David Miller argues that national identity is indispensable for the successful functioning of a liberal democracy. National identity makes important contributions to liberal democratic institutions, including creating incentives for the fulfilment of civic duties, facilitating deliberative democracy, and consolidating representative democracy. Thus, a shared identity is indispensable for liberal democracy and grounds a good claim for self-determination. Because Miller’s arguments appeal to the instrumental values of a national culture, I call his argument ‘instrumental value’ arguments. In this paper, I examine (...) the instrumental value arguments and show that they fail to justify a group’s right to self-determination. (shrink)

In this paper, I propose a new self-defense theory of punishment, the rights-protection theory. By appealing to the interest theory of right, I show that what we call “the right of self-defense” is actually composed of the right to protect our basic rights. The right of self-defense is not a single, self-standing right but a group of derivative rights justified by their contribution to the protection of the core, basic rights. Thus, these rights of self-defense are both justified and constrained (...) by the basic rights they are supposed to protect. I then explain how this theory responds to a common objection. Opponents argue that, to exercise the right of self-defense, some threat must be present. However, in the context of punishment, the threat has already taken effect or is already gone. Thus, the right of self-defense becomes irrelevant when we punish an offender. I show that this objection is based on an implausibly narrow conception of self-defense. A reasonable conception would allow us to exercise our right of self-defense when there is a present definite threat, a future definite threat, or a potential threat. Thus, we may still exercise our right of self-defense in the context of punishment. (shrink)

In this chapter, I consider contemporary consequentialist theories of punishment. Consequentialist theories of punishment look to the consequences of punishment to justify the institution of punishment. Two types of theories fall into this category—teleology and aggregationism. I argue that teleology is implausible as it is based on a problematic assumption about the fundamental value of criminal punishment, and that aggregationism provides a more reasonable alternative. Aggregationism holds that punishment is morally justified because it is an institution that helps society to (...) aggregate important moral values. Several theories fall into this category, including general deterrence theories, specific deterrence theories, and preventionism. I critically evaluate these theories and argue that only one specific deterrence theory, namely, my rights-protection theory, provides the most reasonable consequentialist account of punishment. (shrink)

A number of philosophers argue that the moral value of national identity is sufficient to justify at least a prima facie right of a national community to create its own independent, sovereign state. In the literature, this argument is commonly referred to as the identity argument. In this paper, I consider whether the identity argument successfully proves that a national group is entitled to a state of its own. To do so, I first explain three important steps in the argument (...) and then consider whether they lead to the desired conclusion. My examination reveals that the identity argument relies on the Optimal Protection Principle; however, this principle does not apply to the case of a national community. As a result, the identity argument fails to justify even a prima facie right of a national community to establish its own state. (shrink)

Allen Buchanan proposes a methodological framework with which theorists may evaluate different theories of secession, including the National Self-Determination theory. An important claim he makes is, because the right to secede is inherently institutional, any adequate theory of secession must include, as an integral part, an analysis of institutional morality. Because the National Self-Determination theory blatantly lacks such an analysis, Buchanan concludes that this theory is inherently flawed. In this paper, I consider Buchanan’s framework and the responses from supporters of (...) national self-determination theory. I try to clarify the confusion shared by both parties. I conclude that, although Buchanan’s theory of institutional morality is sound, his critiques of the national self-determination theory fails. (shrink)

Both Kymlicka and Patten argue that the equal treatment of different national groups require that the state officially recognize the right of each to create its own autonomous government. After carefully examining their arguments, I show that they both make the false assumption that, in a multinational state, the state belongs only to the majority group but not the minority, and that a multination state can never treat minority groups equally. Both claims are inherently anti-pluralistic. Thus, the equal treatment of (...) different national cultures does not require that each be granted the right to self-government. (shrink)

The principle of national self-determination holds that a national community, simply by virtue of being a national community, has a prima facie right to create its own sovereign state. While many support this principle, not as many agree that it should be formally recognized by political institutions. One of the main concerns is that implementing this principle may lead to certain types of inequalities—between nations with and without their own states, members inside and outside the border, and members and nonmembers (...) inside the same nation state. While these inequalities may arise, I shall argue that they are not unjust. These worries are partly the results of confusing two types of interests that a national group may have—in cultural affairs and in political affairs. While a national community should enjoy rights over their cultural affairs, this does not grant them authority over other non-cultural, political affairs. Once the distinction is drawn, we can see that there are constraints on the implementation of this principle. Consequently, these inequalities justify setting limits to a group’s right of self-government, although they do not conclusively refute the right itself. (shrink)

In this chapter, Lee considers contemporary consequentialist theories of punishment. Consequentialist theories look to the consequences of punishment to justify the institution of punishment. Two types of theories fall into this category—teleology and aggregationism. Lee argues that teleology is implausible because it is based on a problematic assumption about the fundamental value of criminal punishment. Aggregationism is a more reasonable alternative. It holds that punishment is morally justified because it is an institution that helps society to aggregate important moral values. (...) Several theories fall into this category, including general deterrence theories, specific deterrence theories, and preventionism. Lee critically evaluates these theories and argues that only one specific deterrence theory, namely, her rights-protection theory, provides the most reasonable consequentialist account of punishment. (shrink)

National identity and attachment to national culture have taken root even in this era of globalization. National sentiments find expression in multiple political spheres and cause troubles of various kinds in many societies, both domestically and across state borders. Some of these problems are rooted in history; others are the result of massive global immigration. As US Secretary of State John Kerry tries to broker a new round of Israel-Palestine peace talks, the Israeli government continues expanding its settlements in disputed (...) territories. As this proposal is being written, Japanese citizens are debating whether their politicians should visit the Yasukuni Shrine (靖國神社), where the spirits of fourteen Class A war criminals from WWII and more than one thousand others convicted of war crimes by the International Military Tribunal for the Far East are honored with a distinguished resting place. As the Chinese government’s plan to bring economic prosperity to the Xinjian province unfolds, ethnic conflicts between Han Chinese and local Uyghur Muslims intensify. Tibetans still demonstrate to the Chinese government, some through the dramatic sacrifice of self-immolation, their determination to pursue a Tibet that is truly free and autonomous. The recent inflow of Muslim immigrants across Europa and North America forces those liberal democratic societies to rethink the meaning of multiculturalism. Should the state respect Muslim women’s freedom to wear burkas in public? What about other aspects of certain Muslim traditions such as arranged marriages or the honor killing of teenage girls who see boys their parents do not approve? Since these immigrants voluntarily moved from their homeland to a new society, do they have a duty to give up such practices, which conflict with their new societies’ fundamental commitment to individual autonomy? Eric Hobsbawm suggests that nationalism is a contingent phenomenon in history—it arises with important historical events such as industrialization and print journalism; eventually, it will disappear. Anthony Smith, on the other hand, argues that nationalism is deeply rooted in the human need for collective faith and dignity. How should we understand today’s nationalism? Is it a transient phenomenon that eventually will be eradicated from the world, or is it a timeless issue that confronts and will remain a challenge for every society? Is the conventional distinction between civic and cultural nationalism still relevant or helpful? The problems and ongoing challenges of nationalism are very much alive throughout East Asia where the myth of ethnically and culturally homogeneous nations is still paramount. In addition to the examples provided above, East Asian societies are increasingly multicultural, inevitably forcing their governments to come up with new immigration and border-control policies, revisit their laws regarding labor policies, sociopolitical discrimination, socioeconomic welfare, and, more fundamentally, rethink the constitutional make-up of the citizenry and the ideal of social harmony, one of their most cherished political values. Nevertheless, contemporary theoretical analyses, whether philosophical or empirical, of the phenomena surrounding nationalism, in all its forms, are almost exclusively focused on cases in western cultures and societies, preventing the East Asian people from developing a coherent idea of who they are or should be in a way that can track their deeply-held values and norms (such as Confucianism). One of the primary aims of this conference therefore is to address this ongoing neglect and explore new concepts and theories that are socially relevant in East Asia. Not only will this provide access to the particular experiences of nation, citizenship, and nationalism throughout East Asia but it will bring to bear philosophical concepts, approaches, and styles of reasoning about them that currently are not part of this critical debate. Providing an opportunity to hear these distinct and different East Asian voices and opening up these conceptual and methodological resources to scholars around the world will greatly advance the understanding and appreciation of nationalism. In addition to this primary aim, the proposed conference will achieve two other, novel, and important goals. First, by design, it will bring to bear a multi and interdisciplinary approach to the problems of nationalism. We are not privileging either conceptual or empirical studies in the organization of our conference and will bring together philosophers, political scientists, sociologists, and historians, making every effort to invite scholars who explicitly employ or are interested in exploring different and at times hybrid approaches. Second, we will draw together scholars from around the world: China, South Korea, Japan, Taiwan, North America, and Europe, including leading figures in the field, who will serve as keynote speakers for the conference. Combining these two additional goals will enable us to organize a uniquely diverse conference, both in terms of intellectual discipline and national origin. Along with our primary aim of introducing East Asian voices and theories, this will make our event original, distinctive, and unprecedented in value. Our age is one in which it is unavoidable for people of different cultural backgrounds to live together in many different places. For the sake of justice and stability, a comprehensive re-examination of nationalism is both urgent and necessary. (shrink)

Although national identity is valuable in a variety of ways, I argue that its value is not sufficient to justify a group’s right to govern itself, either in the form of an independent, sovereign state or an autonomous, sub-state government. My thesis is somewhat unusual—most philosophers who affirm the value of national identity also endorse the right of a national community to some form of self-government, and most philosophers who deny that a national community has the right to any form (...) of self-government also deny the value of national identity. (shrink)

A deterrence theory of punishment holds that the institution of criminal punishment is morally justified because it serves to deter crime. Because the fear of external sanction is an important incentive in crime deterrence, the deterrence theory is often associated with the idea of severe, disproportionate punishment. An objection to this theory holds that hope of escape renders even the severest punishment inapt and irrelevant. -/- This article revisits the concept of deterrence and defend a more plausible deterrence theory of (...) punishment—the wide-scope deterrence theory. The wide-scope theory holds that we must make the best use of all the deterrence tools available, including both external and internal sanctions. Drawing on insights from the early Confucian tradition, the article develops a deep deterrence theory, which holds that the most important deterrence tool involves internal, not external, sanction. It describes how internal sanctions deter potential offenses and why relevant policies need not conflict with liberalism’s respect for neutrality. (shrink)

While univariate functional magnetic resonance imaging data analysis methods have been utilized successfully to map brain areas associated with cognitive and emotional functions during viewing of naturalistic stimuli such as movies, multivariate methods might provide the means to study how brain structures act in concert as networks during free viewing of movie clips. Here, to achieve this, we generalized the partial least squares analysis, based on correlations between voxels, experimental conditions, and behavioral measures, to identify large-scale neuronal networks activated during (...) the first time and repeated watching of three ∼5-min comedy clips. We identified networks that were similarly activated across subjects during free viewing of the movies, including the ones associated with self-rated experienced humorousness that were composed of the frontal, parietal, and temporal areas acting in concert. In conclusion, the PLS method seems to be well suited for the joint analysis of multi-subject neuroimaging and behavioral data to quantify a functionally relevant brain network activity without the need for explicit temporal models. (shrink)

To contribute to the debate on the role of social media in responsible business, this article explores blogger buzz in reaction to food companies’ press releases on health and obesity issues, considering the content and the level of fit between the CSR initiatives and the company. Findings show that companies issued more product-related initiatives than promotion-related ones. Among these, less than half generated a substantial number of responses from bloggers, which could not be identified as a specific group. While new (...) product introductions led to positive buzz, modifications of current products resulted in more negative responses, even if there was a high fit with core business. While promotion-related press releases were received negatively in general, particularly periphery promotion generated most reactions. Our exploratory study suggests that companies can increase the likelihood of a positive reaction if they carefully consider the fit between initiatives and their core business, while taking the notion of ‘controversial fit’, relating to the unhealthy nature of original products, into account. Further research avenues and implications, as well as limitations, are discussed. (shrink)

To understand the impact of social, financial, cultural capitals, negative culture, and socioeconomic status of families on educational aspiration in the senior high school student athletes, it will be beneficial to promote their career developments. The purpose of this study is to explore the influence of ethnicity, year of sport experience family income, the educational expectations of significant others, and the three aforementioned types of capital on educational aspiration among the senior high school student athletes. This study was conducted with (...) a sample of 262 U-18 male baseball student athletes. Of the participants, 20.20% had attained the qualifications to play on the national team. The results showed that monthly family income positively affected social capital and positively indirectly affected educational aspirations through social capital, whereas monthly family income negatively affected negative culture and positively affected educational aspirations through negative culture. Moreover, social capital positively affected educational aspirations compared with negative culture negatively affected educational aspirations. The results serve as a reference for the formulation of educational policy as it relates to student athletes. (shrink)

Piracy is the greatest threat facing the music industry worldwide today. This study developed and empirically tested a model examining the antecedents of consumer attitude and behavioral intention toward music piracy behavior. Two types of music piracy behavior, unauthorized duplication/download and pirated music product purchasing, were examined. Based on a field survey in Taiwan, the results showed that attributive satisfaction, perceived prosecution risk, magnitude of consequence, and social consensus are very important in influencing customers attitude and behavioral intention toward two (...) types of music piracy behavior. In addition, singer/band idolization can affect the attitude and behavioral intention in the case of pirated music product purchasing. Perceived proximity was found to affect the attitude and behavioral intention in the case of pirated music product purchasing. However, it only influenced behavioral intention in the case of unauthorized duplication/download. (shrink)

Publication date: 30 November 2016 Source: Author: Wen Lee Ng, Manimangai Mani, Wan Roselezam Wan Yahya While the growing body of research on Tan Twan Eng’s The Gift of Rain focuses on the protagonist, Philip Hutton’s traumatic condition, his Chinese identity, and his ambiguous identity, this study devotes particular attention to the complexity of interactions between various cultures practised by Philip. This study aims to address this gap by applying the concept of transculturalism to analyse the processes of acquiring a (...) foreign culture and incorporating the foreign culture into traditional cultures experienced by Philip. In other words, this study employs the concept of transculturalism to examine multicultural depictions in the novel. Scholars, such as Khan, Tiwari, Sheoran and Tan C. S. who have examined multicultural depictions in various literary texts, have found that multicultural circumstances cause certain ethnic groups to lose their cultures and identities. Hence, the multicultural circumstances depicted are perceived as negative phenomena. However, this study has found that by examining the interactions between various cultures, rather than focusing on the end products such as portrayals of hybridity, the positive sides of multicultural depictions could be revealed. The transculturation process experienced by Philip shows that the new cultural practices he has created are made up of both his traditional cultures and the foreign culture he has acquired. This means that Philip does not totally lose his traditional cultures and identities. Therefore, this study concludes that multicultural depictions in The Gift of Rain could be read positively, provided that the interactions between various cultures, which resulted in the incorporation of a foreign culture into traditional cultures, are examined. (shrink)

Recent studies of the rubber hand illusion (RHI) have shown that the sense of body ownership is constrained by several factors and yet is still very flexible. However, exactly how flexible is our sense of body ownership? In this study, we address this issue by investigating the following question: is it possible that one may have the illusory experience of owning four hands? Under visual manipulation, the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own. Sitting (...) face to face, the participant saw four hands—the experimenter’s two hands from the adopted 1PP together with the subject’s own two hands from the adopted third-person perspective (3PP). We found that: (1) the four-hand illusion did not occur in the passive four-hand condition. (2) In the active four-hand condition, the participants tapped their index fingers, imitated by the experimenter. When tactile stimulations were not provided, the key illusion was not induced, either. (3) Strikingly, once all four hands began to act with the same pattern and received synchronous tactile stimulations at the same time, many participants felt as if they had two more hands. These results show that the sense of body ownership is much more flexible than most researchers have suggested. (shrink)

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social (...) issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. (shrink)

The study of illiberal constitutions has recently generated enormous scholarly interests. Few, however, have focused on whether democracies may still embrace constitutionalism mixed with illiberal elements. This article explores mixed constitutions of South Korea and Taiwan, the two democracies with vibrant civil societies in East Asia. Three distinctive features in both constitutions have demonstrated illiberal elements, including duty clauses imposed upon citizens, directives requiring the State to enact laws to fulfill the goals of governance, and constitutional cultures that exhibit high (...) deference to political elites based on the Confucian tradition. This article further examines the impacts of such mixed constitutions on three challenging issues: managing pandemic crisis, applying artificial intelligence, and combating fake news. This article finds mixed features of illiberal and democratic constitutions in the two countries by giving their governments more space in managing urgent crises, showing higher deference to experts who are generally trusted by the public, and making compromises to individual rights for greater public good. However, this does not imply that the government is not made democratically accountable, or rights and freedoms are not asserted or valued by individuals. To the contrary, nongovernmental organizations and courts in the two countries continue to act as a counterbalancing force, challenging the government’s policies and decisions if not reasonably balanced, weakening the tendency of power concentration that has been seen in other countries where democratic backsliding or authoritarian governance is gradually revived. (shrink)

Abstractp53 is a multifunctional protein which plays a role in modulating gene transcription, policing cell cycle checkpoints, activating apoptosis, controlling DNA replication and repair, maintaining genomic stability and responding to genetic insults. Mutation of the p53 gene confers the single greatest known selective advantage favoring cancer formation. Point mutations result not only in the loss of tumor suppressor functions, but also in the gain of tumor promotion functions. These dual circumstances may be unique to p53 and, in part, could explain (...) the relatively powerful force behind this selection pressure. General mechanisms of gain of function by mutated p53 may include alteration in transcriptional modulation and newly acquired targets for transcriptional regulation and protein binding. Despite the direct significance of p53 mutations, loss of the remaining wild‐type allele is usually required for the formation of tumors in the natural setting. Novel applications of the basic scientific knowledge of p53 could lead to an improvement in cancer treatment, hopefully in the not so distant future. (shrink)

Branching morphogenesis of epithelia is an important mechanism in mammalian development. The last decade has seen the identification of many signalling pathways and intracellular mechanisms that control epithelial branching. Tissue‐level mechanisms that space new branches out have, however, remained an unsolved problem. A recent publication by Nelson et al.1 suggests—if extrapolation from their novel and abstract culture system is valid—that branches may be spaced out by a system of mutual inhibition based on diffusion of TGFβ. Such a system would allow (...) a developing tree to arrange itself, without detailed genetic specification, by adaptive self‐organization. BioEssays 29: 205–207, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Product counterfeiting, a serious problem throughout the world, is particularly challenging for luxury brands, which often have simple designs and a value that depends largely on buyers' perceptions. This study incorporates the concept of customer value into an investigation of the anticounterfeiting strategies. Both hedonic and utilitarian values positively influence customer loyalty toward luxury brands. As a means to strengthen customer values, legal and product strategies positively influence customers' hedonic value, whereas communication and product strategies positively influence their utilitarian value. (...) The managerial implications of these findings and directions for further research are discussed. (shrink)

This study examines the effects of leader emotional intelligence, leadership styles, organizational commitment, and trust on job performance. A questionnaire was administered to the participants, who were real estate brokers in Kaohsiung City. Of the 980 questionnaires administered, 348 valid responses were received, indicating an effective response rate of 35.5%. Structural equation modeling was used for the analysis. The results show that leader emotional intelligence has a significant and positive effect on trust in supervisors, and transformational leadership and trust within (...) a team have significant and positive effects on job performance. In addition, organizational commitment has a significant and positive effect on job performance. Trust within a team mediates the significant and positive effect of leader emotional intelligence on job performance. Although transactional leadership has no direct, positive, and significant effects on employee job performance, trust in the workplace shaped by a leader’s leadership style will empower a team’s spirit and boost their morale, thereby indirectly affecting their job performance in a positive manner. (shrink)

Body ownership concerns what it is like to feel a body part or a full body as mine, and has become a prominent area of study. We propose that there is a closely related type of bodily self-consciousness largely neglected by researchers—experiential ownership. It refers to the sense that I am the one who is having a conscious experience. Are body ownership and experiential ownership actually the same phenomenon or are they genuinely different? In our experiments, the participant watched a (...) rubber hand or someone else’s body from the first-person perspective and was touched either synchronously or asynchronously. The main findings: (1) The sense of body ownership was hindered in the asynchronous conditions of both the body-part and the full-body experiments. However, a strong sense of experiential ownership was observed in those conditions. (2) We found the opposite when the participants’ responses were measured after tactile stimulations had ceased for 5 s. In the synchronous conditions of another set of body-part and full-body experiments, only experiential ownership was blocked but not body ownership. These results demonstrate for the first time the double dissociation between body ownership and experiential ownership. Experiential ownership is indeed a distinct type of bodily self-consciousness. (shrink)

ABSTRACTDeception has been reported to be influenced by task-relevant emotional information from an external stimulus. However, it remains unclear how task-irrelevant emotional information would influence deception. In the present study, facial expressions of different valence and emotion intensity were presented to participants, where they were asked to make either truthful or deceptive gender judgments according to the preceding cues. We observed the influence of facial expression intensity upon individuals’ cognitive cost of deceiving. Larger cost was observed for high intensity faces (...) compared to low intensity faces. These results provided insights on how automatic attraction of attention evoked by task-irrelevant emotional information in facial expressions influenced individuals’ cognitive cost of deceiving. (shrink)

This study proposed and examined a conceptual framework on the influence of real estate brokers’ personalities, psychological empowerment, social capital, and knowledge sharing on their innovation performance, and used moral hazard as a moderating variable. We used structural equation modeling for data analysis and estimation. The participants were real estate brokers in Kaohsiung City. A total of 1,000 questionnaires were administered to 100 branch offices of real estate companies, 571 of which were later recovered from 80 branch offices. After removing (...) 52 for being invalid, we were left with 519 valid questionnaires, indicating a 51.9% recovery rate. The empirical results suggest that the real estate brokers’ personalities and psychological empowerment positively and significantly influence social capital; personality and psychological empowerment also positively and significantly influence their innovation performance; and social capital significantly influences knowledge sharing, which in turn positively and significantly influences the brokers’ innovation performance. In environments with higher levels of moral hazard, the influence of social capital on the brokers’ knowledge sharing is significantly diminished. (shrink)

Background Adherence to ethical guidelines and regulations and protecting and respecting the dignity and autonomy of participants by obtaining a valid informed consent form (ICF) prior to participation in research are crucial; The subjects did not add signatures next to the corrections made to signatures or dates on the ICF, Multiple signatures in other fields, ICF missing/missing signature, Incorrect ICF version Signed after modification, Correction tape used to correct signature, Impersonated signature, Non-research-member signature, however, ICFs are often not properly completed, (...) which must be addressed. This study analyzed ICF signing errors and implemented measures to reduce or prevent these errors. Methods We used the plan–do–check–act (PDCA) cycle to help improve the correctness and validity of ICF signing. Results Interim and final reports from January 2016 to February 2020 including 363 ICFs were studied. The total proportion of correct ICF signatures (200, 83.3%) following the PDCA intervention was significantly higher than that before the intervention (P < 0.05). Analysis of the types of signing error demonstrated that signature errors were significantly reduced after the intervention, particularly for subjects did not add signatures next to the corrections made to signatures or dates on the ICF (16, 6.7%) and impersonated signature (0; P < 0.05). Conclusions The proportions of other error types—multiple signatures in other fields, missing or unsigned ICF, incorrect signature order, incorrect ICF version, use of correction tape to correct signature, and non-medical profession members signing the ICF—did not differ significantly. (shrink)

Self-location—the sense of where I am in space—provides an experiential anchor for one's interaction with the environment. In the studies of full-body illusions, many researchers have defined self-location solely in terms of body-location—the subjective feeling of where my body is. Although this view is useful, there is an issue regarding whether it can fully accommodate the role of 1PP-location—the sense of where my first-person perspective is located in space. In this study, we investigate self-location by comparing body-location and 1PP-location: using (...) a head-mounted display (HMD) and a stereo camera, the subjects watched their own body standing in front of them and received tactile stimulations. We manipulated their senses of body-location and 1PP-location in three different conditions: the participants standing still (Basic condition), asking them to move forward (Walking condition), and swiftly moving the stereo camera away from their body (Visual condition). In the Walking condition, the participants watched their body moving away from their 1PP. In the Visual condition, the scene seen via the HMD was systematically receding. Our data show that, under different manipulations of movement, the spatial unity between 1PP-location and body-location can be temporarily interrupted. Interestingly, we also observed a “double-body effect.” We further suggest that it is better to consider body-location and 1PP-location as interrelated but distinct factors that jointly support the sense of self-location. (shrink)

In a recent study (Chen et al., 2018), we conducted a series of experiments that induced the “four-hand illusion”: using a head-mounted display (HMD), the participant adopted the experimenter’s first-person perspective (1PP) as if it was his/her own 1PP. The participant saw four hands via the HMD: the experimenter’s two hands from the adopted 1PP and the subject’s own two hands from the adopted third-person perspective (3PP). In the active four-hand condition, the participant tapped his/her index fingers, imitated by the (...) experimenter. Once all four hands acted synchronously and received synchronous tactile stimulations at the same time, many participants felt as if they owned two more hands. In this paper, we argue that there is a philosophical implication of this novel illusion. According to Merleau-Ponty (1945/1962) and Legrand (2010), one can experience one’s own body or body-part either as-object or as-subject but cannot experience it as both simultaneously, i.e., these two experiences are mutually exclusive. Call this view the Experiential Exclusion Thesis. We contend that a key component of the four-hand illusion—the subjective experience of the 1PP-hands that involved both “kinesthetic sense of movement” and “visual sense of movement” (the movement that the participant sees via the HMD)—provides an important counter-example against this thesis. We argue that it is possible for a healthy subject to experience the same body-part both as-subject and as-object simultaneously. Our goal is not to annihilate the distinction between body-as-object and body-as-subject, but to show that it is not as rigid as suggested by the phenomenologists. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

We investigate two issues about the subjective experience of one's body: first, is the experience of owning a full-body fundamentally different from the experience of owning a body-part?Second, when I experience a bodily sensation, does it guarantee that I cannot be wrong about whether it is me who feels it? To address these issues, we conducted a series of experiments that combined the rubber hand illusion (RHI) and the “body swap illusion.” The subject wore a head mounted display (HMD) connected (...) with a stereo camera set on the experimenter's head. Sitting face to face, they used their right hand holding a paintbrush to brush each other's left hand. Through the HMD, the subject adopted the experimenter's first-person perspective (1PP) as if it was his/her own 1PP: the subject watched either the experimenter's hand from the adopted 1PP, and/or the subject's own hand from the adopted third-person perspective (3PP) in the opposite direction (180°), or the subject's full body from the adopted 3PP (180°, with or without face). The synchronous full-body conditions generate a “self-touching illusion”: many participants felt that “I was brushing my own hand!” We found that (1) the sense of body-part ownership and the sense of full-body ownership are not fundamentally different from each other; and (2) our data present a strong case against the mainstream philosophical view called the immunity principle (IEM). We argue that it is possible for misrepresentation to occur in the subject's sense of “experiential ownership” (the sense that I am the one who is having this bodily experience). We discuss these findings and conclude that not only the sense of body ownership but also the sense of experiential ownership call for further interdisciplinary studies. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)