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

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

This book is a collection of articles on different aspects of university education in China since the late nineteenth century, addressing how far the ideal of modern university education, which has gradually been developed in the West since the age of European Enlightenment, was adopted or transformed by Chinese universities.

While the movement to ensure patient’s rights to information and informed consent spreads throughout the world, patient rights of this kind have yet to be introduced in mainland China. Nonetheless, China is no different from other parts of the world in that nurses are expected to shoulder the responsibility of safeguarding patients’ best interests and at the same time to uphold their right to information. This paper expounds on the principle of protectiveness grounded in traditional Chinese medical ethics concerning the (...) practice of informed consent. Nurses in China have a moral obligation to treat patients with sincerity. This notion carries a strong sense of parental protectiveness. As far as information-giving is concerned, nurses in China are ambivalent about the notion of truthfulness. The findings of an empirical study undertaken in seven Chinese cities reveal that nurses in China experience similar difficulties related to the disclosure of information as their counterparts in other parts of the world. A nurse’s narrative, the Chan case, is used to illustrate the typical difficult situation that nurses in China often encounter in looking after vulnerable patients who would like to learn more about their therapeutic regimens. The moral tension embedded in nursing practice is analysed. It is found that most nurses would prefer to tell the truth to patients, but their primary ethical justification is not that of respect for patients’ autonomy or safeguarding patients’ right to self-determination. Rather, it is basically beneficent in nature; that is, they base their decision to reveal the truth on whether or not patients will receive more relevant treatment and better nursing care. (shrink)

In this paper, we describe four broad ‘meta-methods’ employed in scientific and philosophical research of qualia. These are the theory-centred metamethod, the property-centred meta-method, the argument-centred meta-method, and the event-centred meta-method. Broadly speaking, the theory-centred meta-method is interested in the role of qualia as some theoretical entities picked out by our folk psychological theories; the property-centred meta-method is interested in some metaphysical properties of qualia that we immediately observe through introspection ; the argument-centred meta-method is interested in the role of (...) qualia in some arguments for non-physicalism; the event-centred metamethod is interested in the role of qualia as some natural events whose nature is hidden and must be uncovered empirically. We will argue that the event-centred metamethod is the most promising route to a comprehensive scientific conception of qualia because of the flexibility of ontological and methodological assumptions it can provide. We also reveal the hidden influences of the different meta-methods and in doing so show why consideration of meta-methods has value for the study of consciousness. (shrink)

Two groups of scientists have just announced what is being described as a leap forward in human stem cell research.1–3 Both have found ways of producing what are being called “induced pluripotent cells” , stem cells that they hope will demonstrate the same key properties of regeneration and unrestricted differentiation that human embryonic stem cells possess, but which are derived from skin cells not from embryos. In simple terms, these scientists have succeeded in reprogramming skin cells to behave like hESCs.Stem (...) cell research has been hailed as one of the most important and exciting areas of science, because it is believed that these types of cells will not only play an important part in regenerative medicine, but also yield valuable scientific information. These latest developments in cell reprogramming represent a milestone for stem cell science. No longer does the paradigm of irreversible cell specialisation hold true; instead, almost any type of cell might have the potential to become any other.The advent of techniques for producing these iPCs has also been hailed as an ethical breakthrough. Up until now, the production of hESCs has required a process which involves the destruction of embryos. Many of these embryos are available as by-products of IVF; but in addition, the process of somatic cell nuclear transfer to produce cloned embryonic stem cells requires a supply of human oocytes, which must currently be harvested from female donors at no insignificant cost. In a nutshell, iPCs seem to enable us to produce “embryo-free” human pluripotent stem cells, and in a “gender-neutral” way—that is, without the need for human oocytes.The response from the scientific community, ethical commentators and the public has, however, reflected an inherent confusion over the ethical significance of this research. The anti-embryo …. (shrink)

The Humility Thesis is a persistent thesis in contemporary metaphysics. It is known by a variety of names, including, but not limited to, Humility, Intrinsic Humility, Kantian Humility, Kantian Physicalism, Intrinsic Ignorance, Categorical Ignorance, Irremediable Ignorance, and Noumenalism. According to the thesis, we human beings, and any knowers that share our general ways of knowing, are irremediably ignorant of a certain class of properties that are intrinsic to material entities … Continue reading Humility Regarding Intrinsic Properties →.

O objetivo deste artigo é descrever o grau de parentesco existente entre várias famílias de origem chinesa que se estabeleceram em Nicoya e analisar como isso influenciou suas contribuições para o desenvolvimento socioeconômico da cidade e seus padrões de mobilidade em todo o Pacífico da Costa Rica desde final do século XIX até meados do século XX. Os participantes do estudo são descendentes de imigrantes que se enraizaram em Nicoya entre 1880 e 1950, que possuíam duas peculiaridades: pertenciam aos mesmos (...) clãs familiares, apesar dos diferentes sobrenomes com os quais estavam registrados ou eram da mesma área geográfica e, às vezes, até da mesma aldeia, que desenvolveu laços de afinidade tão fortes quanto laços consanguíneos. Isso lhes permitiu apoiar-se mutuamente para alcançar o desenvolvimento coletivo do grupo de imigrantes chineses em Nicoya. (shrink)

Drawing on the general ethics and social psychology literature, this study presents a model to delineate the major factors likely to affect consumers’ intentions to bring their own shopping bags when visiting a supermarket (called “bring your own bags” or “BYOB” intention). The model is empirically validated using a survey of 250 Chinese consumers. Overall, the findings support the hypothesized direct influence of teleological evaluation and habit on BYOB intention, as well as that of deontological evaluation and teleological evaluation on (...) ethical judgment about the BYOB practice. Teleological evaluation exerts a much stronger influence on ethical judgment than does deontological evaluation. In addition, the findings reveal that consumers who perceive the BYOB practice to be more important are more inclined to rely on their ethical judgment to derive their BYOB intention. Academically, these findings provide some encouraging evidence for the application of general ethics theories to explain green consumption-related practices. Practically, the findings also suggest that a utilitarian approach (i.e., emphasizing the consequences of BYOB) may represent an effective means for the Chinese government to promote BYOB practice among consumers. (shrink)

Business Ethics, the Environment &Responsibility, Volume 31, Issue 4, Page 904-922, October 2022.

Aristotelian theory, as found in Michael Thompson and Philippa Foot, claims that to be good is to be good as a member of that kind. Moreover, Foot argues in effect that goodness admits of only the kind-based sort, obtaining solely in virtue of something’s satisfying kind-based standards. However, I contend that something can satisfy kind-relative standards but nonetheless be bad—I propose a hypothetical Ebola-like microbe that meets its kind-standards of being destructive for its own sake, but it would plausibly be (...) bad for doing so. In defending my counterexample, I respond to the Aristotelian contention that evaluations should only be made from “within” the standpoint of a particular lifeform conception, rather than an “external” one from which that kind itself can be judged to be bad. (shrink)

More impetus needs to be placed on cord blood donationIn July, the Royal College of Obstetricians and Gynaecologists released a report on the uses and the potential perils of umbilical cord blood collection.1 This report has had the positive effect of drawing attention to what has hitherto been an under addressed topic of medical research and ethics. However, the focus and recommendations of the report say little about one important aspect of cord blood usage—research. Such an omission, although understandable from (...) an organisation primarily concerned with maternal and neonatal health, may nevertheless have implications for the broader applicability of the report’s recommendations, outside the immediate arena of patient care.The RCOG report deals with various aspects of cord blood collection and use—the harvesting procedure itself; cord blood transplantation treatment, either as an autologous cell transplant or as a donation for community use; and whether cord blood banking for personal use should be permitted or encouraged as a privately funded commercial enterprise. It also makes note of some of the legal and ethical issues surrounding cord blood and tissue banking more generally, concerns that will be of increasing importance as more biobanks are established worldwide. A large part of the report deals with concerns on neonatal and maternal safety and whether cord blood collection may pose a risk. These concerns may be valid and certainly, the health of mothers and children should not be compromised. The guidance provided by this report in relation to the collection procedure will undoubtedly assist maternity health professionals in this area.The main relevance of the RCOG …. (shrink)

Questions about sincerity play a central role in our lives. But what makes an assertion insincere? In this paper we argue that the answer to this question is not as straightforward as it has sometimes been taken to be. Until recently the dominant answer has been that a speaker makes an insincere assertion if and only if he does not believe the proposition asserted. There are, however, persuasive counterexamples to this simple account. It has been proposed instead that an insincere (...) assertion that p is one made by a speaker who (a) does not express his belief that p; or (b) does not believe that he believes that p; (c) does not assent to p; or (d) does not express any of these cognitive states. We show that these .. (shrink)

In a recent article Merritt has claimed that current observational data provide “severe tests” falsifying the standard cosmological model. Based on Popper’s idea of conventionalism, he concludes that the introduction of some essential components of the standard cosmological model—including dark matter and dark energy—are a consequence of conventionalist stratagems. In this article, I provide more recent discoveries and discussions showing that the standard cosmological model is not built on any conventionalist stratagem.

Different forms of mindfulness meditation are increasingly integrated in the clinical practice in the last three decades. Previous studies have identified changes in the neurophysiology and neurochemistry of the brain resulting from different mindfulness meditation practices in the general population. However, research on neural correlates of different types of meditation, particularly on the clinical outcomes, is still very sparse. Therefore, the aim of this article is to review the neural impact of mindfulness meditation interventions on different mental disorders via the (...) classification of main components of mindfulness meditation. The clearer classification of mindfulness meditation may inform future clinical practice and research directions. (shrink)

This paper outlines a possible state of affairs in which human moral autonomy and a divine command ethical theory coexist. the theory of human moral autonomy agrees with the divine command theory that moral laws are created by an act of legislation. they disagree on who is the legitimate legislator. the paper argues that a rational agent faced with equally acceptable but incompatible solutions to moral problems or faced with disagreement among agents who insist on exercising their moral autonomy is (...) justified in accepting unconditionally the legitimacy of divine commands legislated by a just, merciful and loving god. (shrink)

In personal relationships, we conceive of the related person as an individual who is more than a combination of qualities, a bearer of claims or a role-occupant. She is envisaged as a distinct and irreplaceable particular. We have immediate concerns for her that are not mediated by consideration of principles such as the promotion of welfare or the fulfillment of duty. The aim of my dissertation is to analyze and defend this particularistic concern and show how it is anchored in (...) what I call an engaged perspective. Recent critics of Kantianism and utilitarianism claim that these theories endorse only an objective or impersonal perspective, which ignores the particularity of individuals. I contrast this with an engaged perspective which I explicate by building on insights embodied in the Confucian account of role-ethics in the period 550 B.C.-290 B.C. I argue that although Confucian ethics has been rightly interpreted to stress the way in which social role mediates between relationships, nonetheless its ideal concerns socially-mediated relations of love between individuals. ;I first examine the cardinal Confucian virtue of jen, or loving, and other role virtues such as filial piety, and show how they help create connectedness and mutuality. People are connected when they share their emotional world and care for each other. And they share an exclusive mutuality when they generate a unique history of reciprocation and participate in the common good of their relationship. In addition, particularity functions as a structural factor to govern the caring, reciprocity, and emotions of love. Consequently, an engaged agent considers her beloved and the relationship she is engaged in as irreplaceable particulars. The engaged perspective is a distinctive "we" perspective arising from the awareness of such connectedness and mutuality. I also contrast the engaged perspective with the personal perspective. ;Finally, I analyze the motivational structure of a Confucian agent by examining the influence of propriety, emotions, thinking and will on Confucian agency. This confirms my analysis of the engaged perspective and further informs us about the type of agency required in engagement. (shrink)

The emergency department (ED) is a fast-paced, highly stressful environment where clinicians function with little or suboptimal information and where time is measured in minutes and hours. In addition, death and dying are phenomena that are often experienced in the ED. Current end-of-life care models, based on chronic illness trajectories, may be difficult to apply in the ED. A philosophical approach examining end-of-life care may help us understand how core medical and nursing values are embodied as care practices and as (...) ethical comportment. The integration of Aristotle's notions of phronesis and praxis with Merleau-Ponty's ontological notions of intentional arc and maximum grip in the context of the culture and practices of the ED offers a unique view of clinical and ethical practice at the end-of-life in the emergency setting. Caring for people at the end-of-life calls us to act virtuously based on previous experience, meanings and local practices. The maximum grip of the ultimate particulars of the situation combined with one's experiential and theoretical knowledge opens up situated possibilities for the expert clinician. (shrink)

This study provides a global perspective on citations of articles published in ten business ethics journals between 1999 and 2012 and establishes three findings. First, the results indicate that Journal of Business Ethics and Business and Society are the two top business ethics journals based on the distribution of normalized citations received. Second, although North America, particularly the US, remains the top producer of business ethics research, it has been surpassed by Europe in terms of weighted normalized research citations received (...) in 2012, implying a potential diminishing global role of US influence in business ethics research over time. Third, the top-ranked US institutions have reduced their business ethics research impact in recent years, while the European institutions have sharply increased theirs. (shrink)

This book offers a new perspective on advance directives through a combined legal, ethical and philosophical inquiry. In addition to making a significant and novel theoretical contribution to the field, the book has an interdisciplinary and international appeal. The book will help academics, healthcare professionals, legal practitioners and the educated reader to understand the challenges of creating and implementing advance directives, anticipate clinical realities, and preparing advance directives that reflect a higher degree of assurance in terms of implementation.