This study investigated the perceptions and attitudes of ICU nurses towards the ‘do not resuscitate’ (DNR) decision and changes in their nursing activities after implementation of the DNR decision in South Korea. A data survey was conducted in South Korea between August and October 2008, with a convenience sample of 252 ICU nurses who had more than one year of clinical experience. The data were collected via a self-administered questionnaire. Most of the nurses perceived the necessity of the DNR decision (...) in cases where there would be no chance of patient recovery despite massive efforts. Very few of the nurses' activities changed, either passively or actively, after implementation of the DNR decision. Moreover, the findings of this research provide suggestions for the future direction of the DNR decision and ethical nursing guidelines in South Korea. Further investigations are needed for the development of decision-making skills and intervention guidelines for end-of-life nursing. (shrink)

Last year in June, British doctors went on strike for the first time since 1975. Amidst a global economic downturn and with many health systems struggling with reduced finances, around the world the issue of public health workers going on strike is a very real one. Almost all doctors will agree that we should always follow the law, but often the law is unclear or does not cover a particular case. Here we must appeal to ethical discussion. The General Medical (...) Council, in its key guidance document for practising doctors, Good Medical Practice, claims that ‘Good doctors make the care of their patients their first concern’. Is this true? And if so, how is this relevant to the issue of striking? One year on since the events, we carefully reflect and argue whether it was right for doctors to pursue strike action, and call for greater discussion of ethical issues such as the recent strikes, particularly among younger members of the profession. (shrink)

In the second edition of this groundbreaking text in non-Western philosophy, sixteen experts introduce some of the great philosophical traditions in the world. The essays unveil exciting, sophisticated philosophical traditions that are too often neglected in the western world. The contributors include the leading scholars in their fields, but they write for students coming to these concepts for the first time. Building on revisions and updates to the original, this new edition also considers three philosophical traditions for the first time—Jewish, (...) Buddhist, and South Pacific philosophy. (shrink)

For children, the collateral damage of the COVID-19 pandemic response has been considerable. In this paper, we use the framework of evidence-based medicine to argue that child abuse is another negative side effect of COVID-19 lockdowns. While it was certain that school closures would have profound social and economic costs, it remains uncertain whether they have any effect on COVID-19 transmission. There is emerging evidence that lockdowns significantly worsened child abuse on a global scale. Low-income and middle-income countries are particularly (...) vulnerable to increases in child abuse. The best available external evidence from systematic research during the pandemic demonstrates an increase in the risk of child maltreatment, an increase in child maltreatment hospitalisations and a concerning decrease in official child maltreatment referrals. The paradoxical phenomenon of increased hospitalisations and decreased reports is unlikely to be explained by a genuine decrease in child abuse. We conclude that lockdowns have an unacceptably high risk of negative side effects for children, as evidenced by child abuse, the true extent of which appears to be masked by lockdown-related disruptions to schools and other surveillance systems. The desire for a sense of security may be a tempting bias towards emphasising the resilience of children, but it is ethically problematic to push children towards abuse in the name of public health. It is our view that the collateral damage of prolonged school closures for society’s most vulnerable members is a powerful ethical consideration against any pandemic response which involves their use. (shrink)

It has often been suggested that people’s ordinary folk understanding of morality involves a rejection of moral relativism and a belief in objective moral truths. The results of six studies call this claim into question. Participants did offer apparently objectivist intuitions when confronted with questions about individuals from their own culture, but they offered increasingly relativist intuitions as they were confronted with questions about individuals from increasingly different cultures or ways of life. In light of these data, the authors hypothesize (...) that people do not have a fixed commitment to moral objectivism but instead tend to adopt different views depending on the degree to which they consider radically different perspectives on moral questions. [NOTE: This is a reprint of Sarkissian et al 2011]. (shrink)

Background Regionalised models of health care delivery have important implications for people with disabilities and chronic illnesses yet the ethical issues surrounding disability and regionalisation have not yet been explored. Although there is ethics-related research into disability and chronic illness, studies of regionalisation experiences, and research directed at improving health systems for these patient populations, to our knowledge these streams of research have not been brought together. Using the Canadian province of Ontario as a case study, we address this gap (...) by examining the ethics of regionalisation and the implications for people with disabilities and chronic illnesses. The critical success factors we provide have broad applicability for guiding and/or evaluating new and existing regionalised health care strategies. Discussion Ontario is in the process of implementing fourteen Local Health Integration Networks (LHINs). The implementation of the LHINs provides a rare opportunity to address systematically the unmet diverse care needs of people with disabilities and chronic illnesses. The core of this paper provides a series of composite case vignettes illustrating integration opportunities relevant to these populations, namely: (i) rehabilitation and services for people with disabilities; (ii) chronic illness and cancer care; (iii) senior's health; (iv) community support services; (v) children's health; (vi) health promotion; and (vii) mental health and addiction services. For each vignette, we interpret the governing principles developed by the LHINs – equitable access based on patient need, preserving patient choice, responsiveness to local population health needs, shared accountability and patient-centred care – and describe how they apply. We then offer critical success factors to guide the LHINs in upholding these principles in response to the needs of people with disabilities and chronic illnesses. Summary This paper aims to bridge an important gap in the literature by examining the ethics of a new regionalisation strategy with a focus on the implications for people with disabilities and chronic illnesses across multiple sites of care. While Ontario is used as a case study to contextualize our discussion, the issues we identify, the ethical principles we apply, and the critical success factors we provide have broader applicability for guiding and evaluating the development of – or revisions to – a regionalised health care strategy. (shrink)

This book introduces Robert Corrington’s “ecstatic naturalism,” a new perspective in understanding “sacred” nature and naturalism, and explores what can be done with this philosophical thought. This is an excellent resource for scholars of Continental philosophy, philosophy of religion, and American pragmatism.

The ethical question is whether university mask mandates should be relaxed. I argue that the use of face masks by healthy individuals has uncertain benefits, which potential harms may outweigh, and should therefore be voluntary. Systematic reviews by the World Health Organization (WHO) and Cochrane Acute Respiratory Infections concluded that the use of face masks by healthy individuals in the community lacks effectiveness in reducing viral transmission based on moderate-quality evidence. The only two randomized controlled trials of face masks published (...) during the pandemic found little to no benefit. Without high-quality evidence, it is difficult to justify a requirement rather than a recommendation. Notwithstanding, one might argue that the precautionary principle justifies mask mandates. If the precautionary principle can justify implementing mask mandates due to the risk of forgoing possible benefit, then it might also be able to justify not implementing mask mandates due to the risk of potential harm caused by the intervention. It is commonly thought that there is little to lose from the use of face masks, but this is not necessarily true. It is possible that masks have done more harm than good. (shrink)

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

In Western political philosophy, democracy is generally the dominant view regarding what the best form of government is, and this holds even in respect to promoting minority rights. However, I argue that there is a better theory for satisfying minority interests and rights. I amass numerous studies from the social sciences demonstrating how democracy does poorly in accounting for minority interests. I then contend that a particular hybrid view that fuses a meritocracy with democracy can do a better job than (...) democracy in accounting for minority interests and in having more equal rights and fair policies coming from the legislative and executive branches. Finally, I defend this thesis from numerous counters. (shrink)

Several contemporary Confucian philosophers have posited differing hybrid views fusing meritocracy to democracy. There is a good deal of interest in a meritocracy in contemporary Confucian thought, and such a view perhaps should receive more serious consideration in liberal democratic thought since it may make for a stronger form of government when appended to democracy. In this paper, four contemporary hybrid theorists who combine elements of a meritocracy with a democracy are critically analyzed concerning an ability for their views to (...) be instantiated in liberal democracies for the legislative branch only. Finally, I provide a modified hybrid view for the legislature that I believe is the best fit for current liberal democracies. (shrink)

This article argues that within the context of settler colonialism, the goal of transitional justice must be decolonisation. Settler colonialism operates according to a logic of elimination that aims to affect the disappearance of Indigenous populations in order to build new societies on expropriated land. This eliminatory logic renders the death of Indigenous peoples “ungrievable”. Therefore, this article proposes a decolonising transitional justice premised on a politics of grief that re-conceptualises Indigenous death as grievable, posing a challenge to the logic (...) of elimination and advancing a “decolonisation of the mind”, and resists a purely affective concept of grief in order to mobilise grief as a political resource to demand transformative structural justice. This article consider deaths at Canada’s Indian Residential Schools as a case study of ungrievability under settler colonialism and the Project of Heart as an illustration of a decolonising form of informal transitional justice. (shrink)

Although accumulating evidence suggests the COVID-19 pandemic is associated with costs in mental health, the development of students' mental health, including the change from their previous levels of depression and anxiety and the factors associated with this change, has not been well-studied. The present study investigates changes in students' anxiety and depression from before the pandemic to during the lockdown and identifies factors that are associated with these changes. 14,769 university students participated in a longitudinal study with two time points (...) with a 6-month interval. Students completed the Anxiety and Depression subscales of the Symptom Checklist 90 before the COVID-19 outbreak, and the Self-rating Anxiety Scale and Self-rating Depression Scale during the pandemic. The prevalence of anxiety and depression symptoms were 1.44 and 1.46% at Time 1, and 4.06 and 22.09% at Time 2, respectively, showing a 181.94% increase in anxiety and a 1413.01% increase in depression. Furthermore, the increases in anxiety and depression from pre-pandemic levels were associated with students' gender and the severity of the pandemic in the province where they resided. This study contributes to the gap in knowledge regarding changes in students' mental health in response to the pandemic and the role of local factors in these changes. Implications for gender and the Typhoon Eye effect are discussed. (shrink)

While there has been much work on cosmological arguments, novel objections will be presented against the modern day rendition of the Kalām cosmological argument as standardly articulated by William Lane Craig. The conclusion is reached that this cosmological argument and several of its variants do not lead us to believe that there is inevitably a supernatural cause to the universe. Moreover, a conditional argument for atheism will be presented in light of the Big Bang Theory.

Lockdowns, or modern quarantines, involve the use of novel restrictive non-pharmaceutical interventions (NPIs) to suppress the transmission of COVID-19. In this paper, I aim to critically analyze the emerging history and philosophy of lockdowns, with an emphasis on the communication of health evidence and risk for informing policy decisions. I draw a distinction between evidence-based and modeling-based decision-making. I argue that using the normative framework of evidence-based medicine would have recommended against the use of lockdowns. I first review the World (...) Health Organization’s evidence-based pandemic preparedness plans for respiratory viruses. I then provide a very brief history of COVID-19 modeling, which was cited as justification for the use of lockdowns in the U.K., the U.S., and much of the world. I focus on the so-called Imperial College model designed by Neil Ferguson et al. as well as the so-called Oxford model designed by José Lourenço et al. I analyze the evidence-based pandemic response known as ‘mitigation’, and I compare it with Ferguson et al.’s experimental strategy known as ‘suppression’. I summarize the strengths and weaknesses of these strategies based on their diametric aims and each model’s parametric assumptions. Based on my critical analysis of the suppression strategy, I attempt to expose what has been called the ‘logic of lockdowns’, which Sunetra Gupta of the Oxford model group has suggested is flawed. Finally, I consider Trisha Greenhalgh’s objection to evidence-based policy based on the precautionary principle, and I attempt to offer a response. I conclude with a brief narrative review of the emerging randomized evidence on restrictive NPIs, which seems to support my claim that mitigation was the strategy that would have been recommended by evidence-based medicine. If this is true, then COVID-19 modeling may serve as an important reminder of the enduring lesson of evidence-based medicine: that one should always ‘Trust the Evidence!’ for better health policy. (shrink)

The exchange between Peter Park, Dan Flory and Leah Kalmanson on Park’s book Africa, Asia and the History of Philosophy: Racism in the Formation of the Philosophical Canon took place during the APA’s 2016 Central Division meeting on a panel sponsored by the Committee on Asian and Asian-American Philosophers and Philosophies. After having peer-reviewed the exchange, JWP invited Sonia Sikka and Mark Larrimore to engage with these papers. All the five papers are being published together in this issue.

The current research examined whether fair consideration—a social norm that people inherently prefer to confirm—would modulate face recognition. Each neutral face was associated with fair offers or unfair offers via an economic decision task, the Ultimatum Game (UG) task. After the UG, participants were asked to identify the faces of proposers who made different offers. Enhanced memory was observed for fair-related faces compared to unfair-related faces. Furthermore, high trait anxiety was associated with reduced memory for fair-related faces. These results were (...) further confirmed by signal detection theory. The current research provided initial evidence that people showed enhanced memory for faces that made fair offers from the economic decision task, and that high trait anxiety was associated with reduced fair-related memory. Possible neural mechanisms and the implication in economic and social situations have been discussed. (shrink)

The other major question in the history of political philosophy besides the issue of distributive justice is what the best form of government is. In Western philosophy, the received view is democracy. However, this paper challenges this thesis by presenting arguments against democracy relying in significant part on empirical data from political science and political psychology. Moreover, it presents a general case for a hybrid view over democracy for the legislative and executive branches that appends a meritocracy or rule by (...) the merited from Eastern philosophy to democracy. (shrink)

Evidence-based medicine is a clinical decision-making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science, evidence-based medicine is a value-laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of uncertainty, evidence-based medicine endorses expected utility (...) theory using the best available evidence in order to avoid doing more harm than good. In accordance with the Kantian respect for individuals as ends in themselves, evidence-based medicine calls for integrating the values and preferences of the patient. De-emphasizing intuition, clinical expertise, and pathophysiologic rationale emphasizes the need for the intellectual virtues of curiosity, critical thinking, and courage. Evidence-based medicine is a successful clinical practice that can be morally justified by all three major ethical theories. Although its focus on maximizing good health outcomes and integrating respect for individual patients has been emphasized, the role of the intellectual virtues in evidence-based medicine remains highly under-explored. (shrink)

Evidence-based medicine is a clinical decision making framework which makes claims about what physicians ought to do. Though heralded as the cutting edge of medical science evidence-based medicine is a value laden normative theory which implicitly depends on substantive views regarding what is morally good or right. In this paper, I provide an ethical analysis of evidence-based medicine. I consider its normative underpinnings in three ethical theories: utilitarianism, Kantian deontology, and virtue ethics. In the face of uncertainty, evidence-based medicine endorses (...) expected utility theory using the best available evidence in order to avoid doing more harm than good. In accordance with the Kantian respect for individuals as ends in themselves, evidence-based medicine calls for integrating the values and preferences of the patient. De-emphasizing intuition, clinical expertise, and pathophysiologic rationale emphasizes the need for the intellectual virtues of curiosity, critical thinking, and courage. Evidence-based medicine is a successful clinical practice that can be morally justified by all three major ethical theories. Although its focus on maximizing good health outcomes and integrating respect for individual patients has been emphasized, the role of the intellectual virtues in evidence- based medicine remains highly under-explored. (shrink)

Rita Charon says that narrative medicine is about honoring stories of illness. In a system where physicians and patients can often feel as though they are reduced to numbers, narrative medicine is a plea to take the narratives of illness seriously. But what does it mean to honor a story? In this essay, I use the framework of narrative medicine to offer narrative reflections on the concept of honor inspired by on three definitions, including respect, moral rightness, and high regard. (...) I explain how each definition illustrates an aspect of honor and its role as an ethical virtue in narrative medicine. (shrink)

_2020 Critics' Choice Book Award, American Educational Studies Association (AESA) In _Race on Campus_, Julie J. Park argues that there are surprisingly pervasive and stubborn myths about diversity on college and university campuses, and that these myths obscure the notable significance and admirable effects that diversity has had on campus life. _ Based on her analysis of extensive research and data about contemporary students and campuses, Park counters these myths and explores their problematic origins. Among the major myths that she (...) addresses are charges of pervasive self-segregation, arguments that affirmative action in college admissions has run its course and become counterproductive, related arguments that Asian Americans are poorly served by affirmative action policies, and suggestions that programs and policies meant to promote diversity have failed to address class-based disadvantages. In the course of responding to these myths, Park presents a far more positive and nuanced portrait of diversity and its place on American college campuses. At a time when diversity has become a central theme and goal of colleges and universities throughout the United States, _Race on Campus _offers a contemporary, research-based exploration of racial dynamics on today’s college campuses. (shrink)

This volume examines the psychological basis of moral judgments and what theories of concepts apply to moral ones. It considers what mental states not only influence but also constitute our moral concepts and judgments by combining philosophical reasoning and empirical insights from the fields of moral psychology, cognitive science, evolutionary psychology, and neuroscience. On this basis, Park proposes a novel pluralistic theory of moral concepts which includes three different cognitive structures and emotions. Thus, our moral judgments are a hybrid that (...) express both cognitive and conative states. -/- In part through analysis of new empirical data on moral semantic intuitions, gathered via cross-cultural experimental research, Park draws on this to reveal that the referents of individuals’ moral judgments and concepts vary across time, contexts, and groups. Due to this, he contends for moral relativism, where moral judgments cannot be universally true across time and location but only relative to groups. -/- This text will benefit researchers, academics, and educators with an interest in cognitive science, moral theory, philosophy of psychology, and moral psychology more broadly. Those interested in ethics, applied social psychology, and moral development will also benefit from the volume. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner-Olson research. (shrink)

As customer return rates increase, retailer bottom lines suffer from customers’ misuse of the policies and to the ethics of such practice. The purpose of this study is to explore customers’ orientation toward return behaviors, and to develop a return orientation assessing these dimensions. This research identified three dimensions relevant to consumer return behavior: the planned/unethical returner; the eager returner; and the reluctant/educated returner. A retest with another sample confirmed these three dimensions. Each dimension was analyzed for its relationship with (...) consumer ethical beliefs as measured by the Muncy–Vitell Consumer Ethics Scale, ethical philosophies and shopping behaviors. These relationships supported the ethical and unethical aspects of returner orientation. Results of this research imply that the core aspect of returner orientation is relevant to ethical behavior and misuse of retail return policies. The three return orientations identified partially support the Rosenbaum & Bitner‐Olson research. (shrink)

This article seeks to answer why North—South climate negotiations have gone on for decades without producing any substantial results. To address this question, we revisit and seek to integrate insights from several disparate theories, including structuralism (new and old), world systems theory, rational choice institutionalism, and social constructivism. We argue that the lack of convergence on climate grew almost inevitably from our starkly unequal world, which has created and perpetuated highly divergent ways of thinking (worldviews and causal beliefs) and promoted (...) particularistic notions of fairness (principled beliefs). We attempt to integrate structural insights about global inequality with the micro-motives of rational choice institutionalism. The structuralist insight that ‘unchecked inequality undermines cooperation’ suggests climate negotiations must be broadened to include a range of seemingly unrelated development issues such as trade, investment, debt, and intellectual property rights agreements. We conclude by reviewing the work of some ‘norm entrepreneurs’ bringing justice issues into climate negotiations and explore how these insights might influence ‘burden sharing’ discussions in the post-Kyoto world, where development is constrained by climate change. (shrink)

BackgroundIn the 1970s, the Federal Trade Commission declared that allowing medical providers to advertise directly to consumers would be “providing the public with truthful information about the price, quality or other aspects of their service.” However, our understanding of the advertising content is highly limited.ObjectiveTo assess whether direct-to-consumer medical service advertisements provide relevant information on access, quality and cost of care, a content analysis was conducted.MethodTelevision and online advertisements for medical services directly targeting consumers were collected in two major urban (...) centres in Nevada, USA, identifying 313 television advertisements and 200 non-duplicate online advertisements.ResultsBoth television and online advertisements reliably conveyed information about the services provided and how to make an appointment. At the same time, less than half of the advertisements featured insurance information and hours of operation and less than a quarter of them contained information regarding the quality and price of care. The claims of quality were substantiated in even fewer advertisements. The scarcity of quality and cost information was more severe in television advertisements.ConclusionThere is little evidence that medical service advertising, in its current form, would contribute to lower prices or improved quality of care by providing valuable information to consumers. (shrink)

Recently, Anglo-American philosophy has become something of a scandal. The disturbing lack of women and minorities in the field, combined with revelations of institutional discrimination and sexual harassment in several departments of Philosophy, have placed philosophy in the national and international spotlight. Women, racial and ethnic minorities, and other under-represented groups in the discipline have created blogs, conferences, task forces, guides, and other sites to give voice to, and address the concerns of, the philosophically marginalized. It is this background that (...) gave rise to the formation of our panel on diversity at the 59th annual meeting of the Florida Philosophical Association. Our remarks here participate in a much larger, continuing conversation that we are inviting the reader to join. A list of resources for those interested in addressing philosophy’s “diversity problem” is attached at the end of the panel. (shrink)

Deep Brain Stimulation is currently being investigated as an experimental treatment for patients suffering from treatment-refractory AN, with an increasing number of case reports and small-scale trials published. Although still at an exploratory and experimental stage, initial results have been promising. Despite the risks associated with an invasive neurosurgical procedure and the long-term implantation of a foreign body, DBS has a number of advantageous features for patients with SE-AN. Stimulation can be fine-tuned to the specific needs of the particular patient, (...) is relatively reversible, and the technique also allows for the crucial issue of investigating and comparing the effects of different neural targets. However, at a time when DBS is emerging as a promising investigational treatment modality for AN, lesioning procedures in psychiatry are having a renaissance. Of concern it has been argued that the two kinds of interventions should instead be understood as rivaling, yet “mutually enriching paradigms” despite the fact that lesioning the brain is irreversible and there is no evidence base for an effective target in AN. We argue that lesioning procedures in AN are unethical at this stage of knowledge and seriously problematic for this patient group, for whom self-control is particularly central to wellbeing. They pose a greater risk of major harms that cannot justify ethical equipoise, despite the apparent superiority in reduced short term surgical harms and lower cost. (shrink)

In response to the COVID-19 pandemic, millions of students in China followed an emergency policy called “Suspending Classes without Stopping Learning” to continue their study online as schools across the country were closed. The present study examines how students adapted to learning online in these unprecedented circumstances. We aimed to explore the relationship between adaptability, academic emotion, and student engagement during COVID-19. 1,119 university students from 20 provinces participated in this longitudinal study (2 time points with a 2-week interval). The (...) results showed that adaptability (the ability to respond to changes) and student engagement are significantly positively correlated with positive academic emotion and negatively correlated with negative academic emotion. Furthermore, adaptability not only directly predicts student engagement, but also affects student engagement through the chain mediation of positive academic emotion and negative academic emotion. The results contribute to the gap in knowledge regarding changes in students’ learning in response to the outbreak. This study further explains the internal mechanisms mediating the relationship between adaptability and student engagement. It may provide references for educational researchers and universities in dampening the negative effects of COVID-19 on students’ learning by improving their adaptability and developing positive academic emotions. (shrink)

Within any organization (e.g. a hospital or clinic) the perception of the way things operate may vary dramatically as a function of one’s location in the organizational hierarchy as well as one’s professional discipline. Interorganizational variability depends on organizational coherence, safety, and stability. In this four-nation (Canada, Ireland, Australia, and Korea) qualitative study of 42 nurses, we explored their perception of how ethical decisions are made, the nurses’ hospital role, and the extent to which their voices were heard. These nurses (...) suggested that their voices were silenced (often voluntarily) or were not expressed in terms of ethical decision making. Finally, they perceived that their approach to ethical decision making differed from physicians. (shrink)