Many factors determine whether and when a class of therapeutic agents will be successfully developed and brought to market, and historians of science, entrepreneurs, drug developers, and clinicians should be interested in accounts of both successes and failures. Successes induce many participants and observers to document them, whereas failed efforts are often lost to history, in part because involved parties are typically unmotivated to document their failures. The GLP-1 class of drugs for diabetes and obesity have emerged over the past (...) decade as clinical and financial blockbusters, perhaps soon becoming the highest single source of revenue for the pharmaceutical industry (Berk 2023). In that context, it is instructive to tell the story of the first commercial effort to develop this class of drugs for metabolic disease, and how, despite remarkable early success, the work was abandoned in 1990. Told by a key participant in the effort, this story documents history that would otherwise be lost and suggests a number of lessons about drug development that remain relevant today. (shrink)

A development project introduces various changes into a community. Some of these changes are positive while others are negative or warrant better planning. Evaluation reports designed strictly for quantitative, targetoriented physical and fiscal achievements often overlook many of these changes. Our personal field observations and experiences with an agricultural development project showed us several examples of impacts brought about in the local farming system in some hill districts of Nepal. These impacts cannot be neglected and project evaluation and (...) progress reports should accommodate such changes. (shrink)

The construct of “choking under pressure” is concerned with the phenomenon of unexpected, sudden, and significant declines in individual athletes’ performances in important situations and has received empirical attention in the field of sport psychology. Although a number of theories about the reasons for the occurrence of choking under pressure exist and several intervention approaches have been developed, underlying mechanisms of choking are still under debate and the effectiveness of existing interventions remains contested. These sudden performance declines also occur in (...) team sport. “Collective sport team collapse,” which describes the situation when an entire sport team underperforms significantly within an important competitive situation, has received less empirical attention, in comparison to individual choking research. While there are a few studies that have investigated causes of collective team collapse, understandably, there has been limited empirical investigation of preventative and intervention strategies. Although the two constructs appear to share several similar characteristics and mechanisms, research has not yet examined the conceptual, theoretical, empirical, and practical links between choking under pressure and collective sport team collapse. In this review article, we seek to examine these similarities and differences and identify new ways of thinking about future interventions. Furthermore, current empirical understandings in the field of choking under pressure and collective sport team collapse are presented and the most effective intervention approaches for both constructs are introduced. On the basis of this examination, we modestly make some initial recommendations for sport psychological practitioners and future research. (shrink)

Prominent tuberculosis (TB) actors are invoking solidarity to motivate and justify collective action to address TB, including through intensified development and implementation (D&I) of technologies such as drugs and diagnostics. We characterize the ethical challenges associated with D&I of new TB technologies by drawing on stakeholder perspectives from 23 key informant interviews and we articulate the ethical implications of solidarity for TB technology D&I. The fundamental ethical issue facing TB technological D&I is a failure within and beyond the (...) TB community to stand in solidarity with persons with TB in addressing the complex sociopolitical contexts of technological D&I. The failure in solidarity relates to two further ethical challenges raised by respondents: skewed power dynamics that hinder D&I and uncertainties around weighing risks and benefits associated with new technologies. Respondents identified advocacy and participatory research practices as necessary to address such challenges and to motivate sustained collective action to accelerate toward TB elimination. We present the first empirical examination of bioethical accounts of solidarity in public and global health. Our study suggests that solidarity allows us better to understand and address the ethical challenges that arrest the D&I of new TB technologies. Solidarity lends credence to policies and practices that address the relational nature of illness and health through collective action. (shrink)

Participation is an important but little understood concept in science and innovation. While participation promises the production of new knowledge, social justice, and economic growth, little research has been done on its contribution to innovation processes at the group level. The concept of imaginaries can provide a window into these processes. Adopting a micro-sociological perspective, we examined the interplay between imaginaries of participation and group development within a long-term ethnographic observation study of an initiative, Energy Avant-garde, as it pursued (...) the development of a decentralized, self-contained, and entirely renewable energy system in one German region. We scaled down the macrolevel concept of imaginaries to the group level. We found that group imaginaries are a resource for bringing order to a group and that a group is a resource for creating, operationalizing, revising, and sustaining imaginaries. We describe a “failure-through-success” story: while imaginaries initially promoted group cohesion, creativity, and productivity, in later stages, these effects were impeded by group dynamics. We therefore distinguish between process imaginaries and outcome imaginaries and conclude that, inherently, participation must be managed and employed at the appropriate stages to make valuable contributions. (shrink)

While substantial effort has been invested in making robots more reliable, experience demonstrates that robots operating in unstructured environments are often challenged by frequent failures. Despite this, robots have not yet reached a level of design that allows effective management of faulty or unexpected behavior by untrained users. To understand why this may be the case, an in-depth literature review was done to explore when people perceive and resolve robot failures, how robots communicate failure, how failures influence people's perceptions (...) and feelings toward robots, and how these effects can be mitigated. Fifty-two studies were identified relating to communicating failures and their causes, the influence of failures on human-robot interaction (HRI), and mitigating failures. Since little research has been done on these topics within the HRI community, insights from the fields of human computer interaction (HCI), human factors engineering, cognitive engineering and experimental psychology are presented and discussed. Based on the literature, we developed a model of information processing for robotic failures (Robot Failure Human Information Processing, RF-HIP), that guides the discussion of our findings. The model describes the way people perceive, process, and act on failures in human robot interaction. The model includes three main parts: (1) communicating failures, (2) perception and comprehension of failures, and (3) solving failures. Each part contains several stages, all influenced by contextual considerations and mitigation strategies. Several gaps in the literature have become evident as a result of this evaluation. More focus has been given to technical failures than interaction failures. Few studies focused on human errors, on communicating failures, or the cognitive, psychological, and social determinants that impact the design of mitigation strategies. By providing the stages of human information processing, RF-HIP can be used as a tool to promote the development of user-centered failure-handling strategies for HRIs. (shrink)

Failure is a central notion both in ethics of engineering and in engineering practice. Engineers devote considerable resources to assure their products will not fail and considerable progress has been made in the development of tools and methods for understanding and avoiding failure. Engineering ethics, on the other hand, is concerned with the moral and social aspects related to the causes and consequences of technological failures. But what is meant by failure, and what does it mean (...) that a failure has occurred? The subject of this paper is how engineers use and define this notion. Although a traditional definition of failure can be identified that is shared by a large part of the engineering community, the literature shows that engineers are willing to consider as failures also events and circumstance that are at odds with this traditional definition. These cases violate one or more of three assumptions made by the traditional approach to failure. An alternative approach, inspired by the notion of product life cycle, is proposed which dispenses with these assumptions. Besides being able to address the traditional cases of failure, it can deal successfully with the problematic cases. The adoption of a life cycle perspective allows the introduction of a clearer notion of failure and allows a classification of failure phenomena that takes into account the roles of stakeholders involved in the various stages of a product life cycle. (shrink)

The duty to protect patient welfare underpins undergraduate medical ethics and patient safety teaching. The current syllabus for patient safety emphasises the significance of organisational contribution to healthcare failures. However, the ongoing over-reliance on whistleblowing disproportionately emphasises individual contributions, alongside promoting a culture of blame and defensiveness among practitioners. Diane Vaughan’s ‘Normalisation of Deviance’ provides a counterpoise to such individualism, describing how signals of potential danger are collectively misinterpreted and incorporated into the accepted margins of safe operation. NoD is an (...) insidious process that often goes unnoticed, thus minimising the efficacy of whistleblowing as a defence against inevitable disaster. In this paper, we illustrate what can be learnt by greater attention to the collective, organisational contributions to healthcare failings by applying NoD to The Morecambe Bay Investigation. By focusing on a cluster of five ‘serious untoward incidents’ occurring in 2008, we describe a cycle of NoD affecting trust handling of events that allowed poor standards of care to persist for several years, before concluding with a poignant example of the limitations of whistleblowing, whereby the raising of concerns by a senior consultant failed to generate a response at trust board level. We suggest that greater space in medical education is needed to develop a thorough understanding of the cultural and organisational processes that underpin healthcare failures, and that medical education would benefit from integrating the teaching of medical ethics and patient safety to resolve the tension between systems approaches to safety and the individualism of whistleblowing. Data sharing not applicable as no datasets generated and/or analysed for this study. (shrink)

In this thesis I focus on F. H. Bradley's theory of judgment and his doctrine of predication. My goal is to present an account of Bradley's views which pays special attention to his belief that all logical predication must necessarily fail to accomplish what it sets out to do. All assertion , we are told, attempts to state truth, whole and complete; but, in the end, it must fall short. All judgment, Bradley claims, must contain an element of untruth or (...) falsity. And the outcome of this theory of predication is a doctrine of "degrees of truth". No truth is understood as entirely true or entirely false; rather, each has a position in a hierarchy of truths with some being truer than others when measured against the theoretical criterion of absolute knowledge. ;But, this is not to be understood as a sceptical doctrine. I argue that Bradley's doctrine of predicative failure should be seen as the only means by which radical scepticism in the theory of knowledge can be avoided. If we were capable of possessing truths which are whole and complete unto themselves then there would exist no legitimate basis upon which the inferential development of thought could expand beyond a self-enclosed circle. ;In this essay I also examine a persisting historical problem. It is my claim that Bradley's theory should be understood as a continuation of and development within the British neo-Kantian tradition. Bradley's association with this tradition has sometimes been questioned based on scattered statements found in the 1883 edition of the Principles of Logic. Collectively these statements have been referred to as the doctrine of "floating ideas". However, I maintain that the doctrine of floating ideas must be distinguished from the theory of predicative failure . I argue that the two theories should in no way be identified and that certain misinterpretations of Bradley's position have resulted from confusing these two incompatible views. (shrink)

This chapter develops criteria of work and failure implicit within the Prisons Information Group (GIP). Reading the group’s documents in conjunction with the thought of Michel Foucault, the chapter asks: How did the GIP characterize work or attribute failure and how did Foucault understand both in this period? By analyzing these discursive practices together, the essay first identifies five criteria of failure: discursive, structural, systemic, deconstructive, and productive failure. Second, it tests the GIP against each criterion, (...) marking where it does and does not fail. The chapter therefore offers an internal assessment of the GIP, one that is sensitive to the movement’s own discourse and development. In closing, the chapter draws several implications from this analysis of failure for contemporary prison activism and analysis. (shrink)

In Achievement, I suggest that failures can be just as good as achievements. Achievements are valuable because of their effort and competence, and some failures have these features too, and are therefore valuable for the same reasons. While that may be true, surely it’s also true that failures are, or can be, genuinely bad – not merely a privation of the good of achievement, but themselves intrinsically bad. As is the case for many bads, it is surprisingly difficult to give (...) an account that is not merely privative: viewed one way, a failure is simply a privation of attaining an end. This challenge is compounded by perfectionist theory of value, which may yield the most plausible account of achievement, but traditionally only offers an account of bads as privative. In this paper, I develop an account of failure as a robust bad by appealing to contrastive ends and the framework of tripartite perfectionism. (shrink)

The prominent, though not exclusive, role of basic needs strategies to attain ethically acceptable development goals raises the question of the ability of development agencies to find and employ basic needs strategies. The obligation to prevent severe human suffering leads to the obligation to employ basic needs strategies to attain basic needs goals. The history of failure by development agencies in finding and employing basic needs tools leads to a further obligation to cultivate bureaucratic environments which (...) foster profound innovation. This requires not only new tools but also new bureaucratic behaviour. An understandable obstacle to simultaneously technological and bureaucratic innovation lies in the tension between responsible behaviour and behaviour promoting fundamental change. Since this tension is based on the unpredictability of creative change, a series of axioms and corollaries which reduce the unpredictability is given. They include: (1) an obligation to seek innovation; (2) a clear statement of basic needs goals and intent to use some basic needs tools; (3) increase in effective knowledge of the poor and their survival strategies; (4) bureaucratic learning flexibility; (5) participatory development and allied emphasis on sustainable resource technologies. The embodiment of these in the learning process approach is illustrated. (shrink)

A possible explanation for policy implementation failure is that the views of the policy’s target groups are insufficiently taken into account during policy development. It has been argued that involving these groups in an interactive process of policy development could improve this. We analysed a project in which several target populations participated in workshops aimed to optimise the utilisation of an expensive novel drug (interferon beta) for patients with Multiple Sclerosis. All participants seemed to agree on the (...) appropriateness of establishing a central registry of Multiple Sclerosis patients and developing guidelines. Nevertheless, these policy measures were not implemented. Possible explanations include (1) the subject no longer had high priority when the costs appeared lower than expected, (2) the organisers had paid insufficient attention to the perceived problems of parties involved, and (3) changes within the socio-political context. The workshops in which representatives of the policy’s target populations participated did not provide enough interactivity to prevent policy implementation failure. (shrink)

With the continuous development of software, it is inevitable that there will be various unpredictable problems in computer software or programs that will damage the normal operation of the software. In the paper, static analysis software is taken as the research object, the errors or failures caused by the potential defects of the software modules are analyzed, and a software analysis method based on big data tendency prediction is proposed to use the software defects of the stacked noise reduction (...) sparse analyzer to predict. This method can learn features from original defect data, directly and efficiently extract required features of all levels from software defect data by setting different number of hidden layers, sparse regularization parameters, and noise ratio, and then classify and predict the extracted features by combining with big data. Through experimental tests, the performance of the presented method is better than that of the comparison method in correct rate, accuracy rate, recall rate, F1-measurement, AUC value, and running time, which proves that the research results in this paper have more accurate failure prediction effect and can timely eliminate software failures. (shrink)

This paper contains a development of the consequences of a form of skepticism closely akin to traditional fallibilism. It is contended that fallibilism properly understood is compatible with actual possession of knowledge and with rationally continuing claims to such possession. In order to justify this contention, the notion of a K—game as a species of game played in accordance with rules is developed, first leaning on Brians Skyrms' notion of a rational dialectic and then on independent grounds. The notion (...) of knowledge which emerges from this is compatible with some but not all of the analyses of knowledge which have recently been put forward. (shrink)

Feigning symptoms distorts diagnostic evaluations. Therefore, dedicated tools known as symptom validity tests have been developed to help clinicians differentiate feigned from genuine symptom presentations. While a deviant SVT score is an indicator of a feigned symptom presentation, a non-deviant score provides support for the hypothesis that the symptom presentation is valid. Ideally, non-deviant SVT scores should temper suspicion of feigning even in cases where the patient fits the DSM’s stereotypical yet faulty profile of the “antisocial” feigner. Across three studies, (...) we tested whether non-deviant SVT scores, indeed, have this corrective effect. We gave psychology students and clinical experts a case alluding to the DSM profile of feigning. In successive steps, they received information about the case, among which non-deviant SVT outcomes. After each step, participants rated how strongly they suspected feigning and how confident they were about their judgment. Both students and experts showed suspicion rates around the midpoint of the scale and did not respond to non-deviant SVT outcomes with lowered suspicion rates. In Study 4, we educated participants about the shortcomings of the DSM’s antisocial typology of feigning and the importance of the negative predictive power of SVTs, after which they processed the case information. Judgments remained roughly similar to those in Studies 1–3. Taken together, our findings suggest that students and experts alike have difficulties understanding that non-deviant scores on SVTs reduce the probability of feigning as a correct differential diagnosis. (shrink)

The U.S. Food and Drug Administration's rationale for supporting the development and approval of BiDil for heart failure specifically in black patients was based on under-powered, post hoc subgroup analyses of two relatively old trials , which were further complicated by substantial covariate imbalances between racial groups. Indeed, the only statistically significant difference observed between black and white patients was found without any adjustment for potential confounders in samples that were unlikely to have been adequately randomized. Meanwhile, because (...) the accepted baseline therapy for heart failure has substantially improved since these trials took place, their results cannot be combined with data from the more recent trial amongst black patients alone. There is therefore little scientific evidence to support the approval of BiDil only for use in black patients, and the FDA's rationale fails to consider the ethical consequences of recognizing racial categories as valid markers of innate biological difference, and permitting the development of group-specific therapies that are subject to commercial incentives rather than scientific evidence or therapeutic imperatives. This paper reviews the limitations in the scientific evidence used to support the approval of BiDil only for use in black patients; calls for further analysis of the V-HeFT I and II data which might clarify whether responses to H-I vary by race; and evaluates the consequences of commercial incentives to develop racialized medicines. We recommend that the FDA revise the procedures they use to examine applications for race-based therapies to ensure that these are based on robust scientific claims and do not undermine the aims of the 1992 Revitalization Act. (shrink)

Why do policies fail? How can we objectively choose the best policy from two (or more) competing alternatives? How can we create better policies? To answer these critical questions this book presents an innovative yet workable approach. Avoiding Policy Failure uses emerging metapolicy methodologies in case studies that compare successful policies with ones that have failed. Those studies investigate the systemic nature of each policy text to gain new insights into why policies fail. -/- In addition to providing intriguing (...) directions for research, this book also suggests a bold new standard for evaluating policies. While this method is broadly generalizable, specific examples are provided showing how to develop better Economic Policy, Military Policy, and Constitutional Organizations. This book shows scholars, researchers, and policy analysts how to develop more effective policies so that we may achieve our highest aspirations and avoid the horrendous failures of the past. (shrink)

Conspiracy Theories and the Failure of Intellectual Critique argues that conspiracy theories, including those that conflict with official accounts and suggest that prominent people in Western democracies have engaged in appalling behavior, should be taken seriously and judged on their merits and problems on a case-by-case basis. It builds on the philosophical work on this topic that has developed over the past quarter century, challenging some of it, but affirming the emerging consensus: each conspiracy theory ought to be judged (...) on its particular merits and faults. The philosophical consensus contrasts starkly with what one finds in the social science literature. Kurtis Hagen argues that significant aspects of that literature, especially the psychological study of conspiracy theorists, has turned out to be flawed and misleading. Those flaws are not randomly directed; rather, they consistently serve to disparage conspiracy theorists unfairly. This suggests that there may be a bias against conspiracy theorists in the academy, skewing “scientific” results. Conspiracy Theories and the Failure of Intellectual Critique argues that social scientists who study conspiracy theories and/or conspiracy theorists would do well to better absorb the implications of the philosophical literature. (shrink)

Philosophy begins and ends in disagreement. Philosophers disagree among themselves in innumerable ways, and this pervasive and permanent dissent is a sign of their inability to solve philosophical problems and establish substantive truths. This raises the question: What should I do with my philosophical beliefs in light of philosophy's epistemic failure? In this open-access book, János Tozsér develops four possible answers into comprehensive metaphilosophical visions and argues that we cannot find peace either by committing ourselves to one of these (...) visions or by abandoning our philosophical beliefs. Tozsér calls this disheartening insight "the experience of breakdown", making the case that philosophy's truth-seeking and justificatory tools are unsuitable for establishing truths. Shedding light on the epistemic status of our philosophical beliefs, Tozsér adopts a broad approach to assess the metaphilosophical visions used by philosophers to interpret their own activity and determine their epistemic self-esteem. Open access was funded by the Research Centre for the Humanities, Hungary. (shrink)

During the nineteenth century, neuroanatomical knowledge and the clinical practice of treating mental illnesses develop at the same time. Some practitioners of mental medicine try to combine the clinical practice of treating mental diseases with neuroanatomical knowledge using the idea of cerebral localisations. This point of view is advocated by Gall and the field of phrenology. But there is no obvious success of such a localisationist project before Broca and Wernicke’s works on aphasia. This discovery will provoke a revival of (...) the desire to localise the cerebral zones involved in mental diseases. However, the cerebral localisation project progressively decreases during the end of the nineteenth century while neurological clinical practice emerges. Moreover, neurological clinical practice aims to localise anatomical lesions through clinical examination. From a philosophy of science point of view, this segment of history brings into question the relation between a scientific object (the cerebral localisation of zones involved in diseases) and a scientific subject (psychiatry and neurology). It stresses how a scientific project can migrate from one subject to another. (shrink)

Philosophers and scientists discuss how failure has influenced the development of science, and how current failures might influence its course in the future. Among the modern examples are nonequilibrium statistical physics, and neoclassical consumer theory; early examples include Aristotelian psychology and molecular biology. Some of the eight articles were presented at an April 1988 workshop at the University of Pittsburgh. No index. Annotation copyright by Book News, Inc., Portland, OR.

The development of agricultural science in the period 1850–1914 is described in the context of various methods of deciding whether or not it was successful. It is concluded that it was more successful after 1890 than before, and an explanation of this is offered, using a model first applied to agricultural research in Germany. In the light of these conclusions there are also comments on the role of the Development Commission in promoting agricultural research.

This paper explores the failure of modernisation theory and its more recent offspring as represented by 'transition to democracy' and 'construction of capitalism' theories to explain the post-communist development of Russia. Some post-modern theories, though, reinterpreted to emphasise the disintegration and fragmentation of the 'hard core' of social structures rather than the 'post-philosophical' mode of thinking and 'aestheticised' styles of consumption, are looked at for a more fruitful conceptual alternative. In the conclusion, the idea of 'multiple fragile modernities' (...) is argued for as the most promising starting point for the conceptualisation of post-communism as well as its correlation with global 'late capitalism'. (shrink)

This commentary tests a methodology proposed by Munk et al. (2022) for using failed predictions in machine learning as a method to identify ambiguous and rich cases for qualitative analysis. Using a dataset describing actions performed by fictional characters interacting with machine vision technologies in 500 artworks, movies, novels and videogames, I trained a simple machine learning algorithm (using the kNN algorithm in R) to predict whether or not an action was active or passive using only information about the fictional (...) characters. Predictable actions were generally unemotional and unambiguous activities where machine vision technologies were treated as simple tools. Unpredictable actions, that is, actions that the algorithm could not correctly predict, were more ambivalent and emotionally loaded, with more complex power relationships between characters and technologies. The results thus support Munk et al.'s theory that failed predictions can be productively used to identify rich cases for qualitative analysis. This test goes beyond simply replicating Munk et al.'s results by demonstrating that the method can be applied to a broader humanities domain, and that it does not require complex neural networks but can also work with a simpler machine learning algorithm. Further research is needed to develop an understanding of what kinds of data the method is useful for and which kinds of machine learning are most generative. To support this, the R code required to produce the results is included so the test can be replicated. The code can also be reused or adapted to test the method on other datasets. (shrink)

On an account of virtue as skill, virtues are acquired in the ways that skills are acquired. In this paper I focus on one implication of that account that is deserving of greater attention, which is that becoming more skillful requires learning from one’s failures, but that turns out to be especially challenging when dealing with moral failures. In skill acquisition, skills are improved by deliberate practice, where you strive to correct past mistakes and learn how to overcome your current (...) limitations. A similar story applies to virtue acquisition, as moral failures will be a part of anyone’s life, and we will all have to learn from these experiences. However, despite the importance of being able to learn from our mistakes, this is very difficult in practice, given that failure of any kind can be distressing, and especially so for moral failure. The distress created by a recognition of moral failure often prompts responses of anger, avoidance, or defensiveness; rather than attempts to make amends and when necessary to work on self-improvement. The most potentially distressing response to moral failure is shame, as it is often associated with defensiveness. It is here where emotion regulation will be important to manage that distress, and I focus on the skill of emotion differentiation. I argue that emotion differentiation is a promising strategy for distinguishing the emotions we may experience in the wake of failure, including shame, and to encourage those emotions that motivate self-improvement. Thus, emotion regulation is important for virtue acquisition. (shrink)

The coronavirus-19 (COVD-19) pandemic has resulted in strains on critical care resources throughout the world. Existing and newly developed guidelines for the allocation of scarce resources, including ventilators, frequently use the Sequential Organ Failure Assessment (SOFA) score for prognostic determination. This article will outline how SOFA scores were neither designed nor tested for this purpose and why guidelines based upon SOFA score groupings do not conform to ethical principles and community values.

Background: Heart failure is a major growing problem and affects not only patients but also their families and community networks and reduces the functional capacity of patients and impairs their social life. Research questions: This study was conducted to investigate relationship between illness-related worries and social dignity in patients with heart failure. Design: The study had a descriptive-analytic design, and data collection was carried out by means of two specific questionnaires. Participants and context: A total of 130 inpatients (...) from cardiac wards in hospitals affiliated with Tehran and Shahid Beheshti University of Medical Sciences participated. Ethical consideration: This study was approved by the Research Committee of Shahid Beheshti University of Medical Sciences. Results: The highest mean score of illness-related worries was attributed to the dimension of patient’s worry of physical–mental complications, and the least mean score was related to the dimension of the worry about the future of disease. The highest mean score of social dignity was associated with the dimension of social communication and support, and the least is attributed to the dimension of burden to others (economic). Pearson’s statistical test showed a significant correlation (r = 0.455, p < 0.05) between the score of illness-related worries and social dignity. Discussion: As the result of this study showed that reducing illness-related worries in patients with heart failure can improve their social dignity, using strategies to decrease worries and promote social dignity in these patients is recommended. Conclusion: This study affirms the importance of careful evaluation of individual patients to determine their needs related to dignity. We hope these results will help to promote actions by patient-care staff that honor and support patient dignity, resulting in benefits to patients and developing the quality of care based on human rights. (shrink)

The purpose of advance care planning is to allow an individual to maintain autonomy in end-of-life medical decision-making even when incapacitated by disease or terminal illness. The intersection of EOL medical technology, ethics of EOL care, and state and federal law has driven the development of the legal framework for advance directives. However, from an ethical perspective the current legal framework is inadequate to make ADs an effective EOL planning tool. One response to this flawed AD process has been (...) the development of Physician Orders for Life Sustaining Treatment. POLST has been described as a paradigm shift to address the inadequacies of ADs. However, POLST has failed to bridge the gap between patients and their autonomous, preferred EOL care decisions. Analysis of ADs and POLST reveals that future policy should focus on a communications-based approach to ACP that emphasizes ongoing interactions between healthcare providers and patients to optimize EOL medical care to the individual patient. (shrink)

Observations on the morphological and functional similarity between embryonic or trophoblast tissues and tumors are very old. Over a period of time many investigators have created different hypotheses on the origin of cancerogenesis or tumor efficiency in relation to the host immune system. Some of these ideas have been rejected but many of them are still current. A presumption of the inefficiency of anti-tumor immunity in mammals due to the high similarity between trophoblast and embryonic cells to tumor cells is (...) very real. The mechanisms for the escape of tumors from the immune response are very similar to the mechanisms for the escape of a fetoplacental unit from the maternal immune response. The similarity between these two mechanisms is so great that any randomness must be banished. At the same time, an incidence of malignant tumors and the types of more frequent tumors in non-mammalian vertebrates is significantly different to that in mammals. Lastly, the mechanisms of anti-tumor immunity in mammals are substantially different from the mechanisms of anti-tumor immunity in other classes of vertebrates. These facts indicate that the immune system of mammals during anti-tumor immune response is tricked by the similarity between tumor cells and trophoblast or other placental cells. From this aspect, our conclusion is that anti-tumor immunity failure in mammals can be defined as an immunoreproductive phenomenon, which is developed under the evolutionary pressure of autoimmunity and reproductive effectiveness. (shrink)

Theories of meaning developed within the analytic tradition, starting with Gottlob Frege, and within continental philosophy, starting with Husserl, can be distinguished by their disagreement about the phenomenon of collapse or failure of meaning. Our text focuses on Frege’s legacy, taken up by Rudolph Carnap, which culminated in a view of the collapse of meaning defined first by a purely syntactic conception of categorial error and second, when Tarski entered the scene, by the paradoxes created by the conflict between (...) the use of the predicate truth and the concept of proof. As positivism’s conventionalism and late model-theoretic semantics became the paradigms derived from this position, the result, in our view, was a conception of meaning success and meaning failure dominated by dependence on a technological conception. We will argue that this dependence leads to the inability to evaluate the breaks in rational parameters and crises of meaning addressed by the phenomenological and transcendental perspectives. Husserl’s critique of logic as technology is the basis for the reflexive standpoint on the phenomena of meaning failure that leads to a theoretical and eidetic ideal approach to that phenomenon. It is then suggested that this phenomenological reflective standpoint on the problem of meaning failure is the origin of the doors that lead to the divergent paths between the analytic and continental traditions. Thus, this is an article with three argumentative phases connected into a larger unity. The first phase presents Husserl’s critique of a purely extensional, syntactic, and recursive conception of logical consequence and the concept of truth; the second presents Hussel’s larger conception of meaning-failure; the third—presented in an appendix— presents a lesson on the division between continental and analytic philosophy. (shrink)

In the 1980s and 1990s the predominant metatheories in development analysis were cast into doubt by their apparent failure in practice. One response to this impasse in development theory was to turn to postmodern ideas to explain their failure. In particular many analysts utilized Foucauldian discourse theory to critique development as a discourse of power. Such analysis gave rise to a post-development school of thought that condemned development as harmful to people in the (...) Global South and advocated its abandonment. This paper argues that most such attempts at a discourse analysis of development were characterized by serious flaws related to skepticism, notably problems of performative contradiction and relativism. Consequently, the paper argues for an alternative approach in the form of a development ethics drawing on aspects of deconstructionist and critical realist thought. (shrink)

BlOMQVIST K, THEANDER E, MOWIDE I and LARSSON V. Nursing Inquiry 2010; 17: 317–323 What happens when you involve patients as experts? a participatory action research project at a renal failure unitAlthough there is a trend towards developing health care in a patient‐centred direction, changes are usually planned by the professionals without involving the patients. This paper presents an ongoing participatory action research project where patients with chronic renal failure, nurses at a specialist renal failure unit, a (...) hospital manager and a researcher worked together to develop patient‐centred care. The project combined the expertise of patients in their own experiences of living with a chronic condition with the professional expertise of nurses, the manager and the researcher. As the workload on the unit was uneven, the development work needed to be low in intensity but long‐term. Based on a number of dialogues in focus groups, four main development areas were identified; access to test results, prerequisites for postponing the progress of the illness, general awareness and understanding of living with chronic renal failure, and family‐focused care. A number of changes have been planned or implemented, such as developing a prototype for a web‐based feed‐back system, expanding patient education to newly diagnosed patients, steering the nurses' role towards a guiding and family‐focused function, and planning a digital story‐telling workshop. Involving committed people who have the mandate to change practices were prerequisites for success. (shrink)

Accounting ethics failures have seized headlines and cost investors billions of dollars. Improvement of the ethical reasoning and behavior of accountants has become a key concern for the accounting profession and for higher education in accounting. Researchers have asked a number of questions, including what type of accounting ethics education intervention would be most effective for accounting students. Some researchers have proposed virtue ethics as an appropriate moral framework for accounting. This research tested whether Smithian virtue ethics training, based on (...) Adam Smith’s “The Theory of Moral Sentiments”, is effective in improving accounting student’s cognitive moral development. This research used a pre-test, treatment, post-test, quasi-experimental design utilizing the Defining Issues Test 2 instrument to measure students’ CMD. Analysis of DIT-2 gain scores did show a significant improvement in subjects’ personal interest scores and a significant improvement in an overall measure of CMD, the DIT N2 index, whereas their DIT-2 post-conventional scores did not improve significantly. This research supports the proposition that the concepts contained in Smithian virtue ethics can contribute to an effective accounting ethics education intervention. However, further research is required to determine what concepts should be included to improve accounting students’ post-conventional moral reasoning. (shrink)

This paper contains a development of the consequences of a form of skepticism closely akin to traditional fallibilism. It is contended that fallibilism properly understood is compatible with actual possession of knowledge and with rationally continuing claims to such possession. In order to justify this contention, the notion of a K—game as a species of game played in accordance with rules is developed, first leaning on Brians Skyrms' notion of a rational dialectic and then on independent grounds. The notion (...) of knowledge which emerges from this is compatible with some but not all of the analyses of knowledge which have recently been put forward. (shrink)

Cognitive failures are lapses in attention, cognition, and actions that everybody experiences in everyday life. Self-reports are mainly used for assessment but those instruments are memory-biased and more related to personality aspects than to actual behavior. Ambulatory assessment is already used for capturing emotions or addictive behavior, but not yet for cognitive failures. The newly developed Questionnaire for Cognitive Failures in Everyday Life was applied via mobile phones wherein an acoustic signal asked participants 4 times daily to answer 13 questions (...) for 1 week. The new instrument showed satisfying reliability and was compared with a self-report method in terms of correlations with cognitive abilities , personality traits, and demographical aspects. Although further validation is needed, first results are promising and eKFA enriches cognitive failures research. (shrink)

School failure is an educational problem that affects academic performance and the trajectory of students, impacts their self-esteem, and contributes to social inequality. This phenomenon, which indicates low educational quality, is linked to a lack of motivation, poor performance, and a scarcity of resources. A critical approach proposes analyzing the institutional structures that perpetuate this situation, fostering dialogue among educational actors to find effective solutions. At the ISENCO high school in Tecomán, efforts are being made to identify internal and (...) external causes, proposing alternatives such as improving reading comprehension, implementing tutoring, and strengthening educational infrastructure. Additionally, it is crucial to develop critical thinking and ethical skills in students, as well as to encourage community participation in the school. This partial report presents advancements and results obtained, using a mixed approach for in-depth analysis that leads to solutions that prevent school dropout and failure. (shrink)

Cases of poor care have been documented across the world. Contrary to professional requirements, evidence indicates that these sometimes go unaddressed. For patients, the outcomes of this inaction are invariably negative. Previous work has either focused on why poor care occurs and what might be done to prevent it, or on the reasons why those who are witness to it find it difficult to raise their concerns. Here, we build on this work but specifically foreground the responsibilities of registrants and (...) students who witness poor care. Acknowledging the challenges associated with raising concerns, we make the case that failure to address poor care is a breach of moral expectation, professional requirement and, sometimes, legal frameworks. We argue that reporting will be more likely to take place if those who wish to enter the profession have a realistic view of the challenges they may encounter. When nurses are provided with robust and applied education on ethics, when “real‐world” cases and exemplars are used in practice and when steps are taken to develop and encourage individual moral courage, we may begin to see positive change. Ultimately however, significant change is only likely to take place where practice cultures invite and welcome feedback, promote critical reflection, and where strong, clear leadership support is shown by those in positions of influence across organisations. (shrink)

This illuminating book is a republican critique of the current system of global governance and its failure to address key global problems. With a republican account of international political theory which transcends prevailing forms of global governance, it develops republican forms of leadership and citizenship to inform the creation of a stronger system of formal international organisations. Republican Global Constitutionalism focuses on the current challenges facing formal international organisations such as the UN, the growing reliance on opaque informal international (...) organisations like the G20, and the inconsistent nature of transnational civil society. As a unique contribution to the field of global constitutionalism, the book provides an account of republican international political theory that emphasises the importance of extending the activity of citizens and constitutionalism beyond the state, in order to support the operation of transnational civil society and create a formal system of international organisations. Providing a concise intervention into the field of global governance, this book will appeal to scholars and students in the disciplines of international relations, political theory, transnational activism studies, international law, and public policy. It will also benefit policymakers and activists looking for alternative forms of global cooperation. (shrink)

Discourses of interdisciplinary health‐care are becoming more centralised in the context of global healthcare practices, which are increasingly based on multisystem interventions. As with all dominant discourses that are narrated into being, many others have been silenced and decentralised in the process. While questions of the nature and constituents of interdisciplinary practices continue to be debated and rehearsed, this paper focuses on the discourse of interdisciplinary collaboration using psychiatry as an example, with the aim of highlighting competing and alternative discourses. (...) The fundamental premise of this paper is that collaborative relationships form the basis of interdisciplinary practices in psychiatry. Through a critical engagement and a deconstructive reading of the pretext, context and subtexts of interdisciplinarity, we interrogate the concept of interdisciplinary practice within psychiatry. We contend that an important part of understanding and further conceptualising the discourse is through fracturing it. This process is illustrated in the successive stages of our conceptual map of discourse development: establishing, maintaining and developing discourses. An understanding of interdisciplinary practice is not only critical for psychiatry, but also offers important insights into the performance of collaborative failures and indeed successes across nursing and allied health professions. (shrink)

These lectures are concerned with the origins of the distinctive policies of the Stockholm School of Economics, of which Erik Lundberg was a leading member. Lundberg explores the historical development of the Stockholm School and considers its place in the wider Keynesian tradition which dominated macroeconomic thinking in the West from the 1930s till the 1970s. The author examines the failure of Keynesian policies both in Sweden and internationally, and offers some tantalising and provocative remedies for future policy-makers (...) to ponder. (shrink)

In case of failure, entrepreneurs could endure various financial, psychological, and social costs. These intertwined costs could affect their learning from failure. All individuals do not react in the same way when dealing with adversity. Rather than focusing on consequences of business failure, we took a more positive approach by using the Conservation of Resources model theory to build our conceptual model. Psychological capital, which refers to “an individual’s positive psychological state of development characterized by high (...) levels of self-efficacy, optimism, hope, and resilience,” could be considered as a resource to recover from entrepreneurial setbacks. We suggest that a high level of psychological capital plays a mediating role in the relationship between the negative consequences of failure and learning from failure. By learning from this experience, failed entrepreneurs will increase their intention to re-create a venture and pursue their entrepreneurial career. This theoretical research, by building a conceptual model based on resources, offers a more positive approach of entrepreneurial failure and investigates key psychological assets, such as psychological capital, that support the development of entrepreneurial resilience rather than the prevention of business failure. (shrink)

In July 2008, Pacific Rim Mining, a socially responsive Canadian gold mining Multinational Corporation (MNC) with $77 million invested in El Salvador, experienced a 30% decline in stock price when it suspended exploration drilling for gold there. In April 2009, the company filed a lawsuit against the government of El Salvador through Central American Free Trade Agreement to recover its investments plus damages. This corporate failure is explored based on: (1) four globalization economic development models, (2) the social, (...) political, and economic history of El Salvador, (3) the El Salvador gold mining industry, and (4) social movement reactions to international mining companies. MNCs must carefully engage "Social Justice" Nongovernment Organizations when pursuing economic development projects to ensure a nation's successful integration into the global economy. (shrink)

In his most recent book, Daniel Batson develops a psychological theory of moral motivation by looking at moral failure. Even under favorable conditions, Batson argues, people frequently behave immorally. In addition to defects of character or judgment and situational pressures, a lack of moral integrity plays an important role in explaining moral failure. Batson’s book sheds light on the most common sources of immoral behavior, providing moral philosophers with the resources to properly target their reasons to be moral.

The specific purpose of this introductory paper is to explicitly introduce readers to some of the important Biblical, Talmudic, andpost-Talmudic texts which deal with business ethics. As the discussion will show, Judaism’s traditional texts treat an amazing variety of issues emphasizing responsibilities in the business context. These texts are both legalistic and aspirational in character. The theme of this study is that an authentic Jewish business ethics needs to grow out of an understanding of the needs of modern, complex economies (...) but need not accept the status quo as binding. Jewish business ethics texts provide rules of behavior, but more importantly, the texts reveal a vision encouraging us to incorporate the highest human and spiritual ideals into the common world of business.The second section of the paper emphasizes that in order to develop Jewish business ethics, especially (but not exclusively) at the levelof the organization, models of aspiration will of necessity play an integral role. A Jewish business ethics which conceptualizes Judaismas merely a set of legal rules is bound to failure. A key conclusion of this section is that Jewish business ethics needs to continue to self-consciously promote models of aspirations, as well as rely on fixed legal norms.Finally, the third section of the paper examines a specific corporate policy (no smoking) in light of a Jewish business ethics. (shrink)

The recent deluge of sexual harassment allegations in the media serves as a reminder that sexual harassment remains a pervasive, destructive occurrence in the workplace. Organizations in the United States have taken a legal‐centric approach to managing workplace sexual harassment, resulting in impotent anti‐harassment policies, ineffective sexual harassment training, and underused reporting mechanisms. In this conceptual paper, I argue that men's differential perceptions of sociosexual behaviors have propagated this legal‐centric approach, which fails to meet organizations’ ethical obligation to provide a (...) safe and healthy work environment. Specifically, men have a different psychological experience of sexual harassment, which may inhibit their ability to take the perspective of targets. This lack of perspective‐taking has influenced the jurisprudence on workplace sexual harassment, which has in turn informed organizations’ approach to managing the phenomenon. I contribute to research on both business ethics and workplace sexual harassment by integrating two bodies of scholarship that have developed largely independent of one another: organizational psychology and legal. In so doing, I offer an explanation for the continued pervasiveness of workplace sexual harassment despite decades of legal sanction, organizational interventions, and research. (shrink)

BackgroundPatients with chronic heart failure and their family caregivers may experience adverse emotional problems, such as depression. Mutuality, which refers to the relationship between caregivers and those they care for, is an important factor affecting depression in the dyads. The purpose of this study was to investigate the relationship between mutuality and depression in patients with CHF and their caregivers in China.MethodsIn this cross-sectional study, we used the Mutuality Scale and the Self-Rating Depression Scale to measure mutuality and depression (...) of patients and caregivers. We used SPSS version 26.0 and AMOS version 21.0 to analyze the data. An APIM was established to analyze the actor-partner effects of patient-caregiver mutuality and depression.ResultsA total of 250 dyads of patients and caregivers were included in the study. There were statistically significant differences in mutuality and depression between CHF patients and caregivers. The 4 dimensions of patients’ mutuality all have the actor effect on depression. There were 3 partner effects of caregivers’ “pleasurable activities”, “shared values”, and “reciprocity” on depression. Regarding caregiver depression, we only found an actor effect of caregivers’ “shared values” on depression.ConclusionThe relationship between patients and caregivers should be evaluated in the clinical setting, and it is very important to develop intervention measures to improve the adverse emotional problems affecting both patients and their caregivers. (shrink)

Leader wisdom is crucial to effective organizations because it is one of the greatest human capacities. However, understanding what factors impact leader wisdom is still developing. In this paper, we rely on a fear-based view of wisdom and empirically examine through a quantitative study of 249 leaders if one of the primary regulators of human behavior (fear) is positively related to wisdom. We are specifically focused on the role of fear of failure and wisdom. Additionally, because we recognize that (...) fear has a negative connotation and has a tipping point regarding leader effectiveness, we propose that psychological empowerment serves as a coping mechanism for fear and mediates the relationship between fear of failure and wisdom. Through structural equation modeling (SEM), we demonstrate that fear of failure does positively impact leader wisdom and that this relationship is mediated by psychological empowerment. This study contributes to the literature by advancing the fear-based view of wisdom which unites two of the most powerful concepts in human history: fear and wisdom. Although wisdom has a resurgence of interest in business literature, fear is not given much attention. By theoretically and empirically linking fear of failure with wisdom, we shed light on how fear is an important motivating mechanism. The study also contributes to practice by suggesting leaders should fear failure and avoid minimizing fears to be wise. (shrink)