ObjectiveOur objective was to evaluate whether those individuals with previous involvement with formal clinical ethics processes differ in their attitudes towards the resolution of prototypical clinical ethics cases than general health care professionals. We hypothesized that those individuals with previous participation in ethics consultation would have significantly different attitudes on the appropriate role of ethics committees in the assessment and resolution of clinical ethical dilemmas than those who have not.MethodsWe conducted a case-based survey of health care professionals at six US (...) hospitals. We administered the survey to health care professionals in a variety of clinical roles at each center and further sub-categorized these by respondents reporting or not reporting their membership on an ethics committee or participation as an ethics consultant/requestor of ethics consult services. Using the analysis of variance test, we present the variation in attitudes using a 5-point Likert scale with 95% confidence intervals and significance set at p ≤ 0.05.ResultsA total of 240 respondents completed the survey (response rate: 63.6%) from all six surveyed centers (128 respondents with involvement with ethics consultation, 112 respondents without). Health care professionals not previously involved with formal clinical ethics processes were less likely to view the ethics committee as having a role in resolving the presented clinical ethical dilemmas ( p = 0.01 for analysis of variance comparison).ConclusionIn this multi-center survey study, health care providers without previous involvement with formal clinical ethics processes were less likely than those with previous involvement to support a role for ethics committees aiding in ethical case resolution. (shrink)

Comments on: JRE Focus on The 50th Anniversary of the Universal Declaration ofHuman Rights, Journal of Religious Ethics 26.2 “Rethinking Human Rights: A Review Essay on Religion, Relativism, and Other Matters” by David Little, Journal of Religious Ethics 27.1.

Arguing that intellectual movements, such as deconstruction, postsecular theory, and political theology, have different implications for cultures and societies that live with the debilitating effects of past imperialisms, Arvind Mandair ...

In lieu of an abstract, here is a brief excerpt of the content:Diasporic Impulses:Sikh Philosophy as an AssemblageArvind-Pal S. Mandair (bio)Let me begin this response by thanking the editors of Philosophy East and West for generously allowing space for this review forum on my recent book, Sikh Philosophy: Exploring Gurmat Concepts in a Decolonizing World (Bloomsbury, 2022), and thanking the reviewers Monika-Kirloskar Steinbach, Ananda Abeysekara, and Jeffery Long for their careful readings of this work. "Sikh Philosophy" names the modern academic (...) discourse that crystallized in the late nineteenth and early twentieth centuries as a result of the encounter between modern Western philosophy and gurmat, a mode of thought-praxis deriving from and associated with Sikhi (lit. "the path of learning"), a spiritual-philosophical tradition hailing from India, which most readers may only have encountered through the modern knowledge system's categorization of it as the religion known as Sikhism. To avoid complicating the discussion, I will be referring interchangeably to gurmat and Sikh philosophy, even though they represent quite different entities. Gurmat represents a tradition of thought-praxis that goes back to Guru Nanak, the founder of Sikhi, whereas Sikh philosophy is a modern formation that emerged from the encounter between gurmat and European thought, which is why I prefer to regard it as an assemblage. The book examines some of the key concepts of Sikh philosophy and how they inform its vision of life, what they tell us about the nature of reality, and whether it is possible to discern a distinct logic, epistemology, and ontology based on the principles of gurmat. In their reviews, Kirloskar-Steinbach, Abeysekara, and Long have provided critical readings and insightful questions, which I address below.Monika Kirloskar-Steinbach asks about the relationship between Sikh philosophy and Indian philosophy, noting that my book does not explicitly engage Indian philosophy. Specifically, she raises two questions: (1) whether Sikh philosophy should or potentially could be part of the broader field of Indian philosophy, and (2) whether I would be inclined to contribute to that field, particularly in light of recent efforts to diversify philosophical practices within Indian philosophy by scholars like Jonardon Ganeri in his Oxford Handbook of Indian Philosophy (2017) and Purushottama Bilimoria and Amy Rayner in their History of Indian Philosophy (2018). My immediate response would be "yes," but with an important caveat. In that vein, I applaud Ganeri's and Bilimoria/Rayner's efforts to open up philosophical inquiry within Indian traditions and take them beyond darśanic framings that narrowly positioned different thought-practices of South Asia either within or [End Page 364] in relation to the Brahmanical/Vedic/Sanskritic paradigm. Ganeri's "multiperspectival" narrative about practices might well enable discussions about Sikh philosophy to flourish, given that the lexicon of gurmat (the teaching, logic, practice of the Guru) is replete with concepts that have cognate terms in the main Hindu philosophical schools including Sāṃkhya, Yoga, Mīmāṃsā, and Vedānta; the Jain and Buddhist traditions; and perhaps most importantly, within the Islamic, especially Sufi, traditions. It is the seeming parity between cognate terms such as the Punjabi dharam (Skt. dharma), karam (Skt. karma), yoga, śabad (Skt. śabda), guru, hukam, and many more, which has given rise to the misperception that Sikh philosophy is a purely syncretic thought system parasitic on earlier Indic systems. A similar misperception might be that Sikhi is more primarily a mode of lived praxis or dharam than it is a philosophy (Bhogal 2018) and therefore has less to do with thought than with spiritual attainment. But this approach is far too narrow in that it opposes "philosophy"/"thought" to spiritual praxis without asking whether there might be a broader definition of thinking at play within Sikhi or gurmat. Such an approach fails to extricate itself from the legacy of imperial categorizations of Indic traditions as essentially religious and therefore unrelated to what is called "thinking." By doing so, it falls prey to another misconception many have, that the closest Indians have come to philosophical thought are the darśanic schools, not realizing that most Indian philosophers and thinkers were at the same time devotees and spiritual adepts who developed rigorous modes of discipline and practice.Having said this, I would premise any... (shrink)

Integrated information theory of consciousness proposes an identity between its causal structure and phenomenology. Through this assertion, IIT aims to explain consciousness by prioritizing first-person experience. However, despite its phenomenology-first stance, developments in IIT have overlooked temporality. As such, we argue that at present IIT’s phenomenological analysis is incomplete. In this critique, we show how IIT takes a non-identical illusionist stance towards the experiences of continuity, flow, and extent of our experiences. Moreover, in isolating temporal grains of experience to a (...) single timescale, IIT misses out on capturing the multi-scale nested nature of temporal phenomena. Hence, we contend that IIT needs an axiom for time, through which its causal structure can be refined to account for temporal experiences. Here, we propose an axiom to address these concerns. We conclude by discussing how IIT may need to be revised if our concerns hold true. (shrink)

“Racial capitalism” has surfaced during the past few decades in projects that highlight the production of difference in tandem with the production of capital—usually through violence. Scholars in this tradition typically draw their inspiration—and framework—from Cedric Robinson’s influential 1983 text, Black Marxism: The Making of the Black Radical Tradition. This article uses the work of Orlando Patterson to highlight some limits of “racial capitalism” as a theoretical project. First, the “racial capitalism” literature rarely clarifies what scholars mean by “race” or (...) “capitalism.” Second, some scholars using this conceptual language treat black subjectivity as a debilitated condition. An alleged byproduct of the Transatlantic slave trade, this debilitated form of black subjectivity derives from an African American exceptionalism that treats slavery as a form of abject status particular to capitalism without providing adequate theoretical justification or historical explanation. By contrast, we demonstrate how Patterson’s insights about property, status, and capital offer an analysis of slavery more attentive to race, gender, sexuality, age, and ability. We close by using the “forensics of capital” to explore the notions of causality and protocols for determining who owes what to whom implicit in Patterson’s concept of “social death.”. (shrink)

For eradication of acute poverty, it is vital to factor in the human experience of it. Building social capital and networks that nurture, empower, and consistently reinforce a new shared economic identity can provide rich socioeconomic dividends. For states tackling extreme poverty at scale, building and strengthening social capital are essential public goods investments.

Explores deep sleep (susupti), one of the three states of consciousness in Advaita Vedanta, and the major role it plays in this philosophy.

Management of meaning inside organizations has been an enduring issue in organization studies. Issues relating to commitment and control through the meaning-making mechanisms have been studied by organization culture theorists for sometime now. However, rapidly changing dynamics of the business environment lend these issues a critical salience today. Two factors of this dynamic context are particularly noteworthy. Firstly, a redefinition of the long-standing employment relationship—loyalty no longer being traded for lifelong employment—has led management to look for alternative sources of gaining (...) commitment from their employees. Second, several factors—socio-cultural, organizational and individual—have led the employees today to explore issues relating to meaning and purpose in their workplaces. Labelled variously by different scholars, the most widely accepted term for this growing movement is ‘Spirituality at Work’. In this article we link the two factors to present a framework wherein the emergence of an issue from the private individual domain to the organizational is seen as having the potential of answering concerns of eliciting commitment from employees in a turbulent environment. However, the SAW movement is accompanied by vigorous debates about the concept itself and on how it is to be studied. In the course of this article we present the central conceptual debates that have characterized the SAW discourse to emerge with three definitional themes to understand and study SAW, and then argue for utilizing the person–organization fit lens to study SAW. We end with a conceptual framework that would enable researchers to make a comprehensive study of the elusive phenomenon of SAW. (shrink)

Jvanmukti or 'living liberation' has been identified as a distinguishing feature of Indian thought; or, upon drawing a narrower circle, of Hindu thought; and upon drawing an even narrower cocentric circle of Vedānta - of Advaita Vedānta. In some recent studies the cogency of its formulation within Advaita Vedānta has been questioned - but without reference to the testimony of its major modern exemplar, Rama a Mahar i (1879-1950). This paper examines the significance of the life and statements of Rama (...) a Mahar i for the current debate in the context of neo-Hinduism. (shrink)

We studied the dynamics of large networks of spiking neurons with conductance-based (nonlinear) synapses and compared them to net- works with current-based (linear) synapses. For systems with sparse and inhibition-dominated recurrent connectivity, weak external inputs in- duced asynchronous irregular firing at low rates. Membrane potentials fluctuated a few millivolts below threshold, and membrane conductances were increased by a factor 2 to 5 with respect to the resting state. This combination of parameters characterizes the ongoing spiking activity typ- ically recorded in (...) the cortex in vivo. Many aspects of the asynchronous irregular state in conductance-based networks could be sufficiently well characterized with a simple numerical mean field approach. In particular, it correctly predicted an intriguing property of conductance-based net- works that does not appear to be shared by current-based models: they exhibit states of low-rate asynchronous irregular activity that persist for some period of time even in the absence of external inputs and with- out cortical pacemakers. Simulations of larger networks (up to 350,000 neurons) demonstrated that the survival time of self-sustained activity increases exponentially with network size. (shrink)

Isolated feedforward networks (FFNs) of spiking neurons have been studied extensively for their ability to propagate transient synchrony and asynchronous firing rates, in the presence of activity independent synaptic background noise (Diesmann et al., 1999; van Rossum et al., 2002). In a biologically realistic scenario, however, the FFN should be embedded in a recurrent network, such that the activity in the FFN and the network activity may dynamically interact. Previously, transient synchrony propagating in an FFN was found to destabilize the (...) dynamics of the embedding network (Mehring et al., 2003). Here, we show that by modeling synapses as conductance transients, rather than current sources, it is possible to embed and propagate transient synchrony in the FFN, without destabilizing the background network dynamics. However, the network activity has a strong impact on the type of activity that can be propagated in the embedded FFN. Global synchrony and high firing rates in the embedding network prohibit the propagation of both, synchronous and asynchronous spiking activity. In contrast, asynchronous low-rate network states support the propagation of both, synchronous spiking and asynchro- nous, but only low firing rates. In either case, spiking activity tends to synchronize as it propagates, challenging the feasibility to transmit information in asynchronous firing rates. Finally, asynchronous network activity allows to embed more than one FFN, with the amount of cross talk depending on the degree of overlap in the FFNs. This opens the possibility of computational mechanisms using transient synchrony among the activities in multiple FFNs. (shrink)

The way we represent and perceive time has crucial implications for studying temporality in conscious experience. Contrasting positions posit that temporal information is separately abstracted out like any other perceptual property through specialized mechanisms or that time is represented through the temporality of experiences themselves. To add to this debate, we investigate alterations in felt time in conditions where only conscious visual experience is altered through perceptual switches while a bistable figure remains physically unchanged. We predicted that if perceived time (...) is a function of temporally evolving conscious content, then a break in it (here via a perceptual switch) would also lead to a break in felt time. In three experiments, we showed participants a Necker cube that was manipulated to induce a perceptual switch (experiments 1(a) and 1(b)) or left to switch on its own (experiment 2). We asked participants to report both perceptual switches and felt durations (experiments 1(a) and 2) or only estimate time (experiment 1(b)). Over these three experiments, we find evidence of contraction of felt time in trials with a perceptual switch, consistent with the idea that perceived time is a function of temporally evolving conscious experience. Additionally, we present a phenomenological demonstration to support our empirical data. Overall, the study provides evidence for temporal mirroring and isomorphism in visual experience, arguing for a link between the timing of experience and time perception. (shrink)

“Humble” and “business school” are not two words you might associate together, but we can address grand challenges only if business school education instills epistemic humility through reflexivity. We hope that this call-to-action challenges educators to consider how we develop future business leaders who are sensitized to the communities around them, open to tackling the range of challenges that the Sustainable Development Goals (SDGs) present to all of society.

With the aging of the general population and the ability of intensivists to support patients using ventilator support, tracheostomy has become a vital tool in the medical management of critically ill patients. While much of the medical literature on tracheostomy has focused on the optimal timing of and indications for performing this procedure, little is written on the ethical tensions that can revolve around decisions by patients, surrogates, and physicians on its use. This article will elucidate the ethical dilemmas that (...) can arise surrounding the use of tracheostomy in critically ill patients and how ethics consultants and committees can approach these cases to allow resolution. (shrink)

Attempted suicide represents a personal tragedy for the patient and their loved ones and can be a challenge for acute care physicians. Medical professionals generally view it as their obligation to aggressively treat patients who are critically ill after a suicide attempt, on the presumption that a suicidal patient lacks decision making capacity from severe psychiatric impairment. However, physicians may be confronted by deliberative patient statements, advanced directives or surrogate decision makers who urge the withholding or withdrawal of life sustaining (...) treatments based on the patient’s underlying medical condition or life experience. How acute care providers weigh these expressions of patient wishes versus their own views of beneficence, non–maleficence and professional integrity poses a significant ethical challenge. This article presents a case that exemplifies the medical and ethical tensions that can arise in treating a patient following a suicide attempt and how to approach their resolution. (shrink)

This paper encapsulates the debate as to whether or not tarka is an additional source of knowledge. In this regard, Jaina thinkers opine that they are, unlike Buddhists and Nyāya thinkers, an additional source of knowledge, for what we come to know through tarka is not known through any other means of knowledge. En route, Jaina’s understanding of tarka is put forth, thereafter their criticism of others’ understanding is supplied. Eventually, some recent discussions over this debate are intimated that seem (...) to go in support of Jaina understanding of tarka. These recent discussions hint at the direction in which Jaina thinkers need to advance their stand. (shrink)

In Bancoult, a majority of the House of Lords upheld the British government's use of the royal prerogative to expel the population of the Chagos Islands from their homeland. The majority acknowledged that the government's treatment of the Chagossians was disturbing, but held that the law left them with no choice but to hold the orders valid. In this article, I draw a parallel between this decision and the 18th-century judicial response to the Zong affair—where over a hundred slaves were (...) thrown off a ship to drown in the sea. Both decisions are cloaked in formalist rhetoric but, as I show through an examination of the law as it stood prior to each of the decisions, the actual legal reasoning in both decisions is so without basis as to be unsustainable on any formalist or legalist account. Rather, the decision in Bancoult, like the decision in the Zong, shows all the hallmarks of being a purely pragmatic one, prompted by broader concerns as to the practical impact of a contrary decision and the precedent it would set. The inherent limitations of this mode of judicial reasoning make its deployment in Bancoult troubling. (shrink)

Slow money, or patient nurturing capital directly invested locally in small firms in food and basic industries, is a new term but an old notion. It gains revival in times of crisis, especially after the recent financial crisis, as people search for meaning and a way out of the ruinous effects of uncontrolled capitalism. This article traces the roots of the movement to Gandhian thought. It examines the cases of the CIGALES clubs of microangels in France and the more recent (...) case of the slow money alliance to ferret out the basic principles and strategies of these movements and how they are aligned with Gandhian values. (shrink)

Despite the prevalence of post-colonial theory in the humanities and social sciences, why is it that the two main secular formations in the study of religion(s), as philosophy of religion and history of religions, continue to deploy very similar mechanisms that reconstitute past imperialisms such as the hegemony of theory as specifically Western and/or the division of labor between universal and particular knowledge formations? To answer this question this paper stages an oblique engagement between the seemingly divergent discourses: (i) philosophy (...) of religion, (ii) history of religion—more specifically the area specialism called South Asian religions, and (iii) post-colonial theory especially where these discourses intersect with the discipline of Indology and the representation of Indic phenomena. A different version of this engagement occurs in Hegel’s Lectures on the Philosophy of Religion (LPR). A post-colonial reading of the LPR reveals closer and often unacknowledged connections between the birth of these two disciplines. More importantly the LPR anticipates the auto-immunizing mechanism that underpins the continued lack of engagement between the various disciplines of contemporary religions. Ironically, this mechanism, it will be argued, is located in the very heart of the comparative enterprise itself. (shrink)

The concept śabad (Word) is central to Sikh scripture, doctrine, philosophy and spiritual praxis. This lecture offers a postsecular interpretation of this important concept and examines the passage of śabad from premodern scriptural sources to its entanglement in contemporary "wars of scholarship".

Jīvanmukti or ‘living liberation’ has been identified as a distinguishing feature of Indian thought; or, upon drawing a narrower circle, of Hindu thought; and upon drawing an even narrower cocentric circle of Vedānta—of Advaita Vedānta. In some recent studies the cogency of its formulation within Advaita Vedānta has been questioned—but without reference to the testimony of its major modern exemplar, Rama a Mahar i. This paper examines the significance of the life and statements of Rama a Mahar i for the (...) current debate in the context of neo-Hinduism. (shrink)

गेटिअर के शोध-पत्र "Is Justified Treu Belief Knowledge" जो कि ANALYSIS में 1963 में प्रकाशित हुआ था उसका यह हिन्दी अनुवाद है। .

Oncogenic transformation is often associated with aberrant glycosylation in experimental and human tumors. The carbohydrate epitopes, resulting either from incomplete synthesis or neosynthesis, accumulate in high density, possibly in a novel conformation, at the tumor cell surface. A variety of monoclonal antibodies have been developed that recognize tumor‐associated carbohydrate antigens and their aberrant organization at the cell surface. These carbohydrate epitopes and the antibodies specific to these structures are being exploited to develop novel diagnostic tools and therapeutic strategies for cancer.

BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to (...) measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as “No Disclosure”, “Partial Disclosure” or “Full Disclosure”. Data was keyed in and analysed using STATA v 13.0.ResultsOnly 10.1% intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.ConclusionMost doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure. (shrink)

The principal aim under the U.N. Framework Convention on Climate Change (UNFCCC) has been to establish a legally-binding regime regulating emission of greenhouse gas. The hopes were tempered at Copenhagen which charted no clear path towards a treaty with binding commitments. The result, instead, was the Copenhagen Accord, a non-binding agreement that captured political consensus on a number of core issues absent its formal adoption by the Conference of the Parties. Thus, the achievement of an agreement in the climate summit (...) at Cancun seemed a herculean task. However, after two weeks of hectic UN-led parleys, the nations of the world arguably reached a forward-looking deal that leaves open an extension of the Kyoto Protocol as well as the crucial question of the level of emission limitation and reduction commitments. Cancun outcome can be perceived in twin contexts; (a) As a continuation of series of efforts since the establishment of UNFCCC to have a legally binding regime; and (b) as a resurgent hope to get on board after a failed effort at Copenhagen. The dynamics of climate change presents varied dilemmas of justice. The paper, in particular, delves upon the issue of distributive justice in reference to Cancun agreements, to intuit the viability of a new era that would lead to a climate responsible pathway. (shrink)

The aged in India have conventionally enjoyed privileges within the framework of a social economy where the needs of the old remained a moral responsibility of family, kith and kin. However the present changing times have forced a shift in the approach to old age care. The old person finds him- or herself in a sticky situation, in between an insensitive state and the demands of globalization. The present paper situates this problem within the framework of globalization and systematically measures (...) the strategic response of the state to this daunting challenge, with respect to economic security and health care in particular. In the conclusion, the paper argues for a rejection of the conventional welfare approach and it advocates an integrated approach based on a coherent social development perspective within the valuation framework of social quality. (shrink)

The article proposes a framework utilizing the Person–Organization fit approach to facilitate spirituality in the workplace. The article argues that spirituality can be described on a continuum varying from low to high at both individual and organizational levels. The interaction of the two continuums is then used to suggest a model to facilitate workplace spirituality. Thus, the approach is to first consider the interaction of person and situation factors and then depending on the compatibility of these two factors, look for (...) specific ways to facilitate spirituality at work. Various suggestions and examples are included to illustrate the practical implementation of our recommendations. (shrink)

Purpose This study aims to endeavor to explore the extent of gender digital divide in Uttar Pradesh, a most populous state of India, with a particular focus on the first and second order of digital divide, including availability, access time and use of the internet. Design/methodology/approach The authors have adopted stratified multistage sampling procedure for this research and conducted an empirical study on the data set of 600 respondents of six districts of U.P. to perform the inter-regional analysis. Furthermore, χ2 (...) method has been used to reveal the factors responsible for the GDD among selected districts of UP. Findings Statistical results clearly indicate that out of 12 sub-districts, most of the districts suffered from first order as well as second order of GDD, and this gender disparity within an increasing digitization environment is due to the existence of exclusion from basic technological skills, social norms and financial constraints. Practical implications The results have implications for the U.P. Government in general and policymakers behind digitization projects in particular as well as the promoters of gender equality including researchers and fellows. Originality/value This study is the first to illustrate the orders of the digital gender gap in a developing economy such as India and to gain an insight into the factors behind it. This research will also consider a promising avenue for future work. (shrink)

With the improvements in medical care and resultant increase in life expectancy of the intellectually disabled, it will become more common for healthcare providers to be confronted by ethical dilemmas in the care of this patient population. Many of the dilemmas will focus on what is in the best interest of patients who have never been able to express their wishes with regard to medical and end-of-life care and who should be empowered to exercise surrogate medical decision-making authority on their (...) behalf. A case is presented that exemplifies the ethical and legal tensions surrounding surrogate medical decision making for acutely ill, never-competent, profoundly intellectually disabled patients. (shrink)

At the end of life, pain management is commonly a fundamental part of the treatment plan for patients where curative measures are no longer possible. However, the increased recognition of opioid diversion for secondary gain coupled with efforts to treat patients in the home environment towards the end of life creates the potential for ethical dilemmas in the palliative care management of terminal patients in need of continuous pain management. We present the case of an end-stage patient with rectal cancer (...) who required a continuous residential narcotic infusion of fentanyl for pain control due to metastatic disease. His functional status was such that he had poor oral intake and ability to perform other activities of daily living, but was able to live at home with health agency nursing care. The patient presented to this institution with a highly suspect history of having lost his fentanyl infusion in a residential accident and asking for a refill to continue home therapy. The treating physicians had concerns of diversion of the infusion medication by caregivers and were reluctant to continue the therapeutic relationship with the patient. This case exemplifies the tension that can exist between wanting to continue with palliative care management of an end-stage patient and the fear of providers when confronted by evidence of potential diversion of opioid analgesic medications. We elucidate how an ethical framework based on a combination of virtue and narrative/relationship theories with reference to proportionality can guide physicians to a pragmatic resolution of these difficult situations. (shrink)