BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to (...) measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as “No Disclosure”, “Partial Disclosure” or “Full Disclosure”. Data was keyed in and analysed using STATA v 13.0.ResultsOnly 10.1% intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.ConclusionMost doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure. (shrink)

BackgroundIn this study, medical errors are defined as unintentional patient harm caused by a doctor’s mistake. This topic, due to limited research, is poorly understood in Malaysia. The objective of this study was to determine the proportion of doctors intending to disclose medical errors, and their attitudes/perception pertaining to medical errors.MethodsThis cross-sectional study was conducted at a tertiary public hospital from July- December 2015 among 276 randomly selected doctors. Data was collected using a standardized and validated self-administered questionnaire intending to (...) measure disclosure and attitudes/perceptions. The scale had four vignettes in total two medical and two surgical. Each vignette consisted of five questions and each question measured the disclosure. Disclosure was categorised as “No Disclosure”, “Partial Disclosure” or “Full Disclosure”. Data was keyed in and analysed using STATA v 13.0.ResultsOnly 10.1% intended to disclose medical errors. Most respondents felt that they possessed an attitude/perception of adequately disclosing errors to patients. There was a statistically significant difference when comparing the intention of disclosure with perceived disclosures. Most respondents were in common agreement that disclosing an error would make them less likely to get sued, that minor errors should be reported and that they experienced relief from disclosing errors.ConclusionMost doctors in this study would not disclose medical errors although they perceived that the errors were serious and felt responsible for it. Poor disclosure could be due the fear of litigations and improper mechanisms/procedures available for disclosure. (shrink)

This article examines how modern Chinese Buddhism has been influenced by Christianity. For our purposes ‘modern Chinese Buddhism’ refers to a form of what has become known in the West as ‘Engaged Buddhism’, but in Chinese is known by titles which can be translated ‘Humanistic Buddhism’ or ‘Buddhism for Human Life’. This tradition was initiated on the Chinese mainland between the two World Wars by the monk Tài X?, and Part one of the article is devoted to him. Since the (...) communist conquest of China, its main branches have flourished in Taiwan, whence two of them have spread worldwide. The most successful, at least in numerical terms, has been Fo Guang Shan, founded by a personal disciple of Tài X?, Hsing Yun, now very old, and it is on this movement that we concentrate in Parts two and three. We differentiate between conscious imitation and analogous development due to similar social circumstances, and show how Protestant Christianity and Roman Catholicism have had different effects. In Part four, we examine Fo Guang Shan as a missionary religion. (shrink)

To define the determinants of impaired facial emotion recognition (FER) in patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis (MTLE-HS), we examined 76 patients with unilateral MTLE-HS, 36 prior to antero-mesial temporal lobectomy (AMTL) and 40 after AMTL, and 28 healthy control subjects with a FER test consisting of 60 items (20 each for anger, fear, and happiness). Mean percentages of the accurate responses were calculated for different subgroups: right vs. left MTLE-HS, early (age at onset <6 years) (...) vs. late-onset, and before vs. after AMTL. After controlling for years of education, duration of epilepsy and number of antiepileptic drugs (AEDs) taken, on multivariate analysis, fear recognition was profoundly impaired in early-onset right MTLE-HS patients compared to other MTLE patients and control subjects. Happiness recognition was significantly better in post-AMTL MTLE-HS patients compared to pre-AMTL patients while anger and fear recognition did not differ. We conclude that patients with right MTLE-HS with age at seizure onset <6 years are maximally predisposed to impaired fear recognition. In them, right AMTL does not further worsen FER abilities. Longitudinal studies comparing FER in the same patients before and after AMTL will be required to refine and confirm our cross-sectional observations. (shrink)

HAUGDAHL HS and STORLI SL. Nursing Inquiry 2012; 19: 238–246 ‘In a way, you have to pull the patient out of that state …’: the competency of ventilator weaningThe introduction of the weaning protocol has reduced weaning time and improved results in patients. However, the evidence is inconsistent. This may reflect that the use of a protocol should not exclude individual considerations and clinical judgement. However, the significant aspects of the context and the competency important in the nurse–patient relationship in (...) weaning have not yet been sufficiently described. This study aimed at exploring these aspects of weaning. Qualitative data from six in‐depth interviews and field observations of three experienced intensive care nurses in weaning situations were analysed through systematic text condensation within a hermeneutic‐phenomenological approach. Competency appeared to be based on thorough knowledge of physiology and ventilator skills, but also on knowing the patient, helping the nurse connect the meaningless to the meaningful for the patient. Behaving competently involves a continuous dialogue with the situation, observation of the patient’s body language and symptoms over a period of time and the ability to see the interrelationships of all these elements. Competency in ventilator weaning may thus be linked to personal qualifications, while it is simultaneously dependent on a professional community that both confirms and acknowledges this competency. (shrink)

Humean Supervenience is a metaphysical model of the world according to which all truths hold in virtue of nothing but the total spatiotemporal distribution of perfectly natural, intrinsic properties. David Lewis and others have worked out many aspects of HS in great detail. A larger motivational question, however, remains unanswered: As Lewis admits, there is strong evidence from fundamental physics that HS is false. What then is the purpose of defending HS? In this paper, we argue that the philosophical merit (...) of HS is largely independent of whether it correctly represents the world’s fundamental structure. In particular, we show that insofar as HS is an apt model of the world’s higher-level structure, it thereby provides a powerful argument for reductive physicalism and explains otherwise opaque inferential relations. Recent criticism of HS on the grounds that it misrepresents fundamental physical reality is, therefore, beside the point. (shrink)

Tn this paper I explore and to an extent defend HS. The main philosophical challenges to HS come from philosophical views that say that nomic concepts-laws, chance, and causation-denote features of the world that fail to supervene on non-nomic features. Lewis rejects these views and has labored mightily to construct HS accounts of nomic concepts. His account of laws is fundamental to his program, since his accounts of the other nomic notions rely on it. Recently, a number of philosophers have (...) criticized Lewis's account, and Humean accounts of laws generally, for delivering, at best, a pale imitation ofthe genuine item. These philosophers think that the notion of law needed by science requires laws-if there are any-to be fundamental features of our world that are completely distinct from and not supervenient on the particular facts that they explain. I side with Lewis against these philosophers. Here I will argue that although Lewis-laws don't fulfill all our philosophical expectations, they do play the roles that science needs laws to play. The metaphysics and epistemology of Humean laws, and more specifically, Lewis-laws, are in much better shape than the metaphysics and epistemology of the main anti-Humean alternatives. However, I do have inisgivings about Lewis's account. Both he and his critics assume that the basic properties are so individuated so that the laws are not metaphysically necessary. If this assumption is rejected, then the question of Humean supervenience lapses. I conclude with a brief discussion of this position. (shrink)

In this article, I present a schema for generating counterexamples to the argument form known as Hypothetical Syllogism with indicative conditionals. If my schema for generating counterexamples to HS works as I think it does, then HS is invalid for indicative conditionals.

This is the first part of a two-part article in which we defend the thesis of Humean Supervenience about Laws of Nature (HS). According to this thesis, two possible worlds cannot differ on what is a law of nature unless they also differ on the Humean base. The Humean base is easy to characterize intuitively, but there is no consensus on how, precisely, it should be defined. Here in Part I, we present and motivate a characterization of the Humean base (...) that, we argue, enables HS to capture what is really stake in the debate, without taking on extraneous commitments. (shrink)

Roche and Sober have offered a new argument for the view that a hypothesis H is not confirmed by its capacity to explain some observation O. Their argument purports to work by showing that O screens H off from the fact that H would explain O. This paper offers several objections to this argument. Firstly, the screening-off test cannot identify whatever evidential contribution Hs explanatoriness may make. Secondly, that H would explain O may be logically necessary, eluding the screening-off test. (...) Thirdly, the test cannot detect an important difference that Hs explanatoriness often makes to Hs confirmation. (shrink)

Many sign languages display crosslinguistic consistencies in the use of two iconic aspects of handshape, handshape type and finger group complexity. Handshape type is used systematically in form-meaning pairings (morphology): Handling handshapes (Handling-HSs), representing how objects are handled, tend to be used to express events with an agent (“hand-as-hand” iconicity), and Object handshapes (Object-HSs), representing an object's size/shape, are used more often to express events without an agent (“hand-as-object” iconicity). Second, in the distribution of meaningless properties of form (morphophonology), Object-HSs (...) display higher finger group complexity than Handling-HSs. Some adult homesigners, who have not acquired a signed or spoken language and instead use a self-generated gesture system, exhibit these two properties as well. This study illuminates the development over time of both phenomena for one child homesigner, “Julio,” age 7;4 (years; months) to 12;8. We elicited descriptions of events with and without agents to determine whether morphophonology and morphosyntax can develop without linguistic input during childhood, and whether these structures develop together or independently. Within the time period studied: (1) Julio used handshape type differently in his responses to vignettes with and without an agent; however, he did not exhibit the same pattern that was found previously in signers, adult homesigners, or gesturers: while he was highly likely to use a Handling-HS for events with an agent (82%), he was less likely to use an Object-HS for non-agentive events (49%); i.e., his productions were heavily biased toward Handling-HSs; (2) Julio exhibited higher finger group complexity in Object- than in Handling-HSs, as in the sign language and adult homesigner groups previously studied; and (3) these two dimensions of language developed independently, with phonological structure showing a sign language-like pattern at an earlier age than morphosyntactic structure. We conclude that iconicity alone is not sufficient to explain the development of linguistic structure in homesign systems. Linguistic input is not required for some aspects of phonological structure to emerge in childhood, and while linguistic input is not required for morphology either, it takes time to emerge in homesign. (shrink)