Regulators around the world are coming under pressure from patients, clinicians, and industry groups to streamline the market approval process for highly novel biomedical technologies, including stem cells and regenerative medicine products. The rationale for streamlining this process centers on the perceived failures of regulatory systems to encourage biomedical innovation and provide patients with timely access to potentially beneficial yet experimental therapies. Critics claim that the process of generating scientific evidence in phased clinical trials is too costly, time-consuming, and poorly (...) suited for stem cell–based products that, unlike bio-pharmaceuticals, are intended to engraft into the body for long... (shrink)

In 2016, the Office of the State Coroner of New South Wales released its report into the death of an Australian woman, Sheila Drysdale, who had died from complications of an autologous stem cell procedure at a Sydney clinic. In this report, we argue that Mrs Drysdale's death was avoidable, and it was the result of a pernicious global problem of an industry exploiting regulatory systems to sell unproven and unjustified interventions with stem cells.

This article proposes a moderated mediation model of emotional dissonance. In the model, emotional leadership negatively affects emotional dissonance, which, in turn, negatively affects helping behavior. Furthermore, the negative effect of emotional dissonance is assumed to be moderated by work-family conflict. Direct effects from both emotional leadership and work-family conflict to helping other behavior are also considered. Previous studies have neglected the mechanism of emotional dissonance, but this paper fills the gap with a moderated mediation model of emotional dissonance. This (...) article not only provides an incremental contribution to the emotional dissonance literature but also suggests means by which companies might enhance employe helping behaviors in order to achieve greater organizational efficiency. (shrink)

The latter part of the twentieth century saw the Chinese economy moving towards a socialist market economy rather than a planned system. Despite growing interest in Chinese business ethics, little work has examined ethical issues concerning the Chinese sales force. This study draws from existing work on Chinese and Western business and sales ethics to develop hypotheses regarding the perceptions of unethical selling behaviour of modern Chinese salespeople. A survey of Chinese sales executives is conducted and statistically analysed. Results are (...) compared with those reported in previous US-based research with regard to differences in perceptions of unethical selling behaviour. The results indicate that contemporary Chinese salespeople were more favourably disposed than expected towards unethical selling behaviour, and also more favourably disposed than previously studied US salespeople. Younger Chinese salespeople evaluated unethical behaviours more favourably than older ones. The results are discussed, along with implications for theory, practice and future work. (shrink)

Ethical issues surrounding the marketing and trade of controversial products such as tobacco require a better understanding. Virginia Slims, an exclusively women’s cigarette brand first launched in 1968 in the USA, was introduced during the mid 1980s to major Asian markets, such as Japan and Korea, dominated by male smokers. By reviewing internal corporate documents, made public from litigation, we examine the marketing strategies used by Philip Morris as they entered new markets such as Japan and Korea and consider the (...) extent that the company attempted to appeal to women in markets where comparatively few women were smokers. The case study of Virginia Slims reveals that the classification of “vulnerable” consumers is variable depending on culture, tobacco firms display responsive efforts and strategies when operating within a “mature” market, and cultural values played a role in informing Philip Morris’ strategic decision to embrace an adaptive marketing approach, particularly when entering the Korean market. Finally, moral questions are raised with tobacco being identified as a priority product for export and international trade agreements being used by corporations, governments, or trade partners in efforts to undermine domestic public health policies. (shrink)

The latter part of the twentieth century saw the Chinese economy moving towards a socialist market economy rather than a planned system. Despite growing interest in Chinese business ethics, little work has examined ethical issues concerning the Chinese sales force. This study draws from existing work on Chinese and Western business and sales ethics to develop hypotheses regarding the perceptions of unethical selling behaviour of modern Chinese salespeople. A survey of Chinese sales executives is conducted and statistically analysed. Results are (...) compared with those reported in previous US-based research with regard to differences in perceptions of unethical selling behaviour. The results indicate that contemporary Chinese salespeople were more favourably disposed than expected towards unethical selling behaviour, and also more favourably disposed than previously studied US salespeople. Younger Chinese salespeople evaluated unethical behaviours more favourably than older ones. The results are discussed, along with implications for theory, practice and future work. (shrink)

The slogan “the personal is political” captures the distinctive challenge to the public-private divide posed by contemporary feminists. As such, feminist activism is not necessarily congruent with civic engagement, which is predicated on the paradoxical need to both bridge and sustain the public-private divide. Lee argues that rather than subverting the divide, the politics of the personal offers an alternative understanding of civic engagement that aims to reinstate individuals’ dignity and agency.

: The slogan "the personal is political" captures the distinctive challenge to the public-private divide posed by contemporary feminists. As such, feminist activism is not necessarily congruent with civic engagement, which is predicated on the paradoxical need to both bridge and sustain the public-private divide. Lee argues that rather than subverting the divide, the politics of the personal offers an alternative understanding of civic engagement that aims to reinstate individuals' dignity and agency.

The slogan “the personal is political” captures the distinctive challenge to the public-private divide posed by contemporary feminists. As such, feminist activism is not necessarily congruent with civic engagement, which is predicated on the paradoxical need to both bridge and sustain the public-private divide. Lee argues that rather than subverting the divide, the politics of the personal offers an alternative understanding of civic engagement that aims to reinstate individuals’ dignity and agency.

The article is a study of Liang Qichao (1873-1929) by focusing on his theory of citizenship as laid out in the work Xinmin shuo (Discourse on the New Citizen). As a treatise on citizenship and nation-building, Xinmin shuo was the first of its kind in the history of Chinese political thought. Chinese studies specialists have typically treated the work as an illustration of a Confucian literati faced with the challenge from the West. Through a close reading of the text, the (...) article argues that Liang had in fact made an original contribution to citizenship theory by addressing the inherent tension between citizenship and nation-building. The article therefore sheds new light on Liang's theory of citizenship by engaging it as an attempt to tackle the universalism- particularism dichotomy rather than the typical Confucianism-liberalism dichotomy. (shrink)

Mahatma Gandhi and Sun Yat-sen are regarded as the respective founding fathers of modern India and China. Given this shared significance, their writings ought to be duly considered as the basis for comparative thought on postcolonial nation-building. Yet a survey of the literature points to the paucity of such study. The article is therefore an attempt to fill in this gap by juxtaposing Gandhi’s Hind Swaraj and Sun’s San Min Chu I as treatises on postcolonial nation-building. Such juxtaposition yields important (...) contrasts between the two regarding postcolonial nationhood at the crossroad of non-western civilization and modernity. Beyond identifying these differences, the author uses the lack of comparative study on the subject as an occasion for pondering over the contrasting contemporary global legacy of the two figures. At stake are two visions of postcolonial nationhood that are lost to the ubiquity of global development. (shrink)

Four instances of how science fiction contributes to the elucidation of novelty in the context of discovery are considered by extending existing discussions on temporal and use-novelty. In the first instance, science fiction takes an already well-known theory and produces its own re-interpretation; in the second instance, the scientific account is usually straightforward and whatever novelty that may occur would be more along the lines of how the science is deployed to extra-scientific matters; in the third instance, science fiction takes (...) an idea that appears impossible within the delimitations of reality and produces a universe where such a possibility becomes feasible; and in the fourth instance, science fiction extends from an idea already known at the time of the work’s production to simulate a possibility that could emerge should the extension be experimentally viable. However, the article will not end with a mere evaluation of these instances, but also proposes instances on how science fiction could contribute to new ways of experiencing, discerning, and working with scientific knowledge. (shrink)

The fluctuation-dissipation theorem is a central theorem in nonequilibrium statistical mechanics by which the evolution of velocity fluctuations of the Brownian particle under a fluctuating environment is intimately related to its dissipative behavior. This can be illuminated in particular by an example of Brownian motion in an ohmic environment where the dissipative effect can be accounted for by the first-order time derivative of the position. Here we explore the dynamics of the Brownian particle coupled to a supraohmic environment by considering (...) the motion of a charged particle interacting with the electromagnetic fluctuations at finite temperature. We also derive particle’s equation of motion, the Langevin equation, by minimizing the corresponding stochastic effective action, which is obtained with the method of Feynman-Vernon influence functional. The fluctuation-dissipation theorem is established from first principles. The backreaction on the charge is known in terms of electromagnetic self-force given by a third-order time derivative of the position, leading to the supraohmic dynamics. This self-force can be argued to be insignificant throughout the evolution when the charge barely moves. The stochastic force arising from the supraohmic environment is found to have both positive and negative correlations, and it drives the charge into a fluctuating motion. Although positive force correlations give rise to the growth of the velocity dispersion initially, its growth slows down when correlation turns negative, and finally halts, thus leading to the saturation of the velocity dispersion. The saturation mechanism in a supraohmic environment is found to be distinctly different from that in an ohmic environment. The comparison is discussed. (shrink)

Ruyu HungNational Chiayi UniversityThis collective writing is intended to portray the contour of philosophy of education in contemporary Taiwan, resounding many beautiful counterparts in EPAT (Bies...

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

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

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

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

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

Wisdom is a multi-component trait that is important for mental health and well-being. In this study, we sought to understand gender differences in relative strengths in wisdom. A total of 659 individuals aged 27–103 years completed surveys including the 3-Dimensional Wisdom Scale and the San Diego Wisdom Scale. Analyses assessed gender differences in wisdom and gender’s moderating effect on the relationship between wisdom and associated constructs including depression, loneliness, well-being, optimism, and resilience. Women scored higher on average on the 3D-WS (...) but not on the SD-WISE. Women scored higher on compassion-related domains and on SD-WISE Self-Reflection. Men scored higher on cognitive-related domains and on SD-WISE Emotion Regulation. There was no impact of gender on the relationships between wisdom and associated constructs. Women and men have different relative strengths in wisdom, likely driven by sociocultural and biological factors. Tailoring wisdom interventions to individuals based on their profiles is an important next step. (shrink)

This paper provides an exposition of the structuralist approach to underdetermination, which aims to resolve the underdetermination of theories by identifying their common theoretical structure. Applications of the structuralist approach can be found in many areas of philosophy. I present a schema of the structuralist approach, which conceptually unifies such applications in different subject matters. It is argued that two classic arguments in the literature, Paul Benacerraf’s argument on natural numbers and W. V. O. Quine’s argument for the indeterminacy of (...) translation, can be analyzed as instances of the structuralist schema. These two applications illustrate different kinds of conclusions that can be drawn through the structuralist approach; Benacerraf’s argument shows that we can derive an ontological conclusion about the given subject matter, while Quine’s structuralist approach leads to a semantic conclusion about how to determine linguistic meanings given radical translation. Then, as a case study, I review a recent debate in metaphysics between Shamik Dasgupta, Jason Turner, and Catharine Diehl to consider the extent to which different instances of the structuralist schema are conceptually unified. Both sides of the debate can be interpreted as utilizing the structuralist approach; one side uses the structuralist approach for an ontological conclusion, while the other side relies on a semantic conclusion. I argue that this has a strong dialectical consequence, which sheds light on the conceptual unity of the structuralist approach. (shrink)

The articles assembled in this volume present an important selection of Professor Jao Tsung-i’s research in the fields of comparative mythology, early Chinese hemerology and the interrelation between divination, morals and ritual in early Chinese thought.

This paper propounds a new reading of Berkeley's account of the activity of finite spirits. Against existing interpretations, the paper argues that Berkeley does not hold that we causally contribute to the movement of our bodies. In contrast, our volitions to move our bodies are but occasions for God to cause their movement. In answer to the question of wherein then consists our activity, the paper proposes that our activity consists in the dual powers to produce (1) our volitions ? (...) the acts of willing ? and (2) our ideas of imagination. (shrink)

To explain why we should be structurally rational – or mentally coherent – is notoriously difficult. Some philosophers argue that the normativity of structural rationality can be explained in terms of substantive rationality, which is a matter of correct response to reason. I argue that the psychological phenomena – positive illusions – are counterexamples to the substantivist approach. Substantivists dismiss the relevance of positive illusions because they accept evidentialism that reason for belief must be evidence. I argue that their evidentialist (...) stance would imply that we are caught in unsolvable dilemmas arising from positive illusions. (shrink)

Selim Berker argues that epistemic consequentialism is pervasive in epistemology and that epistemic consequentialism is structurally flawed. is incorrect, however. I distinguish between epistemic consequentialism and epistemic instrumentalism and argue that most putative consequentialists should be considered instrumentalists. I also identify the structural problem of epistemic consequentialism Berker attempts to pinpoint and show that epistemic instrumentalism does not have the consequentialist problem.

Is a human more conscious than an octopus? In the science of consciousness, it’s oftentimes assumed that some creatures (or mental states) are more conscious than others. But in recent years, a number of philosophers have argued that the notion of degrees of consciousness is conceptually confused. This paper (1) argues that the most prominent objections to degrees of consciousness are unsustainable, (2) examines the semantics of ‘more conscious than’ expressions, (3) develops an analysis of what it is for a (...) degreed property to count as degrees of consciousness, and (4) applies the analysis to various theories of consciousness. I argue that whether consciousness comes in degrees ultimately depends on which theory of consciousness turns out to be correct. But I also argue that most theories of consciousness entail that consciousness comes in degrees. (shrink)

Tao has been built into the foundation of East Asian culture for millennia, and many books have been written to explain it. But Tao cannot fully be explained in words; it can only felt and experienced. Tao is something you live, day by day, moment by moment. Its the omnipresent oneness beyond ephemeral phenomena that expresses itself in everything.

‘Individualized medicine’ is an emerging paradigm in clinical life science research. We conducted a socio-empirical interview study in a leading German clinical research group, aiming at implementing ‘individualized medicine’ of colorectal cancer. The goal was to investigate moral and social issues related to physician–patient interaction and clinical care, and to identify the points raised, supported and rejected by the physicians and researchers. Up to now there has been only limited insight into how experts dedicated to individualized medicine view its problems. (...) Interviews with researchers and clinicians were based on a prestructured questionnaire. The content analysis revealed a broad spectrum of opinions. Major findings were disappointments with the limits of the current therapy regimen and clinical practice; problematic impacts on physician–patient relationship; and an informed consent procedure which is mainly based on paternalistic assumptions. According to our analysis, major problems will be uncertainties related to the biomarker's sensitivity and specificity, and the identification of ‘non-responders’. However, the findings also indicate that experts expect evidence-based medicine to replace decisions based on gut feeling or hierarchical structures. (shrink)

Virtue epistemology maintains that epistemic normativity is a kind of performance normativity, according to which evaluating a belief is like evaluating a sport or musical performance. I examine this thesis through the objection that a belief cannot be evaluated as a performance because it is not a performance but a state. I argue that virtue epistemology can be defended on the grounds that we often evaluate a performance through evaluating the result of the performance. The upshot of my account is (...) that when a belief is evaluated under performance normativity, what we evaluate is not belief, but cognitive performance. My account of virtue epistemology offers a simple explanation of why knowledge is more valuable than true belief. (shrink)