The concept of brain death — first defined decades ago — still presents medical, ethical, and legal challenges despite its widespread acceptance in clinical practice and in law. This article reviews the medicine, law, and ethics of brain death, including the current inconsistencies in brain death determinations, which a lack of standardized federal policy promotes, and argues that a standard brain death policy to be used by all hospitals in all states should be created.

The concept of brain death evolved because advancements in medical science permitted unprecedented artificial maintenance of vital body functions by external means. Although the concept of brain death is accepted clinically, ethically, and legally in the United States, there is no national standard for the determination of brain death. There is evidence that variability and inconsistency in the process of determining brain death exist both in clinical settings and in State statutes. Several studies demonstrate that medical personnel determine brain death (...) in variable ways, and have variable understandings of the definition of brain death. The declaration of death has significant legal consequences such as probate proceedings and liability issues for wrongful death. Inconsistencies in the determination of death may therefore be medically, ethically, and legally problematic. (shrink)

This study examined influential factors of newspaper corporation social responsibility and evaluated corporate social responsibility using a newspaper corporate social responsibility index. Results of this study, which was conducted by survey, showed that arbitrative, essential, and cultural activities were influential factors comprised of newspaper corporate social responsibility. In addition, the findings indicated that higher corporate social responsibility index was not accompanied by Korean newspaper corporations with larger circulations.

The study hypothesizes that the environmental, social, and governance of the host country have a significant effect on clean development mechanism implementation. As CDM incorporates sustainable development as one of the objectives for the green transition, many countries endeavor to adopt and implement CDM as their cleaner production method. Based on the institutional theory, the study aims to investigate the mechanism by which the institutional process of each ESG pillar makes an opportunity for a host country and to see how (...) such country-specific factors influence the implementation of CDM projects. A county-year unbalanced sample drawn from World Bank and multinational CDM project data was analyzed using panel logistic and Poisson regression. Panel regression results show that high-energy intensity and low renewable electricity output as an environmental pillar positively affect CDM implementation. Unemployment and undernourishment as a social pillar positively affect CDM whereas low government effectiveness and the high rule of law positively affect CDM. In the results of zero-inflated Poisson regression, the direction of government effectiveness was upturned. The findings have broadened and deepened the ESG pillar based on the institutional theory and emphasized sustainable development rather than economic outputs. (shrink)

This article presents a phenomenology of artistic painting as an anticipatory process. I propose that the artist seeks to establish a state of equilibrium in a model of self-awareness expressed and represented in a self-constituted physical artefact intended to communicate to others, not representationally but affectively. ‘Neural painting’ is an arts-based research method employing a simple computational model of human aesthetic discrimination to study the creative realization of the artistic image. I use this method to explore the relationship of self (...) and ‘other’ in computationally mediated self-portraiture. I develop an image in an exchange with a neural network by reflecting on its output and inputting autographic modifications to those images, blending visceral gesture with the ‘black box’ of artificial intelligence. Through this deeply personalized and perhaps agonistic interchange between organic self and algorithmic reflection, I seek to expose the tacit mediation implicit in the technical artefact, opening an understanding of the existential relations between natural systems (the artist) and technical entities positioned as collaborators in an anticipatory aesthetics. (shrink)

Specific emotions and colors are associated. The current study tested whether the interference of colors with affective processing occurs solely in the semantic stage or extends to a more complex stage like the lexical processing of emotional words. We performed two experiments to determine the effect of colors on affective processing. In Experiment 1, participants completed a color-emotion priming task. The priming stimulus included a color-tinted image of a neutral face, followed by a target stimulus of gray-scaled emotional and neutral (...) faces after 50 ms. Experiment 2 used a modified emostroop paradigm and superimposed emotion words on the center of the color-tinted emotional and neutral faces. Results showed the priming effect of red for the angry face compared to the control, but not in blue for the sad face compared to the control. However, responses to the blue-sad pair were significantly faster than the red-sad pair. In the color-emostroop task, we observed a significant interaction between color and emotion target words in the modified emostroop task. Participants detected sad targets more accurately and faster in blue than red, but only in the incongruent condition. The results indicate that the influence of color in the processing of emotional information exists at the semantic level but found no evidence supporting the lexical level effect. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

Modern schooling in Korea, which was officially established by law in 1949, is well known for its function as an engine of economic success in modern Korea. Although this fact seems to be world-wid...

This book reconsiders the relationship between aesthetics and theological ethics. The primary question it seeks to answer is whether artistic creativity is a morally relevant activity. Drawing on the work of Jonathan Edwards and Thomas Aquinas, Choi argues that the arts are the cultural medium through which we can better understand what is morally possible, and that aesthetic objects can serve as snapshots of a particular community's perspectives on the good life. Art, in other words, offers glimpses not only (...) into competing moral visions within society but also the extent to which these contested moral views are understood. The arts, in Choi's view, provide a way of assessing the limits and possibilities of moral reasoning, the contextuality of moral discernment, and the need for moral thinking that is dialogical and dialectical. (shrink)

This essay provides an interpretation of Jonathan Edwards's moral thought that calls attention to the motif of perception in his conception of true virtue. The aim is to illumine the extent to which Edwards's virtue ethics can be included in and contribute to prevailing approaches to virtue in contemporary theological ethics. To advance this proposal, this essay attends to the question of moral agency that Edwards's reflections on charity, the new spiritual sense, and religious affections raise. This procedure offers an (...) acute sense of the significance of perception for Edwards's virtue ethics, which in turn allows for a constructive Edwardsean entry into current theological discussions on the narrative character of virtue. (shrink)

The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and develop solutions; (3) the development of alternatives for analysis and comparison; (4) the selection of the best alternatives and justification; (5) the development of diverse, practical ways to implement ethical decisions and actions; and (...) (6) the evaluation of effects and development of strategies to prevent a similar occurrence. From a pilot-test of the model, nursing students reported positive experiences, including being satisfied with having access to a comprehensive review process of the ethical aspects of decision making and becoming more confident in their decisions. There is a need for the model to be further tested and refined in both the educational and practical environments. (shrink)

The history of press freedom in South Korea has been characterized by periods of chaos. The major media companies in Korea have written a history of shame. Since Japanese colonial rule, freedom of the press has been more often restricted than protected by the laws and policies. There have been four main features of press freedom since 1910: severe restriction during the Japanese colonial rule; experiencing freedom with unstable democracy under the American military rule and the First and Second republics; (...) oppression of the military regimes; and the struggle with capital power since the advent of civilian government. Several decades of Japanese colonial rule, American military rule, and military dictators have influenced the Korean society and the media politically, economically, socially and culturally. (shrink)

The zone of proximal development is defined as an overarching concept that integrates the main tenets of Vygotsky’s theory of human development. The conceptualization of the ZPD begins with its social, cultural, and historical context and traces its development as a spatial and temporal metaphor that reflects the sociogenetic root of all human mental functioning. Beyond the explication of sociogenesis, the ZPD is reconceptualized to include the notions of voice and dialogicality. The insights gained from the fields of semiotics and (...) discourse studies allow a broader understanding of the ZPD by bringing to light participant structures and institutional and historical forces that may not have been included in the dominant interpretations of the ZPD. (shrink)

With the advancement of medical technology, various life-sustaining treatments are available at the end of life. Older adults should be encouraged to establish their end-of-life treatment preferences (ELTP) while they are physically and mentally able to do so. The purpose of this study was to explore ELTP among older adults and to compare those preferences in a subset of individuals who had reported their ELTP in a survey completed the previous year. This was a descriptive study of 191 older adults (...) living in a continuing care retirement community. Approximately half of the participants did not want cardiopulmonary resuscitation, to be put on a respirator, or to receive dialysis. The findings in this study suggest that many older adults do not want aggressive interventions at the end of life, but choose rather those measures that will keep them comfortable. Moreover, treatment choices may change over time. Health care providers should initiate discussions about ELTP at regular intervals (yearly) to assist older adults in dictating their end-of-life care. (shrink)

This volume honors Lisa Cahill's 45 years of teaching Christian ethics at Boston College. With contributions from most of the doctoral students she directed during her career, it provides an interpretive overview of Cahill's specific contributions to Christian ethics.

Computerized relaxation training has been suggested as an effective and easily accessible intervention for individuals with psychological distress. To better elucidate the neural mechanism that underpins the effects of relaxation training, we investigated whether a 10-session computerized relaxation training program changed prefrontal gamma-aminobutyric acid levels and cerebral blood flow in women with psychological distress. We specifically focused on women since they were reported to be more vulnerable to develop stress-related disorders than men. Nineteen women with psychological distress but without a (...) diagnosis of psychiatric disorders received the 10-day computerized relaxation training program that consisted of 30-min cognitive-relaxation training and 10-min breathing-relaxation training per day. At baseline and post-intervention, perceived stress levels, anxiety, fatigue, and sleep quality were assessed by self-report questionnaires. Brain magnetic resonance spectroscopy and arterial spin labeling scans were also performed before and after the intervention to evaluate GABA levels and relative CBF in the prefrontal region. Levels of perceived stress, anxiety, fatigue, and sleep quality improved following 10 sessions of computerized relaxation training, resulting in a significant relief in composite scores of stress-related symptoms. The prefrontal GABA levels decreased, while relative CBF increased after the intervention. In addition, a greater increase in relative prefrontal CBF was associated with better composite scores of stress-related symptoms following the intervention. The current findings suggest that computerized relaxation training may improve stress-related symptoms through modulating the prefrontal GABA levels and CBF in women with psychological distress. (shrink)

Many clinical and psychological constructs are conceptualized to have multivariate higher-order constructs that give rise to multidimensional lower-order traits. Although recent measurement models and computing algorithms can accommodate item response data with a higher-order structure, there are few measurement models and computing techniques that can be employed in the context of complex research synthesis, such as meta-analysis of individual participant data or integrative data analysis. The current study was aimed at modeling complex item responses that can arise when underlying domain-specific, (...) lower-order traits are hierarchically related to multiple higher-order traits for individual participant data from multiple studies. We formulated a multi-group, multivariate higher-order item response theory (HO-IRT) model from a Bayesian perspective and developed a new Markov chain Monte Carlo (MCMC) algorithm to simultaneously estimate the (a) structural parameters of the first- and second-order latent traits across multiple groups and (b) item parameters of the model. Results from a simulation study support the feasibility of the MCMC algorithm. From the analysis of real data, we found that a bivariate HO-IRT model with different correlation/covariance structures for different studies fit the data best, compared to a univariate HO-IRT model or other alternate models with unreasonable assumptions (i.e., the same means and covariances across studies). Although more work is needed to further develop the method and to disseminate it, the multi-group multivariate HO-IRT model holds promise to derive a common metric for individual participant data from multiple studies in research synthesis studies for robust inference and for new discoveries. (shrink)

In empiricism, there are only two answers for a question: black or white. Yet, subjective meanings of human behaviours and responses toward health and illness cannot be simply explained with black and white. Gray zones are needed because they are characterized by complexity and require a contextual understanding. In this paper, we present and suggest fuzzy logic as an example of theoretical bases that help transcend the conflicts between objectivity and subjectivity, respect gray zones between black and white answers for (...) questions, and provide a contextual understanding of complex nursing phenomenon. A historical review of fuzzy logic is followed by a definition of fuzzy logic. Then, fuzzy logic is discussed in terms of its compatibility with nursing epistemological views and philosophical thoughts. Fuzzy logic agrees with three categories of epistemological views of nursing, including correspondence, coherence and pragmatism. Fuzzy logic also agrees with four major philosophical thoughts in nursing, including postempiricism, pragmatism, feminism, and postmodernism. Based on the discussion, we propose that fuzzy logic be further explored, used and developed in research and practice in the nursing areas/situations/phenomena that are characterized by complexity, ambiguousness, and vagueness. (shrink)

Ce travail explore l’origine d’un malentendu vieux de cinq siècles concernant la foi justifiante. Dieu justifie-t-il le pécheur par la foi seule ( sola fide ) comme le disent les luthériens ou par la foi formée par la charité ( fide caritate formata ) comme le disent les catholiques? Il s’agit d’une des différences les plus débattues entre les deux traditions. Une étude précise des sources et une comparaison entre les textes de Thomas d’Aquin et de Martin Luther consacrés à (...) l’interprétation de la fides caritate formata permet de constater que, malgré la compréhension différente de la formule, ils ont en réalité la même idée de la foi justifiante en raison d’une même fidélité à l’Écriture. C’est en puisant à cette source commune qu’aujourd’hui encore, ils montrent aux Églises un chemin d’unité. (shrink)

Hinging on a metaphysical examination of the concept of newness and Paul Guyer’s notion of the temporally extended self, this article analyzes what it means that we are a temporally extended being that is fashioned in time, which is none other than a transcendental object = newness, and argues that (fashioned) bodies can be things in themselves and mere phenomena simultaneously. Kant’s doctrine of self-positing assists us in decoding how the subject obtains an embodied experience while a thing in itself, (...) as well as how both a non-empirical affection and an empirical affection are at play, casually affecting the subject. By looking into how double affection is in operation, this article aims to broaden our understanding of Kant’s theory of self-consciousness. (shrink)

En este artículo se realiza un periplo a lo largo de la historia de la península coreana a través de los caminos recorridos por las principales tradiciones religiosas presentes en ella. Analizaremos el papel que han tenido en el modo de entender las relaciones sociales y la creación de mecanismos de inclusión y exclusión dentro de la sociedad coreana. Las interrelaciones establecidas entre ellas como factor que ha contribuido al progreso de la sociedad y que diferentes grupos fueran aceptados o (...) rechazados a lo largo de la historia. Estudiamos como el pensamiento de estas tradiciones religiosas y el modo de entenderlo ha impulsado u obstaculizado los procesos de inclusión y liberación a lo largo de las diferentes etapas de la historia de Corea. (shrink)

The study aimed to examine the influence of personal characteristics on activity preferences using decision tree analysis and examine the effects of the variables using conventional approaches. A descriptive study was conducted with 251 nursing home residents with dementia in Korea to examine the relationship between their personal characteristics and activity preferences. Decision tree analysis was used to classify participants’ activity preferences, and preference levels were examined using logistic regression analysis. Activities were classified as either physical and social activities or (...) cognitive and affective activities. This model showed an accuracy rate of 85.7% for positively predicting physical and social activity preference and 30.3% for positively predicting cognitive and affective activity preference. Gender was the strongest determinant of activity preference. The odds of preferring physical and social activities were 3.179 times higher among women, while the odds for preferring cognitive and affective activities were 0.412 times higher among men. Notably, cognitive and affective activity preference increased to 58.8% for married male participants. This study’s findings can contribute to the development of programs to decrease behavioral and psychological symptoms among older people with dementia residing in nursing homes and provide scientific evidence for integrating these activities into long-term services for this population. (shrink)