführen und in ihre prak­ tischen Konsequenzen hinein zu verfolgen. 1. Vorwort IV Man wolle die zahlreichen Stellenangaben, die auf die hier genannten Schriften Bezug nehmen, zugleich als Hinweise auf die daselbst herangezogene sonstige LHeratur verstehen. (shrink)

In this paper we argue that, if it is true that maximum self-development is better both for individuals and society, and if it is true that that self-development is being seriously curtailed by pervasive environmental tech forces, then clearly educational systems, since they are guardians of “developing” young humans, have a moral imperative to push back against forces that diminish the self. On the other hand, if it is not true that “more self is always better,” that perhaps “goodness of (...) fit” between self and society is optimum, then education systems are justified in continuing to pay scant attention to the forces of self-development (or lack thereof). In line with Sherry Turkle’s (2011) argument that tech forces are diminishing the sort of reflective reasoning necessary for self-development, we will argue that since communicative interchange is necessary for self-development, and an ever-developing self is necessary for ever deeper and more meaningful dialogue (hence forming a dialectic), the fact that social media and other forms of tech connection stunts deep and meaningful interchange has serious implications. Specifically, we will argue that, in contemporary high-tech society (what we are calling Society 2.0), the dialectic between self and communication is going the “wrong” way; that genuine dialogue is becoming ever more rare, which in turn is resulting in “diminished-I’s,” which in turn is resulting in ever more complacency in the face of utterly superficial communicative interchange. We will begin with an overview of what we mean by a “diminished-I,” and then follow by noting how social media, the reading vacuum, roboticism, crowd communication, and decreasing social capital are resulting in diminished-I’s. Since this is resulting in an “I-diminished” society, we will reflect on the question of whether those dialogical educational initiatives that promote self-development are, in fact, making dodos, i.e., making youngsters unfit for the environment in which they find themselves. Ultimately, we will argue that, if educators choose to fight back against the I-diminishing forces of Society 2.0, they need to take selves seriously and actively engage youngsters in dialogue with those with opposing viewpoints. Ultimately, youngsters in Society 2.0 will need all the assistance educators can muster to fight the addictive, literally mind-numbing forces of being “happily” “alone together,” and instead chose the riskier often unhappy-making option of diving into the truth-seeking process with varying coalitions of the willing. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

This study investigated the differences between past and future temporal discounting in terms of neural activity in relation to temporal distance. Results show that brain regions are engaged differently in past and future temporal discounting. This is likely because past temporal discounting requires memory reconstruction, whereas future temporal discounting requires the processing of uncertainty about the future. In past temporal discounting, neural activity differed only when preferences were made between rewards received one hour prior and rewards received further in the (...) past. The peak amplitudes of P2 and P3 varied as the temporal distance increased from 2 weeks to 50 years. In future temporal discounting, neural activity differed only when preferences were evaluated between two delayed rewards. The delay conditions and had a significant influence on P2 and N2. Findings indicate the existence of different decision-making systems operating in past and future temporal discounting. (shrink)

The US neutrino community gathered at the Workshop on the Intermediate Neutrino Program at Brookhaven National Laboratory February 4-6, 2015 to explore opportunities in neutrino physics over the next five to ten years. Scientists from particle, astroparticle and nuclear physics participated in the workshop. The workshop examined promising opportunities for neutrino physics in the intermediate term, including possible new small to mid-scale experiments, US contributions to large experiments, upgrades to existing experiments, R&D plans and theory. The workshop was organized into (...) two sets of parallel working group sessions, divided by physics topics and technology. Physics working groups covered topics on Sterile Neutrinos, Neutrino Mixing, Neutrino Interactions, Neutrino Properties and Astrophysical Neutrinos. Technology sessions were organized into Theory, Short-Baseline Accelerator Neutrinos, Reactor Neutrinos, Detector R&D and Source, Cyclotron and Meson Decay at Rest sessions.This report summarizes discussion and conclusions from the workshop. (shrink)

The purpose of this study was to develop a Physician's Spiritual Well-Being Scale (PSpWBS). The significance of a physician's spiritual well-being was explored through in-depth interviews with and qualitative data collection from focus groups. Based on the results of qualitative analysis and related literature, the PSpWBS consisting of 25 questions was established. Reliability and validity tests were performed on 177 subjects. Four domains of the PSpWBS were devised: physician's characteristics; medical practice challenges; response to changes; and overall well-being. The explainable (...) total variance was 65.65%. Cronbach α was 0.864 when the internal consistency of the whole scale was calculated. Factor analysis showed that the internal consistency Cronbach α value for each factor was between 0.625 and 0.794 and the split-half reliability was 0.865. The scale has satisfactory reliability and validity and could serve as the basis for assessment of the spiritual well-being of a physician. (shrink)

© 2016 Regents of the University of California.The Review summarizes much of particle physics and cosmology. Using data from previous editions, plus 3,062 new measurements from 721 papers, we list, evaluate, and average measured properties of gauge bosons and the recently discovered Higgs boson, leptons, quarks, mesons, and baryons. We summarize searches for hypothetical particles such as supersymmetric particles, heavy bosons, axions, dark photons, etc. All the particle properties and search limits are listed in Summary Tables. We also give numerous (...) tables, figures, formulae, and reviews of topics such as Higgs Boson Physics, Supersymmetry, Grand Unified Theories, Neutrino Mixing, Dark Energy, Dark Matter, Cosmology, Particle Detectors, Colliders, Probability and Statistics. Among the 117 reviews are many that are new or heavily revised, including those on Pentaquarks and Inflation. The complete Review is published online in a journal and on the website of the Particle Data Group. The printed PDG Book contains the Summary Tables and all review articles but no longer includes the detailed tables from the Particle Listings. A Booklet with the Summary Tables and abbreviated versions of some of the review articles is also available. (shrink)

This paper advances an interpretation of Deleuze's Chronos–Aion distinction in The Logic of Sense as a development of Freud's thesis concerning the timelessness of the unconscious. If Chronos forms a unidirectional sequence along the arrow of a living present, the Aion as the eternal truth of events represents a form of time that is transcendentally distinct. While Chronos belongs to consciousness through the functions of good and common sense, the paradoxical insistence of the Aion represents for Deleuze the force of (...) the unconscious. By identifying the Aion with the death drive, Deleuze positions timelessness as the transcendental condition of the living, corporeal ego. (shrink)

ABSTRACTThe present paper evaluates Davis’s analysis of the potential transformational change of current orthodoxy and his main proposition of the potential benefits that will arise from the involv...

This paper aims to offer an analysis of the critique of reason developed by Max Horkheimer and Theodor W. Adorno in three of his most important books: Dialectic of Enlightenment, The critique of instrumental reason and Minima Moralia. Two fundamental questions are posed: Does the thought of the authors set a radical critique? If this is the case, wouldn't it imply a series of meta theorical problems and contradictions? In order to treat these questions, the statement is divided into two (...) parts. The first explores the recurring issues of the critique of reason. In the second, we elaborate a brief reconstruction of two opposite hermeneutics of Horkheimer and Adorno's works: on the one hand, the lecture of Frankfurt School's second generation ; on the other hand, Juan José Sánchez's exposition. Our principal contribution to this debate is to warn Sánchez that, in his justified intention of separating from Habermas and postmodern's reading, he finally weakens the contradictory and negative tone of Adorno and Horkheimer's philosophy.La temática que se aborda en este artículo es la crítica a la razón elaborada por Max Horkheimer y Theodor W. Adorno en tres obras fundamentales: Dialéctica de la Ilustración, Crítica de la razón instrumental y Minima Moralia. Las preguntas que se buscan responder son las siguientes: ¿Constituye el pensamiento conjunto de los autores una crítica radical? Si así fuera, ¿no implicaría una serie de problemas meta teóricos y contradicciones ? El escrito se divide en dos partes. En la primera se abordan los motivos recurrentes de la crítica a la razón. En la segunda, se elabora una sucinta reconstrucción de dos interpretaciones contrapuestas de las obras mencionadas: por un lado, la de los miembros de la segunda generación de la Escuela de Frankfurt, en particular la de Jürgen Habermas y la de Albrecht Wellmer; por otro lado, la del comentarista español Juan José Sánchez. El aporte teórico de este artículo consiste en advertirle a este último autor que, en su justificado afán de distanciarse de la lectura habermasiana y de la postmoderna, termina debilitando el tono contradictorio y negativo de la filosofía conjunta de Adorno y Horkheimer. (shrink)

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China.

Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

In many jurisdictions, legal frameworks afford patients the opportunity to make prospective medical decisions or to create directives that contain a special provision forfeiting their own ability to object to those decisions at a future time point, should they lose decision‐making capacity. These agreements have been described with widely varying nomenclatures, including Ulysses Contracts, Odysseus Transfers, Psychiatric Advance Directives with Ulysses Clauses, and Powers of Attorney with Special Provisions. As a consequence of this terminological heterogeneity, it is challenging for healthcare (...) providers to understand the terms and uses of these agreements and for ethicists to engage with the nuances of clinical decision‐making with such unique provisions surrounding patient autonomy. In theory, prospective self‐binding agreements may safeguard patient's “authentic” wishes from future “inauthentic” changes of mind. In practice, it is unclear what may be comprised within these agreements or how—and to what effect—they are used. The primary focus of this integrative review is to curate the existing literature describing Ulysses Contracts (and analogous decisions) used in the clinical arena, in order to empirically synthesize their shared essence and provide insights into the traditional components of these agreements when used in practice, the requirements of their consent processes, and the outcomes of their utilization. (shrink)

Over the past generation, the rise of East Asia and especially China, has brought about a sea change in the economic and political world order. At the same time, global warming, environmental degradation, food and water shortages, population explosion, and income inequities have created a perfect storm that threatens the very survival of humanity. It is clear now that the Westphalian model of individual sovereign states seeking their own self-interest will not be able to respond effectively to this win-win or (...) lose-lose crisis. In this volume, a cadre of distinguished scholars comes together to reflect on Confucianism and Deweyan pragmatism as possible resources for a new geopolitics that begins from an ontology of interdependence and recognizes the irreducibly ecological nature of the human experience at every level. Both Confucian and Deweyan traditions emphasize the primacy of experience, the importance of vital relationality, and the moral roots of good governance. The potential benefits of conceptually blending the two are many. Indeed, the contemporary Chinese philosopher Tang Junyi provides us with a cosmological understanding of the "idea" of Confucianism that, in parallel to Dewey's "idea" of democracy, can enable us to anticipate the core values, if not the specific contours, of a "Confucian democracy." Just as Dewey's "idea" of democracy is his vision of the flourishing communal life made possible by the contributions of the uniquely distinguished persons that constitute it, Tang Junyi's Confucianism is a pragmatic naturalism directed at achieving the most highly integrated cultural, moral, and spiritual growth for the individual-in-community. In both, we find an affirmation of communal harmony as a process "starting here and going there" through which those involved learn together to do ordinary things in extraordinary ways. Just such a cosmological understanding of democracy is one way of describing what will be needed to address the many predicaments characterizing the environmental, cultural, socioeconomic, and political dynamics of the twenty-first century. (shrink)

Jagiello et al.'s bifocal stance theory provides a useful theoretical framework for attempting to understand the connection between greater adherence to traditional norms and greater sensitivity to threats in the world. Here, we examine the implications of the instrumental and ritual stances with regard to various evolutionary explanations for traditionalism–threat sensitivity linkages.

Our reactions to actual crime-disbelief about the act committed, anger at the hurt caused, a desire to get even, and fear for ourselves and our children-arrive in an indecipherable rush of emotion. We perceive strong, intuitive, and sometimes oppositional reactions at once. So it is little wonder that no single traditional moral justification for punishment is satisfactory. Traditional theories, both retributive and utilitarian, are grounded in a priori truths that ignore the convergence of the theoretical, the practical and the emotional (...) that gives rise to the need to punish. In their stead, we should embrace an advertently pragmatic theoretical approach, which recognize the primary need to protect ourselves against danger, but looks as well to providing reformation wherever possible. Such an approach does not ignore the traditional rationales. To eschew retribution entirely is to deny a deeply-rooted moral intuition and forego efforts to tame it. To jettison utility is to condemn the victim and community to perpetual fear; just to the extent that retributive impulses, by any name, undermine necessary forward-looking concerns about our future's safety, they poorly serve our needs, which include service to the victim, the community and the offender. (shrink)

There is a tendency among those who identify themselves as subjectivists on the issue of defining criminal intent to dismiss or minimize the role of actual non-trivial harm in the determination of criminal liability and punishment. That is to say, they are those who argue that an individual’s subjective intent is a sufficient indication of potential dangerousness and culpability to justify punishment. In this essay, the author presents a view, based on Adam Smith’s recognition of the “irregularity of the sentiments,” (...) that actual physical harm matters; that it reflects the negative component of the two great motivators, pleasure and pain; and that it can release the worst sort of emotional reactivity: retribution. The infliction of a non-trivial first order harm can invoke a deeply felt aesthetic reaction which, in turn, reflects our natural (and cognitively “irregular”) human sentiments. Trying to dispense with harm as a feature in our understanding of criminality seems prima facie absurd. Awareness of the sentiment, as Smith understood, helps temper the worst parts of our nature: that which hopes to crush the people and ideas we find threatening. Ironically, the existence of and need for harm as a necessary condition of criminality heightens our awareness of the limitations of reason in dealing with victims of crime. We are not simply cognitive creatures. (shrink)

I expand modal normativism, a theory of metaphysical modality, to give a normativist account of metaphysical explanation. According to modal normativism, basic modal claims do not have a descriptive function, but instead have the normative function of enabling language users to express semantic rules that govern the use of ordinary non-modal vocabulary. However, a worry for modal normativism is that it doesn’t keep up with all of the important and interesting metaphysics we can do by giving and evaluating metaphysical explanations. (...) So, I advance modal normativism by arguing that metaphysical explanations also have a normative rather than descriptive function. In particular, non-causal explanatory claims have formal and semantic properties that make them expressively stricter than basic modal claims and so are better suited to express fine-grained aspects of semantic rules. A major payoff of my normativist account of metaphysical explanations is that it yields a plausible story about how we come to evaluate and know metaphysical explanations—we do this primarily by conceptual analysis. I also respond to a number of objections, including the objection that the epistemic payoffs of my view are not worth the metaphysical costs. (shrink)

In , Peter van Inwagen asked a good question. (Asking the right question is often the hardest part.) He asked: what do you have to do to some objects to get them to compose something---to bring into existence some further thing made up of those objects? Glue them together or what?1 Some said that you don’t have to do anything.2 No matter what you do to the objects, they’ll always compose something further, no matter how they are arranged. Thus we (...) learned of the fusion of the coins in our pockets and the Eiffel tower. (shrink)