Evidence shows that changes in the architecture, design, and decor of health care facilities can improve patient care and in the long run reduce expenses. These essays detail the state of the research, look inside two hospitals that put some of these innovations into practice, and consider how design fits into the moral mission ofhealth care.

This paper establishes six critical elements – history, political structures, religion, social customs, civil society openness, and level of economic development –needed to understand the context of corporate social responsibility in other countries and other cultures. Labor conditions in China are used as a case study.

Consumers have the power to influence the social performance of corporations, but in the United States this power has gone largely unused. And too little attention has been paid to consumer issues by IABS scholars. To better understand why and when consumer boycotts are either effective or successful, this paper studies the reaction to two oil industry incidents: the Exxon Valdez oil spill in Alaska and the Shell Oil Brent Spar controversy. Five ingredients are identified as important to the understanding (...) of consumer activism: culture, context, cause, challenge, and charisma. (shrink)

This paper explores the social, legal, and political issues Wal-Mart faces in each of the three North American countries and suggests reasons for the quite significant differences. It also issues a call to Business and Society scholars to add prescriptive work to the already large body of descriptive work that has been collected.

The paper compares the business-government-society relationship between China and the U.S. through the analysis of three cases: the tainted milk scandal in China, the beef recall in the U.S., and the peanut scandal in the U.S.

The paper compares the business-government-society relationship between China and the U.S. through the analysis of three cases: the tainted milk scandal in China, the beef recall in the U.S., and the peanut scandal in the U.S.

Recent progress in artificial intelligence (AI) has drawn attention to the technology’s transformative potential, including what some see as its prospects for causing large-scale harm. We review two influential arguments purporting to show how AI could pose catastrophic risks. The first argument — the Problem of Power-Seeking — claims that, under certain assumptions, advanced AI systems are likely to engage in dangerous power-seeking behavior in pursuit of their goals. We review reasons for thinking that AI systems might seek power, that (...) they might obtain it, that this could lead to catastrophe, and that we might build and deploy such systems anyway. The second argument claims that the development of human-level AI will unlock rapid further progress, culminating in AI systems far more capable than any human — this is the Singularity Hypothesis. Power-seeking behavior on the part of such systems might be particularly dangerous. We discuss a variety of objections to both arguments and conclude by assessing the state of the debate. (shrink)

This is a selection of readings about professionalism and ethics in engineering. It addresses topics such as the concept of professionalism, education, and maintenance of competence, registration, professional autonomy, social effects and responsibilities, and enforcement of codes of ethics.

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

Under the impressive editorship of Warren Samuels et al, this book addresses the state of the history of economic thought today. An important contribution to the study of the history of economics, this eagerly-awaited book will develop an unsurprisingly large following.

As compared with conventional vaccine production systems, plant-made vaccines are said to enjoy a range of advantages including cost of production and ease of storage for distribution in developing countries. In this article, we introduce the science of PMV production, and address ethical issues associated with development and clinical testing of PMVs within three interrelated domains: PMVs as transgenic plants; PMVs as clinical research materials; and PMVs as agents of global health. We present three conclusions: first, while many of the (...) ethical issues raised by PMVs are familiar, PMVs add a new dimension to old issues, and raise some novel issues for ethicists and policy-makers; secondly, it is premature to promise broad applicability of PMVs across the developing world without having demonstrated their feasibility; thirdly, in particular, proponents of PMVs as a solution to global health problems must, as a condition of the ethical conduct of their research, define the commercial feasibility of PMVs for distribution in the developing world. (shrink)

Whereas boson coherent states with complex parametrization provide an elegant, and intuitive representation, there is no counterpart for fermions using complex parametrization. However, a complex parametrization provides a valuable way to describe amplitude and phase of a coherent beam. Thus we pose the question of whether a fermionic beam can be described, even approximately, by a complex-parametrized coherent state and define, in a natural way, approximate complex-parametrized fermion coherent states. Then we identify four appealing properties of boson coherent states (eigenstate (...) of annihilation operator, displaced vacuum state, preservation of product states under linear coupling, and factorization of correlators) and show that these approximate complex fermion coherent states fail all four criteria. The inapplicability of complex parametrization supports the use of Grassman algebras as an appropriate alternative. (shrink)

Whereas boson coherent states with complex parametrization provide an elegant, and intuitive representation, there is no counterpart for fermions using complex parametrization. However, a complex parametrization provides a valuable way to describe amplitude and phase of a coherent beam. Thus we pose the question of whether a fermionic beam can be described, even approximately, by a complex-parametrized coherent state and define, in a natural way, approximate complex-parametrized fermion coherent states. Then we identify four appealing properties of boson coherent states and (...) show that these approximate complex fermion coherent states fail all four criteria. The inapplicability of complex parametrization supports the use of Grassman algebras as an appropriate alternative. (shrink)

ObjectiveOverweight and obesity [body mass index ≥ 25 kg/m2] are associated with poorer prognosis among women with breast cancer, and weight gain is common during treatment. Symptoms of depression and anxiety are also highly prevalent in women with breast cancer and may be exacerbated by post-diagnosis weight gain. Altered brain function may underlie psychological distress. Thus, this secondary analysis examined the relationship between BMI, psychological health, and resting state functional connectivity among women with breast cancer.MethodsThe sample included 34 post-menopausal women (...) newly diagnosed with Stage 0-IIa breast cancer who were enrolled in a 6-month randomized controlled trial of aerobic exercise vs. usual care. At baseline prior to randomization, whole-brain analyses were conducted to evaluate the relationship between BMI and seed-to-voxel rsFC of the hippocampus and amygdala. Connectivity values from significant clusters were then extracted and examined as predictors of self-reported depression and anxiety.ResultsMean BMI was in the obese range. For both seeds examined, higher BMI was associated with lower rsFC with regions of prefrontal cortex, including ventrolateral PFC, dorsolateral PFC, and superior frontal gyrus. Hippocampal connectivity with the vlPFC was negatively correlated with self-reported anxiety.ConclusionHigher BMI was associated with lower hippocampal and amygdala connectivity to regions of PFC implicated in cognitive control and emotion regulation. BMI-related differences in hippocampal and amygdala connectivity following a recent breast cancer diagnosis may relate to future worsening of psychological functioning during treatment and remission. Additional longitudinal research exploring this hypothesis is warranted. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S83-S88, March‐April 2022.

The environment can elicit biological responses such as oxidative stress (OS) and inflammation as a consequence of chemical, physical, or psychological changes. As population studies are essential for establishing these environment-organism interactions, biomarkers of OS or inflammation are critical in formulating mechanistic hypotheses. By using examples of stress induced by various mechanisms, we focus on the biomarkers that have been used to assess OS and inflammation in these conditions. We discuss the difference between biomarkers that are the result of a (...) chemical reaction (such as lipid peroxides or oxidized proteins that are a result of the reaction of molecules with reactive oxygen species) and those that represent the biological response to stress, such as the transcription factor NRF2 or inflammation and inflammatory cytokines. The high-throughput and holistic approaches to biomarker discovery used extensively in large-scale molecular epidemiological exposome are also discussed in the context of human exposure to environmental stressors. We propose to consider the role of biomarkers as signs and to distinguish between signs that are just indicators of biological processes and proxies that one can interact with and modify the disease process. (shrink)