Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic (...) concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered “content neutral” not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and “operationalize” the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. (shrink)

Company–community agreements are widely considered to be a practical mechanism for recognising the rights, needs and priorities of peoples impacted by mining, for managing impacts and ensuring that mining-derived benefits are shared. The use and application of company–community agreements is increasing globally. Notwithstanding the utility of these agreements, the gender dimensions of agreement processes in mining have rarely been studied. Prior research on women and mining demonstrates that women are often more adversely impacted by mining than men, and face greater (...) challenges in accessing development opportunities that mining can bring. Nonetheless, there is currently little guidance for companies, government or communities in bringing a gender perspective to the fore in mining and agreement processes. It is undisputed in human development literature that investment in women and sensitivity to gender delivers long-term health, education and local development outcomes. In mining and development, a number of key factors remain unexplored. These include: women’s participation in agreement processes, the gendered distribution of agreement benefits, and the extent to which impacts and benefits influence women’s development and economic inclusion. This paper presents the results of the first phase of an applied research project undertaken by the Centre for Social Responsibility in Mining at The University of Queensland and funded by the Minerals Council of Australia and the Department of Foreign Affairs and Trade. The project sought to connect with experienced practitioners who had been directly involved in mining and agreement processes to document and analyse grounded perspectives on gender dynamics and agreements, and connect those experiences with the broader literature. Findings from this study have implications for the role of mining companies and governments in promoting gender equality and empowerment as part of their commitments to sustainable development. They also have implications for community groups and their representatives in terms of how they might engage in agreement processes to maximise women’s participation and influence. In many social contexts, a key challenge will be navigating the territory of cultural norms and gender equality, particularly in cultures where women’s influence in the public sphere is not strong. The authors argue that without consideration of a gender perspective, including gender’s intersection with other factors such as class, race, poverty level, ethnic group and age, mining agreements will not be inclusive, may exacerbate gender inequalities, and fail to contribute to long-term sustainable development. (shrink)

Little is known about the consequences of moral distress. The purpose of this study was to identify clinical situations that caused nurses to experience moral distress, to understand the consequences of those situations, and to determine whether nurses would change their practice based on their experiences. The investigation used a descriptive approach. Open-ended surveys were distributed to a convenience sample of 204 critical care nurses employed at a university medical center. The analysis of participants’ responses used an inductive approach and (...) a thematic analysis. Each line of the data was reviewed and coded, and the codes were collapsed into themes. Methodological rigor was established. Forty-nine nurses responded to the survey. The majority of nurses had experienced moral distress, and the majority of situations that caused nurses to experience moral distress were related to end of life. The nurses described negative consequences for themselves, patients, and families. (shrink)

Objectives—To assess whether UK and US health care professionals share the views of medical ethicists about medical futility, withdrawing/withholding treatment, ordinary/extraordinary interventions, and the doctrine of double effectDesign, subjects and setting–A 138-item attitudinal questionnaire completed by 469 UK nurses studying the Open University course on “Death and Dying” was compared with a similar questionnaire administered to 759 US nurses and 687 US doctors taking the Hastings Center course on “Decisions near the End of Life”.Results–Practitioners accept the relevance of concepts widely (...) disparaged by bioethicists: double effect, medical futility, and the distinctions between heroic/ordinary interventions and withholding/ withdrawing treatment. Within the UK nurses' group a “rationalist” axis of respondents who describe themselves as having “no religion” are closer to the bioethics consensus on withholding and withdrawing treatment.Conclusions—Professionals' beliefs differ substantially from the recommendations of their professional bodies and from majority opinion in bioethics. Bioethicists should be cautious about assuming that their opinions will be readily accepted by practitioners. (shrink)

In this article, we discuss and compare various positions in leadership theory through the perspective of Kierkegaard’s modes of existence. After a brief presentation of the three modes of existence—aesthetic, ethical and religious—and a description of the ironic–reflective interpretation of the change process, we synthesize leadership theories into the three main positions of instrumental, responsible and spiritual. Later, we compare and integrate the different positions in leadership theory with the three modes of existence. We argue that the various positions in (...) leadership theory represent different modes of existence. This means that leaders anchored within the aesthetical mode of existence tend to prefer the instrumental position, leaders anchored in the ethical mode of existence tend to prefer the responsible position, and leaders anchored in the religious mode of existence tend to prefer the spiritual position. In accordance with this line of reasoning the ironic–reflective interpretation of Kierkegaard’s three modes of existence gives a relevant explanation for development of leadership theory, and we delve deeper into some key dimensions in the expanding contexts of ontology, epistemology, ethics, the image of man and organizational ends. We conclude that it is necessary to start a process of transition in the mode of existence and in leadership theory in order to cope with the underlying patterns of the natural, cultural and economic crises we are facing today. (shrink)

The history of the National Health Service research ethics system in the UK and some of the key drivers for its change into the present system are described. It is suggested that the key drivers were the unnecessary delay of research, the complexity of the array of processes and contradictions between research ethics committee (REC) decisions. It is then argued that the primary drivers for this change are and will be replicated by the systems of research ethics review being put (...) in place at UK universities in response to the Economic and Social Research Council research ethics framework. It is argued that this is particularly problematic for multi-centre review and for researchers who switch institutions. Finally, some potential solutions to this problem and their feasibility are discussed. (shrink)

Purpose. The research is devoted to the analysis of the urgent problem of the information society: the overload of a person with information and, as a result, the impossibility of adequate formation and development of the personality; as well as the problem of "digitization" of human existence and the formation of a new reality of dataism. Theoretical basis. A lot of modern scientific works are devoted to the analysis of the information society, its problems and features. The information society is (...) a logical continuation of the scientific and technological revolution, which led to the rapid growth of scientific knowledge and the technology development. In the 20th century, technologies have touched the sphere of knowledge and information, as a result of which the formation and development of the information society, or "knowledge society", takes place. Information becomes the main resource in it, and, one way or another, a person’s life is inextricably connected with the information space. With the information society formation, the problem of information search and processing becomes one of the most urgent. It turns out that despite the abundance and availability of information, it is very difficult to determine its relevance. A lot of effort is spent on developing information retrieval algorithms. Another problem is related to the person’s inability to process large amounts of data. This situation begins to influence not only the education process and professional activity, but also the formation of a person’s personality. A person is "lost" in the information space and gradually loses his/her "I". Algorithms for data analysis come to the rescue, but gradually, instead of giving a person material for thought, they begin to make decisions on their own, and therefore, live life instead of a person. With the advent of Big Data processing algorithms, a new ideological paradigm appears – dataism, which predicts the merger of a person with the general data flow. Originality. The authors make assumptions that the dataistic future is "natural". A lot of works, including in the framework of philosophy, are focused on the problem of "dissolving" a person in the information space and finding ways to overcome it. But, in our opinion, this process is a completely logical continuation of human evolution. Conclusions. Existence of a person as a data flow is not a problem and a threat, but a new dimension of his/her being, and, therefore, requires a careful study and formulation of the main principles of this form of existence. (shrink)

In this thesis I shall summarize and critically examine the central features of the theories of values of four contemporary moral philosophers: A.J. Ayer, C.L. Stevenson, R.M. Hare, and P.H. Nowell - Smith. I shall first look back, however, to the theory of moral philosophy of the most influential 'forefather' of this group, David Hume. Hume's theory stands as a challenge to moral philosophers who would assume that moral judgments are primarily, in some sense, acts of 'reason'. Although our four (...) contemporaries follow Hume in this, his challenge, in the form I shall indicate shortly, will provide the main theme for this thesis. (shrink)

From its title, which since antiquity has occasioned interpretations of varying ingenuity and implausibility and which the book under review is probably right to judge both inauthentic and inappropriate, to its final chapter, thought to be post-Aristotelian or an exercise by Porphyry and the Greek commentators who followed him, On Interpretation has long been considered one of Aristotle’s most puzzling works. Brief as it is, this treatise was divided into four main parts by Ammonius, dealing with the principles of the (...) assertoric sentence, the proposition consisting of subject and predicate terms only, the proposition which contains an “added predicate”, and modal propositions. Modern commentators tend to find in the work important, but isolated, discussions of general semantic theory, the elements of grammar, and modality and fatalism, but not much else of interest. (shrink)

Criminal jurisdiction; international criminal courts.

Sustained attention, a key cognitive skill that improves during childhood and adolescence, tends to be worse in some emotional and behavioural disorders. Sustained attention is typically studied in non-affective task contexts; here, we used a novel task to index performance in affective versus neutral contexts across adolescence (N = 465; ages 11–18). We asked whether: (i) performance would be worse in negative versus neutral task contexts; (ii) performance would improve with age; (iii) affective interference would be greater in younger adolescents; (...) (iv) adolescents at risk for depression and higher in anxiety would show overall worse performance; and (v) would show differential performance in negative contexts. Results indicated that participants performed more poorly in negative contexts and showed age-related performance improvements. Those at risk of depression performed more poorly than those at lower risk. However, there was no difference between groups as a result of affective context. For anxiety there was no difference in performance as a function of severity. However, those with higher anxiety showed less variance in their reaction times to negative stimuli than those with lower anxiety. One interpretation is that moderate levels of emotional arousal associated with anxiety make individuals less susceptible to the distracting effects of negative stimuli. (shrink)

There has been a troublesome anomaly in the UK between cash payment to men for sperm donation and the effective assumption that women will pay to donate eggs. Some commentators, including Donald Evans in this journal, have argued that the anomaly should be resolved by treating women on the same terms as men. But this argument ignores important difficulties about property in the body, particularly in relation to gametes. There are good reasons for thinking that the contract model and payment (...) for gametes are both inappropriate, and that a model based on altruism should be applied to both sexes. (shrink)

How do we acquire knowledge through a sensory input from our environment? In The Enigma of Perception, D.L.C. Maclachlan revives the traditional causal representative theory of perception which dominated philosophical thinking for hundreds of years by revealing the important element of truth the theory contained. The traditional theory was not a complete explanation of perception, because it presupposed a causal system including both the physical objects and the subjective experiences. The pattern of inference from sensations to external objects, which lies (...) at its heart, is nevertheless legitimate, because the assumptions on which it depends are generally recognized as true. The emerging enigma is how to explain this original knowledge of the world on which the traditional theory depends. The key idea is that sense experience is constructed as a response to sensory input - an act whose purpose is to represent a reality beyond the cognitive subject. The Enigma of Perception develops original ideas to explain this process in detail, with help from numerous philosophers from John Locke to David Chalmers. (shrink)