Developing an intellectualist account of skill, Stanley and Williamson define skill as a kind of disposition to action-guiding knowledge. The present paper challenges their definition of skill. While we don’t dispute that skill may consist of a cognitive, a dispositional, and an action-guiding component, we argue that Stanley and Williamson’s account of each component is problematic. In the first section, we argue, against Stanley and Williamson, that the cognitive component of skill is not a case of propositional knowledge-wh, which is (...) typically indexical. In the second section, we seek to show that Stanley and Williamson face difficulties in arguing for a generic claim about skill as a kind of disposition, and they fail to defend intellectualism about skill based on the dispositional account. In the third section we argue that Stanley and Williamson need a more detailed account of the action-guiding aspect of skill to avoid several difficulties, including a threat of a regress. We close with some lessons for the debate over intellectualism and anti-intellectualism about skill. (shrink)

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

The study aims to identify the efficiency of the university education performance from the perspective of postgraduate and undergraduate students in international and Palestinian universities. The analytical descriptive approach was used for this purpose and the questionnaire was used as a main tool for data collection. The study community consists of: post graduate students, (23850) graduate students and (146355) undergraduate students. The sample of the study was 378 graduate students and 383 undergraduate students. The random stratified sample was used. The (...) Statistical Package of Social Sciences (SPSS) was also used for data analysis. The study reached a number of results, the most important of which are: The level of efficiency of educational performance in Palestinian and international universities from the point of view of postgraduate and undergraduate students was high. And that there are significant differences between the average views of the sample of the study on the efficiency of educational performance in Palestinian and international universities attributed to the University and to the benefit of international universities. The study concluded many recommendations, the most important of which is the necessity of continuing to develop e-learning strategies that affect the efficiency of educational performance and research commensurate with the university's position in the local and international community, which puts it on the best classification between local and international universities through e-learning. (shrink)

Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice improvement, and (...) from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge (embodied, experiential, visual, and cognitive-scientific). In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves. (shrink)

Gaze direction signals another person’s focus of interest. Facial expressions convey information about their mental state. Appropriate responses to these signals should reflect their combined influence, yet current evidence suggests that gaze-cueing effects for objects near an observed face are not modulated by its emotional expression. Here, we extend the investigation of perceived gaze direction and emotional expression by considering their combined influence on affective judgments. While traditional response-time measures revealed equal gaze-cueing effects for happy and disgust faces, affective evaluations (...) critically depended on the combined product of gaze and emotion. Target objects looked at with a happy expression were liked more than objects looked at with a disgust expression. Objects not looked at were rated equally for both expressions. Our results demonstrate that facial expression does modulate the way that observers utilize gaze cues: Objects attended by others are evaluated according to the valence of their facial expression. C 2006 Elsevier B.V. All rights reserved. (shrink)

The paper examines a single, apparently simple argument for the existence of incompatibilities between the virtues as traits of character. This argument appeals not to empirical truths about human psychology or human nature but to the possibility of conflict between the exercise of different virtues in action. There are, for example, situations in which we can exercise the virtue of truthfulness only at the expense of not exercising the virtue of tact, as when we are asked a question to which (...) the straightforward answer will pain our questioner. The person who in these situations would give a straightforward answer possesses the virtue of truthfulness to a higher degree than the person who would respond more evasively, whereas the latter person possesses the virtue of tact to a higher degree than the former. But since the two responses are mutually exclusive, it follows that the degree to which we possess the virtue of truthfulness must, at least in some measure, correlate inversely with the degree to which we possess the virtue of tact. And similarly for many other pairs of virtues. My paper focusses on the two cardinal assumptions of this argument, viz., (i) that sometimes the exercise of one virtue can conflict with the exercise of another, and (ii) that the degree to which a person possesses a virtue correlates directly with the extent of its exercise, and defends both assumptions against a variety of objections which allege that, in different ways, they are insensitive to the complexity of the virtues. (shrink)

A total of 80 authors working in a variety of scientific disciplines commented on the theoretical model of CLimate, Aggression, and Self-control in Humans (CLASH). The commentaries cover a wide range of issues, including the logic and assumptions of CLASH, the evidence in support of CLASH, and other possible causes of aggression and violence (e.g., wealth, income inequality, political circumstances, historic circumstances, pathogen stress). Some commentaries also provide data relevant to CLASH. Here we clarify the logic and assumptions of CLASH (...) and discusses its extensions and boundary conditions. We also offer suggestions for future research. Regardless of whether none, some, or all of CLASH is found to be true, we hope it will stimulate future research on the link between climate and human behavior. Climate is one of the most presing issues of our time. (shrink)

Parents’ freedom to choose infant male circumcision is the correct policyIndividuals and groups lobbying to have infant male circumcision prohibited or restricted often argue that the practice of routinely circumcising infants is unjustified. For instance, in this issue of the journal, John Hutson argues that it is virtually impossible to justify a policy in which the medical establishment should be able to embark on a “mass circumcision” campaign of 100% of the infant male population [see page 238].1Indeed, I would be (...) hard pressed to find anyone who could rationally disagree with this contention. However, this is because no one is currently arguing for the enactment of a policy that stipulates that all healthy male infants should be routinely circumcised . Arguments seeking to support a prohibition of “routine infant circumcision”, such as the one by Hutson, are arguing against a straw man—and a pitiful one at that.2 Such arguments only serve to misconstrue the debate and avoid engaging in the real and pressing issues concerning the legitimacy of the provision of this procedure.The questions that should be considered, and the ones which I shall be interested in discussing here, are what reasons are justifiable for allowing parents to choose to have their son circumcised? After well informed and careful deliberation should parents have the freedom to choose to have their son circumcised? These are the most relevant questions to be considered because there is a growing collection of citizens, medical practitioners, and lawyers who are currently lobbying for the practice of infant male circumcision to be outlawed—for example, there is a bioethicist who argues that the criminal law should be used …. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

The main purpose of this study was to examine the relationship between flow experience and goal orientation theory, as well as, the differences in flow experience based on the orthogonal model of goal orientation theory. Two hundred and seventy eight athletes completed the Task and Ego Orientation Sport Questionnaire based on how they usually feel. The Flow State Scale was completed thirty minutes after an important competition, along with the challenge-skill ratings, based on how athletes felt during the particular competition. (...) The results indicated that the athletes’ task orientation may be the critical factor for attaining flow in competitive sport, feeling more skillful and estimating the upcoming competition as challenging, while ego orientated athletes lack these elements, which are important for them to get into flow. Additionally, the balance between athletes’ goal orientation preferences seems important for the formation of flow experience. (shrink)

UNESCO is an intergovernmental organization with 193 Member States. It is concerned with a broad range of issues regarding education, science and culture. It is the only UN organisation with a mandate in science. Since 1993 it is addressing ethics of science and technology, with special emphasis on bioethics. One major objective of the ethics programme is the development of international normative standards. This is particularly important since many Member States only have a limited infrastructure in bioethics, lacking expertise, educational (...) programs, bioethics committees and legal frameworks. UNESCO has recently adopted the Universal Declaration on Bioethics and Human Rights. The focus of current activities is now on implementation of this Declaration. Three activities are discussed that aim at improving and reinforcing the ethics infrastructure in relation to science and technology: the Global Ethics Observatory, the Ethics Education Programme and the Assisting Bioethics Committees project. (shrink)

OBJECTIVES: To study the opinions of nationals (Emiratis) and doctors practising in the United Arab Emirates (UAE) with regard to informing terminally ill patients. DESIGN: Structured questionnaires administered during January 1995. SETTING: The UAE, a federation of small, rich, developing Arabian Gulf states. PARTICIPANTS: Convenience samples of 100 Emiratis (minimum age 15 years) and of 50 doctors practising in government hospitals and clinics. RESULTS: Doctors emerged as consistently less in favour of informing than the Emiratis were, whether the patient was (...) described as almost certain to die during the next six months or as having a 50% chance of surviving, and even when it was specified that the patient was requesting information. In the latter situation, a third of doctors maintained that the patient should not be told. Increasing survival odds reduced the number of doctors selecting to inform; but it had no significant impact on Emiratis' choices. When Emiratis were asked whether they would personally want to be informed if they had only a short time to live, less than half responded in the way they had done to the in principle question. CONCLUSIONS: The doctors' responses are of concern because of the lack of reference to ethical principles or dilemmas, the disregard of patients' wishes and dependency on survival odds. The heterogeneity of Emiratis' responses calls into question the usefulness of invoking norms to explain inter-society differences. In the current study, people's in principle choices did not provide a useful guide to how they said they would personally wish to be treated. (shrink)

Objectives: To study the consent process experienced by participants who are enrolled in a molecular genetic research study that aims to find new genetic mutations responsible for an apparently inherited disorder.Design: Semi-structured interviews and analysis/description of main themes.Participants: 78 members of 52 families who had been recruited to a molecular genetic study.Results: People were well informed about the goals, risks and benefits of the genetic research study but could not remember the consent process. They had mostly been recruited to take (...) part by trusted clinicians or their relatives but had little memory of, or concern about signing consent forms. Families appeared to regard the research as a continuation of their, or their relatives’, clinical care.Conclusions: Ethical review should be more flexible in its attitude to consent forms and written information sheets for some sorts of research. For rare genetic disease studies where research has been discussed fully within the clinical setting then the consent obtained at that time could suffice rather than needing extra consent at a later stage. However, clinician-researchers will need to ensure that their duty of care extends for the duration of the research and beyond. (shrink)

The current COVID-19 pandemic has reactivated ancient metaphors but also initiated a new vocabulary: social distancing, lockdown, self-isolation, and sheltering in place. Terminology is not ethically neutral but reflects prevailing value systems. I will argue that there are two metaphorical vocabularies at work: an authoritarian one and a liberal one. Missing is an ecological vocabulary. It has been known for a long time that emerging infectious diseases are associated with the destruction of functioning ecosystems and biodiversity. Ebola and avian influenza (...) viruses have been significant warnings. Obviously, this pandemic will not be the last one. As the planet is our common home, the major metaphor to explore is sheltering at this home. (shrink)

Good medical practice requires evidence of effectiveness to address deficits in care, strive for further improvements, and justly apportion finite resources. Nevertheless, the potential of palliative care is still held back by a paucity of good evidence. These circumstances are largely attributable to perceived ethical challenges that allegedly distinguish dying patients as a special client class. In addition, practical limitations compromise the quality of evidence that can be obtained from empirical research on terminally ill subjects.This critique aims to appraise the (...) need for focused research, in order to develop clinical and policy decisions that will guide health care professionals in their care of dying patients. Weighted against this need are tenets that value the practical and ethical challenges of palliative care research as unique and insurmountable. The review concludes that, provided investigators compassionately apply ethical principles to their work, there is no justification for not endeavouring to improve the quality of palliative care through research. (shrink)

Background:Promoting patients’ rights is essential for defining the standards of clinical services within a country. Given their responsibilities, nurses can be the primary target for research to investigate the issue of patients’ rights within a healthcare system. As such, assessing the knowledge of nurses about patients’ rights is an essential step toward improving the quality of healthcare in limited resource settings like Sudan.Objectives:We aimed to assess the level of knowledge about patients’ rights among the nursing staff at Friendship Teaching Hospital (...) in Sudan.Methods:This hospital-based cross-sectional study was carried out at the Friendship Teaching Hospital in Sudan. We surveyed the totality of nurses (95) at the hospital using an amended survey. The data were analyzed in SPSS software using descriptive and inferential statistics.Ethical consideration:The study was approved by the Research Unit of Khartoum Ministry of Health and the Hospital administration. All respondents gave verbal consent prior to participating in the study.Results:Only 48.4% of the participants knew about the existence of the Sudanese Charter of patients’ rights. Nonetheless, our analysis found that 65.8% of nurses had acceptable level of knowledge (scored more than 75% of the total knowledge score) of patients’ rights, and none of the participant scored less than 50% of the total knowledge score. Finally, we found no statistical association between the knowledge score and demographic data, educational level, whether the participant knows about the existence of the Charter or not and a number of other factors.Conclusion:Nurses’ lack of knowledge about the existence of the Sudanese Charter of patients’ rights adopted in 2009 rights confirms the need for further efforts by Ministry of Health to promote the document. Furthermore, further research is needed to investigate the disconnect between nurses’ lack of knowledge about the existence of the charter and their awareness of the rights within the charter as well as the actual implementation of rights. (shrink)

Packing optimization problems have a wide spectrum of real-word applications. One of the applications of the problems is problem of placement of containers with spent nuclear fuel on the storage platform. The solution of the problem can be reduced to the solution of the problem of finding the optimal placement of a given set of congruent circles into a multiconnected domain taking into account technological restrictions. A mathematical model of the prob-lem is constructed and its peculiarities are considered. Our approach (...) is based on the mathematical modelling of rela-tions between geometric objects by means of phi-function technique. That allowed us to reduce the problem solving to nonlinear programming. Today, an important scientific problem is the problem of creating conditions for safe storage of spent nuclear fuel. In the process of creating any dry spent nuclear fuel storage, the following main stages can be identified: site selection, storage design, construction, operation and decommissioning. A full check for compliance of the repository and its elements with these standards usually begins at the design stage. At the stage of site selection, the inspection for compliance with safety standards is carried out only in terms of the impact of the repository as a whole on the environment. This approach cannot be considered fully appropriate, because, taking into account, for example, all the climatic features of the future storage site, it is possible to adjust the thermal storage regimes of spent nuclear fuel. Similarly, it can be considered necessary to analyze and select the shape of the storage site in order to accommo-date the maximum possible number of spent fuel containers. Such a choice, obviously, should be made taking into ac-count the norms of nuclear, radiation and thermal safety, as well as in compliance with technological limitations. The problem of finding the optimal placement of containers taking into account the given technological limitations can be formulated in the form of the problem of optimization of geometric design. Therefore, the purpose of the study is to build a mathematical model of the problem and study its characteristics to develop effective methods of solution. The proposed approach is based on mathematical modeling of relations between geometric objects using the method of phi-functions. This allowed to reduce the solution of the problem to the problem of nonlinear programming. (shrink)

The study aimed to identify E- Learning strategies and their relation to the efficiency of research performance in foreign and Palestinian universities (University of Ottawa, Munster, Suez Canal, Al-Azhar, Islamic, Al-Aqsa). The analytical descriptive approach was used for this purpose, and relying on the questionnaire as a main tool for data collection. The study society is from the senior management, where the number of senior management in the universities in question is 206. The random stratified sample was selected and (SPSS) (...) was used for statistical data analysis. The study found a significant relationship between E- Learning strategies and the efficiency of research performance in universities. It also reached the participation of senior management in the research that develops the university performance in the Palestinian universities. The senior management indicated that they do not care to follow the policies of implementing the development of scientific research. While the senior management in foreign universities indicated that they are interested in following up the policies of implementing the development of scientific research. The study also showed that senior management in Palestinian universities does not care about providing the appropriate budget for E- Learning. The study recommended that the senior management of Palestinian universities should provide an E- Learning budget and encourage employees to continue using E- Learning strategies. The administration in the Palestinian universities should adopt and support outstanding research, and the need to encourage interest in the implementation of policies for the development of scientific research. (shrink)

The House of Lords in F v West Berkshire Health Authority [1989] considered the lawfulness of providing care and treatment for a mentally incapacitated adult. They did not, however, directly consider the use of restraint to enable the provision of care in the face of resistance from the patient. The law has since had good cause to give consideration to this important issue. This paper establishes the present law in the context of using restraint to deliver care. Although the legal (...) principles established have derived from what might be considered to be “hard cases”, life-and-death cases, they apply to all aspects of routine medical, dental and nursing care. Further, the paper considers the recent government proposals and the effect those proposals may have on the routine care of such patients. (shrink)

Can we refer to objects which do not exist? Searle says that we cannot. He postulates an ‘axiom of existence’ such that, if an object does not exist, we cannot refer to it. This ‘axiom of existence’ could be taken simply as a way of defining the notion of ‘reference’; we would not count a reference to a non-existent object as a ‘reference’ in the philosophical sense; or perhaps it might count as a reference but not as a ‘successful’ or (...) ‘consummated’ reference, to use the terminology which Searle sometimes adopts. Whichever way we take Searle's doctrine I wish to argue that it is objectionable. The conceptual scheme he advocates obscures the truth. But I do not deny that there is a temptation to resort to it, and I hope to show that, where lawyers have yielded to the temptation, pernicious doctrines have resulted. (shrink)

By using a tomographic approach to quantum states, we rise the problem of nonlocality within a single particle (single degree of freedom). We propose a possible way to look for such e®ects on a qubit. Although a conclusive answer is far from being reached, we provide some re°ections on the foundational ground.

Gillett and Huang (2013) rightly stress that societal aspects of psychopathology imply society has responsibilities toward psychopaths. In this commentary, I argue that society should not only take...