This paper examines the perceived ethical values of Malaysian managers. It is based on the opinions of 15 hypothetical ethical/unethical business situations from the 81 managers who agreed to participate in the survey. The findings of this study showed that these Malaysian managers have high ethical values. However 53% of the respondents believed that the ethical standards of today are lower than that of 15 years ago. Apparently, this is related to the existence of many unethical business practices prevalent in (...) the modern business world. The behavior of one's immediate superior is the most important factor in influencing managers to commit unethical practices. The results also indicate only a slight variation among the managers in terms of perceived ethical values by virtue of job position, job specialization, type of business activity or the size of the business organization. (shrink)

What could someone represent that would enable her to track, at least within limits, others' perceptions, knowledge states and beliefs including false beliefs? An obvious possibility is that she might represent these very attitudes as such. It is sometimes tacitly or explicitly assumed that this is the only possible answer. However, we argue that several recent discoveries in developmental, cognitive, and comparative psychology indicate the need for other, less obvious possibilities. Our aim is to meet this need by describing the (...) construction of a minimal theory of mind. Minimal theory of mind is rich enough to explain systematic success on tasks held to be acid tests for theory of mind cognition including many false belief tasks. Yet minimal theory of mind does not require representing propositional attitudes, or any other kind of representation, as such. Minimal theory of mind may be what enables those with limited cognitive resources or little conceptual sophistication, such as infants, chimpanzees, scrub‐jays and human adults under load, to track others' perceptions, knowledge states and beliefs. (shrink)

This paper is a sequel to my 'Theological Misinterpretations of Current Physical Cosmology' (Foundations of Physics [1996], 26 (4); revised in Philo [1998], 1 (1)). There I argued that the Big Bang models of (classical) general relativity theory, as well as the original 1948 versions of the steady state cosmology, are each logically incompatible with the time-honored theological doctrine that perpetual divine creation ('creatio continuans') is required in each of these two theorized worlds. Furthermore, I challenged the perennial theological doctrine (...) that there must be a divine creative cause (as distinct from a transformative one) for the very existence of the world, a ratio essendi. This doctrine is the theistic reply to the question: 'Why is there something, rather than just nothing?' I begin my present paper by arguing against the response by the contemporary Oxford theist Richard Swinburne and by Leibniz to what is, in effect, my counter-question: 'But why should there be just nothing, rather than something?' Their response takes the form of claiming that the a priori probability of there being just nothing, vis-à-vis the existence of alternative states, is maximal, because the non-existence of the world is conceptually the simplest. On the basis of an analysis of the role of simplicity in scientific explanations, I show that this response is multiply flawed, and thus provides no basis for their three contentions that (i) if there is a world at all, then its 'normal', natural, spontaneous state is one of utter nothingness or total non-existence, so that (ii) the very existence of matter, energy and living beings constitutes a deviation from the allegedly 'normal', spontaneous state of 'nothingness', and (iii) that deviation must thus have a suitably potent (external) divine cause. Related defects turn out to vitiate the medieval Kalam Argument for the existence of God, as espoused by William Craig. Next I argue against the contention by such theists as Richard Swinburne and Philip L. Quinn that (i) the specific content of the scientifically most fundamental laws of nature, including the constants they contain, requires supra-scientific explanation, and (ii) a satisfactory explanation is provided by the hypothesis that the God of theism willed them to be exactly what they are. Furthermore, I contend that the theistic teleological gloss on the 'Anthropic Principle' is incoherent and explanatorily unavailing. Finally, I offer an array of considerations against Swinburne's attempt to show, via Bayes's theorem, that the existence of God is more probable than not. (shrink)

Payment for research participation has raised ethical concerns, especially with respect to its potential for coercion. We argue that characterising payment for research participation as coercive is misguided, because offers of benefit cannot constitute coercion. In this article we analyse the concept of coercion, refute mistaken conceptions of coercion and explain why the offer of payment for research participation is never coercive but in some cases may produce undue inducement.

Public speakers like politicians carefully craft their words to maximize the clarity, impact, and persuasiveness of their messages. However, these messages can be shaped by more than words. Gestures play an important role in how spoken arguments are perceived, conceptualized, and remembered by audiences. Studies of political speech have explored the ways spoken arguments are used to persuade audiences and cue applause. Studies of politicians’ gestures have explored the ways politicians illustrate different concepts with their hands, but have not focused (...) on gesture's potential as a tool of persuasion. Our paper combines these traditions to ask first, how politicians gesture when using spoken rhetorical devices aimed at persuading audiences, and second, whether these gestures influence the ways their arguments are perceived. Study 1 examined two rhetorical devices—contrasts and lists—used by three politicians during U.S. presidential debates and asked whether the gestures produced during contrasts and lists differ. Gestures produced during contrasts were more likely to involve changes in hand location, and gestures produced during lists were more likely to involve changes in trajectory. Study 2 used footage from the same debates in an experiment to ask whether gesture influenced the way people perceived the politicians’ arguments. When participants had access to gestural information, they perceived contrasted items as more different from one another and listed items as more similar to one another than they did when they only had access to speech. This was true even when participants had access to only gesture (in muted videos). We conclude that gesture is effective at communicating concepts of similarity and difference and that politicians (and likely other speakers) take advantage of gesture's persuasive potential. (shrink)

Whether it is fair to use personal responsibility of patients for their own health as a rationing criterion in healthcare is a controversial matter. A host of difficulties are associated with the concept of personal responsibility in the field of medicine. These include, in particular, theoretical considerations of justice and such practical issues as multiple causal factors in medicine and freedom of health behaviour. In the article, personal responsibility is evaluated from the perspective of several theories of justice. It is (...) argued that in a healthcare system based on both equality of opportunity and solidarity, responsible health behaviour can—in principle—be justifiably expected. While the practical problems associated with personal responsibility are important, they do not warrant the common knee-jerk refusal to think more deeply about responsibility for health as a means of allocating healthcare resources. In conclusion, the possibility of introducing personal responsibility as a fair rationing criterion is briefly sketched. (shrink)

In this paper, it is explained that a dialogical approach to complex argumentation can be fruitful for solving two important problems concerning the analysis of the argumentation structure. First, such an approach makes it possible to clarify the distinction between coordinative and multiple argumentation structures, and to identify clues in the presentation for each of these structures. Second, a dialogical approach can provide a basis for dealing more adequately with refutations of counterarguments.

The total ideology of the revolutionary-political themes of Ukrainian consciousness of the twentieth century, the poetization of the absurdly inverted hierarchy of values, was opposed by the new generation of artists with their philosophical and ethical orientation of their creativity. As I.Franko notes, they "... sought a completely modern European way to portray the peculiarity of the life of the Ukrainian people," revealing the unique collisionality of human existence, the diversity of psychological types, ideological orientations, and the human experience of (...) its existence on the background of this difficult time. However, Ukrainian writersphilosophers who talently laid the foundations of national culture, but are now returning to the generations of the Shattered Renaissance, filling black and bloody spots of troubled history of Ukraine. Among them are V. Pidmogylny, B. Antonovenko-Davidovich, G. Kosinka, D. Falkivsky, M.Ivchenko, T.Osmachka, E.Pluzhnik. This is a non-exhaustive list of the leading figures of the post-revolutionary period who were removed from the creative field, whose works are the golden fund of Ukrainian culture. (shrink)

Annotation "Fearful Symmetry" brings the incredible discoveries of contemporary physics within everyone's grasp. A. Zee, a distinguished physicist and skillful expositor, tells the exciting story of how today's theoretical physicists are following Einstein in their search for the beauty and simplicity of Nature. Animated by a sense of reverence and whimsy, the book describes the majestic sweep and accomplishments of twentieth-century physics. In the end, we stand in awe before the grand vision of modern physics--one of the greatest chapters in (...) the intellectual history of humankind. (shrink)

The problem of human religious consciousness can be attributed to the category of "eternal" philosophical problems, which have never been removed and cannot be removed from the agenda of humanity. The world outlook of a person is updated throughout history as the person, conditions and content of his life, his goals, ideals and perspectives are constantly changing. In each era, this problem retains its fundamental importance, and, being part of all significant philosophical systems, means not a simple continuation of a (...) particular tradition, but the identification of the changing aspects and historical perspectives of human existence. The question of what consciousness, which is its nature and essence, is of great ideological, ideological and practical importance, since it touches upon the foundations of human existence, content and purpose of life. (shrink)

Christian preaching, the main purpose of which is to educate a person in the spirit of the Christian worldview, should answer the questions of the present, give believers concrete recommendations and patterns of behavior in life situations. At the same time, the sermon is based not on the personal opinion of a priest or pastor, but expresses a confessional point of view on one or another problem of modern life facing believers. This point of view, as a rule, is formulated (...) in special documents of confessions, the totality of which is called "Social doctrine of the church". (shrink)

The article provides, for the first time in the philosophical literature, a general description of the Konigsberg Kant studies as a special local direction in the history of philosophy. Core activities in this direction formed the Society of Kant’s Friends, as well as "archival Kant studies" — the work of collecting, annotating and publishing the manuscript heritage, correspondence and lecture notes Kant. Given the large volume of primary and secondary sources, we propose a variant of specification of structure of Kant (...) Studies in Königsberg — four lines of activity: popularization; biographical research and publications; collection and publication of manuskript heritage and conspects of lectures; the interpretation and reception of Kant's ideas. Detailed presented is the history of the first line — popularization of Kants philosophy. The activities of K. Rosenkranz and Society of Kant’s Friends, as well as history of creation of books of J. Schulz and K. Stavenhagen, articles, reports and brochures of R. Brückmann and O. Schöndörffer are described, their content is characterized. There are formulated some conclusions about the main value of this work for Kant studies, for the birth and development of the Kantianism, about the relationship of popularization with other lines of Kant studies in Königsberg, about cooperation of Königsberg researchers of Kant's life and philosophy with each other, and about continuity in their work. It is shown that the popularization work in all its forms has been conducted to date and the first to the last years of this trend, has played a major role in the emergence and development of other lines of activity. An author's translation of a number of fragments of the above publications. The prospects of the development of indepth and detailed analysis of the described compositions, for which this article can serve as a reference point. (shrink)

Purpose. To examine the existential anthropology of G. Marcel and E. Minkowski, in order to demonstrate the necessity of distinguishing the universal-spiritual, as human in human being, apart from the individual-existential in him, and to reveal the hierarchical correlation of biosocial, existential and spiritual spheres in personality. Theoretical basis. Within existential philosophy the author differentiates two separate traditions and proceeds from the insufficiency of the distinction of existential sphere, proposed by phenomenological tradition, showing the necessity of its correlation with the (...) spiritual sphere as a sphere of humanity, proposed by non-phenomenological tradition of G. Marcel and E. Minkowski. Originality. The author presents the anthropological conception of G. Marcel and E. Minkowski, in which human personality is understood as unity of individual-existential and universal-spiritual, which requires a special trans-empirical field of culture, which contains senses, images and symbols of humanity. Also, the author presents the recent developments of existential thinkers in distinguishing existential and spiritual dimensions, both not reducible to the physical and social dimensions. Conclusions. In both existential traditions, the specifically human was founded as a trans-biological and trans-social phenomenon, which appears as indefinable and non-predetermined. But in first tradition, humanity is understood as an existence, as a unique individuality, "project", variant of humanity, equivalent to other variants, and universal is understood as a community of human condition in the world. While in the second tradition, the universal is understood as spiritual. Thus, horizontal level of our private existence, as the process of movement from birth to death, is supplemented by vertical of human, universal ideals and images. Humanity appears as a task, on the way to which human being transcends beyond the limits of his individual "self" to the "super-individual", through inclusion into spiritual community, into universal culture. (shrink)

Background This pilot study evaluated the speaking book ‘What it means to be part of a clinical trial’. The book aims at empowering populations with information on their rights and responsibilities when enrolled in clinical research. Wide publication of the book—at significant cost—is anticipated. It is important that the book is evaluated within the communities for whom it is intended, and the necessary changes (if any) are made, before translation and large-scale publication takes place. Objective The objective of the study (...) was to measure the efficacy and ease of use of the book. Methods Participants were recruited from a catering company. Participants were questioned on their knowledge of clinical trials and were then given the book. Instructions for use of the book were given to one group (‘experimental’ group). The other group (‘control’ group) was not given any instructions. A week later, the investigators returned, repeated the knowledge questions and asked ‘ease of use’ questions. Results A two-way repeated measure of covariants showed a statistically significant positive increase in knowledge of clinical trials among the intervention group (p=0.02). Results for the control group displayed trends that were not statistically significant. Percentage analysis of ‘ease of use’ questions proved that the book is easy to use, although some changes would be beneficial. Conclusion This study revealed that the speaking book is easy to use. It significantly increased knowledge of clinical trials among the study sample if instructions on use of the book were provided. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts in long-term (...) care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

It has been argued that organizational structures (the way tasks are defined, allocated, and coordinated) can influence moral agency in organizations. In particular, low values on different structural parameters (functional concentration, specialization, separation, and formalization) are said to foster an organizational context (allowing for relating to the goals and output of the organization, moral deliberation, and social connectedness) that is conducive to moral agency. In this paper, we investigate the relation between the organizational structure and moral agency in the case (...) of a.s.r. (a large Dutch insurance company). While our empirical results fit the thesis that low values on structural parameters positively relate to moral agency, they also refine our understanding of the influence of structural parameters. In particular, our data suggest that the influence of functional concentration not only depends on whether it is low, but also on the type of criterion used for identifying business units; they suggest that the specific organizational context may put a limit to lowering design parameters and points at several non-structural factors that have an influence on the relation between structure and moral agency. In all, the paper contributes to a more detailed understanding of the conditions conducive to moral agency in organizations. (shrink)

In six experiments, we investigated the role of resource valence in intergenerational attitudes and allocations. We found that, compared to benefits, allocating burdens intergenerationally increased concern with one’s legacy, heightened ethical concerns, intensified moral emotions (e.g., guilt, shame), and led to feelings of greater responsibility for and affinity with future generations. We argue that, because of greater concern with legacies and the associated moral implications of one’s decisions, allocating burdens leads to greater intergenerational generosity as compared to benefits. Our data (...) provide support for this effect across a range of contexts. Our results also indicate that the differential effect of benefits versus burdens in intergenerational contexts depends on the presence of two important structural characteristics that help enact concerns about legacies, including (1) future impact of decisions, and (2) a self-other tradeoff. Overall, our findings highlight how considering resource valence brings to the fore a number of key psychological characteristics of intergenerational decisions—especially as they relate to legacies and ethics. (shrink)

As its subtitle indicates, Democracy’s Discontent is a study of the political philosophies that have guided America’s public life. The “search” Michael Sandel describes has, in his view, temporarily come to a disappointing resolution in America’s acceptance of a liberal “public philosophy” that “cannot secure the liberty it promises” and has left Americans “discontented” with their “loss of self-government and the erosion of community”. This theme is unlikely to surprise readers familiar with Sandel’s earlier work. What may surprise them is (...) how little of Sandel’s second book is devoted to his critique of liberal theory or to his defense of his favored “republican” alternative. Far less than 10 percent of the book is devoted to characterizing liberal and republican political philosophy and to argument concerning their relative theoretical virtues. The body of Democracy’s Discontent is a history of American Constitutional law and political/economic debate, from pre-Revolutionary times to the Clinton presidency, all designed to show that the republican vision that has animated so much of that history has been recently abandoned to our detriment, replaced by a liberal public philosophy whose dramatic failure in practice “recapitulates” its “poverty in theory”. Sandel’s history is lively and engaging, and many of his analyses are insightful and persuasive. But the looseness in his treatment of theory regularly infects the conclusions he draws from this history and undermines his efforts to show that American political practice indicts liberal political philosophy. (shrink)

PrécisThe administration of Pre-Mortem Interventions (PMIs) to preserve the opportunity to donate, to assess the eligibility to donate, or to optimize the outcomes of donation and transplantation are controversial as they offer no direct medical benefit and include at least the possibility of harm to the still-living patient. In this article, we describe the legal analysis surrounding consent to PMIs, drawing on existing legal commentary and identifying key legal problems. We provide an overview of the approaches in several jurisdictions that (...) have chosen to explicitly address PMIs within codified law. We then provide, as an example, a detailed exploration of how PMIs are likely to be addressed in one jurisdiction where general medical consent law applies because there is no specific legislation addressing PMIs — the province of Ontario in Canada. (shrink)

The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't treat (...) you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good. (shrink)

In the introductory remarks to his Mulierum Virtutes, Plutarch notes the value of comparisons for establishing the diverse manifestations of the same virtue: ‘Achilles was brave in one way, Ajax in another; and the intelligence of Odysseus differed from that of Nestor, nor were Cato and Agesilaus just in the same way, nor was Irene loving of her husband () as Alcestis was, nor Cornelia high-minded in the manner of Olympias’. All the examples are well known, and quite apposite, except (...) for Irene (). Who is this paragon of wifely love? A search through encyclopedias and mythological handbooks proves fruitless. Wyttenbach in his note ad loc. suggested the courtesan friend of a minor Ptolemy killed at Ephesus, yet this extremely obscure figure hardly merits mention in the same breath with Alcestis. The name must be corrupt. (shrink)

Consolation is needed when a human being suffers (i.e. feels alienated from him-or herself, from other people, from the world or from his or her ultimate source of meaning). The aim of this study was to illuminate the meaning of consolation. Tape-recorded narrative interviews were carried out with 18 professionals from various spheres. The transcribed interviews were interpreted hermeneutically. A model of consolation is outlined in a drawing. It states that the mediator and the receiver of consolation must become ready (...) for consolation before it can take place. To be ready means to be present and available. Availability means expressing suffering and listening respectively, and thereby opening up for communion and consoling dialogue. Communion brings about contact with the sacred dimension that human beings share and thus with goodness, light, joy, beauty and life. Consolation involves a shift of perspective and an experience of meaning in spite of suffering. (shrink)

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, (...) hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts. (shrink)

Despite its uniform appearance, the cerebellar cortex is highly heterogeneous in terms of structure, genetics and physiology. Purkinje cells (PCs), the principal and sole output neurons of the cerebellar cortex, can be categorized into multiple populations that differentially express molecular markers and display distinctive physiological features. Such features include action potential rate, but also their propensity for synaptic and intrinsic plasticity. However, the precise molecular and genetic factors that correlate with the differential physiological properties of PCs remain elusive. In this (...) article, we provide a detailed overview of the cellular mechanisms that regulate PC activity and plasticity. We further perform a pathway analysis to highlight how molecular characteristics of specific PC populations may influence their physiology and plasticity mechanisms. (shrink)

This article explores and examines the fundamental need for nurses to include the promotion of the spiritual dimension of the health of human beings as well as the physical, mental and social facets if they truly wish to engage in holistic care. The author attempts to define the phenomenon of spirituality, aware of the dilemma that many individuals face when thinking and reflecting on this very personal and intangible issue. To be spiritual is to become fully human, the article argues, (...) and the reverse is also true. Spirituality in health is inextricable in each person’s search for the discovery of the truth about self and the meaning and purpose of life. Healthy communities are the product of healthy individuals who sow spiritual seeds such as unconditional positive regard, acceptance, respect and dignity for the benefit and advancement of individuals and humankind as a whole. The global nature of the phenomenon of spirituality is also shown by using examples of people who demonstrate compassion and communion with other human beings, in other countries in times of suffering, war and disaster. Compassion and empathy is expressed and experienced for victims of earthquakes that happen miles from home and far removed from personal or religious beliefs. Yet at such times we are all connected in the tapestry of life by our own human spirituality and earthiness.themes like compassion and justice are treated in the text within the context of spirituality. The author argues that being just and fair means that all patients have the right to achieve spiritual healing regardless of their belief systems, culture or creed. The works of some spiritual philosophers are used to reflect on this integral aspect of human caregiving. Historical symbols of spirituality are examined. The need for nurses to explore and reflect on the paradoxical concepts involved in their own spirituality is highlighted. Nurses are the essential providers of care and, therefore, the paper argues, guardians of that essential humanity that ensures that patients never become less than full human beings, whatever their condition, faith, culture or belief, or whoever they may be. The author contends that this responsibility is uniquely essential to being a nurse. (shrink)

The ongoing debate within neuroethics concerning the degree to which neuromodulation such as deep brain stimulation (DBS) changes the personality, identity, and agency (PIA) of patients has paid relatively little attention to the perspectives of prospective patients. Even less attention has been given to pediatric populations. To understand patients’ views about identity changes due to DBS in obsessive-compulsive disorder (OCD), the authors conducted and analyzed semistructured interviews with adolescent patients with OCD and their parents/caregivers. Patients were asked about projected impacts (...) to PIA generally due to DBS. All patient respondents and half of caregivers reported that DBS would impact patient self-identity in significant ways. For example, many patients expressed how DBS could positively impact identity by allowing them to explore their identities free from OCD. Others voiced concerns that DBS-related resolution of OCD might negatively impact patient agency and authenticity. Half of patients expressed that DBS may positively facilitate social access through relieving symptoms, while half indicated that DBS could increase social stigma. These views give insights into how to approach decision-making and informed consent if DBS for OCD becomes available for adolescents. They also offer insights into adolescent experiences of disability identity and “normalcy” in the context of OCD. (shrink)

Linking specific nursing actions to outcomes in the healthcare setting is challenging. Patient outcomes are varied and influenced by a myriad of factors, and always involve a wider team than any one nurse. It is difficult to control for a single action or set of actions of a particular nurse. Furthermore, practice is seldom about any ‘one’ action, for one thing leads to another, all within a complex interplay of influencing factors. In this article, we outline a research method which (...) combined Dewey's pragmatism with Gadamer's hermeneutics to explore the consequences of the nurse's use of advanced assessment skills in the acute care setting of medical and surgical wards. This pragmatic hermeneutic methodological approach allowed the complex interplay of influences to be revealed in the unfolding story. Reflection of the nurse brought insights that may otherwise have been passed over. The philosophical notions of Dewey drew attention to the play of ‘means’ and ‘ends’. A hermeneutic approach that calls for ‘thinking’ extends understanding and raises insights that can inform education and practice. (shrink)

In six experiments, we investigated the role of resource valence in intergenerational attitudes and allocations. We found that, compared to benefits, allocating burdens intergenerationally increased concern with one’s legacy, heightened ethical concerns, intensified moral emotions (e.g., guilt, shame), and led to feelings of greater responsibility for and affinity with future generations. We argue that, because of greater concern with legacies and the associated moral implications of one’s decisions, allocating burdens leads to greater intergenerational generosity as compared to benefits. Our data (...) provide support for this effect across a range of contexts. Our results also indicate that the differential effect of benefits versus burdens in intergenerational contexts depends on the presence of two important structural characteristics that help enact concerns about legacies, including (1) future impact of decisions, and (2) a self-other tradeoff. Overall, our findings highlight how considering resource valence brings to the fore a number of key psychological characteristics of intergenerational decisions—especially as they relate to legacies and ethics. (shrink)

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan regarding (...) medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)