BackgroundCommentators believe that the ethical decision-making climate is instrumental in enhancing interprofessional collaboration in intensive care units. Our aim was twofold: to determine the perception of the ethical climate, levels of moral distress, and intention to leave one's job among nurses and physicians, and between the different ICU types and determine the association between the ethical climate, moral distress, and intention to leave.MethodsWe performed a cross-sectional questionnaire study between May 2021 and August 2021 involving 206 nurses and physicians in a (...) large urban academic hospital. We used the validated Ethical Decision-Making Climate Questionnaire and the Measure of Moral Distress for Healthcare Professionals tools and asked respondents their intention to leave their jobs. We also made comparisons between the different ICU types. We used Pearson's correlation coefficient to identify statistically significant associations between the Ethical Climate, Moral Distress, and Intention to Leave.ResultsNurses perceived the ethical climate for decision-making as less favorable than physicians. They also had significantly greater levels of moral distress and higher intention to leave their job rates than physicians. Regarding the ICU types, the Neonatal/pediatric unit had a significantly higher overall ethical climate score than the Medical and Surgical units and also demonstrated lower moral distress scores and lower “intention to leave” scores compared with both the Medical and Surgical units. The ethical climate and moral distress scores were negatively correlated ; moral distress and "intention to leave" was positively correlated ; and ethical climate and “intention to leave” were negatively correlated.ConclusionsSignificant differences exist in the perception of the ethical climate, levels of moral distress, and intention to leave between nurses and physicians and between the different ICU types. Inspecting the individual factors of the ethical climate and moral distress tools can help hospital leadership target organizational factors that improve interprofessional collaboration, lessening moral distress, decreasing turnover, and improved patient care. (shrink)

Matti Eklund (2017) has argued that ardent realists face a serious dilemma. Ardent realists believe that there is a mind-independent fact as to which normative concepts we are to use. Eklund claims that the ardent realist cannot explain why this is so without plumping in favor of their own normative concepts or changing the topic. The paper first advances the discussion by clarifying two ways of understanding the question of which normative concepts to choose: a theoretical question about which concepts (...) have the abstract property of being normatively privileged and a further practical question of which concepts we are to choose even granting some concepts are thus privileged. I argue that the ardent realist’s best bet for answering the theoretical question while avoiding Eklund’s dilemma is to provide a real definition of this property. I point out the difficulties for providing such a definition. I then argue that even with an answer to the theoretical question, the ardent realist faces a further dilemma in answering the practical question. In sum, though I see no knock-down argument against ardent realism, it may nonetheless die a death by a thousand cuts. I close by considering a deeper reason for why ardent realism is so difficult to defend: every argument starts somewhere. It is unclear how there can be an Archimedean point that makes no reference to any normative concepts that can nonetheless be employed to convince everyone to adopt ours. I then briefly propose two options for someone still inclined towards realism: (i) accept that our normative concepts are normatively privileged without attempting to explain why this is so, or (ii) be less ardent and accept a perspective-dependent account of normativity. (shrink)

The use of racial categories in biomedicine has had a long history in the United States. However, social hierarchy and discrimination, justified by purported scientific differences, has also plagued the history of racial categories. Because “race” has some correlation with biological and genetic characteristics, there has been a call not to “throw the baby out with the bathwater” by eliminating race as a research or clinical category. I argue that race is too undefined and fluid to be useful as a (...) proxy for biology or genetics. (shrink)

The Great Synthesis of Wang Yangming Neo-Confucianism in Korea, a pioneering study of Chŏng Chedu (Hagok, 1649-1736) and Korean Yangming Neo-Confucianism, includes an annotated translation of the Chonŏn, Hagok's most important work on self-cultivation, and a comprehensive introduction to his life, scholarship, and thought.

From its inception, genomics has been a speculative endeavor, fixated on a far-off horizon that would deliver on the promise of targeted diagnostics and individualized therapeutics (Fortun 2008). M...

This fortieth anniversary edition features a new afterword by Samuel Bercholz, founder of Shambhala Publications.

The emergence of environmental governance practices raises a fundamental question as to whether they are substantive or symbolic. Toward that end, we analyze the relationship between a firm’s environmental governance and its environmental management as reflected in its ultimate outcome, environmental performance. We posit that substantive practices would bring changes in organizations, most notably in terms of improved environmental performance, whereas symbolic practices would portray organizations as environmentally committed without making meaningful changes to their operations. Focusing on a sample of (...) environmentally sensitive firms, results are consistent with environmental governance mechanisms being predominantly part of a symbolic approach to manage stakeholder perceptions on environmental management, having little substantial impact on organizations. Statistical analyses show mostly that there is no relation between environmental governance mechanisms and environmental performance, measured in terms of regulatory compliance, pollution prevention, and environmental capital expenditures. However, there is some indication that environmental incentives are associated with pollution prevention. Interviews with corporate directors shed further light on these results by underlining that environmental governance mechanisms are employed at the board level to protect the organization from reputational and/or regulatory harm, but are not necessarily intended to proactively improve environmental performance. (shrink)

A collection of Chogyam Trungpa's early teachings in North America--on buddha nature, emptiness, the feminine principle, and the three bodies of enlightenment. At the beginning of a North American teaching career that would span seventeen years, the meditation master Chogyam Trungpa conducted five pivotal seminars covering various dharmic topics. The transcripts from these seminars are collected here so that readers can experience them right at home. Comprising twenty-six talks in total, each one followed by a Q&A, Glimpses of the Profound (...) is sure to provoke glimpses of all kinds: glimpses that inspire you to look further, glimpses that give you confidence, glimpses that upset the apple cart, glimpses that open your heart, glimpses that undermine falsity, glimpses that awaken you to your boundless potential. This book was originally published as four separate volumes by Vajradhatu Publications. Judith L. Lief has written a new introduction. (shrink)

Public investments in genomic and precision medicine have begun to yield clinically useful interventions, most recently, for example, two new, FDA-approved gene therapies for sickle cell disease (F...

Peterson et al. (2023) identify important ethical issues that are relevant to psychedelic therapy and research in various clinical populations and contexts. This is certainly the case in palliative...

현대철학의 핵심문제로 제시되어온 주체의 개념을 유 럽철학사의 맥락으로 논한 저서.

McCradden et al. propose to close the “AI chasm” between algorithms and clinically meaningful application using the norms of evidence-based medicine and clinical research, with the rat...

1-kwŏn. Yugyo ŭi kwagŏ wa hyŏnjae kŭrigo mirae -- 2-kwŏn. Chŏngsang kwa isang ŭi taegyŏl yŏksa.

In this paper we investigate whether, and how, corporate management strategically uses disclosure to manage the perceptions of different organizational audiences. In particular, we examine the interactions between the FIAT Group and three of its key organizational audiences—the local press, the international press, and the financial analysts, which are characterized by different levels of salience for the company. We focus on both how management reacts to the optimism level existing within each audience and how the narrative disclosure tone adopted by (...) FIAT influences the ex-post optimism in the local and international press or in the financial analyst community. We investigate the disclosure of the FIAT Group over a 6-year period , during which 70 price-sensitive press releases were published. On the basis of 1,887 news articles published in Italian newspapers and 411 analyst reports, we report evidence of different strategic patterns in the interaction processes between FIAT and its audiences. Our findings also indicate some differences in the way FIAT is affected by, and in turn, affects the sentiment of each audience, thus highlighting that the salience of the stakeholder is an important driver of the adoption of impression management techniques. Taken together, our findings point to issues related to setting the “tone at the top” and potential ethical matters. (shrink)