It has been argued that organs should be treated as individual tradable property like other material possessions and assets, on the basis that this would promote individual freedom and increase efficiency in addressing the shortage of organs for transplantation. If organs are to be treated as property, should they be inheritable? This paper seeks to contribute to the idea of organs as inheritable property by providing a defence of a default of the family of a dead person as inheritors of (...) transplantable organs. In the course of discussion, various succession rules for organs and their justifications will be suggested. We then consider two objections to organs as inheritable property. Our intention here is to provoke further thought on whether ownership of one's body parts should be assimilated to property ownership. (shrink)

During an outbreak or pandemic involving a novel disease such as COVID-19, infected persons may need to undergo strict medical isolation and be separated from their families for public health reasons. Such a practice raises various ethical questions, the characteristics of which are heightened by uncertainties such as mode of transmission and increasingly scarce healthcare resources. For example, under what circumstances should non-infected parents be allowed to stay with their infected children in an isolation facility? This paper will examine ethical (...) issues with three modes of “family presence” or “being there or with” a separated family member during the current COVID-19 pandemic: physical, virtual, and surrogate. Physical visits, stays, or care by family members in isolation facilities are usually prohibited, discouraged, or limited to exceptional circumstances. Virtual presence for isolated patients is often recommended and used to enable communication. When visits are disallowed, frontline workers sometimes act as surrogate family for patients, such as performing bedside vigils for dying patients. Drawing on lessons from past outbreaks such as the 2002-2003 SARS epidemic and the recent Ebola epidemic in West Africa, we consider the ethical management of these modes of family presence and argue for the promotion of physical presence under some conditions. (shrink)

This comment responds to Kevin Warwick’s article on predictability and responsibility with respect to brain-machine interfaces in action. It compares conventional responsibility for device use with the potential consequences of phenomenological human-machine integration which obscures the causal chain of an act. It explores two senses of “responsibility”: 1) when it is attributed to a person, suggesting the morally important way in which the person is a causal agent, and 2) when a person is accountable and, on the basis of fairness (...) about rewards and sanctions, has a duty to act responsibly and accept liability. The comment suggests that, in the absence of absolute knowledge and predictability, we continue to engage in practical forms of reasoning about the responsibility for BMI-use in ways which are inclusive of uncertainties about the liability of persons versus devices and those who create them. (shrink)

Acts of helping others are often based on mixed motivations. Based on this claim, it has been argued that the use of a financial reward to incentivize organ donation is compatible with promoting altruism in organ donation. In its report Human Bodies: Donation for Medicine and Research, the Nuffield Council on Bioethics uses this argument to justify its suggestion to pilot a funeral payment scheme to incentivize people to register for deceased organ donation in the UK. In this article, I (...) cast a sceptical eye on the above Nuffield report's argument that its proposed funeral payment scheme would prompt deceased organ donations that remain altruistic . Specifically, I illustrate how this scheme may prompt various forms of mixed motivations which would not satisfy the report's definition of altruism. Insofar as the scheme produces an expectation of the reward, it stands diametrical to promoting an ‘altruistic perspective’. My minimal goal in this article is to argue that altruism is not motivationally compatible with reward as an incentive for donation. My broader goal is to argue that if a financial reward is used to incentivize organ donation, then we should recognize that the donation system is no longer aiming to promote altruism. Rewarded donation would not be altruistic but it may be ethical given a persistent organ shortage situation. (shrink)

Healthcare facilities in receiving countries regularly encounter guest workers whose need for acute or subacute care triggers the prospect of termination of employment and repatriation. In these scenarios, country‐specific migration and employment policies and norms of medical professionalism and ethics offer some guidance, but also create tensions. It is not clear under what conditions such medical repatriation is ethically permissible.This paper analyses the application of a previously articulated criteria for the ethical medical repatriation of undocumented immigrants, to the situation of (...) documented guest workers, with focus on the context of Singapore. We examine how these standards could be adapted and applied to the provision of care for guest workers, and argue that healthcare institutions and medical professionals have a duty to intervene in employers’ decisions to repatriate guest workers for medico‐economic reasons when repatriation essentially amounts to ‘patient dumping’. Barriers and challenges in implementing the criteria, and their possible solutions will be discussed. (shrink)

Developing World Bioethics, Volume 21, Issue 4, Page 227-236, December 2021.

This article argues that outbreak preparedness and response should implement a ‘family presence’ policy for infected patients in isolation that includes the option of physical visits and care within the isolation facility under some conditions. While such a ‘physical family presence’ policy could increase infections during an outbreak and may raise moral dilemmas, we argue that it is ethically justified based on the least infringement principle and the need to minimize the harms and burdens of isolation as a restrictive measure. (...) Categorical prohibition of PFP during the course of an outbreak or epidemic is likely to result in unnecessary harms to patients and families, and violate values such as the moral commitments of families to care for each other. Supporting the option of PFP under particular circumstances, on the other hand, will least infringe these moral considerations. An additional reason for a family presence policy is that it may facilitate voluntary cooperation with isolation and other restrictive measures. We provide an analysis of these considerations for supporting modes of family presence during an outbreak emergency, before defending the riskier option of PFP in the isolation facility from plausible objections and concerns. (shrink)

BackgroundHealth screening is undertaken to identify individuals who are deemed at higher risk of disease for further diagnostic testing so that they may possibly benefit from interventions to modify the natural course of disease. In Singapore, screening tests are widely available in the form of a package, which bundles multiple tests in one session and commonly includes non-recommended tests. There are various ethical issues associated with such testing as they may not be clinically appropriate and can result in more harm (...) than benefit. This article describes the practice of health screening packages, identifies the ethical issues arising from such packages and discusses the implications of these ethical issues on policy and practice of screening in Singapore.MethodsA content analysis of the websites of providers offering general health screening packages to individuals was conducted. A total of 14 health screening package providers were analysed for how packages were conducted and promoted, how clinically appropriate screening tests were, and the price range and composition of screening packages. A normative ethical analysis based on the four principles approach of beneficence, non-maleficence, autonomy and justice in biomedical ethics was used.ResultsTwelve of the 14 providers included non-recommended tests such as tumour markers, treadmill stress tests and MRI scans in their general health screening packages. Package prices ranged from S$26 to S$10,561, with providers charging higher when more tests were included. Health screening packages were broadly conducted in three stages: the offer and selection of a health screening package; medical assessment and performance of screening tests; a post-screening review. While material provided by all providers was factual, there was no information on the potential risks or harms of screening.ConclusionSeveral ethical issues were identified that should be addressed with regard to health screening packages in Singapore. A key issue was the information gap between providers and patients, which may result in patients undergoing inappropriate testing that may be more harmful than beneficial. Health screening packages can stimulate unnecessary demand for healthcare and contribute to an inequitable distribution of healthcare resources. (shrink)

Like all research, embryo research can take a variety of forms, some posing substantially more risks to persons than others. Savulescu et al argue persuasively that regulatory regimes specially designed for sensitive embryo research should differentiate between person-affecting and non-person-affecting embryo research, with substantial scrutiny only warranted for the former.1 Yet if we find Savulescu et al ’s argument persuasive, what practical implications would it have? In this commentary, we focus in particular on how such an argument might apply in (...) Singapore, one of the jurisdictions with special regulations for embryo research. We will summarise the way in which approval for oocyte and embryonic research operates in Singapore, and suggest that Savulesc et al ’s distinction requires specification to be useful in such contexts. We propose adopting a risk-stratified framework similar to that employed with Institutional Review Boards. This requires a wider view of risks than the focus by Savulescu et al on future persons. We then illustrate how such a framework would apply in five scenarios discussed in Savulescu et al. Research with embryos and oocytes is regulated in Singapore under the Human Biomedical Research Act.2 Enacted in 2015, this law sets out requirements for consent, IRB review and research oversight. By definition, all research involving gametes and embryos fall within the remit of the Act. Moreover, such research is defined as ‘restricted’; besides the Act, research involving oocytes and embryos is also subject to control under the Human Biomedical Research …. (shrink)

This article poses a response to one argument supporting the force feeding of political prisoners. This argument assumes that prisoners have moral autonomy and thus cannot be force fed in the early stages of their hunger strike. However, as their fasting progresses, their cognitive competence declines, and they are no longer autonomous. Since they are no longer autonomous, force feeding becomes justified. This article questions the recurrent citation of a paper in empirical support of the claim that hunger strike causes (...) mental disorders or cognitive impairments. The paper, written by Daniel Fessler, partially relies on the Minnesota Starvation Experiment conducted in 1944 to 1945 for scientific support. Using widely accepted criteria for assessing the ethical acceptability of clinical research, we argue that the Minnesota Starvation Experiment had significant scientific shortcomings and is a case of unethical research. From this, we question the appropriateness of citing the Minnesota Starvation Experiment and consequently Fessler’s paper. If Citing Fessler’s paper becomes problematic, this particular argument for the force feeding of prisoners loses much of its strength. (shrink)

Active surveillance cultures and contact precautions is a strategy to control the transmission of methicillin-resistant Staphylococcus aureus (MRSA) within healthcare facilities. Whether to implement this strategy to routinely screen and isolate inpatients with MRSA in non-outbreak (endemic) settings, or to remove it and use standard infection control precautions only is scientifically and ethically controversial, in view of the potential adverse effects of contact precautions on patients. To support the use of standard precautions only, it has been argued that active surveillance (...) to identify patients who are asymptomatically colonised with MRSA to place them in contact precautions is unjust or unfair to these patients in various ways. This paper will unpack and examine four distinct arguments, which are advanced from a medical ethics or quality improvement ethical framework, for why this is so. Our analysis shows that while these arguments highlight the injustice of current practices, they do not provide strong ethical reasons for justifying the removal of active surveillance and contact precautions to control MRSA transmission and infection. An implication of our arguments is that the ethical frame for evaluating prevention and control strategies for MRSA, a multi-drug resistant bacteria, should shift from healthcare to primarily public health. From a public health ethics perspective, whether a strategy is unjust, or how ethically significant its lack of fairness is, depends on assessing the evidence for its public health effectiveness and necessity in a given setting, and the extent of the harms and burdens patients with MRSA bear when they are on contact precautions, which remain matters of scientific debate or uncertainty. As an ethical consideration in the debate, the chief normative implication of justice is to provide us further reasons to revise current active surveillance-contact precautions practices, and for the need for research and interventions to minimise their potential adverse effects on patients. (shrink)

This paper will discuss why and how social network sites ought to be used in surrogate decision making (SDM), with focus on a context like Singapore in which substituted judgment is incorporated as part of best interest assessment for SDM, as guided by the Code of Practice for making decisions for those lacking mental capacity under the Mental Capacity Act (2008). Specifically, the paper will argue that the Code of Practice already supports an ethical obligation, as part of a patient-centred (...) care approach, to look for and appraise social network site (SNS) as a source of information for best interest decision making. As an important preliminary, the paper will draw on Berg’s arguments to support the use of SNS information as a resource for SDM. It will also supplement her account for how SNS information ought to be weighed against or considered alongside other evidence of patient preference or wishes, such as advance directives and anecdotal accounts by relatives. (shrink)

This volume presents articles which focus on the ethical evaluation of performance-enhancing technologies in sport. The collection considers whether drug doping should be banned; the rationale of not banning ethically contested innovations such as hypoxic chambers; and the implications of the prospects of human genetic engineering for the notion of sport as a development of 'natural' talent towards human excellence. The essays demonstrate the significance of the principles of preventing harm, ensuring fairness and preserving meaning to appraise whether a particular (...) performance enhancer is acceptable in the context of sport. Selected essays on various forms of human enhancement outside of sport that highlight other principles and concepts are included for comparative purpose. Sport enhancement provides a useful starting point to work through the ethics of enhancement in other human practices and endeavors, and sport enhancement ethics should track broader bioethical debates on human enhancement. As a whole, the volume points to the need to consider the values and meanings that people seek in a given sphere of human activity and their associated principles to arrive at a morally grounded and reasonable approach to enhancement ethics. (shrink)

Healthcare Ethics, Law and Professionalism: Essays on the Works of Alastair V Campbell features 15 original essays on bioethics, and healthcare ethics specifically. The volume is in honour of Professor Alastair V Campbell, who was the founding editor of the internationally-renowned Journal of Medical Ethics, and the founding director of three internationally leading centres in bioethics, in Otago, New Zealand, Bristol, UK, and Singapore. Campbell was trained in theology and philosophy and throughout his career worked with colleagues from various disciplines, (...) including law and various branches of healthcare. The diversity of topics and depth of contributors' insights reflect the breadth and impact of Campbell's philosophical work and policy contributions to healthcare ethics. Throughout his long academic career, Campbell's emphasis on healthcare ethics being practice-oriented, yet driven by critical reflection, has shaped the field in vital ways. The chapters are authored by leading scholars in healthcare ethics and law. Directly engaging with Campbell's work and influence, the essays discuss essential questions in healthcare ethics relating to its methodology and teaching, its intersection with law and policy, medical professionalism, religion, and its translation in different cultural settings. Chapters also grapple with specific enduring topics, such as the doctor-patient relationship, justice in health and biomedical research, and treatment of the human body and the dead. (shrink)

Background Several jurisdictions, including Singapore, Australia, New Zealand and most recently Ireland, have a public interest or public good criterion for granting waivers of consent in biomedical research using secondary health data or tissue. However, the concept of the public interest is not well defined in this context, which creates difficulties for institutions, institutional review boards and regulators trying to implement the criterion. Main text This paper clarifies how the public interest criterion can be defensibly deployed. We first explain the (...) ethical basis for requiring waivers to only be granted to studies meeting the public interest criterion, then explore how further criteria may be set to determine the extent to which a given study can legitimately claim to be in the public interest. We propose an approach that does not attempt to measure magnitude of benefit directly, but rather takes into account metrics that are more straightforward to apply. To ensure consistent and justifiable interpretation, research institutions and IRBs should also incorporate procedural features such as transparency and public engagement in determining which studies satisfy the public interest requirement. Conclusion The requirement of public interest for consent waivers in secondary biomedical research should be guided by well-defined criteria for systematic evaluation. Such a criteria and its application need to be periodically subject to intra-committee and intra-institution review, reflection, deliberation and amendment. (shrink)

Meat is a multi-billion-dollar industry that relies on people performing risky physical work inside meat-processing facilities over long shifts in close proximity. These workers are socially disempowered, and many are members of groups beset by historic and ongoing structural discrimination. The combination of working conditions and worker characteristics facilitate the spread of SARS-CoV-2, the virus that causes COVID-19. Workers have been expected to put their health and lives at risk during the pandemic because of government and industry pressures to keep (...) this “essential industry” producing. Numerous interventions can significantly reduce the risks to workers and their communities; however, the industry’s implementation has been sporadic and inconsistent. With a focus on the U.S. context, this paper offers an ethical framework for infection prevention and control recommendations grounded in public health values of health and safety, interdependence and solidarity, and health equity and justice, with particular attention to considerations of reciprocity, equitable burden sharing, harm reduction, and health promotion. Meat-processing workers are owed an approach that protects their health relative to the risks of harms to them, their families, and their communities. Sacrifices from businesses benefitting financially from essential industry status are ethically warranted and should acknowledge the risks assumed by workers in the context of existing structural inequities. (shrink)

During the WHO-GloPID COVID-19 Global Research and Innovation Forum meeting held in Geneva on the 11th and 12th of February 2020 a number of different ethical concepts were used. This paper briefly states what a number of these concepts mean and how they might be applied to discussions about research during the COVID-19 pandemic and related outbreaks. This paper does not seek to be exhaustive and other ethical concepts are, of course, relevant and important.

Culling is used in traditional public health policies to control animal populations. These policies aim primarily to protect human interests but often fail to provide scientific evidence of effectiveness. In this article, we defend the need to move from a strictly anthropocentric approach to disease control towards a One Health ethics, using culling practices as an example. We focus on the recent badger culls in the UK, claiming that, based on data provided by the English Government, these culls may be (...) unjustified, all thing considered. We highlight the relevance of ethical reasoning rooted in One Health for this discussion, and make several suggestions including a moratorium on culling until data are provided to support the effectiveness of culling; to conduct a randomized trial to compare proactive culling with alternative methods; to apply deliberative democratic methods to assess public opinion towards the culls, and to find in Brexit an opportunity for aiming for more effective control measures. (shrink)

High degrees of uncertainty and a lack of effective therapeutic treatments have characterized the COVID-19 pandemic and the provision of drug products outside research settings has been controversial. International guidelines for providing patients with experimental interventions to treat infectious diseases outside of clinical trials exist but it is unclear if or how they should apply in settings where clinical trials and research are strongly regulated. We propose the Professional Oversight of Emergency-Use Interventions and Monitoring System as an alternative pathway based (...) on guidance developed for the ethical provision of experimental interventions to treat COVID-19 in Singapore. We support our proposal with justifications that establish moral duties for physicians to record outcomes data and for institutions to establish monitoring systems for reporting information on safety and effectiveness to the relevant authorities. Institutions also have a duty to support generation of evidence for what constitutes good clinical practice and so should ensure the unproven intervention is made the subject of research studies that can contribute to generalizable knowledge as soon as practical and that physicians remain committed to supporting learning health systems. We outline key differences between POEIMS and other pathways for the provision of experimental interventions in public health emergencies. (shrink)

Brain death certification can be a clinically and ethically challenging affair. Healthcare workers are expected to refer patients for brain death certification to identify potential organ donors, but family members may be ill-prepared for this turn of events. Already distraught families may not appreciate delays in brain death certification, but such delays are common because of the need to manage the patient’s altered physiological state to allow testing. Opportunities for donation are sometimes lost because of the unnecessary delay. With focus (...) on an opt-out organ donation law, we discuss causes of delays in brain death certification, and the ethical issues faced by clinicians in using tests to certify patients. To resolve the issues, we argue for the use of supplementary confirmatory tests as part of a more protocol-driven approach to brain death certification to avoid delays. Such tests should be regarded as part of the donation process funded by the state. (shrink)

Teck Chuan Voo and Soren Holm argue that “organs should be inheritable if they were to be socially and legally recognised as tradable property.”1 To support this view they first observe that “…legal recognition of objects as property… opens up the possibility of the legal recognition of the survival of the property rights and their inheritability after the death of the source/owner, even if those rights are intimately bound with the person.”1 They also note that if organs are (...) tradable property then they could be sold by their current owners for removal by the buyer after the original owner dies. Having established that a person's property rights in her organs should be respected in this way if organs are tradable property, Voo and Holm hold that “[p]rima facie, organs should be disposable by testation”.1 They believe that this claim is supported by the same consequentialist reasons that support organs being recognised as tradable property: that this increases persons’ freedom and control over their organs, and increases transfers of transplantable organs to persons who need them. But while these reasons support recognising organs as tradable property, they do not support their being …. (shrink)

The coming of bioethics to Singapore / W. Calvin Ho and Sylvia S.N. Lim -- The impact of the bioethics advisory committee on the research community in Singapore / Charmaine K.M. Chan and Edison T. Liu -- Engaging the public : the role of the media / Chang Ai-Lien and Judith Tan -- Confucian trust and the biomedical regulatory framework in Singapore / Anh Tuan Nuyen -- The clinician-researcher : a servant of two masters? / Alastair V. Campbell, Jacqueline Chin, (...) and Teck Chuan Voo -- The US model for oversight of human stem cell research / Lindsay Parham and Bernard Lo -- Genetics and stem cell research : models of international policy-making / Bartha Maria Knoppers, Emily Kirby and Rosario Isasi -- Public engagement and bioethics commissions / Thomas H. Murray and Ross S. White -- Norm-making on human-animal chimeras and hybrids in Singapore, the United Kingdom and the international domain / W. Calvin Ho and Martin Bobrow -- How will future bioethical issues engage Singapore? / John Elliott. (shrink)

Since the introduction of Ethereum in 2015, blockchain technology (BT) has been evolving, and BT has been associated with the concept of the sharing economy by business academics. Despite the marketing research on the sharing economy that has been extensively conducted in the last decade, the linkage between BT and ethical marketing in the sharing economy remains unclear. Through a systematic literature review of 163 articles and a co-citation analysis, this study identifies the key elements of blockchain capabilities, blockchain attributes, (...) and the underlying economic theories of blockchain. It also synthesizes and proposes a shift of ethical marketing logic in the blockchain-based sharing economy that delineates the principles of stakeholder capitalism. The article concludes with a list of future research directions that underline three approaches of stakeholder theory (i.e., the descriptive, instrument, and normative approaches). These directions aim to guide marketing scholars concerning how BT enables an institutionally embedded view of ethical marketing activities and practices that enhance collaborative marketing and subsequently innovate value chains and create sustainable business models in the sharing economy, as well as to the metaverse. (shrink)

Background: A significant concern for patients treated for cancer is fear of cancer recurrence. Although a common experience, some patients report high levels of FCR that are difficult to manage and result in over vigilant checking and high use of health services. There has been speculation about the relationship of FCR with gender with mixed reports from several systematic reviews.Aims: To determine the association of FCR with gender in previous reported studies and investigate the strength of this relationship with various (...) moderators including year of publication, type of cancer and measurement attributes of self-reported FCR instruments.Methods: A systematic review was conducted with searches of the literature from the MEDLINE, PubMed, Embase, and PsycINFO databases following PRISMA guidelines. All the included papers were divided into two groups, namely: “pure” that comprise only of patients with cancer types that both men and women can contract and “mixed” that report on patients with a variety of cancer types. The association between gender and FCR level was assessed by meta-analysis. A meta-regression was performed to investigate the moderating effects of factors including: the year of publication, cancer type, mean age of the sample and the length of the FCR scale measurement. This review was registered with PROSPERO, ID: CRD42020184812.Results: Finally, 29 studies were included. The N size of pooled participants was 33,339. The meta-analysis showed females to have an overall higher level of FCR than males. The meta-regression of moderating or control variables found little, if any, systematic variation in effect-sizes.Conclusion: This systematic review has clarified a potentially confused pattern of previous results in understanding the relationship between gender and FCR. Women report higher levels of FCR than men and this feature is one that clinicians and researchers can factor into their practice and future studies. The effect size is moderate, hence there is ample variation in FCR level, independent of gender, that requires further investigation. (shrink)

Quantum B-algebras, the partially ordered implicational algebras arising as subreducts of quantales, are introduced axiomatically. It is shown that they provide a unified semantic for non-commutative algebraic logic. Specifically, they cover the vast majority of implicational algebras like BCK-algebras, residuated lattices, partially ordered groups, BL- and MV-algebras, effect algebras, and their non-commutative extensions. The opposite of the category of quantum B-algebras is shown to be equivalent to the category of logical quantales, in the way that every quantum B-algebra admits a (...) natural embedding into a logical quantale, the enveloping quantale. Partially defined products of algebras related to effect algebras are handled efficiently in this way. The unit group of the enveloping quantale of a quantum B-algebra X is shown to be always contained in X, which gives a functorial subgroup X× of X. Similar subfunctors are obtained for the non-commutative extensions of BCK-algebras and effect algebras. The results of Galatos, Jónsson, and Tsinakis on the splitting of generalized BL-algebras into a semidirect product of a partially ordered group operating on an integral residuated poset are extended to a characterization of twisted semidirect products of a po-group by a quantum B-algebra. (shrink)

Because of the coronavirus disease 2019 pandemic, the traditional didactic teaching method that is practiced in Confucian culture, an Eastern cultural model, is being challenged by multiple alternative teaching modes. In Western cultures, the teaching behavior of teachers is dependent on their ability to influence the temperament of students; in contrast, teachers in Eastern cultures are influenced by changes in external environment. This phenomenon can mainly be explained by the tendency of students in Eastern cultures to adopt a passive learning (...) style because of Confucianism. On the basis of Confucian culture and literature review, we conducted a Chinese-language questionnaire survey of temperament scales and learning motivation, and 724 effective questionnaires were collected and used to explore the relationship between students’ temperament and learning motivation under three teaching modes, namely, online teaching, traditional offline classroom teaching, and online–offline mixed teaching. Conclusions drawn were as follows. In a Chinese Confucian cultural system, the passive learning style of students and its relationship with the surrounding collective culture creates the temperament characteristics of sanguinity and phlegmatism. Influenced by the traditional Confucian values of benevolence and honesty, students with a melancholic temperament do not focus on their learning motivations. Furthermore, changes in external information, to which such students are sensitive, cause them to give up opportunities easily. Similarly, students with a choleric temperament are sensitive and prone to fluctuating emotions, and they tend to be affected by changes in their external environment. Although students have a strong learning motivation under the traditional offline teaching mode, a paradox in individual cognition exists because of differences between Chinese and Western cultures. Therefore, students generally prefer the online–offline mixed teaching mode to the traditional single teaching mode. This study explored factors that influence students’ learning motivation, namely, individual temperament and educational environment, and provides a reference for the future development of post epidemic education. (shrink)

This paper argues that, for Richard Titmuss, the rationale of the gift relationship (TGR) as a national blood policy is to reconcile liberty with social justice in the provision of an essential health resource. Underpinned by a needs-based distributive principle, TGR provides a social space for a plurality of values in which to engage with and motivate people to voluntarily give blood and other body materials as a common good. This understanding of TGR as a value pluralistic framework and its (...) implications will be used to discuss the issue of using economic mechanisms to increase the supply of body materials or goods, including organs for transplantation. It is argued that, while TGR excludes a policy in which body goods are treated as private commodities and distributed primarily on the basis of achieving market efficiency, it is not in principle opposed to the use of material rewards, including financial ones, to motivate people to donate. (shrink)

On the basis of the Conservation of Resource theory and using the Job Demands-Resources model, this study examines the relationships among job demands and job resources of online teaching, perceived instructional efficacy of OT, mindfulness in teaching, and emotional exhaustion to understand the psychological stress experienced by teachers engaged in OT and how mindfulness has moderating effects on relieving anxiety and preventing burnout. A total of 476 teachers with OT experience completed online a self-report survey with items adapted from related (...) scales. The hypotheses were validated using structural equation modeling. Causal relationships were assessed using path analysis, and multi-group analysis was performed to examine the moderating effect of MiT. JD-OT has significant and negative impact on PIE-OT, JR-OT has significant and positive impact on PIE-OT, and PIE-OT has significant and negative impact on EE. Moreover, PIE-OT mediates the positive relationship of JD-OT with EE and the negative relationship of JR-OT with EE. The moderating role of MiT in the relationship of JD-OT and JR-OT with PIE-OT was also validated. In OT work environments, teachers have great need and desire for JR, which can have a positive impact on PIE. Mindfulness training contributes to improving OT efficacy and reducing EE. Enhancing teachers’ MiT enables them to deal with demands from work and their superiors and motivates them to respond with ease to the stressful external environment. (shrink)

Previous research on corporate community involvement (CCI) initiatives indicates that such behaviour is critical for building neighbourhood relationships and extending corporate influence in the community, but there is little theoretical work that provides a clear picture of managing the nature of the initiatives from different stakeholder management approaches. Drawing from theoretical insights of stakeholder theory and the concept of social capital, this article proposes nine strategic directions for CCI initiatives, and concludes by discussing the management implications of the proposed strategic (...) directions. Our proposed approaches have the potential to improve current understanding and practice of corporations and their CCI initiatives. (shrink)

This study aims to explore the current situation and strategy formulation of sports psychology teaching in colleges and universities following adaptive learning and deep learning under information education. The informatization in physical education, teaching methods, and teaching processes make psychological education more scientific and efficient. First, the relevant theories of adaptive learning and deep learning are introduced, and an adaptive learning analysis model is implemented. Second, based on the deep learning automatic encoder, college students’ sports psychology is investigated and the (...) test results are predicted. Finally, the current situation and development strategy of physical education in colleges and universities are analyzed. The results show that when the learning rate is 1, 0.1, and 0.01, there is no significant change in the analysis factors of recall, ndcg, item_coverage, and sps. When the learning rate is 1, their analysis factors change obviously, and it is calculated that the optimal learning rate of the model is 1. And the difficulty of the recommended test questions by using the sports psychology teaching method based on adaptive learning and deep learning is relatively stable. The test questions include various language points of sports psychology. Compared with others methods, adaptive learning and deep learning can provide comprehensive test questions for sports psychology teaching. This study provides technical support for the reform of sports psychology teaching in colleges and universities and contributes to optimizing the information-based teaching mode. (shrink)

Following the COVID-19 pandemic, online learning has become a new mode of learning that students must adapt to. However, the mechanisms by which students receive and grasp knowledge in the online learning mode remain unknown. Cognitive load theory offers instructions to students considering the knowledge of human cognition. Therefore, this study considers the CLT to explore the internal mechanism of learning under the online mode in an experimental study. We recruited 76 undergraduates and randomly assigned them to four groups in (...) which they will watch videos at four different kinds of speed. The study observed and analyzed how video playback speed affected students' learning and cognitive load to obtain the following results: Video playback speed significantly influenced the students' learning effect. The best effect was observed at the speed of 1.25× and 1.5×. The speed that affected the learning effect best differed according to the students' learning abilities. High-level group students performed best at the speed of 1.5×, whereas low-level group students performed best at the speed of 1.25×. The 1.5× speed showed significant differences in the learning effect by students' majors. This indicates that the cognitive load of liberal arts students increased greatly at this speed. A change in playback speed has a significant impact on the cognitive load. Accelerated playback speed increases the cognitive load of students. The highest learning effect is observed under medium cognitive load. (shrink)

This study provides an overview of social media usage among researchers in Malaysia and examines factors affecting their use for science communication. The online questionnaire gathered the opinions of 425 researchers from over 20 science disciplines. The descriptive analysis highlighted usage preferences for 10 commonly used social media, while statistical analysis in particular MANOVA and correlation analysis, identified significant factors influencing researchers’ social media use. Up to 62% of respondents believe that social media is more effective in reaching the public, (...) compared to other media. WhatsApp, Facebook, YouTube, Google Scholar, and ResearchGate are routinely used or perceived as beneficial to use. However, Twitter, Instagram, WordPress, and LinkedIn are seldom used because they are less preferred for science communication. Seniority, perceived importance, and perceived credibility are significantly correlated with both intention and actual use. Meanwhile, age and experience are significantly correlated with actual use, but not the intention. Researchers are likely to post and share more on social media if they believe that science communication is important or if they are credible enough to present a scientific consensus. This study offered important insights into the perceptions, concerns, and factors influencing their use for science communication. By determining the perceptions, concerns and motivators affecting researchers, the findings shed light on effective ways to promote researchers’ use of social media to communicate scientific knowledge. (shrink)

本書引入伽達默爾哲學詮釋學為理論視角，以唐代僧人的傳記史料為研究對象，用新角度審視老問題，把“佛教中國化”還原為“理解如何可能”與“真理如何可能”兩個基本的哲學議題進行討論，以此來嘗試證明佛教中國化過 程的必然性以及中國佛教的合法性。本書論述了佛教在中國的樣態是儒家文化“前理解”與佛教本身“出世”特點相融合的“視域融合”的佛教。.

Based on the assumption that the long-term value of a venture capital satisfies the algebraic Brownian motion, we develop a continuous-time exit model of venture capital under different exit modes, namely, initial public offering and mergers and acquisitions. The employee incentive problem is analyzed jointly with the exit decision of the firm in terms of the exit timing and the exit mode. Further, the problem of capital exit is considered from two perspectives, namely, optimal venture capital and social welfare maximization, (...) and the differences between these exit decisions are compared. Our model predicts that the timing of an IPO, the purpose of which is to maximize the utility of the capitalists, lags behind the exit timing, whose purpose is to maximize social welfare. Using a numerical analysis, this paper also proves that increasing the production efficiency, lowering the interest rates, and improving risk management can make the exit decision of venture capitalists converge with that of maximizing social welfare. (shrink)

BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees (CEC) s to carry out effective ethics consultations (CECons). However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality (...) of CECons.MethodsGuided by Levac et al’s (2010) methodological framework for conducting scoping reviews, the research team performed independent literature reviews of accounts of assessments of CECons published in six databases. The included articles were independently analyzed using content and thematic analysis to enhance the validity of the findings.ResultsNine thousand sixty-six abstracts were identified, 617 full-text articles were reviewed, 104 articles were analyzed and four themes were identified – the purpose of the CECons evaluation, the various domains assessed, the methods of assessment used and the long-term impact of these evaluations.ConclusionThis review found prevailing assessments of CECons to be piecemeal due to variable goals, contextual factors and practical limitations. The diversity in domains assessed and tools used foregrounds the lack of minimum standards upheld to ensure baseline efficacy.To advance a contextually appropriate, culturally sensitive, program specific assessment tool to assess CECons, clear structural and competency guidelines must be established in the curation of CECons programs, to evaluate their true efficacy and maintain clinical, legal and ethical standards. (shrink)

Homeobox genes play essential roles in specifying the fates of different cell types during embryogenesis. In Drosophila, the homeotic gene caudal is important for the generation of posterior structures. In the mouse, the caudal homologue Cdx2 has been implicated in directing early processes in intestinal morphogenesis and in the maintenance of the differentiated phenotype. A recent study showed that Cdx2 null mutation was embryonically lethal, whereas Cdx2+/− mice developed multiple intestinal polyps in the proximal colon in addition to developmental defects(1). (...) There are striking phenotypic similarities and differences between Cdx2+/− and other mice predisposed to intestinal neoplasia. The possible role of Cdx2 in human colorectal tumorigenesis is discussed. (shrink)