This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and (...) quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues. (shrink)

ABSTRACT Objective: To contrast relief efforts for the 26 December 2004 tsunami with current global HIV/aids relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Results: Just over 273,000 people died in the tsunami, resulting in relief efforts of more than US$10 bn, which is sufficient to achieve the United Nation’s long‐term recovery plan for South East Asia. In contrast, 14 times more people died from HIV/aids in 2004, with UNAIDS predicting a US$8 bn (...) funding gap for HIV/aids in developing nations between now and 2007. This disparity raises two important ethical questions. First, what is it that motivates a more empathic response to the victims of the tsunami than to those affected by HIV/AIDS? Second, is there a morally relevant difference between the two tragedies that justifies the difference in the international response? The principle of justice requires that two cases similarly situated be treated similarly. For the difference in the international response to the tsunami and HIV/aids to be justified, the tragedies have to be shown to be dissimilar in some relevant respect. Are the tragedies of the tsunami disaster and the HIV/aids pandemic sufficiently different, in relevant respects, to justify the difference in scope of the response by the international community? Conclusion: We detected no morally relevant distinction between the tsunami and the HIV/aids pandemic that justifies the disparity. Therefore, we must conclude that the international response to HIV/aids violates the fundamental principles of justice and fairness. (shrink)

This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical (...) ethics consultants can draw methods and strategies for effectively delivering ethics consultation. (shrink)

Health care providers’ interpretation of law can have intended and unintended effects on health care delivery in Canada. At times, health care providers encounter situations where they perceive the law to conflict with their sense of what is most ethically justified. In many cases, these health care providers feel especially torn because they assume that the legal requirements must dictate the decision, and cannot be explored or questioned. We challenge this assumption: the law is not as cut-and-dried as some assume; (...) therefore, its significance to health care decisions should be carefully considered. Within a systematic ethics process, legal considerations can be a source of values and information and can create opportunities for further dialogue. This approach is justified because it appropriately reflects the relationship of the law to ethics. This way of thinking about the law and ethics also avoids potentially harmful consequences of legalistic approaches to decision-making, such as breakdowns in communication, adversarial relationships, and a reduction of ethically complex decisions to simple rule following. (shrink)

It is urgent that we address the causes and harmful effects of racism in health care. We propose that building diversity competence in the way we deliver health care services is key to this effort....

Ranging from miniaturized biological robots to organoids, multi-cellular engineered living systems (M-CELS) pose complex ethical and societal challenges. Some of these challenges, such as how to best distribute risks and benefits, are likely to arise in the development of any new technology. Other challenges arise specifically because of the particular characteristics of M-CELS. For example, as an engineered living system becomes increasingly complex, it may provoke societal debate about its moral considerability, perhaps necessitating protection from harm or recognition of positive (...) moral and legal rights, particularly if derived from cells of human origin. The use of emergence-based principles in M-CELS development may also create unique challenges, making the technology difficult to fully control or predict in the laboratory as well as in applied medical or environmental settings. In response to these challenges, we argue that the M-CELS community has an obligation to systematically address the ethical and societal aspects of research and to seek input from and accountability to a broad range of stakeholders and publics. As a newly developing field, M-CELS has a significant opportunity to integrate ethically responsible norms and standards into its research and development practices from the start. With the aim of seizing this opportunity, we identify two general kinds of salient ethical issues arising from M-CELS research, and then present a set of commitments to and strategies for addressing these issues. If adopted, these commitments and strategies would help define M-CELS as not only an innovative field, but also as a model for responsible research and engineering. (shrink)

In Computer Science stepwise refinement of algebraic specifications is a well-known formal methodology for rigorous program development. This paper illustrates how techniques from Algebraic Logic, in particular that of interpretation, understood as a multifunction that preserves and reflects logical consequence, capture a number of relevant transformations in the context of software design, reuse, and adaptation, difficult to deal with in classical approaches. Examples include data encapsulation and the decomposition of operations into atomic transactions. But if interpretations open such a new (...) research avenue in program refinement, (conceptual) tools are needed to reason about them. In this line, the paper’s main contribution is a study of the correspondence between logical interpretations and morphisms of a particular kind of coalgebras. This opens way to the use of coalgebraic constructions, such as simulation and bisimulation, in the study of interpretations between (abstract) logics. (shrink)

The study aimed at measuring the dominant pattern of leadership and its relation to the performance of the administrative staff in the Palestinian universities. The study community consists of all the administrative staff from Al-Azhar University and the Islamic University, and through the census of the study society it was found to consist of (655) administrative staff. In order to achieve the objectives of the study, the researchers used the method of random sample in the study, and the study was (...) conducted on a sample of (221) administrative staff of the surveyed universities and the response rate was (82.35%). The study found that there is a high degree of satisfaction with the Dominant Pattern of Leadership in the Palestinian universities in Gaza Strip from the point of view of the administrative staff, which reached (71.67%). There is a high level of performance from the point of view of administrative staff, with a percentage of (82.53%). There is a direct correlation between the dominant pattern of leadership and the functional Performance of Administrative Staff, the absence of differences between the sample according to the gender variable in their perception of the dominant pattern of leadership and the functional Performance of Administrative Staff, the absence of differences in the perception of employees of the dominant pattern of leadership and the functional Performance of Administrative Staff depending on the age variable. There are differences of statistical significance according to the variable of scientific qualification in the Dominant Pattern of Leadership, while there were no differences in performance, the differences in the dominant pattern of leadership according to the scientific qualification were in favor of those who obtained the diploma degree compared to other practical qualifications, the absence of differences in the perception of employees of the dominant pattern of leadership and the functional Performance of Administrative Staff depending on the variable years of service, the absence of differences in the perception of employees of the dominant pattern of leadership and the functional Performance of Administrative Staff depending on the variable level of career (Director, Head of Department, and Administrative Officer). There were differences in the perception of workers to the dominant pattern of leadership depending on the variable of the workplace, where there were differences in favor of workers in deanships and colleges compared with the workers in the technical departments. While there were no differences in job performance according to the workplace variable, the existence of differences in the perception of workers to the dominant pattern of leadership depending on the university in which they work in favor of the Islamic University and the absence of differences in performance between the Islamic University and Al-Azhar University. The study reached a number of recommendations, the most important of which is that the interest of the managements of the Palestinian universities in improving the dominant pattern of leadership, to give universities the opportunity to participate in decision-making, the continued administration of universities interest and continuous improvement of the performance of its employees, enhance the periodic evaluation of job performance and to inform employees and express their opinion, solving workers' problems and giving them the opportunity to contribute to solving their own problems, the use of the staff rotation method periodically and strengthening the democratic the dominant pattern of leadership and empowering university staff. -/- . (shrink)

In this paper, I plan to show that the use of a specific population concept—Millstein’s Causal Interactionist Population Concept (CIPC)—has interesting and counter-intuitive ramifications for discussions of the reality of biological race in human beings. These peculiar ramifications apply to human beings writ large and to individuals. While this in and of itself may not be problematic, I plan to show that the ramifications that follow from applying Millstein’s CIPC to human beings complicates specific biological racial realist accounts—naïve or otherwise. (...) I conclude with the notion that even if biological races do exist—by fulfilling all of the criteria needed for Millstein’s population concept (which, given particular worries raised by Gannett (Synthese 177:363–385, 2010), and Winther and Kaplan (Theoria 60:54–80, 2013) may not)—the lower-bound limit for the scope of biological racial realism is at the level of populations, and as such they cannot say anything about whether or not individual organisms themselves have races. (shrink)

Deception is part of the natural repertoire of adaptive behaviours in many organisms. In humans we see it in all domains of human activity including health care. Within health care, deception can be a matter of concern, but it is also used to protect patients, for instance against overwhelming and negative diagnostics. This paper demonstrates that deception and self‐deception are closely interlinked and that self‐deception facilitates deception. Furthermore, self‐deception tends to be used to reduce the discomfort we feel when we (...) are dishonest (cognitive dissonance). The paper includes references to core psychological mechanisms and ethical aspects. (shrink)

This chapter aims to bring to the fore some of the ontological presuppositions that undergird the concepts of race and racism as they are used in public health. Included are discussions of differing accounts for race in public health, the ways in which racism is understood to be a public health issue, and where future research in public health, as it relates to the concepts of race and racism, is headed.

First published in 1995. Routledge is an imprint of Taylor & Francis, an informa company.

First published in 1995. Routledge is an imprint of Taylor & Francis, an informa company.

A new characterization of tabularity in tense logic is established, namely, a tense logic L is tabular if and only if $\mathsf {tab}_n^T\in L$ for some $n\geq 1$. Two characterization theorems for the Post-completeness in tabular tense logics are given. Furthermore, a characterization of the Post-completeness in the lattice of all tense logics is established. Post numbers of some tense logics are shown.

Jan Narveson has articulated a deeply held, widely shared intuition regarding what moral law has to say about bringing additional people into existence: while we are “in favour of making people happy,” we are “neutral about making happy people.” Various formulations of the Narvesonian intuition (closely related to the _person-affecting intuition_ or _restriction_) have been widely criticized. This present paper outlines an off-the-beaten-path alternate construction of the intuition—the _existence condition_—and argues that that particular construction has the resources to avoid some (...) of those criticisms. But still other considerably more widely recognized alternate constructions have been offered as well. Thus John Broome outlines what he calls the _neutrality intuition_. While Broome finds the underlying intuition “strongly attractive,” he nonetheless argues that the neutrality intuition itself leads us quickly into inconsistency. Wlodek Rabinowicz disagrees. On his view, Broome’s inconsistency argument shows, not that the neutrality intuition is false, but rather that it doesn’t follow, from the fact that the outcome, or possible future or _world_, that includes the additional person is neither better nor worse than the (otherwise similar) world that excludes that person, that the one world is exactly as good as the other. The better view, according to Rabinowicz, is that, on occasion, and specifically when the coming into existence of additional people is at stake, the one world is _incommensurate_ with the other. What is called the _principle of trichotomy_ is, in other words, false. Difficulties arise, however, when we try to reject that seemingly compelling conceptual principle. This present paper concludes with the argument that the availability of the existence condition—which, together with certain other uncontroversial moral principles and a handful of conceptual principles, forms the _existential approach_—shows that we can maintain the most intuitive parts of neutrality intuition while avoiding both Broome’s inconsistency worry and Rabinowicz’s commitment to incommensurability. Incommensurability may be correct on other grounds—but not, this present paper argues, on the grounds provided by Broome’s inconsistency argument. (shrink)

The vast majority of contributions to the literature on spirituality in nursing make extravagant claims about transcendence, eternity, the numinous, higher powers, higher levels of existence, invisible forces, cosmic unity, the essence of humanity, or other supernatural concepts. Typically, these assertions are made without the support of argument or evidence; and, as a consequence, alternative ways of theorizing ‘spirituality’ have been closed off, while the lack of consistent scholarship has turned the topic into a metaphysical backwater. In this paper, I (...) adopt a different premise, rejecting unsupported claims, and surveying the ‘spirituality’ terrain from a naturalistic and reductionist perspective. I argue that, if we rid ourselves of non‐naturalistic assumptions, we will discover theoretical and clinical resources in health psychology, social psychology, neuropsychology, and pharmacopsychology – resources which confirm that it is possible to conceptualize the study of existential concerns, and how health professionals might respond to them, in a properly scientific manner. In order to illustrate the potential usefulness of these resources, I will take palliative care as an example. (shrink)

When people engage in conversation, they tailor their utterances to their conversational partners, whether these partners are other humans or computational systems. This tailoring, or adaptation to the partner takes place in all facets of human language use, and is based on a mental model or a user model of the conversational partner. Such adaptation has been shown to improve listeners' comprehension, their satisfaction with an interactive system, the efficiency with which they execute conversational tasks, and the likelihood of achieving (...) higher level goals such as changing the listener's beliefs and attitudes. We focus on one aspect of adaptation, namely the tailoring of the content of dialogue system utterances for the higher level processes of persuasion, argumentation and advice-giving. Our hypothesis is that algorithms that adapt content for these processes, according to a user model, will improve the usability, efficiency, and effectiveness of dialogue systems. We describe a multimodal dialogue system and algorithms for adaptive content selection based on multi-attribute decision theory. We demonstrate experimentally the improved efficacy of system responses through the use of user models to both tailor the content of system utterances and to manipulate their conciseness. (shrink)

Positive changes or transformations have been the subject of study within spiritual traditions as well as humanistic and transpersonal psychology. The aim of the current study is to understand the process of transformation among Moslems in Indonesia, who follow spiritual practices, to achieve the nafs al-muṭma ínnah [tranquil self]. Ten participants in Yogyakarta province were involved in this study. They were recruited using nafs al-muṭmaʾinnah scale developed by the authors. In-depth interviews of both the participants and their significant others were (...) conducted. To analyse the data, an interpretative phenomenological analysis was employed. Five themes emerged from the data, including deviation from the basis of religious environment, spiritual discipline, transformative experiences, new characters and a continuous process. We conclude that participants experience spiritual-religious transformation and achieve the state of nafs al-muṭma ínnah [tranquil self]. The process of transformation occurs gradually after a sudden experience, and it continuously happens throughout the course of life. Three factors contribute to the transformation, including the role of predisposition, the role of a spiritual guide and the role of spiritual experiences.Contribution: As the study of spiritual-religious transformation is mainly conducted within a Judea-Christian tradition, this study significantly contributes to the literature by providing spiritual-religious transformation from an Islamic-Sufi perspective. (shrink)

Code-based cryptography is currently the second most promising post-quantum mathematical tool for quantum-resistant algorithms. Since in 2022 the first post-quantum standard Key Encapsulation Mechanism, Kyber (a latticed-based algorithm), was selected to be established as standard, and after that the National Institute of Standards and Technology post-quantum standardization call focused in code-based cryptosystems. Three of the four candidates that remain in the fourth round are code-based algorithms. In fact, the only non-code-based algorithm (SIKE) is now considered vulnerable. Due to this landscape, (...) it is crucial to update previous results about these algorithms and their functioning. The Fujisaki-Okamoto transformation is a key part of the study of post-quantum algorithms and in this work we focus our analysis on Classic McEliece, BIKE and HQC proposals, and how they apply this transformation to obtain IND-CCA semantic security. Since after security the most important parameter in the evaluation of the algorithms is performance, we have compared the performance of the code-based algorithms of the NIST call considering the same architecture for all of them. (shrink)

This text explores how human beings construe experience: experience as a resource, as a potential for understanding, representing and acting on reality.

Psychological research has shown that cognitive illusions, of which visual illusions are just a special case, are systematic and pervasive, raising epistemological questions about how error in all forms of research can be identified and eliminated. The quantitative sciences make use of statistical techniques for this purpose, but it is not clear what the qualitative equivalent is, particularly in view of widespread scepticism about validity and objectivity. I argue that, in the light of cognitive psychology, the ‘error question’ cannot be (...) dismissed as a positivist obsession, and that the concepts of truth and objectivity are unavoidable. However, they constitute only a ‘minimal realism’, which does not necessarily bring a commitment to ‘absolute’ truth, certainty, correspondence, causation, reductionism, or universal laws in its wake. The assumption that it does reflects a misreading of positivism and, ironically, precipitates a ‘crisis of legitimation and representation’, as described by constructivist authors. (shrink)

Many contemporary logicians acknowledge a plurality of logical theories and accept that theory choice is in part motivated by logical evidence. However, just as there is no agreement on logical theories, there is also no consensus on what constitutes logical evidence. In this paper, I outline Jean Piaget’s psychological theory of reasoning and show how he used it to diagnose and solve one of the paradoxes of material implication. I assess Piaget’s use of psychology as a source of evidence for (...) logical theory in light of reservations raised by psychologism, and I highlight some ramifications for exceptionalism and anti-exceptionalism about logic by considering his use of psychology as logical evidence in the framework of genetic epistemology, Piaget’s research programme. I conclude that Piaget’s psychological theory of reasoning not only plausibly serves as a source of evidence for logical theory but also makes a strong case for anti-exceptionalism about logic. (shrink)

Two major functions of the visual system are discussed and contrasted. One function of vision is the creation of an internal model or percept of the external world. Most research in object perception has concentrated on this aspect of vision. Vision also guides the control of object-directed action. In the latter case, vision directs our actions with respect to the world by transforming visual inputs into appropriate motor outputs. We argue that separate, but interactive, visual systems have evolved for the (...) perception of objects on the one hand and the control of actions directed at those objects on the other. This 'duplex' approach to high-level vision suggests that Marrian or 'reconstructive' approaches and Gibsonian or 'purposive-animate-behaviorist' approaches need not be seen as mutually exclusive, but rather as complementary in their emphases on different aspects of visual function. (shrink)