Introduction Substitute decision making on behalf of incapable patients is based on the ethical principle of ‘respect for autonomy’. This study was conducted to assess patients' wishes and preferences in terms of a substitute decision maker and determinants of such preferences. Methods The authors conducted a cross-sectional study and selected samples randomly from patients presenting at Farabi Eye Hospital clinics who were 18 years of age or older. Questionnaires were completed through interviews. Results 200 patients between the ages of 18 (...) and 83 years were interviewed. About 52% (N=105) were men and 73% (N=77) were married. Among married patients, the spouse was chosen as the substitute decision maker in only 51% of cases. Single men preferred their father first in 36% (N=9) of cases, while single girls chose their father in 5.6% (N=1) of cases and their most prevalent choice was other unmentioned people (33.3%, N=6). Most patients (93.5%) wished to be asked about their substitute decision maker when hospitalised. Conclusion The results of this study show that the people we usually consult for decisions concerning patient treatment are significantly different from the patients' preferred substitute decision makers. The authors suggest patients be allowed to choose their substitute decision maker while conscious. (shrink)

Medical ethics is a realm where four important subjects of philosophy, medicine, theology and law are covered. Physicians and philosophers cooperation in this area will have great efficiency in the respective ethical rules formation. In addition to respect the autonomy of the patient, physician's obligation is to ensure that the medical intervention has benefit for the patient and the harm is minimal. There is an obvious conflict between duty of confidentiality and duty of mandatory reporting. Professional confidentiality is one of (...) the basic components in building a constant physician-patient relationship which nowadays, beside the novelty, it is the subject of discussion. Legal obligation of confidentiality is not absolute. In physician-patient relationship, keeping patient's secrets and maintaining confidentiality is a legal and ethical duty, and disclosure of such secrets is mainly through specific statutes. Thus, there are a number of situations where breach of confidentiality is permitted in different legal systems. One of the situations where breaching confidentiality is permitted is the medical mandatory reporting to the relevant authority which is in accordance with many countries' legal systems. Some situations are considered in many countries legal systems' such as notification of births and deaths, infectious diseases, child abuse, sport and relevant events, medical errors, drug side effects and dangerous pregnancies. In this paper, we will examine and discuss medical mandatory reporting and its ethical and legal aspects in the judicial and legal system of Iran and few other countries. Finally we will suggest making Medical Mandatory Reporting Law in Iran. (shrink)

The literature acknowledges a distinction between immoral, amoral and moral management. This paper makes a case for the employee (at any level) as a moral agent, even though the paper begins by highlighting a body of evidence which suggests that individual moral agency is sacrificed at work and is compromised in deference to other pressures. This leads to a discussion about the notion of discretion and an examination of a separate, contrary body of literature which indicates that some individuals in (...) corporations may use their discretion to behave in a socially entrepreneurial manner. My underlying assumption is that CSR isn’t solely driven by economics and that it may also be championed as a result of a personal morality, inspired by employees’ own socially oriented personal values. A conceptual framework is put forward and it is suggested that individuals may be categorized as Active or Frustrated Corporate Social Entrepreneurs; Conformists or Apathetics, distinguished by their individualistic or collectivist personal values. In a discussion of the nature of values, this paper highlights how values may act as drivers of our behavior and pays particular attention to the values of the entrepreneur, thereby linking the existing debate on moral agency with the field of corporate social responsibility. (shrink)

A business association is a collaborative organization founded and funded by businesses or business owners and usually represents companies operating in an industry or across industries. Business associations often institute a code of ethics, code of practice, and/or code of conduct that guide member company policy and behavior. Specifically, the paper will thoroughly define codes of ethics, conduct, and practice; their relationship to each other is delineated and explained; examples of three business associations’ codes of ethics and/or conduct are explored; (...) and the U.S. legal environment—focusing on antitrust considerations that governs their organizational use—evaluated for business association compliance enforcement. Given this exploratory and explanatory research foundation, managerial recommendations are offered in the discussion section to assist business associations, and by extension, their member companies, in effectively utilizing such association governance codes in both association and company planning, policy development, and operational management activities in domestic and global commerce. (shrink)

This paper compares two approaches that attempt to explain the origin of life, or biogenesis. The more established approach is one based on chemical principles, whereas a new, yet not widely known approach begins from a physical perspective. According to the first approach, life would have begun with—often organic—compounds. After having developed to a certain level of complexity and mutual dependence within a non-compartmentalised organic soup, they would have assembled into a functioning cell. In contrast, the second, physical type of (...) approach has life developing within tiny compartments from the beginning. It emphasises the importance of redox reactions between inorganic elements and compounds found on two sides of a compartmental boundary. Without this boundary, “life” would not have begun, nor have been maintained; this boundary—and the complex cell membrane that evolved from it—forms the essence of life. (shrink)

Despite their growing usage in commercial and industrial applications, nanomaterials have yet to be been thoroughly researched as to their potential health, safety, and environmental risk to human life after incorporation into new product improvement, development, design, and manufacturing processes. Identifying the appropriate governance framework for effective risk assessment analysis of toxicological risk to human beings—specifically manufacturing employees and consumers—and other living organisms, resulting from the development and application of these nanotechnology-based products, has yet to be scientifically determined. With major (...) regulatory gaps in the public regulation framework at national and international levels of governance, a proposed private governance framework is needed to assist the existing public regulatory framework with the proliferation of products and manufacturing processes utilizing nanomaterials. There are three distinct (yet complimentary) approaches available to develop a private governance framework to complement existing national public regulatory frameworks: responsible innovation, risk management, and voluntary guidelines/industry standards. The case for supporting a hybrid governance framework, combining public and private governance mechanisms, for nanotechnology is reflective of the current public policy environment that has emerged to best address health, safety, and environmental risk assessment issues concerning nanotechnology and nanomaterials. (shrink)

The present narrative review seeks to unravel where we are now, and where we need to go to delineate the active ingredients in psychotherapy delivered by conversational agents (e.g., chatbots). While psychotherapy delivered by conversational agents has shown promising effectiveness for depression, anxiety, and psychological distress across several randomized controlled trials, little emphasis has been placed on the therapeutic processes in these interventions. The theoretical framework of this narrative review is grounded in prominent perspectives on the active ingredients in psychotherapy. (...) Based on search terms derived from various theoretical perspectives, we conducted a systematic literature search of four scientific databases and identified 17 studies. Across the selected studies, three themes emerged: relationship variables, emotional venting, and cognitive factors. While methodological issues compromise the epistemic value of this evidence base, core questions also remain to be answered. Such questions include, but are not limited to, whether humans can form affectionate bonds to inanimate beings and whether these kind of mental health treatments should be understood as psychotherapy or something else. Researchers should therefore be cautious when applying theories of psychotherapy in the realm of conversational agents. We conclude the paper by introducing recommendations for future research, which we hope will help instigate methodologically sound studies in this field. (shrink)

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a (...) questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the ‘four principles’ determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in ‘real’ settings and this information may help educators prepare students for these clinical ethical dilemmas. (shrink)

This third edition of The Infinite includes a new part 'Infinity Superseded' which contains two new chapters refining Moore's ideas through a re-examination of the ideas of Spinoza, Hegel, and Nietzsche. Much of this is heavily influenced by the work of Deleuze. There is also a new technical appendix on still unresolved issues about different infinite sizes.

This paper argues that public sector organizational failure may be best understood from a perspective of collective denial. The rise of this phenomenon is examined using testimony from a Public Inquiry into the downfall of a UK hospital, where falling organizational standards led to unethical decision making and an unacceptable number of patient deaths. In this paper, we show how collective denial, over time, became a process that resided within the fabric of organizational life. To explore the organizational processes associated (...) with collective denial, and how and why it occurs, we identify the influence of a ‘narrative of silence.’ This narrative allows ever more serious failings to be justified as organizational members lose contact with reality entering a downward spiral with no recovery. The combined impact of assumptions about leadership capability, enculturated professional identities, and organizational loyalty create an environment where a narrative of silence can develop. (shrink)

The paper builds on the postulate of “myths we live by,” which shape our imaginative life (and hence our social expectations), but which are also open to reflective study and reinvention. It applies this principle, in particular, to the concepts of love and vulnerability. We are accustomed to think of the condition of vulnerability in an objectifying and distancing way, as something that affects the bearers of specific (disadvantaged) social identities. Against this picture, which can serve as a pretext for (...) paternalist and controlling attitudes to the groups in question – notably to women – Anderson urges us to reimagine our vulnerability as a condition not merely of exposure to violence but of openness to mutual affection, love, and friendship. Hegel’s celebrated image of the owl of Minerva, which takes wing only with the coming of dusk, suggests an association of (philosophical) wisdom with negativity – with the experience of death or loss. Anderson, by contrast, proposes an alternative and more hopeful image of the dawn of enlightenment, in the guise of new ethical dispositions shaped by an emancipatory (and so, no longer an oppressive or sexist) conception of our capacity for love. Her main interlocutors or influences in this piece are Judith Butler (who contributes the idea of a “relational ontology”), Michèle Le Doeuff, and Mary Midgley. (shrink)

. I challenge the psychology of religion to move beyond its merely descriptive status and, by focusing on spirituality as the essential dimension of religion, to approach the traditional ideal of science as explanation: a delineation of the necessary and sufficient to account for a phenomenon such as to articulate a general “law” relevant to every instance of the phenomenon. An explanatory psychology of spirituality would elucidate the scientific underpinnings of the psychology of religion as well as that of the (...) social sciences in general, all of which grapple with the issues of human meaning making. Three prevalent and debilitating errors preclude that achievement: the confounding of the spiritual and the divine and the importation of “God” into psychology, the uncritical association of any spiritual phenomenon with spirituality, and the attempt to eschew value judgments from the study of religion and spirituality. To confirm the possibility of avoiding these errors in the face of radical postmodernism, I build on Bernard Lonergan's analyses of intentional consciousness, or human spirit, and thus intimate a psychology of spirituality that is fully nontheological and potentially explanatory. (shrink)

:In this paper, the influence of speech act theory and Grice’s the- ory of conversational implicature on the study of argumentation is discussed. First, the role that pragmatic insights play in van Eemeren and Grootendorst’s pragma-dialectical theory of argumentation and Jackson and Jacobs’ conver- sational approach to argumentation is described. Next, a number of examples of recent work by argumentation scholars is presented in which insights from speech act theory play a prominent role.

Despite its successes, to date Artificial Intelligence (AI) is still characterized by a number of shortcomings with regards to different application domains and goals. These limitations are arguably both conceptual (e.g., related to the underlying theoretical models, such as symbolic vs.connectionist), and operational (e.g., related to robustness and ability to generalize). Biologically inspired AI, and more specifically brain-inspired AI, promises to provide further biological aspects beyond those that are already traditionally included in AI, making it possible to assess and possibly (...) overcome some of its present shortcomings. This article examines some conceptual, technical, and ethical issues raised by the development and use of brain-inspired AI. Against this background, the paper asks whether there is anything ethically unique about brain-inspired AI. The aim of the paper is to introduce a method that has a heuristic nature and that can be applied to identify and address the ethical issues arising from brain-inspired AI (and from AI more generally). The conclusion resulting from the application of this method is that, compared to traditional AI, brain-inspired AI raises new foundational ethical issues and some new practical ethical issues, and exacerbates some of the issues raised by traditional AI. (shrink)

Introduction Currently, The nature and scope of Clinical Ethics Protocols in Madrid are not well understood.Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.Methods We collected CEPs produced and in process by CECs accredited (...) in the public hospitals in Madrid, Spain, from 1996 to 2008.Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment . If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common . There is a relationship between the age of the CEC and the development of CEPs . CECs now seem to be more likely to engage in CEP development.Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient. (shrink)

This article explores how cross-sector partnerships (CSPs) operating in a development context built resilience during the outbreak of the COVID-19 pandemic. Based on a qualitative analysis of eight partnerships operating in East-Africa, Central America, and Indonesia, I show how CSPs engaged in three practices of resilience building (i.e., forming unconventional alliances, mobilizing digital technologies, and building subnetworks), which allowed them to remain functional despite facing adversity. In addition to fostering their resilience, my findings show how engaging in these practices enabled (...) the CSPs to develop new capabilities (i.e., improved abilities to engage with beneficiaries) that benefit them in the long run. Based on these insights, I advance our understanding of resilience building by unpacking this concept on a CSP level. Furthermore, by unfolding the relevance of incidental learning in a cross-sectoral setting, I widen our knowledge of learning processes in CSPs. (shrink)

Based on the concern of Adela Cortina and Federico Nietzsche about the difficulty, opportunity, convenience, incapacity and even the danger of acting according to rational parameters and universal principles, the document analyzes the possibilities of autonomous decision of individuals, taking into account the institutional or organizational context and the regulations that capitalism imposes on a global level. From this reflection, the relative character of the value systems and the local human relations close to each individual are recognized. They validate or (...) invalidate one or another type of behavior beyond the individual and the universal. The incursion and permanence of universal principles proper to neoliberal rationality and classical ethics are also explored. Therefore, in practice, human beings are obliged to compete with others, without breaking legal rules and universal values, to access social and economic capital that allows them to enter a particular lifestyle, an identity, constituted and represented with products and services that the market offers. A partir de la preocupación de Adela Cortina y Federico Nietzsche por la dificultad, oportunidad, conveniencia, incapacidad e incluso el peligro de actuar conforme a parámetros racionales y principios universales, se analizan las posibilidades de decisión autónoma de los individuos, teniendo en cuenta el contexto institucional u organizacional y las regulaciones que el capitalismo impone a nivel global. A partir de esta reflexión se reconoce el carácter por completo relativo de los sistemas de valores y de las relaciones humanas locales y próximas a cada individuo, que validan o invalidan uno u otro tipo de comportamiento más allá de lo individual y lo universal. También se explora la incursión y arraigamiento de principios universales propios de la racionalidad neoliberal y de la ética clásica. Se tiene, por ende, que en la práctica los seres humanos están obligados a competir unos con otros, sin quebrantar reglas legales y valores universales, para acceder al capital social y económico que les permita ingresa a un estilo de vida particular, una identidad, constituida y representada con productos y servicios que el mercado ofrece. (shrink)

This paper investigates the role that the stylistic device of praeteritio (or paralipsis) can play in arguers’ attempts to reconcile their rhetorical with their dialectical aims by manoeuvring strategically when carrying out particular discussion moves of the dialectical procedure for resolving a dispute. First, attention will be paid to the ways in which praeteritio can be realized in discourse. Next, an analysis is given of the effects the use of praeteritio may have as a result of the presentational means that (...) are employed. This analysis will be used to establish the possibilities for strategic manoeuvring with this device in the different stages of an argumentative discussion. Finally, an indication is given of how the types of strategic manoeuvring that a praeteritio can be instrumental in may derail, and in which violations of the rules for critical discussion such derailed manoeuvrings may result. (shrink)

Ethical attitudes and behaviour are complex. This complexity extends to the influencers operating at different levels both outside and within the organisation, and in different combinations for different individuals. There is hence a growing need to understand the proximal and distal influencers of ethical attitudes, and how these operate in concert at the individual, organisational, and societal levels. Few studies have attempted to combine these main research streams and systematically examine their combined impact. The minority of studies that have taken (...) a combined approach have often done so using conventional statistical and analytical techniques which imply linearity between variables—a situation that rarely exists in business settings and is likely to lead to simplistic or even erroneous conclusions. Applying a fuzzy-set qualitative comparative analysis approach, this paper reports on the mutual and simultaneous influence of individual demographic factors, as well as proximal and distal factors stemming from within and outside the work environment to understand individuals’ ethical views within the workplace. The multiple configurations that emerged reveal the complex nature of influencers of ethical attitudes, and reinforce the view that “one size does not fit all”. We discuss these implications together with managerial recommendations and future research directions. (shrink)

International Mindedness (IM) has become an underpinning philosophy of the International Baccalaureate and schools which adopt its programmes. However, the concept of IM is relevant to any school that offers international education given its potential and importance to drive the school’s mindset and mission. The international school market has grown significantly in terms of the number of schools and their diversity. Increasing in popularity are schools that follow the British-based International General Certificate of Secondary Education (IGCSE) and A-level programmes. Moreover, (...) the dgreatest expansion of international schools is now occurring in local markets, in which students are no longer predominantly expatriates but come from the host countries. This study explores the concept of international mindedness in six international schools in Cyprus. Based on data collected from headteachers and teachers, we argue that international mindedness is applicable in various contexts of international schooling and that factors other than the curriculum can affect its development within a school. (shrink)

Political and social thoughts of Muḥammad Ḥusayn Ṭabāṭabāʼī and Thomas Hobbes,1588-1679.

This contribution seeks to understand the pervasive phenomenon of work compulsion among knowledge workers in our present network society. Knowledge workers not only have to work all the time from anywhere, but they also appear to want to. This study argues that this curious phenomenon may be attributed to the thumotic satisfaction that knowledge work generates. What is more, the neoliberal theory of human capital has found a way to harness thumotic satisfaction to the profit incentive, and has created arguably (...) the most productive working subject to date. The argument is divided into four parts: First, the paper analyses the government(- ality) of control operative in the network society by defining “neoliberalism”. It then focuses on Foucault’s examinations of German and American neoliberalism in the 20th century, treating them as instances of governmentality. The aim is to assess whether employing a governmentality lens is a valid approach for critically analysing present-day neoliberalism. If it proves justifiable, which I argue it does, the study explores the potential valuable insights gained from examining contemporary neoliberalism through this particular analytical framework. Second, the study turns to the “spiritedness” of knowledge workers under the conditions of stealth control that typify the neoliberal network society. Curiously, these highly engaged workers have reportedly experienced increased overall well-being. However, their overinvestment in work appears to be disproportionate to absolute necessity, increased earnings or improved overall quality of life. This paper contends that work compulsion generates and is in turn fuelled by thumotic satisfaction. Third, the study tries to ascertain the connection between neoliberal governmentality and thumos. Neoliberal governmentality appears to have found a way to appropriate thumotic satisfaction to produce and sustain the competitive entrepreneurial spirit. The fourth part of the study considers how the knowledge worker might resist the compulsion to work incessantly. (shrink)

ObjectivesTo describe reporting of informed consent in pragmatic trials, justifications for waivers of consent and reporting of alternative approaches to standard written consent. To identify factors associated with (1) not reporting and (2) not obtaining consent.MethodsSurvey of primary trial reports, published 2014–2019, identified using an electronic search filter for pragmatic trials implemented in MEDLINE, and registered in ClinicalTrials.gov.ResultsAmong 1988 trials, 132 (6.6%) did not include a statement about participant consent, 1691 (85.0%) reported consent had been obtained, 139 (7.0%) reported a (...) waiver and 26 (1.3%) reported consent for one aspect (eg, data collection) but a waiver for another (eg, intervention). Of the 165 trials reporting a waiver, 76 (46.1%) provided a justification. Few (53, 2.9%) explicitly reported use of alternative approaches to consent. In multivariable logistic regression analyses, lower journal impact factor (p=0.001) and cluster randomisation (p<0.0001) were significantly associated with not reporting on consent, while trial recency, cluster randomisation, higher-income country settings, health services research and explicit labelling as pragmatic were significantly associated with not obtaining consent (all p<0.0001).DiscussionNot obtaining consent seems to be increasing and is associated with the use of cluster randomisation and pragmatic aims, but neither cluster randomisation nor pragmatism are currently accepted justifications for waivers of consent. Rather than considering either standard written informed consent or waivers of consent, researchers and research ethics committees could consider alternative consent approaches that may facilitate the conduct of pragmatic trials while preserving patient autonomy and the public’s trust in research. (shrink)

The authors attempt to speculatively reconstruct the concept of the “So­viet computer game”. They propose to consider gaming practices associ­ated with computers as a derivative of the accepted ideological guidelines that accompany the Soviet project of machine modernization. Within this framework, the concept of the Soviet computer game appears as an unre­alized historical alternative to the normative game design that has devel­oped in countries with market economies. Despite the industry — or the electronic entertainment market — not having had the (...) time to be properly established in the USSR, there were a number of discursive attitudes re­garding the game as such, and the gaming function of computing devices in particular. Even early Soviet pedagogical theories assumed that “playing like a Soviet” involves performing activities structurally similar to labor, where the player becomes part of production. Later, cybernetic discourse, through game theory, indicated the possibility of formalizing any prag­matic activity as a game model; with the advancement of programming, the pragmatics of digital gaming as a way of educating and solving utili­tarian tasks was developed. Based on the memoir archive of Soviet cyber­netics, and publications in the late-Soviet press, the authors demonstrate that the Soviet computer game was not seen an entertainment product, but a representative model for solving problems in an algorithmic form. Thus, the article is not about specific games that could be called Soviet, but about the logic that guided and set the tone for the interpretation of certain computer-game phenomena in the USSR. (shrink)

Ethical reasons are presented for requiring 1) that a proposal for a clinical trial should be accompanied by a thorough review of all previous trials that have examined the same and closely related questions, and 2) that a trial should be approved by a research ethics committee only if the investigator undertakes to register it in an appropriate register of clinical trials as soon as one exists.

En el socialismo de la transición, De los Ríos fue una figura a recuperar. Su sentido humanista del socialismo permitió al PSOE fundar en su propia historia republicana el nuevo compromiso del socialismo con la libertad. En el socialismo de los derechos civiles también tiene un lugar. De los Ríos apadrinó a Federico García Lorca, desde Granada a Nueva York y con La Barraca. El amor y el exilio acabó uniendo sus familias. También nombra a la primera mujer alto cargo (...) gubernamental: Victoria Kent, directora de prisiones.Se conoce menos otra dimensión de su trayectoria política de la que se ocupa este libro: su laicismo religioso. Dos rasgos que en la España de duelos a garrotazos parecen antagónicos. Sin embargo, ambos son característicos de su personalidad política e intelectual. Fue el ministro que lideró la política laicizadora de la II República, desde Justicia, primero, e Instrucción pública, después, llevando "siempre la batuta"?como informaba Tedeschini, el nuncio de la época -. Por otra parte, desde un cristianismo heterodoxo, no dejó de estimar la emoción religiosa, como lugar donde "fecundan los más hondos deseos del ideal". Se autodefinió "cristiano erasmista". Así le caracterizan Indalecio Prieto, en el obituario tras su muerte en el exilio, y el propio García Lorca, su poeta. (shrink)

New humanism theory of M. N. Roy, 1887-1954; a study.