BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The (...) present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital. The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices. (shrink)

The introduction of genes into plants encoding potent antibacterial proteins, derived from insects, may significantly augment the level of their resistance to bacterial disease. Using modern techniques, genes of choice can be introduced into plant tissue and this tissue can be manipulated to produce viable plants. The potato has been chosen as the model system, not only because of its plasticity of development, which allows for the relatively easy regeneration of whole plants from transformed tissue, but also because the potato (...) ranks among the top four plants in the world in terms of economic importance. (shrink)

En este artículo proponemos reflexionar en torno a una cuestión que ocupa un lugar central en la práctica educativa, política y evangelizadora, a saber, el problema de la paz. Asunto que toma especial relevancia, sobre todo si se tiene en cuenta el momento coyuntural por el que atraviesa Colombia y en general la sociedad contemporánea. La tesis que sostiene el artículo es que la ausencia de la guerra no supone necesariamente la consecución de la paz, pues ella conlleva a una (...) suerte de condiciones de aceptación de un ethos que naturaliza prácticas bélicas que dividen, atomizan la sociedad creando un sentido de desesperanza y de despolitización. Proponemos que, para afrontar esta situación, es decir, para desnaturalizar dicho ethos hace falta una dimensión espiritual que permita el establecimiento de fuertes lazos sociales y del reconocimiento de las diferencias, la particularidad e individualidad. Para desarrollar esta labor proponemos, entonces, un diálogo a partir de los presupuestos de la espiritualidad y el pensamiento franciscano, especialmente desde los conceptos de fraternidad y de minoridad con la cuestión en mención. Con esto entendemos que el marco de comprensión que nos brindan los presupuestos franciscanos cuenta con un potencial relevante para contribuir al debate sobre de la paz en tiempos actuales del posconflicto colombiano. (shrink)

BackgroundMoral distress (MD) is the psychological damage caused when people are forced to witness or carry out actions which go against their fundamental moral values. The main objective was to evaluate the prevalence and predictive factors associated with MD among health professionals during the pandemic and to determine its causes.MethodsA regional, observational and cross-sectional study in a sample of 566 professionals from the Public Health Service of Andalusia (68.7% female; 66.9% physicians) who completed the MMD-HP-SPA scale to determine the level (...) of MD (0-432 points). Five dimensions were used: i) Health care; ii) Therapeutic obstinacy-futility, iii) Interpersonal relations of the Healthcare Team, iv) External pressure; v) Covering up of medical malpractice.ResultsThe mean level of MD was 127.3 (SD=66.7; 95% CI 121.8-132.8), being higher in female (135 vs. 110.3; p<0.01), in nursing professionals (137.8 vs. 122; p<0.01) and in the community setting (136.2 vs. 118.3; p<0.001), with these variables showing statistical significance in the multiple linear regression model (p<0.001; r2=0.052). With similar results, the multiple logistic regression model showed being female was a higher risk factor (OR=2.27; 95% CI 1.5-3.4; p<0.001). 70% of the sources of MD belonged to the dimension "Health Care" and the cause "Having to attend to more patients than I can safely attend to" obtained the highest average value (Mean=9.8; SD=4.9).ConclusionsFemale, nursing professionals, and those from the community setting presented a higher risk of MD. The healthcare model needs to implement an ethical approach to public health issues to alleviate MD among its professionals. (shrink)

Is it possible to establish a line of research that brings Gabriel Marcel and Jean-Paul Sartre closer together? With this article, we will positively support this idea, by distancing ourselves from the overly rigid interpretations that exclusively focus on antinomic elements sliding into a reductionist and nowadays “canonical” presentation of the relationship between these philosophers. Beyond the undeniable and, fortunately, unmediated differences between the two philosophers, this article aims to investigate their positions regarding the concept of “relationship”. In doing so, (...) we will highlight how Gabriel Marcel’s “coesse” and Jean-Paul Sartre’s “being-for-others” have numerous points of contact that place both philosophers, beyond their personal positions in the religious sphere, within the common ground of “existentialism”. (shrink)

This volume offers the first-ever complete English translation of Leibniz’s Dissertatio De Arte Combinatoria together with a critical edition of the original Latin text on fa...

Reference is a central topic in philosophy of language, and has been the main focus of discussion about how language relates to the world. R. M. Sainsbury sets out a new approach to the concept, which promises to bring to an end some long-standing debates in semantic theory.There is a single category of referring expressions, all of which deserve essentially the same kind of semantic treatment. Included in this category are both singular and plural referring expressions, complex and non-complex referring (...) expressions, and empty and non-empty referring expressions. Referring expressions are to be described semantically by a reference condition, rather than by being associated with a referent. In arguing for these theses, Sainsbury's book promises to end the fruitless oscillation between Millian and descriptivist views. Millian views insist that every name has a referent, and find it hard to give a good account of names which appear not to have referents, or at least are not known to do so, like ones introduced through error, ones where it is disputed whether they have a bearer and ones used in fiction. Descriptivist theories require that each name be associated with some body of information. These theories fly in the face of the fact names are useful precisely because there is often no overlap of information among speakers and hearers. The alternative position for which the book argues is firmly non-descriptivist, though it also does not require a referent. A much broader view can be taken of which expressions are referring expressions: not just names and pronouns used demonstratively, but also some complex expressions and some anaphoric uses of pronouns.Sainsbury's approach brings reference into line with truth: no one would think that a semantic theory should associate a sentence with a truth value, but it is commonly held that a semantic theory should associate a sentence with a truth condition, a condition which an arbitrary state of the world would have to satisfy in order to make the sentence true. The right analogy is that a semantic theory should associate a referring expression with a reference condition, a condition which an arbitrary object would have to satisfy in order to be the expression's referent.Lucid and accessible, and written with a minimum of technicality, Sainsbury's book also includes a useful historical survey. It will be of interest to those working in logic, mind, and metaphysics as well as essential reading for philosophers of language. (shrink)

Falsafat wa-ḥayāt Abī Hāshim al-Jubbāʼī wa-madrasatuh -- al-Tawallud ʻinda al-Muʻtazilah.

In the first half of this two-part article, we analyzed a cognitive psychology experiment where participants were asked to select pairs of directions that they considered to be the best example of Two Different Wind Directions, and showed that the data violate the CHSH version of Bell’s inequality, with same magnitude as in typical Bell-test experiments in physics. In this second part, we complete our analysis by presenting a symmetrized version of the experiment, still violating the CHSH inequality but now (...) also obeying the marginal law, for which we provide a full quantum modeling in Hilbert space, using a singlet state and suitably chosen product measurements. We also address some of the criticisms that have been recently directed at experiments of this kind, according to which they would not highlight the presence of genuine forms of entanglement. We explain that these criticisms are based on a view of entanglement that is too restrictive, thus unable to capture all possible ways physical and conceptual entities can connect and form systems behaving as a whole. We also provide an example of a mechanical model showing that the violations of the marginal law and Bell inequalities are generally to be associated with different mechanisms. (shrink)

We present a cognitive psychology experiment where participants were asked to select pairs of spatial directions that they considered to be the best example of Two different wind directions. Data are shown to violate the CHSH version of Bell’s inequality with the same magnitude as in typical Bell-test experiments with entangled spins. Wind directions thus appear to be conceptual entities connected through meaning, in human cognition, in a similar way as spins appear to be entangled in experiments conducted in physics (...) laboratories. This is the first part of a two-part article. In the second part (Aerts et al. in Found Sci, 2017) we present a symmetrized version of the same experiment for which we provide a quantum modeling of the collected data in Hilbert space. (shrink)

Obiettivo di questo articolo sarà presentare l’analisi fenomenologica e teoretica che Sartre propone del concetto di malafede, a partire dal romanzo La Nausea fino all’opera L’essere e il nulla. Ricostruendo il procedimento sartriano, che dall’atteggiamento interrogativo dell’uomo di fronte all’essere porta alla posizione del non-essere, giungeremo alla libertà e all’angoscia, quali caratteri costitutivi dell’essenza umana. Il tentativo di fuggire dalla libertà, a cui per Sartre siamo condannati, e dall’angoscia che da essa deriva, condurrà l’uomo sartriano all’autoinganno, ad una vita inautentica… (...) alla malafede. (shrink)

This book presents state of the art philosophical work on conspiracy theory research that brings in sharp focus on central and important insights concerning the supposed irrationality of conspiracy theory and conspiracy theory belief, while also proposing several novel solutions to long standing issues in the broader academic debate on these things called ‘conspiracy theories’. -/- It features a critical history of conspiracy theory theory, emphasising the role of the ‘first generation’ of philosophers in conspiracy theory research. This book also (...) includes discussions of a range of key issues such as: -/- What counts as conspiracy theory? Who counts as a conspiracy theorist? How are these terms variously understood by academics and the wider public, and Are conspiracy theories automatically suspect, and is it ever reasonable to be a conspiracy theorist? The book then builds upon that work by looking at how people’s political views affect both the conspiracy theories they believe and their beliefs about conspiracy theories; how we might defend conspiracy theorising without endorsing mad, bad or dangerous conspiracy theories; and contains several proposals for unifying conspiracy theory research under one theoretical framework: particularism. -/- This volume will be a key resource for philosophers and social scientists interested in recent work on the philosophy of conspiracy theory theory and its implications for conspiracy theory research. It will also appeal to members of the public, who want to know what, if anything, is wrong with these things called “conspiracy theories”. It was originally published as a special issue of Social Epistemology. (shrink)

Zhizneopisanie -- Kniga znanii︠a︡ -- Ukazanii︠a︡ i nastavlenii︠a︡ -- Kniga o dushe.

This book analyzes for the first time in English the ethical theory that underpins Qur’anic legislation by providing a classification of specific verses in which Islam’s holy book discusses moral issues. The principal purpose of this book is to demonstrate the ways in which the Qur’an theoretically and practically provides the moral code to which Muslims around the world adhere. The author divides his analysis into a survey of Qur’anic attitudes towards the basic ethical issues of obligation and responsibility, issues (...) of moral psychology such as motivation and intention, as well as matters of social ethics such as the function of law in society. He then explores the meanings of individual morality, morality within the family and civil society, and the relationship of morality to the idea of the state. (shrink)

Richard M Weaver, a thinker and writer celebrated for his unsparing diagnoses and realistic remedies for the ills of our age, is known largely through a few of his works that remain in print. This new collection of Weaver's shorter writings, assembled by Ted J Smith III, Weaver's leading biographer, presents many long-out-of-print and never-before-published works that give new range and depth to Weaver's sweeping thought. Included are eleven previously unpublished essays and speeches that were left in near-final form at (...) the time of Weaver's death in 1963. In all, there are some one hundred and twenty-six essays, speeches, book reviews, and editorials. (shrink)

Foundation models such as GPT-4 are fine-tuned to avoid unsafe or otherwise problematic behavior, such as helping to commit crimes or producing racist text. One approach to fine-tuning, called reinforcement learning from human feedback, learns from humans' expressed preferences over multiple outputs. Another approach is constitutional AI, in which the input from humans is a list of high-level principles. But how do we deal with potentially diverging input from humans? How can we aggregate the input into consistent data about "collective" (...) preferences or otherwise use it to make collective choices about model behavior? In this paper, we argue that the field of social choice is well positioned to address these questions, and we discuss ways forward for this agenda, drawing on discussions in a recent workshop on Social Choice for AI Ethics and Safety held in Berkeley, CA, USA in December 2023. (shrink)

In nursing, expectations of honesty and integrity are clearly stipulated throughout professional standards and codes of conduct, thus the concept of academic integrity has even more impetus in preparing students for graduate practice. However, a disparity between policy and practice misses the opportunity to instil the principles of academic integrity, and at its core honesty, a pivotal trait in the nursing profession. This study draws upon the experience of the nursing faculty to explore how academic integrity policy of deterrence operate (...) in nursing education.While participants deplored cheating behaviours, they expressed frustration in having to ‘police’ large numbers of students who had little awareness of the academic standards to meet policy requirements. In addition, they were cynical because of a perceived lack of severity in sanctions for students who repeatedly breached integrity. Participants expressed a moral obligation as educators to meet student learning needs and preferred to engage with students in a more meaningful way to uphold academic integrity. The ambivalence to detect and report breaches in integrity undermines the effectiveness of policy. Therefore, faculty must recognise the importance of their role in detecting and escalating cases of dishonesty and execute deterrence in a more consistent way. To do this, greater support at an institutional level, such as smaller class sizes, inclusion in decision making around sanctions and recognition of additional workload, will enable faculty to uphold policy. Although policing was not their preferred approach, the role of faculty in detecting and reporting cases of misconduct is crucial to increase the certainty of students getting caught, which is essential if policy is to be effective in deterring dishonest behaviour. (shrink)

On September 1, 2023, Texas made important revisions to it its decades‐old statute granting legal safe harbor immunity to physicians who withhold or withdraw life‐sustaining treatment over the objection of critically ill patients’ surrogate decision‐makers. However, lawmakers left untouched glaring flaws in a key safeguard for patients—the transfer option. The transfer option is ethically important because, when no hospital is willing to accept the patient in transfer, that fact is taken as strong evidence that the surrogates’ treatment requests fall outside (...) accepted medical practice. But there are serious shortcomings in how the transfer option is carried out in Texas and many other states, which undermines the ethical usefulness of the process. We identify these shortcomings and recommend revisions to state statutes and professional guidelines to overcome them. (shrink)