The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.

The American Journal of Bioethics, Volume 11, Issue 8, Page 58-59, August 2011.

Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)

Background Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. Methods This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, (...) 2013 were reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. Results We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Conclusion Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (shrink)

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...

Global climate change arouses people’s attention to environmental protection and, therefore, changes consumption habits. Food overconsumption not only produces extra waste but also pollutes the environment. Therefore, it is important to understand the factors that motivate people to eat green, an eco-friendly way to consume food. To keep the body in good shape, the fitnessers concern more about diet than the general people. This study explored intrinsic motivations, such as social recognition, environmental ethics, curiosity, joy of purchase, perceived usefulness, subjective (...) norm, and perceived behavior control as constructs that affect fitnesser’s green eating intention. All constructs except curiosity have significant impacts on behavior intention. The results demonstrate that social recognition and environmental ethics have significant effects on curiosity, joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. The mediation effects between social recognition and behavior intention are not supported. The mediators between environmental ethics and behavior intention are joy of purchase, perceived usefulness, subjective norm, and perceived behavior control. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (shrink)

Political scientists generally consider that the incentive for legislators to switch parties lies in their desire to be re-elected. While some scholars attribute defection to the legislators’ popularity and strong connections with their constituents which enable them to be re-elected without relying on party labels, others assert that legislators switch if they perceive that staying put might threaten their chances of re-election. In this paper, we find that the two assumptions, to some extent, contradict each other. More surprisingly, the two (...) contradictory hypotheses cohabit under the single non-transferable vote system. From an analysis of the switching in the Taiwanese Legislative Yuan, the empirical evidence shows that because of fierce intraparty competition in the multimember districts, not only barely elected but also top-ranked legislators switched party affiliation in order to avoid the loss in votes or even seats to their copartisans and to maximize their chances of re-election. (shrink)

The Green Party Taiwan represents an important case both for scholars of environmental politics but also Taiwanese politics. Established in 1996, it is the oldest Asian green party and is one of the most active parties in the Asia-Pacific Greens network. The party has enjoyed mixed electoral fortunes. After promising early election results, the GPT virtually ceased contesting elections between 2000 and 2005. However, from 2006 the party began a gradual revival in its vote shares. This process culminated in the (...) January 2012 Legislative Yuan election when the GPT surprised many observers by coming fifth in the proportional party vote. Considering the limited resources at the party's disposal this was quite an achievement. In this study, we examine and explain the changing electoral fortunes of the GPT since its establishment in 1996. We are interested to see whether standard theories for explaining small or ecological party success, that have been developed in western Europe, work well in the Taiwan context. Our research is based on a range of new fieldwork conducted between 2012 and 2014. These include in-depth interviews with campaigners and party leaders, focus group sessions with party leaders and candidates, and interviews with party supporters. (shrink)

One of the interpretive devices that Ch'eng-kuan (澄 觀) is famous for having employed to distill the essence of the vast Mahāvaipulya Buddhāvataṃsaka Sūtra (Tafang-kuang fo-hua-yen ching 《大方廣佛華嚴經》 was a series of variations on the contemplative theme (kuan-men 觀門) of the complete interfusion (yüan-jung 圓融) of the scripture's three chief protagonists (san-sheng 三聖) ── the Buddha Vairocana (Pi-lu-che-na 毘盧遮那) and the bodhisattvas Mañjuśrī (Wen-shu-shih-li 文殊師利) and Samantabhadra (P'u-hsien 普賢). By aligning these three powerful sacred persons with a number of philosophical (...) categories that he believed to be central to the sūtra ── categories like "cause" (yin 因 ), "fruition" (kuo 果 ), "faith" (hsin 信 ), "understanding" (chieh 解), "insight" (chih 智), "practice" (hsing 行), "principle" (li 理), etc. ── he provided a focal point at which the rich and vivid meditative and liturgical lives of Hua-yen devotees could be made to converge with their philosophical reflections. -/- Although Ch'eng-kuan invoked this device in several of his writings, his most concerted development of it is a short essay entitled San-sheng yüan-jung kuan-men, which appears to have been written relatively late in his long career. Like many important Hua-yen texts, this essay seems to have been lost in China not long after its author's death. However, it was preserved in Korea and Japan and from the latter country was reintroduced to China in the last years of nineteenth century. Neither in China nor in the West has it yet been adequately studied. -/- The core of the present article is a critical edition of the Chinese text of the essay based on a careful comparison of all available versions and presented together with a copiously annotated English translation. The edition translation are preceded by a brief interpretive introduction and followed by an appendix in which are given: a detailed discussion of the work's textual history, detailed accounts of its various editions, and descriptions of its several surviving paraphrases and commentaries. (shrink)

Do people with different views of what is fair attribute different intentions to actions? In a novel experimental design, participants were significantly more likely to attribute a no-redistribution vote to selfishness if they considered redistribution as being fair. I define this—attributing actions that do not adhere to one’s own fairness view to selfishness—as suspicious attribution. I develop a theory of intention attribution to show how suspicious attribution arises from two other findings from the experiment: the participants underestimate the number of (...) people with fairness views differing from their own and overestimate the selfishness of participants with other fairness views. I discuss how the findings can help explain political polarization. (shrink)

RESUMEN Los casos de "ver-como", presentados por Wittgenstein en la Segunda Parte de Philosophical Investigations, muestran que el concepto de "ver" se encuentra cercano al de "interpretar" y resiste su separación. El presente artículo propone un argumento para aclarar la noción de "interpretación" presente en estos casos, a partir de su comparación con los usos presentes en el Tractatus y en la Primera Parte de Philosophical Investigations. Se sostiene que dicha noción cumple el rol de determinar el sentido de lo (...) visualmente experimentado. Además, "ver" e "interpretar" mantienen un tipo de relación interna y "ver-como" puede considerarse como una "representación elástica". ABSTRACT The "seeing-as" cases, presented by Wittgenstein in the Second Part of Philosophical Investigations, show that the concept of 'seeing' is close to that of 'interpretation' and resists its separation. This article proposes an argument to clarify the notion of 'interpretation' present in these cases, from its comparison with the uses present in the Tractatus and in the First Part of Philosophical Investigations. It is argued that this notion fulfills the role of determining the sense of the visually experienced. In addition, 'to see' and 'to interpret' maintain a type of internal relationship and 'seeing-as' can be considered an "elastic representation". (shrink)

In response to the Covid-19 pandemic, online learning has been carried out in many countries with different types of online learning models being promoted and implemented. In the global pandemic continues, the education environment is forced to change from traditional classroom or blended teaching mode to online learning teaching model. With the outbreak of COVID-19, China was the first to announce that online courses are to be implemented in February 2020. In China, whether online learning can replace traditional offline teaching (...) has become a topic worth discussing. Therefore, this study investigates university students in China by questionnaires and discussions of this topic. The study is based on the Push–Pull Mooring model. Based on 854 valid responses collected from an online survey questionnaire, structural equation modeling was employed to examine the research model. The results show that push effects, pull effects, and mooring effects all significantly influence users' switching intentions from offline to online learning platform. Finally, this study explores whether push–pull–mooring can be a reference for promoting and implementing online learning courses in Chinese colleges and universities in the future after the pandemic. (shrink)

"Science and religion are often viewed as dichotomies. But although our contemporary society is often perceived as a rationalization process, we still need broad, metaphysical beliefs outside of what can be proven empirically. Rituals and symbols remain at the core of modern life. Do our concepts of science and religion require revitalization? Can science itself be considered a religion, a belief, or an ideology? Science's authority and prestige allows for little in the way of alternate approaches not founded in empirical (...) science. It is not unusual to believe that technology and science will solve the world's fundamental problems. Has truth been colonized by science? Have scientific disciplines become so specialized and "operationally closed" that they have constructed barriers to other disciplines as well as the general public? The writers of this book set out to investigate whether the symbols of academia may in some cases take on a quality of sacrality, whether the rule of experts can be said to have the character of a "priesthood of knowledge", whether religion has a place in scientific contexts, and a selection of other questions concerning science and its relations to religious belief."--P. [4] of cover. (shrink)

Ever since the ancient Chinese paradox "white horse is not horse" was brought into the context of Western philosophy, various interpretations have been proposed by modern scholars based on different theoretical considerations, although no satisfactory consensus has been reached. Controversy focuses especially on whether the paradox implies a realist or nominalist ontology.The controversy starts from Fung Yu-lan's realist reading of Gongsun Long. Fung read "white horse is not horse" as "white-horseness is different from horseness." "The universal, horseness, is the essential (...) attribute of all horses. … Such 'horseness' is distinct from 'white-horseness'". He ascribes to Gongsun Long a Platonic realism... (shrink)

The Dao Companion to Chinese Philosophy of Logic is the first general overview of Chinese logical philosophy in English, presumably providing students and researchers of Chinese thought in the Engl...

Industrial investment funds are a new financing innovation mode that can build an effective financing channel for enterprises.Based on the panel data of Chinese Listed Companies in 2008–2017, this manuscript constructed a static panel model between industrial investment funds, government R&D subsidies, and technological innovation to empirically analyze the effects of industrial investment fund involvement and government R&D subsidies on companies’ technological innovation. The research shows that industrial investment fund involvement can increase the company’s R&D investment by providing financial funds (...) for the company, which can effectively solve the company’s lack of funds in the process of technological innovation and guarantee the smooth running of the company’s innovation activities. Secondly, government R&D subsidies can alleviate the pressure of R&D investment to a certain extent, which is conducive to promote a higher level of technological innovation in the company. Thirdly, for companies with industrial investment fund involvement, government R&D subsidies are conducive to promote technological innovation. In contrast, for companies without industrial investment fund involvement, government R&D subsidies have no significant impact on technological innovation to a certain extent or even have a “crowding out effect.”. (shrink)

The tradeactortargetconflict model to garner implications concerning trade and conflict interactions where third-party blocs are involved. The theoretical propositions supported by proofs are: (1) if the actor increases trade with a third-party who is a friend of the target, then the actor will decrease conflict toward the target; (2) if the actor increases trade with a third-party who is a rival of the target, then the actor will increase conflict toward the target. A 30-country sample from the Conflict and Peace (...) Data Bank (COPDAB) is used and divided into three blocs, namely a Western bloc, a Middle Eastern bloc, and an Eastern bloc. The empirical analysis supports the hypotheses. A similar relationship is also discussed and tested for situations in which conflict increases or decreases between the actor and third-party bloc. In addition, the evidence shows that Western bloc countries play a central role in world political and economic relationships. (shrink)

The paper examines the role of organizational commercial slack (OCS) in mediating the relationship between entrepreneurial orientation (EO) and the effectiveness of knowledge transfer (KT) in universities. The paper identifies two types of commercial slack in the university setting: financial and promotional. Four research hypotheses are proposed. Pooled data, that is, a combination of a questionnaire survey of 110 Taiwanese universities with a data set of university KT effectiveness from the Ministry of Education, Taiwan, are collected to test the aforementioned (...) research hypotheses. The empirical results indicate that the EO of a university enables the university to provide appropriate OCS. Furthermore, the commercial slack of a university positively mediates the relationship between EO and KT effectiveness. The paper concludes that developing EO and OCS are crucial for improving the KT effectiveness of a university. Moreover, some managerial and policy implications for promoting EO and OCS in universities are suggested. (shrink)

本书共分十二章,内容包括刑事法理论的逻辑形态;刑事法哲学的理论特征;刑事法本体论范式辨证以及活的刑事法的历史起源等。.

In “Normativity and Epistemic Intuitions”, Weinberg, Nichols and Stich famously argue from empirical data that East Asians and Westerners have different intuitions about Gettier -style cases. We attempted to replicate their study about the Car case, but failed to detect a cross - cultural difference. Our study used the same methods and case taken verbatim, but sampled an East Asian population 2.5 times greater than NEI’s 23 participants. We found no evidence supporting the existence of cross - cultural difference about (...) the intuition concerning the Gettier car case. Taken together with the failures of both of the existing replication studies, our results provide strong evidence that the purported cross - cultural difference in Gettier intuitions does not exist. (shrink)

Corporate citizenship represents various organizational activities and status related to the organization's societal and stakeholder obligations. This study develops five different dimensions of corporate citizenship and examines the relationship between the five dimensions and purchase intention by including two key mediators. In the proposed model of this study, purchase intention is indirectly affected by economic, legal, ethical, general philanthropic, and strategic philanthropic citizenship via the mediation of corporate identification and brand trust. Empirical testing using a survey of 353 consumers from (...) various industries confirms most of our hypothesized effects. Last, managerial implications for corporate leaders and limitations of our findings are discussed in depth. (shrink)