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)

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...

Although Fair Trade has recently experienced rapid growth around the world, there is lack of consumer research that investigates what determines consumers' loyalty toward Fair Trade brands. In this research, we investigate how ethical consumption values (ECV) and two mediating variables, Fair Trade product beliefs (FTPB) and Fair Trade corporate evaluation, (FTCE) determine Fair Trade brand loyalty (FTBL). On the basis of two empirical studies that use samples from the U.S. and Korea, we provide evidence demonstrating that the manner in (...) which ECV influence FTBL differs in the U.S. and Korea. In the U.S., ECV determine FTBL only indirectly via FTPB, whereas in Korea they determine FTBL directly as well as indirectly via FTCE. We discuss theoretical and managerial implications of these findings. (shrink)

Role-based database management systems are most widely used for information storage and analysis but are known as vulnerable to insider attacks. The core of intrusion detection lies in an adaptive system, where an insider attack can be judged if it is different from the predicted role by performing classification on the user’s queries accessing the database and comparing it with the authorized role. In order to handle the high similarity of user queries for misclassified roles, this paper proposes a deep (...) metric neural network with strategic sampling algorithm that properly extracts salient features and directly learns a quantitative measure of similarity. A strategic sampling method of heuristically generating and learning training pairs through Monte Carlo search is proposed to select a training pair that can represent the entire dataset. With the TPC-E–based benchmark data trained with 11,000 queries for 11 roles, the proposed model produces the classification accuracy of 95.41%, which is the highest compared with the previous models. The results are verified through comparison of quantitative and qualitative evaluations, and the feature space modelled in the neural network is analysed by t-SNE algorithm. (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.

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)

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 purpose of this essay is to discuss Deleuze and Guattari's concept of the Third World. For Deleuze and Guattari, however, the Third World is not only a geographical term, but also one that denotes the linguistic zones, another term of the minority. The essay argues that the concept of the Third World is related to minor literature, the minor or intense use of language. This ‘transcendental exercise’ of writing is an opposition to the initial purpose of language, namely representation. (...) Language must escape from its normative usage, and then be liberated to a new spatio-temporality, in other words, the linguistic Third World zones. My conclusion is that the creation of Third World linguistic zones is the repetition of differences against the generalisation of representation, such as becoming non-human and non-European, not in imitation of the molar form of the animal or a non-continent extending terrestrial power into the ocean, but as the right way to invent the people missing in the Third World. Inventing the people of the Third World is the right condition in which alternative political subjects can be produced through desubjectification, not domestication, by capitalist axiomatics. In this way, Deleuze's political philosophy aims to use the virtual politics of the Third World to radicalise the actual representation of the existing Left. (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)

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)

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)

This paper deals with two different problems in which infinity plays a central role. I first respond to a claim that infinity renders counting knowledge-level beliefs an infeasible approach to measuring and comparing how much we know. There are two methods of comparing sizes of infinite sets, using the one-to-one correspondence principle or the subset principle, and I argue that we should use the subset principle for measuring knowledge. I then turn to the normalizability and coarse tuning objections to fine-tuning (...) arguments for the existence of God or a multiverse. These objections center on the difficulty of talking about the epistemic probability of a physical constant falling within a finite life-permitting range when the possible range of that constant is infinite. Applying the lessons learned regarding infinity and the measurement of knowledge, I hope to blunt much of the force of these objections to fine-tuning arguments. (shrink)

When Western Christianity came to Asia, it merged with Eastern religions and histories and developed very differently in different places. Today Asian women in each country build up very unique images of God. They practice Eastern forms of worship and liturgical rites, and do indigenized theologies. They simultaneously try to find their own ways of naming, imaging, believing in and communicating with their own God. Korean Christianity has inherited many images of God from Western Christian doctrines and theologies. However, when (...) it meets and merges with Koreanized Buddhism, Confucianism, and Shamanism, some of the images of God in Christianity are transformed and re-imagined in Korean women's social cultural and religious contexts. As an Asian woman, especially a Korean woman, I would like to introduce one of the many Asian women's theologies, Korean women's images of God. It cannot represent all Asian women's ways of doing theologies, but it will give some clues to show how Asian women do theologies in their own context. In particular, I will examine three images of God that demonstrate how Western Christianity and Eastern religions meet and are transformed in Korean Christian women's living contexts. (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)

This book investigates the different meanings and logics that the notion of qi/gi has acquired within the East Asian traditions in order to understand the diversity of these traditions. More specifically, this work focuses on investigating how the notion was understood by traditional Chinese and Korean philosophers.

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)

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)

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)

In the 1990s P.H. Hirst criticizes his influential forms of knowledge theory, suggesting a new concept of education. In this paper I explain why Hirst suggests the new concept of ‘education as initiation into practices’. Although the latter Hirst’s position had positive implications on education, it is frequently confused with theutilitarian position. In order to provide a more coherent concept of education, I compare basic features of the rationalist (R), the utilitarian (U), and the practices-based (P) approach. Then I discuss (...) the implications of this concept. The main features of R, U, and P are respectively as this: 1) A person is seen as a rational being, a being of wants and desires, and a rational practitioner who is socially constructed. 2) The nature of reason is conceived as ‘rational’,‘instrumental’, and ‘practical’. 3) The aim of education is education for theoretical rationality, education for maximum satisfaction of desires, and education for identity formation by participating in practices. 4) The contents of education are theoretical knowledge, instrumental knowledge with utility, and practical knowledge for various practices. 5) R pursues absolute transcendental values, U pursues extrinsic instrumental values, and P pursues values internal to a practice. 6) R conceives education as ‘seeing’, U as ‘doing’, and I suggest ‘listening’ model for P. Based on this conception of practices-based position, I hope we can provide better education. (shrink)