This study addresses two issues. First, does corporate social performance matter in Hong Kong. Second, if yes, is it relevant to some industries more than others. To answer these questions, we develop a corporate social performance index (CSP) to measure the quality of corporate social performance of major Hong Kong listed firms. The criteria are based on the OECD Principles of Corporate Governance. Using the 3-year period from 2002 to 2005, we find that firm valuation is positive and significantly associated (...) with CSP. Interestingly, this relation matters less in China related firms and firms with a concentrated ownership structure. The results also show that CSP impacts firm valuation more positively when the firm is in the service sector. We further find that CSP is positively related to the market valuation of the subsequent year. (shrink)

Since the official history-writing is a defining aspect for the formation and consolidation of nation-states, it is crucial to explore the attempts to legitimize particular discourses regarding historical atrocities. The selective representations of the past, in this regard, contradict counter-memories and propagate hegemonic patterns of remembrance and/or forgetting of past crimes. This article accordingly addresses how the representations of counter-memories as threats to national security and the silencing of gender-specific experiences and remembrances by sanctioned historical narratives become manifest in the (...) history-making of the Turkish nation-state. By focusing on the Holocaust and the Armenian Genocide as two cases of crimes against humanity, it is intended to discuss the shifting positions and roles that the Turkish state adopts in the remembering and forgetting of historical offences. The article argues that through prioritizing national security and national interests, the securitization of memory reconstructs collective traumas of distinct ethnic and religious groups on the basis of a nation-state’s perceived internal and external threats. It also claims that the competing voices of women and their distinct experiences and patterns of remembrance and forgetting past atrocities are suppressed for the sake of the preservation of national security. By incorporating the issue of gender into the debate on the securitization of memory, this article elucidates the mismatch between positions of femininity and masculinity within the official national historiography of the Turkish state. (shrink)

The present study aims to determine the key antecedents that affect consumers' electric vehicle (EV) purchasing behavior. In this context, the study expanded the existing framework of TPB (attitude, subjective norms, perceived behavioral control) by incorporating four new variables (product attributes, cognitive status, monetary incentive policies, and nonmonetary incentive policies). At this point, the study is of great importance in terms of understanding consumers' perspectives on EV purchasing behavior and to help policymakers, businesses, and marketers support sustainable production and consumption (...) by creating effective strategies. In addition, this study conducted in Türkiye, which shares similar consumption behaviors with Middle Eastern, Asian, and European societies, provides valuable insights for a rapid transition to the adoption of EVs. In the study, data were collected from 390 respondents with the survey method and the collected data were analyzed using Smart PLS 4.0 and SPSS 26 statistical software. The findings showed that only attitude together with cognitive status, product attributes, and monetary incentives policy contribute to EV purchasing behavior. In light of these findings, it can be argued that there is a need to increase efforts to develop more positive consumer attitudes toward EVs, to enhance their cognitive status, and to promote product attributes to encourage the widespread adoption of EVs. At the same time, monetary incentives policies are an important element in the adoption of EVs and therefore policymakers need to make great efforts. (shrink)

In Australia research projects proposing the use of linked data require approval by a Human Research Ethics Committee . A sound evaluation of the ethical issues involved requires understanding of the basic mechanics of data linkage, the associated benefits and risks, and the legal context in which it occurs. The rapidly increasing number of research projects utilising linked data in Australia has led to an urgent need for enhanced capacity of HRECs to review research applications involving this emerging research methodology. (...) The training described in this article was designed to respond to an identified need among the data linkage units in the Australian Population Health Research Network and HREC members in Australia. (shrink)

BackgroundPreprint usage is growing rapidly in the life sciences; however, questions remain on the relative quality of preprints when compared to published articles. An objective dimension of quality that is readily measurable is completeness of reporting, as transparency can improve the reader’s ability to independently interpret data and reproduce findings.MethodsIn this observational study, we initially compared independent samples of articles published in bioRxiv and in PubMed-indexed journals in 2016 using a quality of reporting questionnaire. After that, we performed paired comparisons (...) between preprints from bioRxiv to their own peer-reviewed versions in journals.ResultsPeer-reviewed articles had, on average, higher quality of reporting than preprints, although the difference was small, with absolute differences of 5.0% [95% CI 1.4, 8.6] and 4.7% [95% CI 2.4, 7.0] of reported items in the independent samples and paired sample comparison, respectively. There were larger differences favoring peer-reviewed articles in subjective ratings of how clearly titles and abstracts presented the main findings and how easy it was to locate relevant reporting information. Changes in reporting from preprints to peer-reviewed versions did not correlate with the impact factor of the publication venue or with the time lag from bioRxiv to journal publication.ConclusionsOur results suggest that, on average, publication in a peer-reviewed journal is associated with improvement in quality of reporting. They also show that quality of reporting in preprints in the life sciences is within a similar range as that of peer-reviewed articles, albeit slightly lower on average, supporting the idea that preprints should be considered valid scientific contributions. (shrink)

In this essay, I draw upon Ellen J. Langer’s notions of mindlessness and mindfulness to identify and delineate Confucius’ views on mindfulness. Langer’s theory exemplifies a social-cognitive approach to mindfulness which is a prominent orientation in the extant research. I argue that Confucius, like Langer, rejects mindlessness that is characterised by an over-reliance on automatic responses based on past knowledge and experiences. Furthermore, Confucius supports Langerian mindfulness by underlining the importance of a flexible mindset that is demonstrated through making novel (...) distinctions, appreciating new perspectives and being sensitive to the context. But Confucius’ formulation of mindfulness goes beyond Langer’s by advocating the setting of one’s heart-mind on learning and the application of virtues. A Confucian interpretation of mindfulness debunks an East-West dichotomy on mindfulness and illustrates the harmonisation of the cognitive, affective, moral and social dimensions of mindfulness. (shrink)

In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...) economic destruction. It proposes proceeding in three phases: the first addresses premature death, the second long-term health issues and economic harms, and the third aims to contain viral transmission fully and restore pre-pandemic activity. -/- To those who may deem an ethical framework irrelevant because of the belief that many countries will pursue "vaccine nationalism," we argue such a framework still has broad relevance. Reasonable national partiality would permit countries to focus on vaccine distribution within their borders up until the rate of transmission is below 1, at which point there would not be sufficient vaccine-preventable harm to justify retaining a vaccine. When a government reaches the limit of national partiality, it should release vaccines for other countries. -/- We also argue against two other recent proposals. Distributing a vaccine proportional to a country's population mistakenly assumes that equality requires treating differently situated countries identically. Prioritizing countries according to the number of front-line health care workers, the proportion of the population over 65, and the number of people with comorbidities within each country may exacerbate disadvantage and end up giving the vaccine in large part to wealthy nations. (shrink)

Live donor kidney transplantation is the best treatment option for most patients with late-stage chronic kidney disease; however, the rate of living kidney donation has declined in the United States. A consensus conference was held June 5-6, 2014 to identify best practices and knowledge gaps pertaining to live donor kidney transplantation and living kidney donation. Transplant professionals, patients, and other key stakeholders discussed processes for educating transplant candidates and potential living donors about living kidney donation; efficiencies in the living donor (...) evaluation process; disparities in living donation; and financial and systemic barriers to living donation. We summarize the consensus recommendations for best practices in these educational and clinical domains, future research priorities, and possible public policy initiatives to remove barriers to living kidney donation. (shrink)

Artificial Intelligence (AI) is transforming our world: today machines not only can mimic human actions but out-perform human agents in many activities, including learning and thinking. AI offers revolutionary solutions and new possibilities in transportation, business, communication, medicine, law, and other domains. While some welcome this brave new world, others fear the threats AI pose to people’s livelihoods, social relations, individuality, freedom, and perhaps even the very survival of the human species. No doubt some of this existential angst is exaggerated, (...) but AI does raise questions for our understanding of the world and ourselves that require serious reflection, including questions about adequacy of education in various aspects. This chapter offers, from the perspectives of John Dewey’s Pragmatism as well as Confucianism, some reflections on the role of the humanities in education in response to the opportunities and challenges of the development and widespread use of AI. It shows that Dewey and Confucius share similar views regarding the humanistic purpose of education and their philosophies of education offer arguments for why humanities education will be relevant, if not more important, when many jobs we are familiar with become obsolete. Their attitudes toward the economic motive in education will help us rethink the meaning of work in a “world without work.” At the same time, they offer a critical evaluation of contemporary humanities education, which have failed to realize their visions of personal cultivation and growth. Among its failings is the continued dichotomy between the humanities and the sciences. In the age of AI, it has become even more vital to integrate them to avoid science and technology from becoming materialistic and anti-human while the humanities become merely literary and without any means to transform the world. (shrink)

In two recent papers, Mr Robert Young maintains that all attempts by philosophers to bolster the-violation-of-law concept of miracles are bound to fail and propounds what he claims to be a novel non-reductivist concept of miracles which avoids the conceptual difficulties of the violation-model. His view of miracles is of god being ‘an active agent-factor in the set of factors which actually was causally operative’ [p. 123] in an event dubbed a miracle. God is put in among ‘the plurality of (...) causes’ [p. 122, S p. 33] that could determine the event, but if he acts in a miracle, then ‘his presence…alters the outcome from what it would have been if, contrary to fact , he had not been present’ [p. 122]. Young claims that his concept ‘is neither a violation of … laws nor is it a coincidental occurrence religiously interpreted’ [p. 122, S p. 33], and so it avoids the difficulties, which he thinks are faced by the violation-model, of having an intelligible notion of an occurrence of the physically impossible, and also the reductivism inherent in taking mere coincidences as miracles. He also suggests a procedure of settling the epistemological issue regarding particular alleged miracles, an inquiry he thinks he has made possible by having first given a sense to miracles. [p. 126]. (shrink)

This article clarifies the relationship between moral personhood and moral management in ethical leadership from a Confucian perspective. Drawing from four Confucian classics, this study integrates the leader’s ethical values and activities undertaken to promote virtues in followers. The harmonisation of moral personhood and moral management is facilitated by two cardinal Confucian beliefs: innate human nature and moral self-cultivation. From a Confucian viewpoint, all human beings are endowed with a good nature that enables them to become virtuous persons and leaders. (...) Ethical leaders subdue their selfish desires and extend their natural moral feelings of true goodness, righteousness, propriety and wisdom to others. Moral personhood and moral management are inseparable because to cultivate oneself morally is to help others to become moral persons. By synthesising moral personhood and moral management, a Confucian worldview of ethical leadership contributes to leadership studies in two main ways: safeguarding against the leader’s abuse of power, and advancing organisational change through path-shaping. (shrink)

What is social entrepreneurship? In, particular, what’s so social about it? Understanding what social entrepreneurship is enables researchers to study the phenomenon and policy-makers to design measures to encourage it. However, such an understanding is lacking partly because there is no universally accepted definition of entrepreneurship as yet. In this paper, we suggest a definition of social entrepreneurship that intuitively accords with what is generally accepted as entrepreneurship and that captures the way in which entrepreneurship may be altruistic. Based on (...) this we provide a taxonomy of social entrepreneurship and identify a number of real cases from Asia illustrating the different forms it could take. (shrink)

All parties involved in researching, developing, manufacturing, and distributing COVID-19 vaccines need guidance on their ethical obligations. We focus on pharmaceutical companies' obligations because their capacities to research, develop, manufacture, and distribute vaccines make them uniquely placed for stemming the pandemic. We argue that an ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability. All parties' obligations should be coordinated and mutually consistent. For (...) instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges. Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others. (shrink)

In the 1920s, John Dewey's followers in China, led by his student Hu Shih, attempted to put his pragmatism into practice in their quest for democracy. This essay compares Hu Shih's thought, especially his emphasis on pragmatism as method, with Dewey's philosophical positions and evaluates Hu's achievement as a pragmatist in the context of the tumultuous times he lived in. It assesses Hu's claim that the means to democracy lies in education rather than politics, since democracy as a way of (...) life requires a cultural renewal beyond institutional changes. It argues that a problem‐centered approach to social change does not preclude radical action, even revolution. But pragmatism is against gratuitous use of violence in the service of wholesale and abstract ideals advocated by various “isms.” While Hu's experiment of democracy in China is a significant episode in the history of pragmatism, its “failure” does not prove that there are inherent flaws in the pragmatist method, that pragmatism is unviable for China. The failure needs to be understood in the context of the pragmatist conception of experiment, in which failures are to be expected; what is important is to learn from them to achieve better results in the next stage of inquiry. Hu Shih's pragmatism contains lessons for pragmatists and for those interested in the continued quest for democracy in China—the experiment continues. (shrink)

This article highlights the significance of the “Za shuo” 雜說 (Miscellaneous discourses) series for the study of Han Yu’s 韓愈 (768–824) political ideology, which proposes a three-tier system of governance that is made up of the emperor, the feudal lords, and the bureaucrats. The emperor is the pinnacle of the system; he collaborates with his ministers to devise state policies in the inner palace. The feudal lords protect the emperor in the regional areas. The bureaucrats form the machinery of the (...) government and implement its policies. Challenging current scholarship, which treats each of Han Yu’s essays independently, the article proposes a new interpretation of them as a whole It argues that the three essays “Long shuo” 龍說 (Discourse on the dragon), “Yi shuo” 醫說 (Discourse on physicians), and “Ma shuo” 馬說 (Discourse on horses) form an organic unit that provides internally consistent counsel to the ruler for his governance, and that a fourth essay, “Ti Cui Shanjun zhuan” 題崔山君傳 (Foreword to the biography of Cui Shanjun), is likely an interpolation. Through unearthing the true meaning of this series, the article also narrows down its time of composition, which has traditionally been left unspecified. This article also reveals Han Yu’s attitude toward the revived concern over the enfeoffment of princes in medieval China and toward his political ideology, which is not purely Confucian. The article thus is a contribution to the study of both political history and literary creation in the mid-Tang era. (shrink)

COVID-19 vaccines are likely to be scarce for years to come. Many countries, from India to the U.K., have demonstrated vaccine nationalism. What are the ethical limits to this vaccine nationalism? Neither extreme nationalism nor extreme cosmopolitanism is ethically justifiable. Instead, we propose the fair priority for residents framework, in which governments can retain COVID-19 vaccine doses for their residents only to the extent that they are needed to maintain a noncrisis level of mortality while they are implementing reasonable public (...) health interventions. Practically, a noncrisis level of mortality is that experienced during a bad influenza season, which society considers an acceptable background risk. Governments take action to limit mortality from influenza, but there is no emergency that includes severe lockdowns. This “flu-risk standard” is a nonarbitrary and generally accepted heuristic. Mortality above the flu-risk standard justifies greater governmental interventions, including retaining vaccines for a country's own citizens over global need. The precise level of vaccination needed to meet the flu-risk standard will depend upon empirical factors related to the pandemic. This links the ethical principles to the scientific data emerging from the emergency. Thus, the FPR framework recognizes that governments should prioritize procuring vaccines for their country when doing so is necessary to reduce mortality to noncrisis flu-like levels. But after that, a government is obligated to do its part to share vaccines to reduce risks of mortality for people in other countries. We consider and reject objections to the FPR framework based on a country: having developed a vaccine, raising taxes to pay for vaccine research and purchase, wanting to eliminate economic and social burdens, and being ineffective in combating COVID-19 through public health interventions. (shrink)

In his paper ‘The Problem of the Meaning of “Miracle” , Professor Michael J. Langford proffers a concept of miracles that derives its intelligibility from the familiar phenomenon of the interaction of minds. Miraculous occurrences are portrayed as a variant, though abnormal, form of what we may term ‘inter-psychosomatic influence’, God's mind being the ultimate determinant. Langford thinks that to speak significantly of miracles, the phenomenon should be understood as ‘not totally dissimilar to our previous experience’ ; hence the familiar (...) notion of inter-psychosomatic influence. He thinks, too, that to talk of miracles as God interfering directly with the natural order would be to admit that such interference would not upset our concept of human nature and responsibility, a consequence which, to Langford, would make it inconsistent for Christians to maintain the free-will defence in the face of the problem of evil. According to Langford, human interference with the natural order does not vitiate the preconditions of human responsibility, and so he thinks that his concept of miracle, which is only ‘an extension of the same phenomenon, of a kind that also does not disrupt either human freedom or the stable order that is the necessary context for human life’ , will provide a way out of the dilemma. Having agreed with Hume and Flew that it would be unreasonable ‘to explain an unusual event by introducing divine causation if we hadn't already got independent evidence for the divine’ , Langford nevertheless maintains that ‘unthought possibilities’ should not be ruled out in the manner of a ‘prejudiced theorist’ . He thinks that such possibilities are left open in his concept of miracle, which makes the prior assumption that ‘independent grounds for belief in God’ exist before affirming that, given that God exists, miracles may be consistently and substantively understood in terms of a special distinguishable sort of inter-psychosomatic influence. He concedes, of course that his concept would rule out ‘those miracles that appear to be quite apart from the working of grace through human minds’ . I think, however, that Langford's thesis is faulty at key places. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Decision-Making as a Broader ConceptJacinta O. A. Tan (bio), Anne Stewart (bio), and Tony Hope (bio)KeywordsCompetence, decision-making, capacity, anorexia nervosa, autonomy, values, identityWe thank Demian Whiting for the thoughtful critique of aspects of our paper (Tan et al. 2006a). A primary aim of our research was to provide empirical grounds on which to stimulate discussion about the nature of decision-making capacity (DMC). Whiting criticizes in particular the concept of (...) 'pathological values' that we suggested might be relevant in the assessment of DMC and in the related issue of deciding when a patient's refusal of beneficial treatment should be overridden.Whiting's central concern is with DMC. Whiting argues that the absence of pathological values should not be a criterion for DMC. We are unclear whether he is also arguing that pathological values do not provide a reason of any kind for overriding treatment refusal. At the end of the paper he writes: "we cannot justify compulsory treatment of patients who have pathological values... on the grounds that these patients lack DMC" (2009, XX). This seems to leave open the possibility that we may be able to justify compulsory treatment of patients who have pathological values on grounds other than that they lack DMC. As we wrote in our response to the discussants of our original paper, "The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests" (Tan et al. 2006b, 300).In deciding on whether to use compulsory treatment, there are other relevant factors that may need to be considered, such as the seriousness of the decision, which determines the threshold for competence. However, in this response we consider three issues. First, we argue that the current concept of DMC is by no means so clear cut or generally agreed upon as Whiting implies, and that some of the lack of clarity relates to pathological values. Second, that the concept of DMC is itself dependent on accounts of autonomy, and that it is plausible that pathological values can affect autonomy. Third, we directly consider the question of whether a coherent account of pathological values might be given based on a concept of authenticity.The Current Criteria for DMCWhiting argues that the current criteria for DMC are correct and that an additional criterion along the lines of absence of pathological values should not be added. This argument assumes that there is a clear and agreed understanding of the current criteria. We believe this is not the case for three reasons.(i) Whiting begins his account of DMC by saying that it is normally taken to include: "(1) [End Page 345] understanding (and appreciation)" (2009, 341). Already there is an area of dispute, and the use of parentheses reflects this. The concept of 'appreciation' was developed by Grisso and Applebaum (Grisso, Appelbaum, and Hill-Fotouhi 1997). It is not included in either English common law development, for example (ReC), nor in the criteria specified in the Mental Capacity Act 2005. More important, Grisso and Appelbaum in their comment on our original paper (2006) argue that our work advances thinking about 'appreciation' rather than requiring that we add new elements. The implication is that they believe that what we have called pathological values are relevant to the assessment of capacity and are already included in an account of capacity that incorporates the criterion of 'appreciation.' In our response, we argued that pathological values are not entirely captured within the account of appreciation that Grisso and Appelbaum had previously given. We do not want to revisit that issue here, but the point of relevance is that on one view (that of Grisso and Appelbaum) pathological values are already included in the current criteria for DMC as part of the concept of appreciation, whereas on Whiting's view they are not.(ii) Even if there were agreement over the wording and concepts relevant to DMC there is a further important issue: how are those concepts... (shrink)

This essay argues two main points by analyzing Sengzhao’s contentions regarding several basic Buddhist concepts such as emptiness, being, and nonbeing. First, Sengzhao synthesizes Daoist methods of argumentation into his description of the middle path and other Buddhist concepts. Second, he revives Daoist concepts, giving them Buddhist meaning and expressing them in Buddhist terms. In the process, he consciously differentiates Madhyamika Buddhism from earlier Buddhism as understood from a Daoist perspective, such as the teachings of the School of Original Non-Being (...) and the School of No-Mind. However, because his understanding of the middle path is not sufficiently deep, he wavers between Buddhist and Daoist understandings of terms such as prajñā and nirvāṇa, rest and movement, and name and reality. Despite these inconsistencies, his discourse, as the first attempt to differentiate Madhyamika from Daoism, is still a milestone in the development of Chinese Buddhism and has exerted a far-reaching influence on later generations. (shrink)

This is a brief review of the Civics and Moral Education programme currently in use in Singapore schools. The paper offers an appraisal of the rationale provided in policy statements and of selected official and students' workbook descriptions of curricular content, activities and pedagogic theories. It shows that the Civics and Moral Education programme is more a matter of training students to absorb pragmatic values deemed to be important for Singapore to achieve social cohesion and economic success, rather than moral (...) education as the development of intrinsic commitment to and habituation in the practice of values, defended on autonomous moral considerations and not mere national expediency. Whilst educationists would be inclined to take issue with the programme's ultimate stand on values, they might warm to the pedagogy it prescribes in terms of the need for character-building by practice and experience, and also the importance of reasoning in the resolving of disputes and dilemmas. (shrink)

In his stimulating and provocative collection of essays, Globalization and Justice, Kai Nielsen defends a cosmopolitan account of global justice. On the cosmopolitan view, as Nielsen understands it, individuals are entitled to equal consideration regardless of citizenship or nationality and global institutions should be arranged in such a way that each person's interest is given equal consideration. Nielsen's defense of cosmopolitan justice in this collection will be of no surprise to readers familiar with his socialist egalitarian commitments. Indeed, the internationalism (...) underlying socialism, Nielsen would argue, naturally entails the cosmopolitan account of justice. (shrink)

Anonymous didactic verse work, with paraphrase in Tamil and English; transcribed from a palm-leaf manuscript preserved in the Tanjore Maharaja Serfoji's Sarasvati Mahal Library.

YOUNG DESCRIBES A MIRACLE AS DESCRIPTION OF AN EVENT EFFECTED BY A SET OF CAUSALLY OPERATIVE FACTORS, A NECESSARY ONE OF WHICH BEING GOD’S PRESENCE. BUT THE ACCOUNT IS ONLY A REDRESSING OF THE VIOLATION-OF-LAW MODEL OF MIRACLES AND DOESN’T ESCAPE THE CONCEPTUAL DIFFICULTIES OF THE MODEL NOR THE METHODOLOGICAL DIFFICULTIES CONCERNING IDENTIFYING AND ASCERTAINING PURPORTED MIRACLES.

In lieu of an abstract, here is a brief excerpt of the content:Studying Penguins to Understand BirdsJacinta O. A. Tan (bio), Anne Stewart (bio), Ray Fitzpatrick (bio), and Tony Hope (bio)Keywordsanorexia nervosa, treatment decision-making, competence, valuesWe are grateful to Grisso, Appelbaum, Charland, and Vollmann for their thoughtful commentaries on our paper. We would like to respond by picking up on some of the points they make, although we do not address all the issues raised.Our general aims in the paper are (...) less immediately pragmatic than are the central concerns of Grisso and Appelbaum. Our interest is primarily in a number of ethical, and related conceptual, issues that arise from empirical data. In the long run, of course, we believe that these ethical and conceptual issues are important to the care of people with mental disorders, but our focus is philosophical.Our central interest is what justifies overriding treatment refusal. We are unhappy with a "status" approach according to which, for example, the mere fact that a person suffers a mental disorder provides grounds for overriding her wishes. Such an approach, it seems to us, fails to identify reasons, and discriminates against those with mental disorder, a view shared by the Law Commission (The Law Commission 1995). We are, on the other hand, attracted by the approach that grounds any overriding of treatment refusal on lack of capacity (or competence) to make treatment decisions. The concept of capacity has been well developed through legal cases and conceptual analysis, not least by Grisso and Appelbaum themselves. We were struck, however, first through clinical experience, and subsequently from the pilot study reported in our paper, that many patients with anorexia nervosa who refuse treatment do not necessarily lack capacity, using the current criteria, and yet show features or give reasons that raise serious doubts as to whether it is right to respect their refusal of treatment.To avoid reliance on a "status" approach, the issue with which we are grappling is whether the concept of capacity (and therefore lack of capacity) can be developed to encompass some of our findings, and whether it is ethically right to do so. Charland makes the important point that the concept of competence, or capacity, has both a descriptive and a prescriptive component. It is for this reason that the question of whether, for example, we should extend the criteria for capacity is part of the question of when it is morally right to override treatment refusal.Grisso and Appelbaum suggest that our work advances "our thinking about appreciation, rather than requiring that we add new elements" (2006, 297). From our perspective, and at this stage, it is a secondary issue whether we are suggesting a development of appreciation, or a new element (e.g., "pathological values"). The primary issue for us is whether the reasons for refusal to which we draw attention provide grounds for overriding refusal, and if they do how they can be characterized in [End Page 299] such a way as to avoid the ever-present danger of simply overriding autonomy in a patient's best interests.We chose to study anorexia nervosa for various reasons, but we expect that the issues raised have a more general relevance (such as to substance abuse and impulse control disorders as Grisso and Appelbaum and Charland suggest). We do not expect the results to be relevant to all, or even most, mental disorders. Our main interest is not the specific management of people with anorexia, but how the data challenge, and help to develop, the concept of capacity, and the ethical analysis of overriding patient refusal of treatment. Our paper aims to address what we understand Charland to be referring to by the "pretheoretical desiderata" (2006, 283) of the concept of capacity. One reason why we chose anorexia as the focus of this work is because it is different from many mental disorders in the issues that it raises. In this it is, perhaps, rather like studying penguins to better understand the concept of bird just because penguins, although clearly birds, have unusual features.We agree, therefore, with Grisso and Appelbaum's caution that it would be unwise to jump in and change the MacCAT-T on the basis of the results... (shrink)

University human research ethics application procedures can be complicated and daunting, especially for international students unfamiliar with the process and the language. We conducted focus groups and interviews with four research higher degree and 21 Master’s coursework international students at an Australian university to gain their views on the human ethics application process. We found the most important influences on their experience were: the time it took to do an application; support from supervisors, peers and others; their own language skills; (...) and their lack of familiarity with research ethics procedures. To improve the experience of international students undertaking research involving human research ethics applications, we recommend universities provide guidance on institutional ethics review processes, concepts and terminology, with translations in a range of languages, together with guidance on how to conduct research ethically within and outside the students’ own countries. We also recommend curricula be developed to further students’ understanding of the importance of ethical research practice, and that these curricula be embedded in undergraduate and postgraduate degree programs and reflected in course learning outcomes. (shrink)

Differences in guidance from various organisations is preventing uniform standards of practiceThe emphasis in medical law and ethics on protecting the patient’s right to choose is at an all time high. Apart from circumscribed situations, for instance where the Mental Health Act 19831 is applicable, the only justification for medically treating an adult patient against his or her wishes is on the basis of common law, using the principle of best interests, and only when he or she lacks capacity to (...) refuse treatment. As a result, it is important that clinicians should be able to assess capacity to refuse treatment. Given that judgements of incapacity involve deciding that a person does not have the ability to refuse treatment, a great deal of care needs to go into the assessment and characterisation of incapacity.There is divergence between the characterisation of capacity that is used by the courts and that which is recommended by the British Medical Association . The BMA usefully expands on the first element of capacity as set out in the standard legal definition of capacity in the Re C judgment2 but ignores the other two elements. By doing this, the BMA makes it unclear whether it is rejecting these as relevant to capacity; it also misses the opportunity to expand on these elements in a clinically useful way.We will begin with a description of the BMA’s advice3 and the standard English legal definition of capacity.2,4 Then we will show that there are important discrepancies between these two sources of advice. We think that the BMA ought to clarify its position on capacity in order to safeguard the interests of physicians, healthcare workers, and patients.THE RE C TESTMr C was a patient in a psychiatric secure hospital who had chronic paranoid schizophrenia with …. (shrink)

Le visage d'Edith Stein a disparu dans le martyre qu'elle subit à Auschwitz le 9 août 1942. Depuis lors, ses différents biographes ont tenté de recomposer les éléments de sa vie et de sa personnalité à partir d'une facette de sa personnalité. Edith Stein philosophe, Edith Stein carmélite, Edith Stein féministe: les approches se succèdent et esquissent les différents traits d'un visage dont l'unité demeure cachée dans le secret d'une destinée. Dans ce livre, Philibert Secretan propose une approche synchronique d'Edith (...) Stein. "Le portrait que je propose ici s'organise autour de trois données de fait : la conversion du judaïsme au christianisme ; le passage de la phénoménologie à la sagesse philosophique ; l'entrée au Carmel. Autant de faits qu'il s'agit de traiter non plus en diachronie, comme autant d'étapes d'une existence étalée dans le temps, mais en synchronie, comme autant de strates d'une personnalité dans laquelle continuent à résonner des échos de ces moments constitutifs de son être singulier". En conclusion, Philibert Secretan s'attache à montrer comment la vertu d'obéissance - à la vérité vue par l'intelligence jusqu'à la volonté de Dieu, de l'université au Carmel - unifie les strates qui constituent la personnalité d'Edith Stein. Un livre de vie. Un testament aussi, de celui qui sur le conseil de Paul Ricoeur a introduit la pensée d'Edith Stein en France. (shrink)

Regards inquiets est une somme de réflexions qui s'échelonnent sur de nombreuses années. Elles témoignent avant tout d'un souci de clarté sur ce qui se dit, se pense, se débat sur cette place publique mondiale que sont les médias, sans pourtant prétendre y mêler sa voix. L'auteur a vu naître l'écologie et a appris à la prendre au sérieux. Il a vu s'effondrer la superstructure religieuse de notre civilisation. Il continue à penser que rien ne pourra la remplacer, que la (...) paix des religions est une condition essentielle du développement du monde, et que la démocratie est source de trop d'illusions pour que l'on puisse en faire une manière de modèle platonicien, de validité planétaire. L'auteur a vu le pouvoir du virtuel menacer d'obsolescence le réel, qui pourtant permet encore de penser à un ordre créé, incontournable et incomparable. Il croit à des valeurs jugées obsolètes et ne craint de se faire juger de réactionnaire, car il admet qu'il n'y a de vrai progrès que là où de nouvelles forces sont puisées au fondement des choses. La lucidité critique est la lumière dans laquelle il a rédigé ces pages. (shrink)

“No, dear, you must not eat the soap; it’s not good for you.” Well-intentioned interference frustrates our desires even in the happiest childhood. Less happy is the perpetual state of adolescent rebellion against apparently arbitrary and unreasonable curtailments of one’s freedom, too frequently justified by the familiar refrain “It’s for your own good” adding insult to injury. Such interference does not necessarily cease with the eagerly awaited entry into adulthood. Not only parents are guilty of it; the state also engages (...) in such interference. Can paternalism where one person deliberately interferes with another for the latter’s own good be morally justified? (shrink)