Mo Yan’s multi-layered and allegorical tales were highly inspired by William Faulkner. Mo Yan’s semi-fictional Gaomi Northeast Township was often linked to William Faulkner’s fictional Yoknapatawpha, and he himself was extolled by the Chinese scholars to be “China’s Faulkner.” Inside China, there have emerged a great number of comparative studies on Faulkner and Mo Yan, which are usually conducted from the perspectives of literary forms, native-soil complex, attitudes towards tradition, the influence of local culture, and so on. However, despite the (...) strong record of research on these two writers in China, there is still room for improvement in the study, for after the initial stage of the superficial and sporadic comparison between individual works, the comparative study of Faulkner and Mo Yanis in pressing need of comprehensive and systematic research of these criticisms. (shrink)

Harmony is a concept essential to Confucianism and to the way of life of past and present people in East Asia. Integrating methods of textual exegesis, historical investigation, comparative analysis, and philosophical argumentation, this book presents a comprehensive treatment of the Confucian philosophy of harmony. The book traces the roots of the concept to antiquity, examines its subsequent development, and explicates its theoretical and practical significance for the contemporary world. It argues that, contrary to a common view in the West, (...) Confucian harmony is not mere agreement but has to be achieved and maintained with creative tension. Under the influence of a Weberian reading of Confucianism as "adjustment" to a world with an underlying fixed cosmic order, Confucian harmony has been systematically misinterpreted in the West as presupposing an invariable grand scheme of things that pre-exists in the world to which humanity has to conform. The book shows that Confucian harmony is a dynamic, generative process, which seeks to balance and reconcile differences and conflicts through creativity. Illuminating one of the most important concepts in Chinese philosophy and intellectual history, this book is of interest to students of Chinese studies, history and philosophy in general and eastern philosophy in particular. (shrink)

Though there is a wide and varied literature on ethical supererogation, there has been almost nothing written about its epistemic counterpart, despite an intuitive analogy between the two fields. This paper seeks to change this state of affairs. I will begin by showing that there are examples which intuitively feature epistemically supererogatory doxastic states. Next, I will present a positive theory of epistemic supererogation that can vindicate our intuitions in these examples, in an explanation that parallels a popular theory of (...) ethical supererogation. Roughly, I will argue that a specific type of epistemic virtue—the ability to creatively think up plausible hypotheses given a body of evidence—is not required of epistemic agents. Thus, certain exercises of this virtue can result in supererogatory doxastic states. In presenting this theory, I will also show how thinking about epistemic supererogation can provide us a new way forward in the debate about the uniqueness thesis for epistemic rationality. (shrink)

In this article, I argue that the current literature on political hope overlooks its non-instrumental value. By proposing a Kant-inspired account of treating reasonable hopes as fundamental hopes, I argue that it is rational for people to hold certain political hopes not only because such hopes promote particular ends but also because they are constitutive of a person’s practical identity as a responsible political agent with limited power to make changes. This view reveals that victims of injustice face an affective (...) injustice because the unjust social system forces them to face a double bind in upholding their fundamental political hopes. (shrink)

Few studies have examined the relationship between personality traits and social networking sites (SNSs) with a dominant concentration on the personality alterations under SNSs influence. The relationship between personality and privacy control was less focused and discussed. In order to figure out the internal mechanism of such link among youth SNSs users, the Theory of Planned Behavior (TPB) was extended by including Five-Factor Model of Personality to explore how personality traits interact with privacy control behavior on SNSs. The investigation using (...) the theoretical method mentioned led to several hypotheses which were later assessed by an online study conducted within randomly chosen college students (N = 201) from two randomly chosen universities in China. This sampling strategy was designed to mimic the situation of targeted research population in the most reasonable way. The results suggested neuroticism and openness predicted SNSs privacy. Neuroticism and openness predicted “networked privacy” was also found. Theoretical implications of these findings were addressed. (shrink)

Nurses are experiencing new ethical issues as a result of global developments and changes in health care. With health care becoming increasingly sophisticated, and countries facing challenges of graying population, ethical issues involved in health care are bound to expand in quantity and in depth. Blended learning rather as a combination of multiple delivery media designed to promote meaningful learning. Specifically, this study was focused on two questions: (1) the students’ satisfaction and attitudes as members of a scenario-based learning process (...) in a blended learning environment; (2) the relationship between students’ satisfaction ratings of nursing ethics course and their attitudes in the blended learning environment. In total, 99 senior undergraduate nursing students currently studying at a public nursing college in Taiwan were invited to participate in this study. A cross-sectional survey design was adopted in this study. The participants were asked to fill out two Likert-scale questionnaire surveys: CAAS (Case Analysis Attitude Scale), and BLSS (Blended Learning Satisfaction Scale). The results showed what students felt about their blended learning experiences — mostly items ranged from 3.27—3.76 (the highest score is 5). Another self-assessment of scenario analysis instrument revealed the mean scores ranged from 2.87—4.19. Nearly 57.8% of the participants rated the course ‘extremely helpful’ or ‘very helpful.’ This study showed statistically significant correlations (r = 0.43) between students’ satisfaction with blended learning and case analysis attitudes. In addition, results testified to a potential of the blended learning model proposed in this study to bridge the gap between students and instructors and the one between students and their peers, which are typical of blended learning, and to create meaningful learning by employing blended pedagogical consideration in the course design. The use of scenario instruction enables students to develop critical analysis and problem solving skills through active learning and social exchange of ideas. (shrink)

Does morality require the filial obligation of grown children toward their aged parents? First, problems with some accounts of filial morality that have been put forth in recent years in the West are examined (Jane English, Jeffrey Blustein, and others), and then it is shown how Confucianism provides a sensible alternative perspective.

The last two decades have witnessed the rising prevalence of both co-publishing and retraction. Focusing on research collaboration, this paper utilizes a unique dataset to investigate factors contributing to retraction probability and elapsed time between publication and retraction. Data analysis reveals that the majority of retracted papers are multi-authored and that repeat offenders are collaboration prone. Yet, all things being equal, collaboration, in and of itself, does not increase the likelihood of producing flawed or fraudulent research, at least in the (...) form of retraction. That holds for all retractions and also retractions due to falsification, fabrication, and plagiarism. The research also finds that publications with authors from elite universities are less likely to be retracted, which is particularly true for retractions due to FFP. China stands out with the fastest retracting speed compared to other countries. Possible explanations, limitations, and policy implications are also discussed. (shrink)

Capitalist reforms usually drive outmigration of peasants to cities, while elders, children, and women responsible for their care are “left behind” in the countryside. The plight of these “left behind” populations is a major focus of recent agrarian studies in China. However, rural women are not merely passive victims of these transformations. Building on ethnographic research in Guangxi and Henan provinces from 2013 to 2017, and drawing on critical gender studies and feminist political ecology, I show how the food safety (...) crisis in China creates conditions for peasant women to increase control and income from organic food production, often establishing alternative food networks with the support of female scholars and NGO organizers. Thus, I shift focus of scholarship on rural women from “left behind” to leaders in struggles for justice and food sovereignty. (shrink)

Background Nurses often face ethical issues in their daily work that can have an impact on their level of job embeddedness. And positive job embeddedness is essential to reduce burnout among nurses and improve professional retention in the medical industry. However, few studies have focused on the relationship between moral distress, moral resilience, and job embeddedness. Objectives To investigate the relationship between moral distress, moral resilience, and job embeddedness, and explore the mediating role of moral resilience between moral distress and (...) job embeddedness among nurses. Design A quantitative, cross-sectional study. Methods Nurses from a number of tertiary general hospitals in central China were surveyed and assessed using the Moral Distress Scale, the Nurse Moral Resilience Scale, and the nurse job embeddedness Scale from February to March 2023. The study was conducted in line with the 1964 Declaration of Helsinki. Ethical consideration All study procedures were approved by the Ethics Committee of Hunan Normal University (No. 2023-313). Findings Moral distress was positively correlated with moral resilience ( β = 0.525, p < 0.01) and negatively correlated job embeddedness ( β = −0.470, p < 0.01). Moral resilience partially mediated the relationship between moral distress with job embeddedness ( β = −0.087, p < 0.01). Discussion The findings reveal a relationship between moral distress, job embeddedness, and moral resilience among nurses. Conclusion Moral distress and moral resilience are important correlates of job embeddedness in nurses. Interventions to reduce moral distress and increase moral resilience may have potential benefits for improving nurses’ job embeddedness. It is recommended that clinical nursing administrators create a favorable ethical atmosphere, educate nurses about ethics, and increase nurses' moral resilience. (shrink)

This study discusses the impact of different economic indicators on economic stability, including honest leadership, improved infrastructure, revenue generation, and CPEC taking into account the double mediating role of environmental sustainability and sustainable development, while considering the latest COVID-19 situation. This study adopted primary data collection methods and obtained data from the employees of CPEC by using questionnaires and smart-PLS for analysis purposes. The results revealed that honest leadership, improved infrastructure, revenue generation, and CPEC have a positive nexus with economic (...) stability. Despite the severe impact of COVID-19 on the country’s economy, the economic corridor plays a vital role in stabilizing the state’s economy and supports all those related to this phenomenal project either directly or indirectly. (shrink)

This study conducts a bibliometric analysis of news discourse analysis using CiteSpace to sketch its scientific landscape based on journal articles in English in the Scopus database from 1988 through 2020. The statistical analysis provides evidence for the interdisciplinarity of this area, and shows an upward trend in general over these years as well as an accelerating growth rate in the past decade. Findings also indicate that the problem-oriented CDA has gained the most popularity in this area since its emergence, (...) and the appraisal framework, multimodality analysis, and discursive news values have become three hotspots of news discourse analysis. In addition, the authors in the West have contributed most in this area, but those from Chinese Mainland, Malaysia, South Africa, and Indonesia have gradually been an emerging powerhouse, which has added diversity in topics and will enhance equality and promote dialogue between different communities, ethnics, and races across the globe. (shrink)

This essay analyses two kinds of harmony as exemplified in Confucianism and Daoism and examines their relation with domination and freedom.

Integrating affective events theory, work-family compensation, and moral balance theory, the present study proposes a model that examines how and when abusive supervisory behavior is related to employees’ deviant behavior toward their supervisor. Using a diary method that involved two surveys per day over two weeks, we found support for our model based on 707 daily observations from 130 employees. Specifically, anger toward one’s supervisor mediated the relationship between abusive supervisory behavior and deviant behavior toward one’s supervisor. In addition, the (...) degree to which employees engaged in deviant behavior toward their supervisor depended on their prior-day deviant behavior toward their family. When employees engaged in lower prior-day deviant behavior toward their family, anger toward their supervisor was positively related to subsequent deviant behavior toward their supervisor. In contrast, when employees had higher prior-day deviant behavior toward their family, the relationship between anger toward their supervisor and deviant behavior toward their supervisor was weaker. We conclude by discussing the implications of our findings for research on abusive supervision, work-family interface, and moral balance theory. (shrink)

Our age is one of globalization. A major characteristic of this age is the interaction, contention, and integration of various cultural and philosophical traditions. In such an environment, Chinese studies can no longer be conducted in isolation, independently of external influences. If we call the 18th-19th centuries the age of reason, the 20th century the age of analysis, the 21st century is the age of comparative study. In our age, the mantra of “interpreting China in terms of (only) Chinese perspectives” (...) is no longer appropriate. Comparative approaches are becoming a quasi-paradigm in Chinese studies. (shrink)

All cultures are infused by or even rooted in certain values. Although those values are generally recognised in all societies, they are diversely ranked or proritised in different human groups and different perceptions partly account for cultural diversity as not all values can be equally upheld in any community or by any individual. Though value universalism in a strict sense is unachievable, we can all agree on a pluralistic mutual understanding of and tolerance for diversity.

In Aristotle’s moral psychology, deliberation (βούλευσις) is a very important concept that bridges the agent’s desire and action. However, his theory of what kind of desire is connected to deliberation creates puzzle for the reader: on the one hand, he repeatedly emphasizes that wish (βούλησις) sets the end for the agent, and deliberation finds the means for the agent to achieve the end of the action, and on the other hand, his moral psychology suggests that there are three kinds of (...) desires, namely, wish, spiritedness (θυμός), and appetite (ἐπιθυμία), and that, according to this division, all three kinds of desires can set the end of the action for deliberation. The traditional way of resolving this puzzle is to abandon wish as the only kind of desire that sets the end of deliberation and action, and to argue that at least appetite can also set the end of deliberation and action for the agent. The key rationale is that the akratic fails to achieve the object of her wish, but instead achieves the object of their appetite, and thus appetite sets the ends for their deliberation and actions. In addition, although the intemperate achieves the object of her wish, she also achieves the object of her appetite. This article argues against this traditional interpretation. Instead, I defend the view that, first, the end of all actions is set by the wish of the agent, and, second, the starting point of every act of deliberation is the end of the action set by the wish. On the basis of this interpretation, I also explain why the intemperate and the akratic agents initiate their deliberation with the end set by the wish. (shrink)

In his feature article,1 McCullough LB et al highlights the importance of civility among medical educators and academic leaders in shaping the professional habits of junior doctors. He emphasises the role of medical educators in correcting unprofessional behaviour and emphasises the need for academic leaders to motivate junior doctors to develop virtuous professional habits. The relationship between junior doctors and medical educators can be likened to that between students and teachers. Through active or passive learning from medical educators, junior doctors (...) gain the necessary knowledge, experience and professional virtues. Academic leaders, as prominent experts in their field, play a guiding role in this process. Therefore, their relationship with junior doctors is akin to that between idols and fans. In this regard, academic leaders can serve as exceptional role models for guiding junior doctors to develop the inclination to …. (shrink)

Humans can learn complex functional relationships between variables from small amounts of data. In doing so, they draw on prior expectations about the form of these relationships. In three experiments, we show that people learn to adjust these expectations through experience, learning about the likely forms of the functions they will encounter. Previous work has used Gaussian processes—a statistical framework that extends Bayesian nonparametric approaches to regression—to model human function learning. We build on this work, modeling the process of learning (...) to learn functions as a form of hierarchical Bayesian inference about the Gaussian process hyperparameters. (shrink)

In this essay I attempt to articulate a Confucian idea of gender equality from a perspective of yin-yang philosophy.

Abstract: In this essay I will discuss five major challenges faced by Confucianism in recent times. Two of these challenges have been widely acknowledged, namely those of science and democracy. I believe that Confucianism's problem with science has been largely solved, even though more constructive work would further strengthen Confucianism in this regard. The problem of democracy is still being dealt with. I will examine three more major challenges. The third major challenge for Confucianism comes from environmentalism. Confucianism has taken (...) note of its important message and has begun to respond to it. The fourth major challenge is the feminist challenge. Even though contemporary Confucianism accepts sexual equality, philosophically significant progress is yet to be made. The final challenge is the challenge of Confucianism's own survival. After serving three major assults in the 20th century, especially the most recent assult by "the glorious cat," Confucianism needs to find a way to renew itself into future. . (shrink)

Engaging in dialogue with African philosophy, I respond to questions raised by Thaddeus Metz on characteristics of Confucian philosophy in comparison with African philosophy. First, in both Confucian philosophy and African philosophy, harmony/harmonization and self-realization coincide in the process of person-making. Second, Confucians accept that sometimes it is inevitable to sacrifice individual components in order to achieve or maintain harmony at large scales; the point is how to minimize such costs. Third, Confucians give family love a central place in the (...) good life before extend love to the rest of the world. Fourth, the Confucian philosophy of gender equality is based on appropriate division of labor consistent with its yin-yang philosophy, rather than equal split of power in the family. Fifth, in the Confucian view, hierarchy and harmony do not necessarily contradict each other, though hierarchy is not essential to all forms of harmony. The two can co-exist. (shrink)

Narcissism is considered a generally undesirable trait in the workplace, but is this the whole story? In grandiose narcissism, two dimensions (narcissistic rivalry and narcissistic admiration) are recognized corresponding to self-protecting and self-enhancing regulatory processes separately. Applying the self-regulation theory and the conservation of resources theory, we investigated the distinct outcomes and influencing mechanisms of the two dimensions in an organizational context using multilevel structural equation modeling. Whereas previous literature has found narcissism to be mainly related to negative outcomes in (...) the workplace, our dimensional framework indicates that grandiose narcissism may have a Janus face—i.e., a dark side of unethical behaviors and a light side of prosocial behaviors. From a sample of 646 frontline employees in a Chinese call center, we found that while employee narcissistic rivalry was positively related to customer-directed sabotage through the mediation of emotional exhaustion, narcissistic admiration was positively related to organizational citizenship behavior toward customers (OCB-C) through the mediation of self-perceived status. In addition to the internal self-regulation of these two narcissism dimensions, political skill provides an external self-regulation that moderates the mediating effect of self-perceived status at the first stage—that is, the positive relationship between narcissistic admiration and self-perceived status is stronger when political skill is high rather than low. Our post hoc analyses further reveal that narcissistic rivalry is negatively related to OCB-C through the mediation of self-perceived status. Theoretical contributions and practical implications are discussed. (shrink)

Although data sharing platforms host diverse data types the features of these platforms are well-suited to facilitating biomarker research. Given the current state of biomarker discovery, an innovative paradigm to accelerate biomarker discovery is to utilize platforms such as Vivli to leverage researchers' abilities to integrate certain classes of biomarkers.

This book is the first academic work on the philosophy of engineering in China that reflects two decades of research. It puts forward a new thesis, namely that the core maxim in the philosophy of engineering is “I create, therefore I am,” which is radically different from the Cartesian maxim: “I think, therefore I am.” In addition, the book offers the first detailed portrait of the roots and evolution of the philosophy of engineering in China. The book begins by discussing (...) the triptych thesis of science, technology and engineering, which argues that there are a number of important distinctions between the three, e.g. scientific activities are chiefly based on discovery, while technological activities center on invention, and engineering activities focus on creation. Considering the latest developments in the philosophy of engineering, the author also analyzes engineering communities, engineering practice and a micro–meso–macro framework. In subsequent chapters, the author separately analyzes the three stages of engineering activities: planning, operating and using artifacts. In the closing chapter, two views on the philosophy of engineering are briefly explained. (shrink)

This book explores and elaborates three theories of public reason, drawn from Rawlsian political liberalism, natural law theory, and Confucianism. Drawing together academics from these separate approaches, the volume explores how the three theories critique each other, as well as how each one brings its theoretical arsenal to bear on the urgent contemporary debate of medical assistance in dying. The volume is structured in two parts: an exploration of the three traditions, followed by an in-depth overview of the conceptual and (...) historical background. In Part I, the three comprehensive opening chapters are supplemented by six dynamic chapters in dialogue with each other, each author responding to the other two traditions, and subsequently reflecting on the possible deficiencies of their own theories. The chapters in Part II cover a broad range of subjects, from an overview of the history of bioethics to the nature of autonomy and its status as a moral and political value. In its entirety, the volume provides a vibrant and exemplary collaborative resource to scholars interested in the role of public reason and its relevance in bioethical debate. (shrink)

We conducted an intertemporal online experiment to examine the contagion of others’ positive and negative donation behaviors. We collected two sets of data during and after the peak of the COVID-19 pandemic in China. The participants donated to the charitable fund, “Against COVID-19, The China Charity Federation Is on the Move.” We further investigated the mediating effect of social anxiety on the link between the contagion of donation behaviors and the changes in the COVID-19 situation. A total of 1022 participants (...) participated in the intertemporal online experiment and were considered in the statistical analyses. Our findings were as follows. First, the donation behaviors of others significantly changed these participants’ initial donation decisions, with increased or decreased donation amounts being associated with a positive or negative donation behavior, respectively. Others’ positive donation behavior was more likely to nudge these participants into changing their initial decisions than negative donation behavior during the peak of the pandemic. However, such difference disappeared after the peak because the contagion of positive donation behavior significantly decreased along with the abatement of the pandemic. Second, the participants’ social anxiety decreased along with the abatement of the pandemic, and social anxiety completely mediated the relationship between the pandemic abatement and the decrease in the contagion of positive donation behaviors. These findings advance our understanding of the motivations and influence mechanism of individuals’ donation decisions in the current pandemic situation and help make informed policy making decisions. (shrink)

Since antiquity, Confucians have sought to work with the state in order to implement their philosophy through state sponsorship. And yet, whenever Confucians have sought state sponsorship, naturally the government has adopted Confucian philosophy selectively to serve its own purposes and thus compromised the integrity of Confucianism. Throughout Chinese history, countless Confucian officials attempted to help rulers to do the right thing. They often failed when their advice went against the fundamental interest of rulers. On reflection, this outcome should not (...) be unexpected. The primary goal of rulers is to solidify power; the primary concern of Confucianism is the wellbeing of the people. When the two conflict, it is highly unlikely for a government to prioritize Confucian ideals. In a democratic era, Confucianism can influence society without joining the state apparatus. It can and must promote its social ideals through grassroots democratic participation rather than leave itself to the mercy of state sponsorship. (shrink)

Michael Sandel has been one of the most powerful critics of liberalism in the past decades. His work, especially in Liberalism and the Limits of Justice, exposes some of the fundamental flaws of Rawlsian liberalism and shows the need for a community-based framework in order for us to adequately understand and appreciate the concept of the individual and just society. Confucians can endorse many of Sandel’s critiques of liberalism. From a Confucian perspective, however, Sandel’s version of communitarianism is nevertheless too (...) thin for a robust communitarian society. Confucians maintain a thick notion of community and take it to be vital to human flourishing. In this essay, I first discuss a key point where Confucians converge with Sandel as an example of the common ground between the two philosophies before turn to one important difference between them. The key point of convergence is about the circumstances of justice; the difference is on harmony. Harmony lies in the very center of the Confucian notion of community, whereas it has been given no place in Sandel’s conception of community. This essay offers a Confucian critique as well as an endorsement of Sandel’s communitarian philosophy. It also extends a friendly invitation to Sandel for him to take harmony into his conception of community. (shrink)

Research on action memory has been pursued for more than 30 years, but it is still unclear what drives the recollection process of performed actions. In this study, we used the remember/know paradigm and designed two experiments to examine the relation between item-specific processing and retrieval awareness of subject-performed tasks (SPT). The results showed that SPT allows remember responses in remember-know judgments more easily; that is, SPT can enhance the frequency of recalling re-collective experience. Item-specific processing can improve the memory (...) performance and the proportion of remember judgments of verbal tasks (VT), but it does not improve the memory performance and proportion of remember judgments of SPT, indicating that SPT can enhance item-specific processing, which leads to more remember responses in judgment. The relation between item-specific processing and retrieval awareness of SPT is also discussed. (shrink)

长期以来，中国学术界流行把儒家的基本思想乃至整个中国文化归结为“天人合一”，并常常把“天人合一” 的源头归结于《易经》。其实考诸中国思想史，把儒家的基本思想总结为“天人合一”，特别是把“天人合一” 的来源归结于《易经》的说法并不准确，是一种误导。《易经》的“天、地、人”三才思想较之于“天人合一”更为符合儒家思想的本旨。在儒家三才和谐的理念中，天、地、人三者各自都有自身的功能与价值。身为三才和谐结 构中的积极参与者，人类拥有促进与维持宇宙和谐的重要责任。就环境哲学而言，儒家的“三才”说既不是“环境保护主义”，也不是“自然保护主义”，而且相对于大地伦理学与深层生态学等西方的整体性环境哲学而言，儒家 整体性的环境哲学赋予人类在宇宙间以一个更崇高的地位和责任。 .

Previous research has demonstrated that duration of implied motion (IM) was dilated, whereas hMT+ activity related to perceptual processes on IM stimuli could be modulated by their motion coherence. Based on these findings, the present study aimed to examine whether subjective time perception of IM stimuli would be influenced by varying coherence levels. A temporal bisection task was used to measure the subjective experience of time, in which photographic stimuli showing a human moving in four directions (left, right, toward, or (...) away from the viewer) were presented as probe stimuli. The varying coherence of these IM stimuli was manipulated by changing the percentage of pictures implying movement in one direction. Participants were required to judge whether the duration of probe stimulus was more similar to the long or short pre-presented standard duration. As predicted, the point of subjective equality was significantly modulated by the varying coherence of the IM stimuli, but not for no-IM stimuli. This finding suggests that coherence level might be a key mediating factor for perceived duration of IM images, and top-down perceptual stream from inferred motion could influence subjective experience of time perception. (shrink)

Previous studies have shown that individuals in collectivist cultures may be more corrupt than those in individualist cultures when they are interacting with outgroup members. The countries that are least corrupt, according to the Transparency International Corruption Perceptions Index, tend to have horizontal individualist cultures, with Singapore being a prominent counterexample. Can findings at the cultural level of analysis be replicated at the individual level of analysis? To answer this question the authors examined the relationship between deception and cultural orientation (...) in a Singaporean sample. The results indicate that, despite the fact that Singapore is very low in corruption on the Transparency International Corruption Perceptions Index, vertical collectivism was still able to account for the variance in deception. Theoretical and practical implications are discussed. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)