Research misconduct remains an important problem in health research despite decades of local, national, regional, and international efforts to eliminate it. The ultimate goal of every health research project, irrespective of setting, is to produce trustworthy findings to address local as well as global health issues. To be able to lead or participate meaningfully in international research collaborations, individual and institutional capacities for research integrity are paramount. Accordingly, this paper concerns itself not only with individuals’ research skills but also with (...) institutional and national policies and governance. Such policies and governance provide an ethical scaffold for the production of knowledge and structure incentives. This paper’s operational definition of research therefore draws from Institute of Medicine’s articulation of health research as an inquiry that aims to produce knowledge about the structure, processes, or effects of personal health services; and from an existing health systems framework. The paper reviews the research regulatory environment and the ethics apparatus in Ghana, and describes a project jointly undertaken by Ghanaian researchers in collaboration with New York University to assess the perceived adequacy of current institutional practices, opportunities, and incentives for promoting RI. (shrink)

Many commentators call for a more ethical approach to planning for influenza pandemics. In the developed world, some pandemic preparedness plans have already been examined from an ethical viewpoint. This paper assesses the attention given to ethics issues by the Ghana National Integrated Strategic Plan for Pandemic Influenza.

Healthcare rationing during pandemics has been widely discussed in global bioethics literature. However, existing scenarios and analyses have focused on high income countries, except for very few disease areas such as HIV treatment where some analyses related to African countries exist. We argue that the lack of scholastic discourse, and by extension, professional and democratic engagement on the subject constitute an unacceptable ethical omission. Not only have African governments failed to develop robust ethical plans for pandemics, ethicists in this region (...) have been unable to ignite public discourse on rationing. Therefore, we aim to initiate a debate on how rationing health and social goods could be done ethically in Ghana during the current and future pandemics. The paper discusses and critiques some moral considerations for rationing and their relevance in the Ghanaian context. This contribution may facilitate ethical decision-making during the current pandemic - in Ghana and other African settings where hardly any rationing guidelines exist. (shrink)

Child assent is recommended in addition to parental consent when enrolling children in clinical research; however, appreciation and relevance ascribed to these concepts vary in different contexts, and information on attitudes towards storage of biological samples for future research is limited, especially in developing countries. We assessed caregivers’ understanding and appreciation of consent and assent procedures, and their attitudes towards use of stored blood samples for future research prior to enrolling a child in clinical research. A total of 17 in-depth (...) interviews were conducted with primary caregivers of children at enrolment or on the immediate follow-up date. All caregivers recalled significant amount information from the study information sheet and were able to appropriately link such information to the consent process. While all participants confirmed information received prior to blood sampling as adequate, a few noted that the purpose was not sufficiently well communicated. Caregivers felt children were cognitively vulnerable, and prone to decisions that were not necessarily in their best interest. Nearly all caregivers felt it was their right and responsibility to overrule objections from their ward’s regarding enrolment into specific study or receipt of a therapeutic procedure. There were no objections or concerns regarding use of stored biological samples for future research purposes. There is thus, a need to improve understanding of caregivers on the information provided during the informed consent process. Context-specific studies on the age of assent in specific populations are needed. (shrink)

This study assessed challenges faced by researchers with the informed consent process (ICP). In‐depth interviews were used to explore challenges encountered by Investigators, Research assistants, Institutional Review Board members and other stakeholders. An electronic questionnaire was also distributed, consisting of Likert‐scale responses to questions on adherence to the ICP, which were derived from the Helsinki Declaration and an informed consent checklist of the US Department of Health and Human Research (HSS). Responses were weighted numerically and scores calculated for each participant. (...) The median score of the level of adherence to the informed consent process was 93%. Most of the respondents (60%) cited the lack of time for the ICP to be a challenge, with 65% indicating a lengthy consent document to be the main challenge with the informed consent document. Challenges with language and communication were the dominant theme among informants. Despite the high adherence of Ghanaian researchers and research assistants to the ICP, challenges are still prevalent, requiring diligent and continuous efforts in research implementation. (shrink)

Moral distress has been well reviewed in the literature with established deleterious side effects for all healthcare professionals, including nurses, physicians, and others. Yet, little is known about the quality and effectiveness of interventions directed to address moral distress. The aim of this integrative review is to analyze published intervention studies to determine their efficacy and applicability across hospital settings. Of the initial 1373 articles discovered in October 2020, 18 were appraised as relevant, with 1 study added by hand search (...) and 2 after a repeated search was completed in January and then in May of 2021, for a total of 22 reviewed articles. This review revealed data mostly from nurses, with some studies making efforts to include other healthcare professions who have experienced moral distress. Education-based interventions showed the most success, though many reported limited power and few revealed statistically lowered moral distress post intervention. This may point to the difficulty in adequately addressing moral distress in real time without adequate support systems. Ultimately, these studies suggest potential frameworks which, when bolstered by organization-wide support, may aid in moral distress interventions making a measurable impact. (shrink)

Blood service organizations employ various ways to ensure transfusion blood safety, including the testing of all donations for transfusion-transmissible infections (TTI) and the exclusion of donors who are at increased risk of a recent infection. As some TTIs are more common among men who have sex with men (MSM), many jurisdictions (temporarily) defer the donation of blood by sexually active MSM. This boils down to a categorical exclusion of a large group solely on the basis of their sexual orientation, which (...) is seen as unduly discriminatory and stigmatizing. Blood service organizations in the U.K. and the Netherlands have recently changed their deferral policies for MSM. The problem of the MSM deferral involves a conflict between fundamental rights: the right of MSM to equal treatment and the right to health of the recipients of blood and blood products. We distinguish and discuss three broad alternative options to the current categorical deferral of MSM donations: (1) completely abandoning donor selection on the basis of sexual behavior, (2) individual risk assessment of the sexual activities of each potential donor, and (3) individual risk assessment of the sexual activities of MSM only. The new U.K. policy falls within the second category, and the new Dutch policy is in the third category. We argue that each approach comes with moral costs but that the most reasonable option is different from the policies of both the U.K. and the Netherlands. (shrink)

This article compares two radically opposed views concerning “race” in the first half of the 20th century: the one of Franz Boas , the founder of American cultural anthropology, and the other of Hans F.K. Günther , the most widely read theoretician of race in Nazi Germany. Opposite as their views were, both derived from a similar non-evolutionist German anthropological matrix. The article reconstructs their definitions of racial objects and studies their analyses of racial intermixture. Although both believed that contemporary (...) peoples were racially deeply mixed, Boas moved towards an antiracist conception of race-as-population, whereas Günther moved towards a racist conception of homogenous races in mixed peoples. The comparison shows that the major difference between them concerns their ideals or guiding principles. Their respective ideals seeped into their versions of science and transformed the nature and the significance of their respective ideas. (shrink)

Blood service organizations employ various ways to ensure transfusion blood safety, including the testing of all donations for transfusion-transmissible infections (TTI) and the exclusion of donors who are at increased risk of a recent infection. As some TTIs are more common among men who have sex with men (MSM), many jurisdictions (temporarily) defer the donation of blood by sexually active MSM. This boils down to a categorical exclusion of a large group solely on the basis of their sexual orientation, which (...) is seen as unduly discriminatory and stigmatizing. Blood service organizations in the U.K. and the Netherlands have recently changed their deferral policies for MSM. The problem of the MSM deferral involves a conflict between fundamental rights: the right of MSM to equal treatment and the right to health of the recipients of blood and blood products. We distinguish and discuss three broad alternative options to the current categorical deferral of MSM donations: (1) completely abandoning donor selection on the basis of sexual behavior, (2) individual risk assessment of the sexual activities of each potential donor, and (3) individual risk assessment of the sexual activities of MSM only. The new U.K. policy falls within the second category, and the new Dutch policy is in the third category. We argue that each approach comes with moral costs but that the most reasonable option is different from the policies of both the U.K. and the Netherlands. (shrink)

This study adapts a Medical English Language Anxiety Scale based on Horwitz’s Foreign Language Classroom Anxiety Scale and examines students’ anxiety in medical English vocabulary, listening and speaking, communication, literature reading, and academic paper writing. The biographical factors related to medical English language anxiety were also tested. The questionnaire sets including five dimensions were distributed to the students from a medical university in Sichuan, China, and were statistically analyzed by using SPSS 22.0 and AMOS 21.0. By employing the adapted (...) MELAS, it was found that 85.2% of the medical students surveyed suffered moderate and higher anxiety. Among all dimensions, students with listening and speaking anxiety recorded the highest, followed by literature reading anxiety, English academic writing anxiety, communication anxiety, and vocabulary learning anxiety. We also found that the anxiety of rural medical students in each dimension was higher than that of urban medical students. This study suggests that English teachers should be fully aware of their students’ language anxiety situation, design interesting class activities, and create a relaxed English learning atmosphere in classroom teaching to make students less nervous when learning medical English in class. (shrink)

The purpose of this research is to investigate the effectiveness of Digital Content Marketing on a Mixed Reality training platform environment with the consideration of online purchase intention through social media. E-commerce today encounters several common issues that cause customers to have reservations to purchase online. With the absence of physical contact points, customers often perceive more risks when making purchase decisions. Furthermore, online retailers often find it hard to engage customers and develop long-term relationships. In this research, a Structural (...) Equation Model is proposed to examine the efficacy of DCM from both immediate and long-term OPI. The results examine whether adopting DCM on an MR training platform environment through social media brings positive results in OPI. Empirical research was carried out through online questionnaires collected in 2021 and 2022. A total of 374 questionnaires were qualified for data analysis in this study, conducted with IBM SPSS and AMOS. The results imply that DCM is critical to stimulating both immediate and long-term OPI. The immediate OPI is positively affected by increasing perceived value through MR in DCM. Regarding the long-term OPI, increased customer engagement with DCM under MR environment can cultivate brand trust and significantly affect the long-term OPI. (shrink)

Religion is among the determinants of human beliefs and values in various societies, shaping people’s behaviours in a range of life aspects, including the workplace. In view of the influence of religion in Malaysia, this issue becomes highly significant. With regard to the profound impact of religion on creating individual and collective behaviours, the present study aims to investigate the effects of religious behaviours (RBs) on organisational commitment (OC) among Malaysian healthcare workers (HCWs) in 2022, by a survey method implemented (...) using standardised questionnaires for data collection. The statistical population comprised of 2500 HCWs from 10 hospitals in Kuala Lumpur, Georgetown and Malacca, Malaysia, selected by the simple random sampling among the Muslim staff. The data analysis was further fulfilled using the AMOS software package for structural equation modelling (SEM). In general, the study results demonstrated a significant and positive relationship between RBs and OC among Malaysian HCWs (p-value = 0.84, t-statistic = 6.50).Contribution: As demonstrated by the study results, it is possible to inspire OC among employees through strengthening RBs and take advantages of the results. Thus, RBs shown by employees can definitely bring positive results to organisations; therefore, OC in Malaysian HCWs improves. (shrink)

Since the very beginning of modern Comenius studies there have been attempts to examine the relationship of the Czech philosopher, theologian, and educational reformer Jan Amos Comenius to the English philosopher and statesman Francis Bacon. A study dealing with the efforts of both philosophers to reform philosophy is, nevertheless, still lacking. The aim of this paper is, therefore, to introduce Comenius’s relationship to the work of Francis Bacon in this regard. In the first part, the author presents an overview (...) of Comenius’s references to Bacon. The following section focuses on a description and comparison of the structure and fundamental concepts held by both Comenius and Bacon in their works relevant for the topic. In the last part of the paper, the reader will find the characteristics of both philosophers’ projects of the restoration of knowledge. The author concludes that although both Comenius and Bacon directed their intellectual powers towards restoring the original immaculate knowledge of Adam, they approached its implementation in their own unique and original ways. © Filosofia, 2017. (shrink)

Some critical reactions hardly give clues to the arguer as to how to respond to them convincingly. Other critical reactions convey some or even all of the considerations that make the critic critical of the arguer’s position and direct the arguer to defuse or to at least contend with them. First, an explication of the notion of a critical reaction will be provided, zooming in on the degree of “directiveness” that a critical reaction displays. Second, it will be examined whether (...) there are normative requirements that enhance the directiveness of criticism. Does the opponent have in circumstances a dialectical obligation to provide clarifications, explanations, or even arguments? In this paper, it is hypothesized that the competitiveness inherent in critical discussion must be mitigated by making the opponent responsible for providing her counterconsiderations, if available, thus assisting the proponent in developing an argumentative strategy that defuses them. (shrink)

Amos departs from Austin, who Amos considered "the true founder of the science of law", in important fundamentals. In this text, Amos sets out to draw a "clear line of demarcation between ethical & legal conceptions".

This article described three heuristics that are employed in making judgements under uncertainty: representativeness, which is usually employed when people are asked to judge the probability that an object or event A belongs to class or process B; availability of instances or scenarios, which is often employed when people are asked to assess the frequency of a class or the plausibility of a particular development; and adjustment from an anchor, which is usually employed in numerical prediction when a relevant value (...) is available. These heuristics are highly economical and usually effective, but they lead to systematic and predictable errors. A better understanding of these heuristics and of the biases to which they lead could improve judgements and decisions in situations of uncertainty. (shrink)

Women’s empowerment is a concept describing the promotion of women doing things independently and in their own interests, being more conducive to their future and physical and mental development; this includes participation in different outdoor activities, including sports. This qualitative study presents data collected from 18 young female students at sports and physical education universities in Southern Punjab (SP) in Pakistan, selected using a snowball sampling technique. The current study explores their gendered and lived experiences of playing sports and engaging (...) in physical activities in patriarchal systems by emphasizing the concept of women’s empowerment in the context of feminism in sports theory. The findings suggest that the participants faced typical gender stereotypes in their families and communities, which position sports and physical activities as being not feminine. The chances for women to participate in sports and physical activities decrease as they grow up. However, the participants used a range of strategies to advance their interests and academic careers in sports and physical activities by resisting and incorporating dominant discourses of women’s participation in sports and physical activities, which also has implications in the internal and external policy domains at the local and national levels. The participants displayed great resilience and optimism, empowering them to enter the male-dominated domains, and thus we labeled them as change agents. (shrink)

This pioneering work in the history of science, which originated in a series of three Gauss Seminars given at Princeton University in 1984, demonstrated how the roots of the scientific revolution lay in medieval scholasticism.

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

This book offers a fresh account of one of the remarkable figures in the Renaissance, Giovanni Pico della Mirandola (1463-1494), by focusing on a neglected aspect of his work; his reading of scholasticism and its reception in the fifteenth century.

Negotiation is not only used to settle differences of interest but also to settle differences of opinion. Discussants who are unable to resolve their difference about the objective worth of a policy or action proposal may be willing to abandon their attempts to convince the other and search instead for a compromise that would, for each of them, though only a second choice yet be preferable to a lasting conflict. Our questions are: First, when is it sensible to enter into (...) negotiations and when would this be unwarranted or even fallacious? Second, what is the nature of a compromise? What does it mean to settle instead of resolve a difference of opinion, and what might be the dialectical consequences of mistaking a compromise for a substantial resolution? Our main aim is to contribute to the theory of argumentation within the context of negotiation and compromise formation and to show how arguing disputants can shift to negotiation in a dialectically virtuous way. (shrink)

The purpose of this paper is to show the pervasive, though often implicit, role of arguments in negotiation dialogue. This holds even for negotiations that start from a difference of interest such as mere bargaining through offers and counteroffers. But it certainly holds for negotiations that try to settle a difference of opinion on policy issues. It will be demonstrated how a series of offers and counteroffers in a negotiation dialogue contains a reconstructible series of implicit persuasion dialogues. The paper (...) is a sequel to van Laar and Krabbe, in which we showed that for some differences of opinion it may be reasonable to shift from persuasion dialogue, aimed at a resolution of the difference on the merits, to negotiation dialogue, aimed at compromise, whereas in the present paper we show that such a shift need not amount to the abandonment of argumentation. Our main aim in this paper as well as in the previous one is to contribute to the theory of argumentation within the context of negotiation and compromise formation. (shrink)

Some critical reactions hardly give clues to the arguer as to how to respond to them convincingly. Other critical reactions convey some or even all of the considerations that make the critic critical of the arguer’s position and direct the arguer to defuse or to at least contend with them. First, an explication of the notion of a critical reaction will be provided, zooming in on the degree of “directiveness” that a critical reaction displays. Second, it will be examined whether (...) there are normative requirements that enhance the directiveness of criticism. Does the opponent have in circumstances a dialectical obligation to provide clarifications, explanations, or even arguments? In this paper, it is hypothesized that the competitiveness inherent in critical discussion must be mitigated by making the opponent responsible for providing her counterconsiderations, if available, thus assisting the proponent in developing an argumentative strategy that defuses them. (shrink)

The three research questions of this study have been: what exactly is active ambiguity?; how should we assess active ambiguities in an argumentative discussion?; what does an adequate dialectical account of active ambiguity look like? These three questions have been answered by giving a definition of active ambiguity, and by elaborating on the properties of active ambiguity. Based on the survey of possible consequences of active ambiguities, and based on the basic division of labour in a persuasion dialogue, we arrived (...) at a set of requirements that a normative, procedural account of active ambiguity should satisfy. The model for ambiguity dialectic both provides a detailed account of evaluating active ambiguities, as well as a dialectical account of dealing with alleged active ambiguity. The distinction between constitutive and regulative rules for discussion has made it possible to provide a discussion model in which discussants can raise the issue of active ambiguity, and in which they can argue about the correctness of such points of order. This immanent dialectical approach has lead to a fourfold classification of fallacies: by using an actively ambiguous expression a party either violates a regulative, or a constitutive rule for persuasion dialogue, and if this party violates a rule, he or she either commits a fallacy of ambiguity, and possibly also the more complex fallacy of equivocation. This model for ambiguity dialectic has been shown to be useful for the analysis and evaluation of complex debates and discussions. The present study can be extended in various ways:  A model for critical discussion can be enriched so that it accommodates other regulative rules, such as the rule that requires arguments to be valid. By doing so, other points of order and other fallacy criticisms can be studied from the perspective of a critical metadiscussion.  The results concerning active ambiguity can be applied to other modes of reasoning, such as visual argumentation.  The results can be applied to ambiguity at the level of larger stretches of argumentative discourse. That could lead to a fruitful contribution to the theory of argument structures.  There still is a need for dialectical models that concern the use of usage declaratives different from providing a disambiguation, such as the use of definitions, clarifications of unfamiliar expressions, amplifications, etc., and the question would have to be answered how the rules with respect to active ambiguity would relate to those models.  The model can be enriched by inserting a specific ‘linguistic utterance meaning testing machine’. That would be a major step towards implementing the model in a computer program.  The use of descriptive profiles of dialogue could be improved further. In order to analyse the way parties respond to dialectically complex contributions, we are in need of a dialectical theory that provides the parties with specific rights and obligations for putting forward complex contributions and for responding to complex contributions. (shrink)

Some critical reactions hardly give clues to the arguer as to how to respond to them convinc-ingly. Other critical reactions convey some or even all of the considerations that make the critic critical of the arguer’s position and direct the arguer to defuse or to at least contend with them. First, an explication of the notion of a critical reaction will be provided, zooming in on the degree of ‘directiveness’ that a critical reaction displays. Second, it will be examined whether (...) and to what extent there is a normative requirement to strive after criticism that is more than minimally directive. In this paper, it is hypothesized that the com-petitiveness inherent in critical discussion must be mitigated by making the opponent responsible for providing her counterconsiderations, if available, thus assisting the proponent in developing an argumenta-tive strategy that defuses them. (shrink)

Negotiation is not only used to settle differences of interest but also to settle differences of opinion. Discussants who are unable to resolve their difference about the objective worth of a policy or action proposal may be willing to abandon their attempts to convince the other and search instead for a compromise that would, for each of them, though only a second choice yet be preferable to a lasting conflict. Our questions are: First, when is it sensible to enter into (...) negotiations and when would this be unwarranted or even fallacious? Second, what is the nature of a compromise? What does it mean to settle instead of resolve a difference of opinion, and what might be the dialectical consequences of mistaking a compromise for a substantial resolution? Our main aim is to contribute to the theory of argumentation within the context of negotiation and compromise formation and to show how arguing disputants can shift to negotiation in a dialectically virtuous way. (shrink)

This paper provides further evidence to the argument that Smith' theory of justice did not follow the natural justice school and that subsequently the ethical position on acquiring private property is not independent of the effects which such acquisition may have on the property-less individuals. I will show that the justification for private ownership is based on “reasonable expectations” which owners of assets have with regard to the fruits of the asset. The expectation to subsist through the use of one's (...) natural assets is equally reasonable. This is not to say that Smith believed that society should equally distribute income. But it does mean that the acquisition of private property must not interfere with the rights of individuals to subsist. Consequently, distribution is clearly an important part of Smith's conception of justice. (shrink)