원로 문인의 철학에세이. 삶에 대한 철학적 사색부터 서양철학 사상의전개, 현대 영.미철학의 특성까지를 면밀히 검토하였다.

BackgroundClinical ethics case consultations (CECCs) provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital.MethodsSemi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May 31, 2020. (...) All documents were analysed by two researchers independently.ResultsTwenty-four CECCs were requested within the study period, of which most (n = 22; 92%) had been initiated by physicians of the department. The patients were an average of 79 years old (R: 43–96), and 14 (58%) patients were female. The median length of stay prior to request was 12.5 days (R: 1–65 days). The most frequent diagnoses (several diagnoses possible) were cardiology-related (n = 29), followed by sepsis (n = 11) and cancer (n = 6). Twenty patients lacked decisional capacity. The main reason for a CECC request was uncertainty about the balancing of potential benefit and harm related to the medically indicated treatment (n = 18). Further reasons included differing views regarding the best individual treatment option between health professionals and patients (n = 3) or between different team members (n = 3). Consensus between participants could be reached in 18 (75%) consultations. The implementation of a disease specific treatment intervention was recommended in five cases. Palliative care and limitation of further disease specific interventions was recommended in 12 cases.ConclusionsTo the best of our knowledge, this is the first in-depth evaluation of a CECC service set up for an academic department of cardiology and intensive medical care. Patient characteristics and the issues deliberated during CECC provide a starting point for the development and testing of more tailored clinical ethics support services and research on CECC outcomes. (shrink)

A perception-action system may underlie the mechanisms by which human speech exchange in social interaction is managed, as well as the evolutionary precursors of these mechanisms in closely related species. Some phenomena of interaction well-studied by sociologists are suggested as a point of departure for further research.

Work-integrated learning is an educational approach that aims to support students’ integration of theory to practice. These rich learning opportunities provide students with real-world experiences and introduce practice and ethical situations that help consolidate and bridge their knowledge and skill. Academic integrity has been defined as the ongoing commitment to values that are consistent with ethical practice: honesty, trust, fairness, respect, responsibility, and courage. It is important to understand what specifically influences students’ intentions to behave with integrity in WIL settings. (...) This paper reports on one study that explored predictors to students’ intentions to behave with integrity across three different WIL settings in their upper years of studies. The findings and recommendations from the research may help to inform other professional programs that include WIL through their educational offerings. (shrink)

BackgroundResistance training can offer beneficial physiological and psychological effects. The regular continuation of this exercise can be accomplished by improving the recovery and mood after a workout. Frequency-specific microcurrent might offer a solution here as it has been shown to improve physical injuries, mood state, and sleep. However, knowledge is lacking about the impact of microstimulation after RT on said parameters. The present study aimed to test the effects of RT and muscle-microstimulation on mood and physical recovery in healthy men (...) after performing conventional deadlifts, which is a type of RT.MethodsThe study was conducted according to a single-blind, randomized, placebo-controlled, and two-way crossover study. Twenty participants naïve to microstimulation engaged in RT twice on separate days. They were randomized to receive MS on 1 day and no microstimulation on another day. Before and after the workout and after their treatment, participants self-rated their mood state and mental and physical exhaustion levels.ResultsFindings showed that MS increased the self-ratings of well-rested and sociable and, most importantly, reduced the feeling of exercise-induced exhaustion. There were no MS effects on ratings of feeling sad, happy, or exhausted, although the workout, independent of MS, negatively influenced the level of exhaustion.ConclusionThe combination of enhanced sociableness, reduced fatigue, and exercise-induced exhaustion after a workout, followed by microstimulation, has important implications for professional sporters and nonprofessionals who try to get the best result after a workout. Future studies using a double-blind approach including different types of exercises, different durations of programs, and both sexes can shed more light on the full potential of microstimulation after a workout on mood state and exercise-induced exhaustion. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 28-31, January/February 2022.

Robust technology infrastructure is needed to enable learning health care systems to improve quality, access, and cost. Such infrastructure relies on the trust and confidence of individuals to share their health data for healthcare and research. Few studies have addressed consumers’ views on electronic data sharing and fewer still have explored the dual purposes of healthcare and research together. The objective of the study is to explore factors that affect consumers’ willingness to share electronic health information for healthcare and research. (...) This study involved a random-digit dial telephone survey of 800 adult Californians conducted in English and Spanish. Logistic regression was performed using backward selection to test for significant associations of each explanatory variable with the outcome variable. The odds of consent for electronic data sharing for healthcare decreased as Likert scale ratings for EHR impact on privacy worsened, odds ratio = 0.74, 95% CI [0.60, 0.90]; security, OR = 0.80, 95% CI [0.66, 0.98]; and quality, OR = 0.59, 95% CI [0.46–0.75]. The odds of consent for sharing for research was greater for those who think EHR will improve research quality, OR = 11.26, 95% CI [4.13, 30.73]; those who value research benefit over privacy OR = 2.72, 95% CI [1.55, 4.78]; and those who value control over research benefit OR = 0.49, 95% CI [0.26, 0.94]. Consumers’ choices about electronically sharing health information are affected by their attitudes toward EHRs as well as beliefs about research benefit and individual control. Design of person-centered interventions utilizing electronically collected health information, and policies regarding data sharing should address these values of importance to people. Understanding of these perspectives is critical for leveraging health data to support learning health care systems. (shrink)

Bioethicists have long been concerned that seriously ill patients entering early phase (‘phase I’) treatment trials are motivated by therapeutic benefit even though the likelihood of benefit is low. In spite of these concerns, consent forms for phase I studies involving seriously ill patients generally employ indeterminate benefit statements rather than unambiguous statements of unlikely benefit. This seeming mismatch between attitudes and actions suggests a need to better understand research ethics committee members’ attitudes toward communication of potential benefits and risks (...) of early phase studies to potential subjects. We surveyed the members of two U.S. research ethics committees using a phase I gene transfer study scenario, and compared the results to a previous survey of potential subjects’ perceptions and attitudes toward benefit and risk for the same protocol. The results show that there is indeed a gap between the subjects’ perceptions and the committee members’ views on what is appropriate to be communicated to research subjects. This discrepancy is the product of both the commonly assumed optimism of the subjects and to a “protective pessimism” of the research ethics committee members. We discuss this discrepancy using “frameworks of trust” and demonstrate the need to incorporate these frameworks into the existing model of informed consent. (shrink)

Journalists covering the 2007 shootings at Virginia Tech aggravated the trauma felt by victims' families and survivors, raising ethical questions about the role of media at major news events in an Internet-enabled era of continuous coverage. Some journalists breached professional norms by knocking on doors at 6 a.m., claiming a hidden camera was a breast pump and bullying reluctant interviewees. Even conscientious journalists, however, exacerbated the ordeal through their overabundance. By forcing survivors to endure repetitious interviews and making mourners feel (...) they were being stalked, journalists demonstrated they must embrace press pools to minimize harm in the future. (shrink)

Subjects enrolled in studies testing high risk interventions for incurable or progressive brain diseases may be vulnerable to deficiencies in informed consent, such as the therapeutic misconception. However, the definition and measurement of the therapeutic misconception is a subject of continuing debate. Our qualitative pilot study of persons enrolled in a phase I trial of gene transfer for Parkinson disease suggests potential avenues for both measuring and preventing the therapeutic misconception. Building on earlier literature on the topic, we developed and (...) tested an interview guide that focuses on how the subjects decided to participate, emphasizing the integration of subjects’ various statements that are relevant to assessing the therapeutic misconception, rather than evaluating them as isolated statements. The results indicate that a subject’s understanding of the purpose of research is best explored in juxtaposition to the subject’s motivation for participating. (shrink)

Taking up the idea that sanity is a necessary condition for responsibility, Susan Wolf sets forth two criteria for determining whether an actor is sane. I argue that the second criterion is inappropriate for this determination since it invokes some hidden axiological standard. I reexamine a case study that Wolf describes and arrive at a different judgment about the responsibility of the actor. I argue that the foremost criterion for determining whether an actor is sane is functional rather than axiological. (...) The theory of responsibility, rather than the notion of sanity, must do the work of appraising the value of an actors’ behavior, and that must be done in light of the fact that responsible moral agents enjoy varying degrees of sanity. (shrink)

Part 1 of this exploratory study demonstrated that for terminal, instrumental, and work values, supervisors could only accurately assess the extent to which their terminal values are congruent with their employees, whereas, employees could only accurately describe degrees of alignment with their supervisors' work values. Thus, supervisors appear to possess conscious awareness of the terminal values held by their employees and employees similarly possess conscious awareness of their supervisors' work values. Part 2 of the study examined what each of these (...) two parties might do with their conscious knowledge concerning value congruence with the other member. Supervisor ratings and employee self-ratings concerning employee job performance, citizenship, climate fit, working relationship (LMX), and other issues, were correlated with supervisor terminal value congruence estimates and employee work value congruence estimates respectively. For supervisors, only one significant finding was noted, indicating a positive relationship between the supervisors' awareness of terminal value congruence with the employee and the supervisors' estimate of the employee's potential for future promotion. For employees, seven hypotheses received support demonstrating relationships between the employees' awareness of supervisor/employee work value congruence and self-ratings of work behaviours, citizenship behaviours, volunteerism behaviours, work climate behaviours, work climate attitudes, work climate organizational-wide attitudes, and the supervisor/employee working relationship. Implications for management and future research are discussed. (shrink)

Part 1 of this exploratory study demonstrated that for terminal, instrumental, and work values, supervisors could only accurately assess the extent to which their terminal values are congruent with their employees, whereas, employees could only accurately describe degrees of alignment with their supervisors’ work values. Thus, supervisors appear to possess conscious awareness of the terminal values held by their employees and employees similarly possess conscious awareness of their supervisors’ work values. Part 2 of the study examined what each of these (...) two parties might do with their conscious knowledge concerning value congruence with the other member. Supervisor ratings and employee self-ratings concerning employee job performance, citizenship, climate fit, working relationship (LMX), and other issues, were correlated with supervisor terminal value congruence estimates and employee work value congruence estimates respectively. For supervisors, only one significant finding was noted, indicating a positive relationship between the supervisors’ awareness of terminal value congruence with the employee and the supervisors’ estimate of the employee’s potential for future promotion. For employees, seven hypotheses received support demonstrating relationships between the employees’ 0awareness of supervisor/employee work value congruence and self-ratings of work behaviours, citizenship behaviours, volunteerism behaviours, work climate behaviours, work climate attitudes, work climate organizational-wide attitudes, and the supervisor/employee working relationship. Implications for management and future research are discussed. (shrink)

P S Wilson; Perspectives on Punishment—Reply to Pamela Moore, Journal of Philosophy of Education, Volume 8, Issue 1, 30 May 2006, Pages 103–134, https://doi.org.

P S Wilson; Interests, Values and Educational Language, Journal of Philosophy of Education, Volume 10, Issue 1, 30 May 2006, Pages 147–166, https://doi.org/10.1.

P S Wilson; Child-Centred Education, Journal of Philosophy of Education, Volume 3, Issue 1, 30 May 2006, Pages 105–126, https://doi.org/10.1111/j.1467-9752.1969.

P S Wilson; Interests and Educational Values, Journal of Philosophy of Education, Volume 8, Issue 2, 30 May 2006, Pages 181–199, https://doi.org/10.1111/j.1467-.

P S Wilson; Interests, Values and Educational Language, Journal of Philosophy of Education, Volume 10, Issue 1, 30 May 2006, Pages 147–166, https://doi.org/10.1.

R. E. Ewin has argued that corporations are moral persons, but Ewin describes them as being unable to think or to act in virtuous and vicious ways. Ewin thinks that their impoverished emotional life would not allow them to act in these ways. In this brief essay I want to challenge the idea that corporations cannot act virtuously. I begin by examining deficiencies in Ewin's notion of corporate personhood. I argue that he effectively reduces corporations to the status of incompetent (...) patients. I shall make use of a richer notion of corporate personhood as I explore the logical relationship between corporate action and the quality of the corporate emotional life. After discussing an alternate methodology for making moral assessments of action I consider briefly two corporate disasters: the crash on Mt. Erebus, the Imperial Foods plant fire. These cases are used to show the inadequacy of Ewin's thesis that only corporate managers are capable of displaying vice. (shrink)

If the agent responsible for an action is to be given praise or blame by the moral community for that action, then accurate responsibility ascriptions must be made. Since the moral community may have to evaluate the actions of corporate agents, care must be taken to insure that the assumption of Methodological Individualism (MI) does not infect that process. Nevertheless, there is no guarantee that accurate responsibility ascriptions will be made in cases connected with corporate action as long as corporate (...) scapegoating may occur. Because corporate scapegoating is a behavior pattern that attempts to falsify correct responsibility ascriptions it will be of interest to the moral theorist. Once I have considered three objections to the idea of corporate scapegoating I shall offer a fictional description of it found in Ayn Rand''s work,Atlas Shrugged. Finally, I shall raise a question about its present day use by corporations in our society. (shrink)