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.

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)

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)

Case law retrieval is the task of locating truly relevant legal cases given an input query case. Unlike information retrieval for general texts, this task is more complex with two phases (legal case retrieval and legal case entailment) and much harder due to a number of reasons. First, both the query and candidate cases are long documents consisting of several paragraphs. This makes it difficult to model with representation learning that usually has restriction on input length. Second, the concept of (...) relevancy in this domain is defined based on the legal relation that goes beyond the lexical or topical relevance. This is a real challenge because normal text matching will not work. Third, building a large and accurate legal case dataset requires a lot of effort and expertise. This is obviously an obstacle to creating enough data for training deep retrieval models. In this paper, we propose a novel approach called supporting model that can deal with both phases. The underlying idea is the case–case supporting relation and the paragraph–paragraph as well as the decision-paragraph matching strategy. In addition, we propose a method to automatically create a large weak-labeling dataset to overcome the lack of data. The experiments showed that our solution has achieved the state-of-the-art results for both case retrieval and case entailment phases. (shrink)

Jerry Fodor and Ernest Lepore (1999/2002) frame the debate over meaning holism in terms of a distinction between meaning atomism and meaning anatomism. The former holds that the meaning of an expression E is determined by some relation between E and some extra-linguistic entity. The latter holds that the meaning of E is at least partly determined by some of E’s “inward” relations (IRs) with other expressions in the very language. They (1992) argue that meaning anatomism inevitably collapses into meaning (...) holism, which is the view that the meaning of E is determined by E’s IRs with every other expression in the very language because there is no principled distinction for the anatomist to divide the meaning-determining IRs from the non-meaning-determining ones. In response, the non-holistic anatomist urges that Fodor and Lepore’s no-principled-basis consideration is groundless because the lack of a generally accepted criterion for such a distinction does not undermine the viability of the distinction itself. While this point is well taken, I think that Fodor and Lepore are onto an important question here. That is, what does it make non-holistic anatomism distinctive from its holistic counterpart if without a principled basis for the distinction among IRs? I look into this question and give an alternative argument from Fodor and Lepore’s to suggest that non-holistic anatomism cannot bypass the no-principled-basis consideration. The non-holistic anatomist will need a principled distinction in kind between IRs to back her point. (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)

We study whether changes in analyst recommendation ratings systems encouraged by the implementation of NASD 2711 in 2002 are associated with improved objectivity and independence in analyst recommendations. Using recommendations issued during windows surrounding major investment banking events, we show that reductions in analyst optimism following the reforms concentrate in the recommendations of analysts whose employer adopted a three-tier rating system at the time of the reforms, and that this effect is generally stronger for analysts whom the underlying incentives to (...) engage in unethical behaviour is greatest. We also find evidence that adoption of the three-tier system improved the market’s perception of the objectivity of analyst recommendations issued after SEOs, and that for hold and sell-type recommendations this effect was stronger for analysts subject to the greatest potential ethical conflicts. While we find some evidence of a general post-reform increase in the profitability of recommendations issued following equity transactions, this improvement was only conditioned by changes to the rating system in our IPO sample. (shrink)

Notwithstanding the numerous critiques that have been leveled at the field of positive psychology over its short history, the field and its practitioners continue to enjoy substantial growth and popularity. Although several factors have no doubt contributed to their advancement, work in the field of science studies suggests that rhetorical demarcation in scientific writing, by which scientific fields establish their domains and distinguish themselves from other forms of intellectual activity, may be equally significant. Such “boundary work” is an important means (...) through which fields defeat their competitors, persuade their public, and compete for legitimacy. In light of this, I examine the discursive demarcation and legitimization of positive psychology as performed through historical narratives of its origins in its own writings. I offer an analysis of the ways in which these narratives exploit alternating and contradictory images of scientists, legitimate scientific activity, and in particular, images of American society, to perform the ideological and rhetorical work of describing, and making visible, the kinds of issues and problems for which positive psychology presents itself as the natural solution. 2012 APA, all rights reserved). (shrink)

In this paper I will argue that normativity in its pure form is a matter of gap. I will elucidate this idea in three aspects. First, I will suggest that the ‘ought’ is the unique creation of human language to deal with the contingencies and the complexity of the world. And the particular merit of the nature of ‘ought’ or the normativity is not what it positively can offer or do, but what it negatively leaves rooms for, because the ‘ought’ (...) opens up some space for reason or action. Second, every normative system must transform the real human being into its own normative construction of person. I call it the subjugation process. Third, the normativity can show its force more deeply through the escape, resistance and refusal, in another word, through struggle for recognition of the agents. This aspect has certain connection with the critical theory. (shrink)

The study reported here considers the relationship between emotional state and cooperation. An experiment is conducted in which the emotions of fear, happiness, and disgust are induced using 360-degree videos, shown in virtual reality. There is also a control condition in which a neutral state is induced. Under the Fear, Happiness, and Disgust conditions, the cooperation level is lower than under the Neutral condition. Furthermore, cooperation declines over time in the three emotion conditions, while it does not under Neutral. The (...) findings suggest that emotions are associated with the dynamic pattern of declining cooperation over time. (shrink)

This paper looks at the tragedy of Qiao Feng in Jin Yong’s The Demi-Gods and the Semi-Devils. While it is common practice for Žižekean scholars to examine genre writing and popular culture with Lacanian theory, the martial arts genre has received little attention. In Demi-Gods, Qiao Feng experiences an ‘identity crisis’ at the peak of his career: rumour has it that though he was raised and trained in China, he was born a Khitan. Qiao Feng at first believes it is (...) a just conspiracy, and henceforth is blind-sided by the imaginary relation between his ego and small others. He mis-recognises others’ scheming as ‘the Other of the Other,’ while his supposedly deceased Khitan father occupies the corner of the Other in the schema L to orchestra the manipulation game. However, what Qiao Feng is really under prey is the desire of the father, and of the two fatherlands, one Han-Chinese, one Khitan: his tragedy lies in the split of the national Other, in the impossibility of the ethical imperative Your duty is to be loyal to your country. And yet, it is exactly because of the emptiness in the ethical call that Qiao Feng can start to act as a subject, a subject that is by definition already always split. This paper thus interprets the actions of Jin Yong’s hero according to Lacan’s schema L, and also provides variations of the schema based on the twists and turns of this martial arts tragedy. (shrink)

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

This paper investigates the representation of authors with different linguistic backgrounds in academic publishing. We first review some common rebuttals of concerns about linguistic injustice. We then analyze 1039 authors of philosophy journals, primarily selected from the 2015 Leiter Report. While our data show that Anglophones dominate the output of philosophy papers, this unequal distribution cannot be solely attributed to language capacities. We also discover that ethics journals have more Anglophone authors than logic journals and that most authors are affiliated (...) with English-speaking universities, suggesting other factors may also play significant roles. Moreover, some interesting results are revealed when we combine the factor of sex with place of affiliation and linguistic background. It indicates that while certain linguistic injustice is inevitable in academic publishing, it may be more complex than thought. We next introduce Broadbent’s :457–476, 2012, Philosophy of epidemiology, Palgrave Macmillan, New York, 2013, Stud Hist Philos Biol Biomed Sci 48:250–257, 2014) contrastive account of causation to give a causal explanation of our findings. Broadbent’s account not only well characterizes the multifaceted causality in academic publishing but also provides a methodological guideline for further investigation. (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)

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.

In this paper, we analyze how citizens evaluate their president, especially focusing on why voters lower their evaluations at an individual-level perspective. We assert that citizens raise their evaluations of a new president when their expectations are met and lower their opinions when his or her performance disappoints them. Furthermore, the evaluations of the president are not only affected by a government's economic and diplomatic performance, but are also influenced by individual awareness of salient political issues, the contents of the (...) news, and their own perceived influence on politics. We test the theoretical hypotheses using Taiwan's Election and Democratization Study panel survey data. The statistical results support our theoretical hypotheses and show that when President Ma's performance did not meet respondents media exposure and political efficacy are significantly associated with the change in their opinions of Ma. (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)

This paper discusses how the theory of evolutionary Asiacentrism and the Peking Man findings at the Zhoukoudian site stimulated Chinese intellectuals to construct Sinocentric ethno-nationalism during the period from the late 1920s to the early 1940s. It shows that the theory was first popularized by foreign scientists in Beijing, and the Peking man discoveries further provided strong evidence for the idea that Central Asia, or to be more specific, Tibet, Xinjiang, and Mongolia, was the original cradle of humans. Chinese scholars (...) in the late 1930s and 1940s appropriated the findings to construct the monogenesis theory of the Chinese, which designated that all the diverse ethnic groups within the territory of China shared a common ancestor back to antiquity. (shrink)

In the early 2000s, some scholars suggested integrative ethical education as an approach to reconcile the gap between cognitive-development education, based on rule ethics, and traditional character-ethics education, inspired by character ethics in Western ethical education. Darcia Narvaez also tried to establish a comprehensive and systematic model. Nonetheless, she has indicated four questions that need further research. This paper aims to respond to Narvaez’s project and its questions from the angle of Xunzi’s ritual education. It argues that Xunzi’s thought may (...) provide some insights for Narvaez’s approach. To present this, it begins its discussion with an introduction of the main ideas of Xunzi’s thought. Later, it tries to show the insights from certain notions and elements, such as Junzi, reasoned judgment, of Xunzi’s ritual education for Narvaez’s project of integrative ethical education. Some relevant questions are also discussed. (shrink)

Whereas using artificial intelligence (AI) to predict natural hazards is promising, applying a predictive policing algorithm (PPA) to predict human threats to others continues to be debated. Whereas PPAs were reported to be initially successful in Germany and Japan, the killing of Black Americans by police in the US has sparked a call to dismantle AI in law enforcement. However, although PPAs may statistically associate suspects with economically disadvantaged classes and ethnic minorities, the targeted groups they aim to protect are (...) often vulnerable populations as well (e.g., victims of human trafficking, kidnapping, domestic violence, or drug abuse). Thus, determining how to enhance the benefits of PPA while reducing bias through better management is important. In this paper, we propose a policy schema to address this issue. First, after clarifying relevant concepts, we examine major criticisms of PPAs and argue that some of them should be addressed. If banning AI or making it taboo is an unrealistic solution, we must learn from our errors to improve AI. We next identify additional challenges of PPAs and offer recommendations from a policy viewpoint. We conclude that the employment of PPAs should be merged into broader governance of the social safety net and audited publicly by parliament and civic society so that the unjust social structure that breeds bias can be revised. (shrink)

Modelling data in applied areas particularly in reliability engineering is a prominent research topic. Statistical models play a vital role in modelling reliability data and are useful for further decision-making policies. In this paper, we study a new class of distributions with one additional shape parameter, called a new generalized exponential-X family. Some of its properties are taken into account. The maximum likelihood approach is adopted to obtain the estimates of the model parameters. For assessing the performance of these estimators, (...) a comprehensive Monte Carlo simulation study is carried out. The usefulness of the proposed family is demonstrated by means of a real-life application representing the failure times of electronic components. The fitted results show that the new generalized exponential-X family provides a close fit to data. Finally, considering the failure times data, the Bayesian analysis and performance of Gibbs sampling are discussed. The diagnostics measures such as the Raftery–Lewis, Geweke, and Gelman–Rubin are applied to check the convergence of the algorithm. (shrink)

Western thought has dominated scientific development for a long time, and nursing has not escaped the influence of such ideology. Nurse scholars, in an attempt to fit the dominant scientific ideology, typically have had to struggle with non-empirical elements of nursing. This orientation in science, however, may have contributed inadvertently to a form of scientific ethnocentrism in the culture of inquiry in nursing as in other fields. The result has been a narrow view of science and knowledge and failure to (...) recognize the potential significance of Eastern philosophy in nursing knowledge development. Recently, intensive cultural exchanges between the East and the West have contributed to Western scientists becoming aware of the limits of Western linear thinking and concomitant efforts to explore the mysteries of Eastern philosophy. In this article, we explore Buddhism as one example of such philosophies that have great potential to enrich nursing as it continues to strive for definition and identity. (shrink)

In the early twentieth century, with the development of Western scientific imperialism, Asia, South America, and Africa became sites for Western scientific exploration. Many paleontological specimens, including dinosaur bones, were discovered in China by foreign scientists and explorers and exported to museums in France, Sweden, and the United States. After the establishment of the Nationalist Government in Nanjing in 1927, anti-imperialist Chinese intellectuals attempted to prevent foreigners from exporting specimens unearthed on Chinese territory. In the summer of 1928, the fossils (...) discovered in the Gobi Desert by the Central Asiatic Expedition of the American Museum of Natural History were detained in China. A series of negotiations ensued between Chinese and American diplomats and scientists over the issues of the ownership of fossils and the format of international scientific collaborations. By studying the interests and stakes for players in the different social worlds involved in the dispute, this essay explores the relations among science, diplomacy, and the politics of deep time. (shrink)

Weiming, as a leading spokesman for contemporary New Confucianism, has been reinterpreting the Confucian tradition in the face of the challenges of modernity. Tu takes selfhood as his starting point, emphasizing the importance of cultivating the human mind-and-heart as a deepening and broadening process to realize the anthropocosmic dao. He highlights the concept of a fiduciary community and advocates that, because of it, Confucianism remains a dynamic inclusive humanism. Tu’s mode of thinking tallies well with Wilfred C. Smith’s vision of (...) religion, specifically the latter’s exposition of faith as a universal human quality and proposal of corporate critical self-consciousness. This article details the theories of both scholars, highlights their similarities, and contrasts their differences. It argues that Smith’s world theology provides a heuristic framework through which one understands how Tu has advanced his Confucian humanism from a Chinese philosophical or cultural tradition to the midst of world religions. (shrink)