Intensive care nursing is prone to episodic anxiety linked to patients’ immediate needs for treatment. Balancing biomedical interventions with compassionate patient‐centred nursing can be particularly anxiety provoking. These patterns of anxiety may impact compassion and patient‐centred nursing. The aim of this paper is to discuss the application of Bowen Family Systems Theory to intensive care nursing, mapping a framework to support critical care nurses’ well‐being and, consequently, the quality of care they provide. This article is founded on research, theoretical papers (...) and texts focused on Bowen Family Systems Theory (BFST), and findings from a constructivist study on patient‐centred nursing and compassion in the intensive care unit. The goal of Bowen Family Systems Theory is to empower individuals, decreasing blame and reactivity. Bowen Family Systems Theory can be applied to the sometimes intimate relationships that develop in this environment, aiding understanding of nurses’ experience of compassion satisfaction and fatigue. Where organizational factors and management styles fall short in supporting critical care nurses to meet expectations, BFST can offer a perspective on the processes that occur within the intensive care unit, impacting nurse well‐being and quality of care. This paper makes plain the importance of understanding the anxiety that occurs within the intensive care unit as a system, so that individuals, such as critical care nurses, can be supported appropriately to ensure nurse well‐being and quality care. (shrink)

The primary purpose here is to ascertain what Heidegger's comportment toward East-West dialogue is most plausibly like in the light of his philosophical concerns and orientations. Considering that one should not uncritically take at face value occasional remarks by Heidegger that seem to suggest that he is preparing an East-West dialogue, we will proceed from Heidegger's own path of thinking and bring to light fundamental presuppositions in his thought and the response he may accordingly give to the issue of East-West (...) dialogue. (shrink)

As robots slip into more domains of human life - from the operating room to the bedroom - they take on our morally important tasks and decisions, as well as create new risks from psychological to physical. This book answers the urgent call to study their ethical, legal, and policy impacts.

Background Moral distress is a common challenge among professional nurses when caring for their patients, especially when they need to make rapid decisions. Therefore, leaving moral distress unconsidered may jeopardize patient quality of care, safety, and satisfaction. Aim To estimate moral distress among nurses. Methods This systematic review and meta-analysis conducted systematic search in Scopus, PubMed, ProQuest, ISI Web of Knowledge, and PsycInfo up to end of February 2022. Methodological quality of included studies was assessed using the Newcastle Ottawa checklist. (...) Data from included studies were pooled by meta-analysis with random effect model in STATA software version 14. The selected key measure was mean score of moral distress total score with its’ 95% Confidence Interval was reported. Subgroup analyses and meta-regressions were conducted to identify possible sources of heterogeneity and potentially influencing variables on moral distress. Funnel plots and Begg’s Tests were used to assess publication bias. The Jackknife method was used for sensitivity analysis. Ethical consideration The protocol of this project was registered in the PROSPERO database under decree code of CRD42021267773. Results Eighty-six manuscripts with 19,537 participants from 21 countries were included. The pooled estimated mean score of moral distress was 2.55 on a 0–10 scale [95% Confidence Interval: 2.27–2.84, I2: 98.4%, Tau2:0.94]. Publication bias and small study effect was ruled out. Moral distress significantly decreased in the COVID-19 pandemic versus before. Nurses working in developing countries experienced higher level of moral distress compared to their counterparts in developed countries. Nurses' workplace (e.g., hospital ward) was not linked to severity of moral disturbance. Conclusion The results of the study showed a low level of pooled estimated score for moral distress. Although the score of moral distress was not high, nurses working in developing countries reported higher levels of moral distress than those working in developed countries. Therefore, it is necessary that future studies focus on creating a supportive environment in hospitals and medical centers for nurses to reduce moral distress and improve healthcare. (shrink)

This paper presents the principal findings from a three-year research project funded by the US National Science Foundation on ethics of human enhancement technologies. To help untangle this ongoing debate, we have organized the discussion as a list of questions and answers, starting with background issues and moving to specific concerns, including: freedom & autonomy, health & safety, fairness & equity, societal disruption, and human dignity. Each question-and-answer pair is largely self-contained, allowing the reader to skip to those issues of (...) interest without affecting continuity. (shrink)

An accumulating amount of research has documented the harmful effects of abusive supervision on either its victims or third parties (peer abusive supervision). The abusive supervision literature, however, neglects to investigate the spillover effects of abusive supervision through third-party employees’ (i.e., peers’) mistreatment actions toward victims. Drawing on social learning theory, we argue that third parties learn mistreatment behaviors from abusive leaders and then themselves impose peer harassment and peer ostracism on victims, thereby negatively affecting victims’ performance. Further, we posit (...) that, if a victim has a proactive personality, this will weaken these indirect, negative effects. We conducted two studies, both with three-wave longitudinal data, to verify the hypotheses. The results of Study 1 evidence the significant indirect effects of abusive supervision on employee creative performance via both peer harassment and peer ostracism. Contrary to our moderation hypothesis, the analysis shows that victims’ proactive personality strengthens rather than weakens the negative indirect effects of peer harassment. Study 2 generally replicated the results of Study 1 with employee’s objective job performance as outcome. Our research contributes to the abusive supervision literature by highlighting a social learning process of third-party peer mistreatment, suggesting a spillover channel of abusive supervision on the victim’s performance. (shrink)

In contemporary analytic philosophy of art, the intentionalist debate is about whether the author’s intention is relevant to the interpretation of her work. Various positions have been proposed, and in this paper I defend what I call hypothetical author-hypothetical intentionalism, the position that interpretation is based on the intention attributed to the author constructed from the work. There are three aims to achieve: (1) to give a general account of hypothetical author-hypothetical intentionalism; (2) to present a moderate version of hypothetical (...) author-hypothetical intentionalism; (3) to defend the moderate version of hypothetical author-hypothetical intentionalism against actual intentionalism and actual author-hypothetical intentionalism. Against the current trend that focuses on actual authors, I hope to show that the hypothetical author account is still a sustainable contender in the intentionalist debate. (shrink)

The ideas of continental philosopher Martin Heidegger have been influential in cognitive science and artificial intelligence, despite the fact that there has been no effort to analyze these ideas empirically. The experiments reported here are designed to lend empirical support to Heidegger’s phenomenology and more specifically his description of the transition between ready-to-hand and unready-to-hand modes in interactions with tools. In experiment 1, we found that a smoothly coping cognitive system exhibits 1/fβ type positively correlated noise and that its correlated (...) character is reduced when the system is perturbed. This indicates that the participant and tool constitute a self-assembled, extended device during smooth coping and this device is disrupted by the perturbation. In experiment 2, we examine the re-organization of awareness that occurs when a smoothly coping, self-assembled, extended cognitive system is perturbed. We found that the disruption is accompanied by a change in attention which interferes with participants’ performance on a simultaneous cognitive task. Together these experiments show that a smoothly coping participant-tool system can be temporarily disrupted and that this disruption causes a change in the participant’s awareness. Since these two events follow as predictions from Heidegger’s work, our study offers evidence for the hypothesized transition from readiness-to-hand to unreadiness-to-hand. (shrink)

Nanoethics is a contentious field for several reasons. Some believe it should not be recognized as a proper area of study, because they believe that nanotechnology itself is not a true category but rather an amalgamation of other sciences, such as chemistry, physics, and engineering. Critics also allege that nanoethics does not raise any new issues but rather revisits familiar ones such as privacy. This paper answers such criticisms and sets the context for the papers that follow in this nanoethics (...) symposium. (shrink)

With complex buyer-driven global production networks and a labour-intensive manufacturing process, the fashion industry has become a focal point for debates on the social responsibility of business. Utilising an interview methodology with influential actors from seven export garment manufacturers in Sri Lanka, we explore the situated knowledge at one nodal point of the production network. We conceptualise factory management perspectives on the implementation of corporate social responsibility in terms of the strategic balancing of ethical considerations against the commercial pressures of (...) cost and lead time. Factory managers framed CSR in terms of compliance, rather than going above and beyond regulatory requirements; seeing it as a strategic competitive imperative and less a developmental mechanism. Sri Lankan manufacturers maintain that they have benefitted from a unique combination of factors, including strict national labour laws, an educated workforce, the characteristics of the garments produced, industrial upgrading, and long-term non-adversarial buyer–supplier relationships, which they argue has supported the establishment and maintenance of CSR practices. The paper thus provides managerial implications that relate CSR activities to CSR outcomes which include both reputational and production benefits. Such insights will be of strategic relevance for lead retail buyers as well as apparel producers keen to invest in CSR to partly mitigate against increasing price-based competition. (shrink)

As a presumed bastion of the Enlightenment values that support a critical intelligentsia, the university is often regarded as both the bedrock and beneficiary of liberal democracy. By contrast, authoritarian regimes are said to discourage higher education out of fear that the growth of a critical intelligentsia could imperil their survival. The case of China, past and present, challenges this conventional wisdom. Imperial China, the most enduring authoritarian political system in world history, thrived in large part precisely because of its (...) sponsorship of a form of higher education closely tied to state interests. Although twentieth-century revolutions brought fundamental change to Chinese politics and pedagogy, the contemporary party-state also actively promotes higher education, cultivating a mutually advantageous state-scholar nexus and thereby reducing the likelihood of intellectual-led opposition. As in the imperial past, authoritarian rule in China today is buttressed by a pattern of educated acquiescence, with academia acceding to political compliance in exchange for the many benefits conferred upon it by the state. The role of educated acquiescence in enabling Chinese authoritarianism highlights the contributions of a cooperative academy to authoritarian durability and raises questions with prevailing assumptions that associate the flourishing of higher education with liberal democracy. (shrink)

Resumo: Chuang Tzu (《庄子》), como um cânone tradicional chinês, foi traduzido para o inglês por mais de 100 anos, desde 1881, conquistando com sucesso um nicho no reino da literatura mundial, que se tornou um evento cultural devastador na academia de sinologia ultramarina e literatura mundial. Segundo as estatísticas, o livro foi traduzido em 12 traduções completas, 50 traduções selecionadas e duas adaptações. No processo de metamorfose da “tradução completa - tradução profunda - retradução diversificada”, passou por quatro fases, nomeadamente (...) fases religiosas, literárias, filosóficas e reinterpretações diversificadas. Assim, na perspectiva da visão de Damrosch a respeito da literatura mundial, o artigo resume as características de diferentes estágios, com base em diferentes contextos espaço-temporais. À luz da forma tradutória, dos resultados tradutórios e do modo de leitura tradutória, especifica-se o caminho pelo qual Chuang Tzu entrou no campo da literatura mundial, para apreender o mecanismo operacional de promoção da literatura nacional à literatura mundial, que se dedica ao esclarecimento para o trabalho prático de tradução da introdução da literatura chinesa no exterior. Enquanto isso, revisando a história das traduções inglesas de Chuang Tzu, o artigo resume as deficiências das atuais atividades de tradução e pesquisa, com a tentativa de fornecer sugestões construtivas, bem como apontar a direção para o desenvolvimento futuro de estudos de Chuang Tzu no exterior. (shrink)

Financial ties between physicians and pharmaceutical companies are pervasive and controversial. However, little is known about how patients perceive such ties. This paper describes an experiment examining how a national sample of U.S. adults perceived a variety of financial relationships between physicians and drug companies. Each respondent read a single scenario about a hypothetical physician and his financial ties to the pharmaceutical industry; scenarios varied in terms of payment type of and amount. Respondents then evaluated the physician on several dimensions (...) . Findings revealed that perceptions of the physician were more strongly influenced by payment type than by payment amount. Specifically, respondents were quite critical of doctors who owned drug company stock or received industry payments for meals and lodging, but were more forgiving of physicians who received free drug samples or consulting fees . Interestingly, physicians who received no payments, while seen as honest, were also viewed by some respondents as inexperienced or uninformed about new treatments. Implications for public policy and future research are discussed. (shrink)

This study examines the representations of human gene patents in Chinese newspapers. We conducted a qualitative content analysis of news articles published between 2006 and 2017 to identify the major themes in media coverage, ethical considerations, perceptions of risks and benefits, and attitudes towards the patentability of human genes. The results show that two key ethical concerns were expressed by journalists: that it is morally wrong to own or patent human genes and that gene patents could potentially impede patients’ access (...) to healthcare services. Nonetheless, the press coverage has tended to be largely favorable, rather than opposed to human gene patenting. There were no normative claims that human genes should not be patentable in China, which indicates a generally positive attitude towards patentability in media discourse. Most articles that expressed criticism toward gene patenting discussed challenges in other countries, with significant attention given to the United States Supreme Court’s ruling in the Myriad case that invalidated Myriad Genetics’ patents on the BRCA1 and BRCA2 genes. Overall, the newspapers were uncritical of the Chinese gene patenting regime. News reporting on the issue was highly suggestive of a strong pro-commercialization stance, although some discussions emphasized potential risks over benefits. Our analysis highlights the need for balanced media reporting on human gene patents in China and a top-down approach to engage the public in substantive discussions on the ethical and societal implications of the existing patent regime. (shrink)

Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart from (...) decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (shrink)

EDITOR’S ABSTRACTThis article argues that Shang Yang’s philosophy of law was not only a means to enrich the state and strengthen its army, but also envisioned the orderly rule of all All-under-Heaven. Through a fair, universal, and reliable use of rewards, punishments, and also teaching, this vision of laws could ultimately lead to the promotion of moral values, popular consensus, and people’s self-governance. While the authors admit that in Shang Yang’s own historical context, law was no more than a tool (...) used by the ruler to suppress his people, potentially his ideas could contribute to a future Chinese society fully ruled by law and morality, and inspired by the rule of law. (shrink)

My interest in China was rekindled several years ago by an invitation to a conference, "Modernization, Globalization and China's Path to Economic Development," to he held in Hangzhou, July, 2002. The conference was organized by Cao Tian Yu, a philosopher of science at Boston University and his wife Lin Chun of the London School of Economics--both deeply concerned about the future of China. It was attended by a number of Western Leftists (Samir Amin, Perry Anderson, Robin Blackburn and myself), (...) by China specialist Joseph Fewsmith, by representatives from Singapore, Taiwan and India, by representatives from China's developing "New Left," (among them Wang Hui, whose book China's New Order was recently published by Harvard University Press1), by the president of Hangzhou College of Commerce (where the event was held) and by three retired, once prominent government officials, among them Du Runsheng, a principal architect of China's agricultural reform of the late 70s, early 80s. (shrink)

Trading on non-public material information is fertile ground for a discussion of ethical behavior. The long-running legal tug-of-war over what constitutes illegal insider trading delivers challenges to regulatory authorities charged with detecting and enforcing the law, and is likely one of the reasons that prosecution of insider trading events remains rather uncommon. One can observe both increased volume in the equity and option markets and run-ups in the stock price prior to the announcement of the acquisitions; however, the detection of (...) illegal or unethical insider trading can be difficult. Given the legal uncertainty around insider trading and the circumstantial evidence from the trading activity, it is almost impossible to identify unethical insider trades unless there is a whistleblower or trades are large in size and impeccable in timing. Using call option trading around two merger announcements with similar firms that resulted in different ultimate treatment from the SEC, we illustrate the struggle regulators and prosecutors have with identifying and enforcing unethical insider trades. (shrink)

The complex mechanisms by which nonlinear classical conservative systems undergo a transition from quasiperiodic to chaotic behavior are now fairly well understood. This transition is associated with a breakdown of quasi-constants of motion (KAM surfaces). There is growing evidence that similar mechanisms may govern the behavior of quantum systems. While K-type mixing behavior has not yet been found, there does appear to be a transition associated with the destruction of a quantum quasi-constant of motion (quantum KAM states) which changes qualitatively (...) the spectrum of quantum systems. (shrink)

Background This study used a scenario- and discussion-based approach to teach preclinical medical students the socio-philosophical aspects of psychiatry and qualitatively evaluated the learning outcomes in a medical humanities course in Taiwan. Methods The seminar session focused on three hypothetical psychiatry cases. Students discussed the cases in groups and were guided by facilitators from multiple disciplines and professions. At the end of the semester, students submitted a narrative report comprising their reflections on the cases and discussions. The authors utilized content (...) analysis to categorize students’ narratives into three facets, namely, the philosophical, social and individual. Results In total 163 preclinical medical students participated in the class; 150 of them mentioned the scenario-based lesson in their reports; 33.3% of these reports discussed the case at the philosophical dimension (n = 50), 45.3% at the social dimension (n = 68), and 26.6% at the individual dimension (n = 40). Four major themes emerged: (1) a psychiatric diagnosis has far-reaching consequences for an individual’s life, (2) the social structure affects how patients experience psychiatric disorders, (3) students related personal experience or those of friends and family to understand psychiatric disorders, and (4) medical humanities are of particular importance in psychiatric education. Conclusions This study demonstrated that the scenario-based discussions led by a multidisciplinary team of facilitators can benefit medical students with limited clinical experience to contemplate the socio-philosophical aspects of psychiatry. The authors suggest that this pedagogical model during preclinical education should be encouraged. (shrink)