The first part of this paper examines the practice of informed treatment decisions in the protective medical system in China today. The second part examines how health care professionals in China perceive and carry out their responsibilities when relaying information to vulnerable patients, based on the findings of an empirical study that I had undertaken to examine the moral experience of nurses in practice situations. In the Chinese medical ethics tradition, refinement [jing] in skills and sincerity [cheng] in relating to (...) patients are two cardinal virtues that health care professionals are required to possess. This notion of absolute sincerity carries a strong sense of parental protectiveness. The empirical findings reveal that most nurses are ambivalent about telling the truth to patients. Truth-telling would become an insincere act if a patient were to lose hope and confidence in life after learning of his or her disease. In this system of protective medical care, it is arguable as to whose interests are being protected: the patient, the family or the hospital. I would suggest that the interests of the hospital and the family members who legitimately represent the patient's interests are being honoured, but at the expense of the patient's right to know. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

The Dutch policy objective of a fully sustainable livestock sector without mutilations by 2023 is not compatible with the routine practice of tail docking to minimize the risk of tail biting. To examine farmer attitudes towards docking, a telephone survey was conducted among 487 conventional and 33 organic Dutch pig farmers. “Biting” (of tails, ears, or limbs) was identified by the farmers as a main welfare problem in pig farming. About half of the farmers reported to have no tail biting (...) problems in their own herd. When farmers did report problems, they most often reported figures between 1 and 5 % of the animals. High incidences of tail biting were anticipated when trying to keep undocked pigs. Enrichment materials used in the conventional sector included mainly chains (52–63 % of the farms) and hanging rubber or plastic balls (22–30 %). Straw, sawdust, or wood shavings was hardly provided in conventional pig farming (2–3 %), in contrast to organic farming (88–100 % of farms). Conventional pig farmers feel a curly tail is not very important for sustainable pig farming. They consider enrichment to be less effective and tail docking to be less stressful for them and their piglets than their organic colleagues do. Pig farmers identified climate as a main risk factor for tail biting as opposed to enrichment. The objective of reducing routine tail docking requires solutions for dealing with tail biting problems at the farm level. In this process, transfer of scientific knowledge about enrichment materials and other measures to prevent and cure tail biting is critical, as is a change in farmer attitudes and awareness of the moral issues involved. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

This handbook presents a comprehensive introduction to the core areas of philosophy of education combined with an up-to-date selection of the central themes. It includes 95 newly commissioned articles that focus on and advance key arguments; each essay incorporates essential background material serving to clarify the history and logic of the relevant topic, examining the status quo of the discipline with respect to the topic, and discussing the possible futures of the field. The book provides a state-of-the-art overview of philosophy (...) of education, covering a range of topics: Voices from the present and the past deals with 36 major figures that philosophers of education rely on; Schools of thought addresses 14 stances including Eastern, Indigenous, and African philosophies of education as well as religiously inspired philosophies of education such as Jewish and Islamic; Revisiting enduring educational debates scrutinizes 25 issues heavily debated in the past and the present, for example care and justice, democracy, and the curriculum; New areas and developments addresses 17 emerging issues that have garnered considerable attention like neuroscience, videogames, and radicalization. The collection is relevant for lecturers teaching undergraduate and graduate courses in philosophy of education as well as for colleagues in teacher training. Moreover, it helps junior researchers in philosophy of education to situate the problems they are addressing within the wider field of philosophy of education and offers a valuable update for experienced scholars dealing with issues in the sub-discipline. Combined with different conceptions of the purpose of philosophy, it discusses various aspects, using diverse perspectives to do so. Contributing Editors: Section 1: Voices from the Present and the Past: Nuraan Davids Section 2: Schools of Thought: Christiane Thompson and Joris Vlieghe Section 3: Revisiting Enduring Debates: Ann Chinnery, Naomi Hodgson, and Viktor Johansson Section 4: New Areas and Developments: Kai Horsthemke, Dirk Willem Postma, and Claudia Ruitenberg. (shrink)

When the COVID-19 surge hit New York City hospitals, the Division of Medical Ethics at Weill Cornell Medical College, and our affiliated ethics consultation services, faced waves of ethical issues sweeping forward with intensity and urgency. In this article, we describe our experience over an eight-week period (16 March through 10 May 2020), and describe three types of services: clinical ethics consultation (CEC); service practice communications/interventions (SPCI); and organizational ethics advisement (OEA). We tell this narrative through the prism of time, (...) describing the evolution of ethical issues and trends as the pandemic unfolded. We delineate three phases: anticipation and preparation, crisis management, and reflection and adjustment. The first phase focused predominantly on ways to address impending resource shortages and to plan for remote ethics consultation, and CECs focused on code status discussions with surrogates. The second phase was characterized by the dramatic convergence of a rapid increase in the number of critically ill patients, a growing scarcity of resources, and the reassignment/ redeployment of staff outside their specialty areas. The third phase was characterized by the recognition that while the worst of the crisis was waning, its medium- and long-term consequences continued to pose immense challenges. We note that there were times during the crisis that serving in the role of clinical ethics consultant created a sense of dis-ease as novel as the coronavirus itself. In retrospect we learned that our activities far exceeded the familiar terrain of clinical ethics consultation and extended into other spheres of organizational life in novel ways that were unanticipated before this pandemic. To that end, we defined and categorized a middle level of ethics consultation, which we have termed service practice communication intervention (SPCI). This is an underappreciated dimension of the work that ethics consult services are capable of in times of crisis. We believe that the pandemic has revealed the many enduring ways that ethics consultation services can more robustly contribute to the ethical life of their institutions moving forward. (shrink)

While resilience is a major concept in development, climate adaptation, and related domains, many doubts remain about how to interpret this term, its relationship with closely overlapping terms, or its normativity. One major view is that, while resilience originally was a descriptive concept denoting some adaptive property of ecosystems, subsequent applications to social contexts distorted its meaning and purpose by framing it as a transformative and normative quality. This article advances an alternative philosophical account based on the scrutiny of C.S. (...) Holling’s original work on resilience. We show that resilience had a central role among Holling’s proposals for reforming environmental science and management, and that Holling framed resilience as an ecosystem’s capacity of absorbing change and exploiting it for adapting or evolving, but also as the social ability of maintaining and opportunistically exploiting that natural capacity. Resilience therefore appears as a transformative social-ecological property that is normative in three ways: as an intrinsic ecological value, as a virtue of organizations or management styles, and as a virtuous understanding of human–nature relations. This interpretation accounts for the practical relevance of resilience, clarifies the relations between resilience and related terms, and is a firm ground for further normative work on resilience. (shrink)

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed (...) the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics. (shrink)

One INTRODUCTION: IN SEARCH OF THE VOICES OF NURSES IN CHINA Two motives launched this study to search for the voices of nurses in China. ...

It has recently been argued that hope is polysemous in that it sometimes refers to hoping and other times to being hopeful. That it has these two distinct senses is reflected in the observation that a person can hope for an outcome without being hopeful that it will occur. Below, I offer a new argument for this distinction. My strategy is to show that accepting this distinction yields a rich account of two distinct ways in which hope can be lost, (...) ways that map onto the two senses of hope: A person can lose hope either by ceasing to hope for an outcome (hopelessness) or by ceasing to be hopeful that it will obtain (despair). Thinking about these negative attitudes in these two ways, I contend, is explanatorily rich and fruitfully reveals how they differ in phenomenology, behavioral differences, and the ways in which a person can escape them. (shrink)

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and (...) professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)

Nursing research in China is at an early stage of development and little is known about the practices of Chinese nurse researchers. This interview study carried out at a university in central China explores the informed consent practices of Chinese nurse researchers and the cultural considerations of using a western technique. Nine semistructured interviews were conducted in English with assistance and simultaneous translation from a Chinese nurse with research experience. The interviews were analyzed by one western and two Chinese researchers (...) and major themes were identified. All participants endorsed informed consent as ethically required. Differences were noted between some of the informed consent practices typically recommended in the USA and those identified in this study, such as: recruitment using local and government officials, recruiting directly from medical records without special permission, family consultation in consent and consent control, and not revealing randomization to intervention groups receiving different treatments. (shrink)

The answer to philosophical questions will often depend on the position one takes regarding the fact-value problem. It is, therefore, not surprising that, in the tradition of western philosophy, the past 200 years or so record an animated discussion of it. In the present collection the debate is continued by representatives of various "schools" in contemporary western thought. A number of philosophers from non-western cultures, too, enter into it. The contributions do not all reflect on the same theme, nor do (...) they use the same approach. Essays written by philosophers sympathetic to the analytical tradition are followed by reflections on the part of those inspired by phe nomenology. A third group of contributions is by non-western thinkers, who are more likely to approach the problem in terms of culture. Their engage ment with the issue clearly shows, among other things, that it is almost exclusively in the western tradition that the fact-value distinction is often understood as an outright dichotomy. The occasion for the publication of this collection is Dr. Cornelis Anthonie van Peursen's retirement as Professor of Philosophy. This year he leaves the Free University, Amsterdam; until 1982 he was professor at the University of Leyden as well. In the Netherlands and beyond he has become known for his concern with constructive comparison of diverging philosophical trends and the cross-cultural fertilization of thought. Characteristic of his career are his efforts to render the results of academic philosophizing understand able to a broader audience. (shrink)

Physicians have an ethical responsibility to their patients to offer the best available medical care. This responsibility conflicts with their role as gatekeepers of the limited health care resources available for all patients collectively. It is ethically untenable to expect doctors to face this trade-off during each patient encounter; the physician cannot be expected to compromise the wellbeing of the patient in the office in favour of anonymous patients elsewhere. Hence, as in other domains of public policy where individual and (...) collective interests conflict, some form of collective solution is required. Collective solutions may take the form of placing explicit resource constraints on resources available to physicians, or clinical practice guidelines that recognise cost-effective care as acceptable. Such solutions will be politically and ethically sustainable only if patients as citizens of the larger population accept the need for rationing of limited resources in health care. (shrink)

Today's modern car is an assemblage of mechanical and digital components, of metal panels that comprise its structure and silicon chips that run its functions. Communication and information studies scholars have interrogated the problematic aspects of the programs that run those functions, revealing serious issues surrounding privacy and security, worker surveillance, and racial, gendered, and class-based bias. This article contributes to that work by taking a step back and asking about the issues inherent not in the software running on these (...) chips, but on the microchips themselves. Using the lens of “chipification”—the process by which a device is rendered capable of reading and processing data through the embedding of microchips—this article explores how the integration of microchips also involves processes that are often borne from, replicate, or create troubling power dynamics of their own. It takes light-duty passenger vehicles as a case study into how chipification is radically reshaping such processes as resource allocation, labor flows, and cultural practices around car manufacture, use, repair, and modification. By naming the process of chipification, this article allows researchers to identify and analyze the ways that integrating data processing capabilities into everyday devices is not a frictionless practice, but rather one that implicates a variety of power dynamics within these massive industries. (shrink)

The requirement of gauge invariance for the Schwinger-DeWitt equations, interpreted as a manifestly covariant quantum theory for the evolution of a system in spacetime, implies the existence of a five-dimensional pre-Maxwell field on the manifold of spacetime and “proper time” τ. The Maxwell theory is contained in this theory; integration of the field equations over τ restores the Maxwell equations with the usual interpretation of the sources. Following Schwinger's techniques, we study the Green's functions for the five-dimensional hyperbolic field equations (...) for both signatures ± [corresponding to O(4, 1) or O(3, 2) symmetry of the field equations] of the proper time derivative. The classification of the Green's functions follows that of the four-dimensional theory for “massive” fields, for which the “mass” squared may be positive or negative, respectively. The Green's functions for the five-dimensional field are then given by the Fourier transform over the “mass” parameter. We derive the Green's functions corresponding to the principal part ΔP and the homogeneous function Δ 1 ; all of the Green's functions can be expressed in terms of these, as for the usual field equations with definite mass. In the O(3, 2) case, the principal part function has support for x2⩾τ2, corresponding to spacelike propagation, as well as along the light cone x2=0 (for τ=0). There can be no transmission ofinformation in spacelike directions, with this propagator, since the Maxwell field, obtained by integration over τ, does not contain this component of the support. Measurements are characterized by such an integration. The spacelike field therefore can dynamically establish spacelike correlations. (shrink)

This volume sheds light on still unexplored issues and raises new questions in the main areas addressed by the philosophy of science. Bringing together selected papers from three main events, the book presents the most advanced scientific results in the field and suggests innovative lines for further investigation. It explores how discussions on several notions of the philosophy of science can help different scientific disciplines in learning from each other. Finally, it focuses on the relationship between Cambridge and Vienna in (...) twentieth century philosophy of science. The areas examined in the book are: formal methods, the philosophy of the natural and life sciences, the cultural and social sciences, the physical sciences, and the history of the philosophy of science. (shrink)

Recent research suggests holding a structural, rather than interpersonal, understanding of racism is associated with greater impetus to address racial disparities. We believe greater acknowledgment of structural racism also functions to mitigate against empathic failures in response to structural injustices. Given South Africa’s situatedness as a country characterized by historical racialized oppression and continuing unjust legacies, it is appropriate to examine these ideas there. Across three studies, we tested the hypotheses that members of advantaged groups’ perspective taking and empathic concern (...) may be compromised in response to people challenging the unequal status quo, and that a priori perceptions about the impact of structural racism may mitigate or exacerbate such empathic failures. In Study 1, a national sample of White South Africans endorsed perceptions of interpersonal racism more readily than perceptions of structural racism, and expressed high levels of competitive victimhood for perceived anti-White structural racism. Studies 2 and 3 showed that White participants at a historically White university responded with impaired perspective taking and intergroup empathy bias in response to people challenging structural disparities. Finally, reduced recognition of continuing structural racism predicted greater intergroup empathy bias, which, in turn, was associated with reduced willingness to engage in intergroup discussions about past harm. We propose that greater acknowledgment of structural racism is necessary not only to surmount intergroup empathic failures, but also to transcend the socioeconomically unequal legacies of apartheid and beyond. (shrink)