Ethical decision making in medicine has recently seen calls to move towards less prescriptive- based approaches that consider the particularities of each case. The main alternative call from the literature is for better understanding of phronesis concepts applied to decision making. A well-cited phronesis-based approach is Kaldjian’s five-stage theoretical framework: goals, concrete circumstances, virtues, deliberation and motivation to act. We build on Kaldjian’s theory after using his framework to analyse data collected from a three-year empirical study of phronesis and the (...) medical community. The data are a set of narratives collected in response to asking a medical community what making ethically wise decisions means to them. We found that Kaldjian’s five concepts are present in the accounts to some extent but that one of the elements, motivation, is constructed as playing a different, though still crucial role. Rather than being an end-stage of the process as Kaldjian’s framework suggests, motivation was constructed as initiating the process and maintaining the momentum of taking a phronesis-based approach. The implications for medical ethics decision-making education are significant as motivation itself is a highly complex concept. We therefore theorise that motivation is required for leading in, continuing and completing the actions of the ethical decision taken. Appreciating the central importance of motivation through the whole of Kaldjian’s framework has implications for cultivating the virtues of phronesis and courage to take the right course of action. (shrink)

Contemporary clinical ethics was founded on principlism, and the four principles: respect for autonomy, nonmaleficence, beneficence and justice, remain dominant in medical ethics discourse and practice. These principles are held to be expansive enough to provide the basis for the ethical practice of medicine across cultures. Although principlism remains subject to critique and revision, the four-principle model continues to be taught and applied across the world. As the practice of medicine globalizes, it remains critical to examine the extent to which (...) both the four-principle framework, and individual principles among the four, suffice patients and practitioners in different social and cultural contexts. Using the four-principle model we analyze two accounts of surrogate decision making – one from the developed and one from the developing world – in which the clinician undertakes medical decision-making with apparently little input from the patient and/or family. The purpose of this analysis is to highlight challenges in assessing ethical behaviour according to the principlist model. We next describe cultural expectations and mores that inform both patient and clinician behaviors in these scenarios in order to argue that the principle of respect for persons informed by culture-specific ideas of personhood may offer an improved ethical construct for analyzing and guiding medical practice in a globalized and plural world. (shrink)

Volume 20, Issue 3, March 2020, Page 73-74.

Multinational companies commonly and increasingly undertake their research in low and middle-income countries through commercial clinical research organizations (CROs). The involvement of these scientific middle men complicates the application of the theories of justice. We examine those complexities, and conclude that while the difficulties are not immune to analysis in terms of these theories, the theories have to be deployed in new ways in order to be useful in the new commercial world.

BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any (...) given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. (shrink)

The ‘right not to know’ can be used by patients as a safeguard against the effects that certain medical information can have on their well-being. At first glance, one might reason it suitable for a patient to enact their RNTK. However, although Davies states that RNTK gives people the ability to both protect themselves from self-perceived harm and exercise their autonomy, I will argue that ‘not knowing’ hinders patients’ ability to exercise their existential freedom and represents what Sartre calls an (...) instance of ‘bad faith’. Davies argues that the RNTK takes precedence over many related issues and objections associated with a patient’s decision to implement such a resolution.1 Fundamentally, the RNTK gives patients power to protect themselves from subjective harm and to exercise their autonomy. In most cases, objectors of RNTK cite the negative impact on the patient’s state of health, which affects not only the patient but also those persons who would also be negatively affected by patient health outcomes. For the majority of objectors, patients have moral obligations to lessen the degree of burden on others, which refusal can initiate. However, Davies concludes, ‘…the burden placed on others is not sufficiently significant …. (shrink)

This article explores how the type of consent given for organ donation should affect the judgement of a patient's overall benefit with regards to donation of their organs and the pre-mortem interventions required to facilitate this. The findings of a qualitative study of the views of 10 healthcare professionals, combined with a philosophical analysis inform the conclusion that how consent to organ donation is given is a reliable indicator only of the strength of evidence about views on donation and subsequent (...) willingness to undergo pre-mortem interventions. It is not an indicator of the strength of actual desire to donate. Clinical management of living patients prior to donation after circulatory death must therefore respect the values, wishes and beliefs of the potential donation after circulatory death donor. Our participants, however, suggested that the information currently provided is sufficient to authorise donation and that this consent, however provided, was sufficient to proceed with pre-mortem interventions. Respect for autonomy underpinned this ‘all or nothing’ approach. Although the legal requirements for donation authorisation and the protection of patients without capacity are clear, practice and policy regarding consent in donation after circulatory death may be based on donation following brainstem death where the patient is already dead when the family is approached. Custom and practice in donation after circulatory death may need to be revised to protect the interests of the dying potential donor. (shrink)

This paper presents a cross-sectional study that demonstrates how King Abdulaziz University has responded to the lockdown imposed by the Ministry of Education in Saudi Arabia due to the Covid-19 pandemic. The purpose of this study was to examine the perceptions of students and faculty towards assessment that had to take place online due to physical or social distancing rules and lockdowns. A descriptive mixed-method study was conducted with two different self-administered questionnaires that were developed for students and faculty, respectively. (...) A total of 547 responses were received from undergraduate students and 213 from faculty. The main finding suggests the need for a multilevel approach to the problems of cheating and plagiarism, including raising student awareness and ethics, training teachers to detect cheating methods, and institutions activating their code of practice and applying severe sanctions on those who engage in such practices. (shrink)

Objective: There is lack of information on the presentation of eating disorders (EDs) in Saudi Arabia using gold standard clinical tools. The present study aimed to provide data on the presentation of EDs in Saudi Arabia using clinically validated measures.Method: Hundred and thirty-three individuals (33 male) with a mean age of 22 years (2.63) completed three measures: the Eating Disorder Examination (EDE), a semi-structured interview, the Eating Disorder Examination Questionnaire (EDE-Q), a self-report measure, and the Depression Anxiety and Stress Scale (...) (DASS-21) to measure comorbid symptoms.Results: Individuals in Saudi Arabia reported higher levels of restraint, eating concern and shape concern and a higher global score, but lower levels of weight concern on the EDE-Q compared to the EDE. Female participants reported a higher global score, alongside significantly higher scores on the restraint, shape concern and weight concern subscales than males. The most common ED subtype was other specific feeding or ED. Compared with Western community samples, symptom severity in this purposive sample obtained from community settings was significantly higher in this sample.Discussion: Individuals with eating, weight and shape concerns in Saudi Arabia may feel more comfortable expressing their symptoms on a self-report tool compared with a face to face interview. However, it is possible that a self-report measure may over-estimate the severity of symptoms. The data suggest that clinicians in Saudi Arabia should regularly screen for EDs in all genders. It is also important to note that ED symptoms are a cause for concern in young people in Saudi Arabia. (shrink)

Prince of philosophers -- The emergence of Islam -- Boy genius -- Court physician -- A traveling philosopher -- Death of an intellectual -- A lasting legacy.

With the increasing interest in Islam and evolution, some Islamic thinkers have vehemently rejected evolution, while others have eagerly embraced it. However, those seeking to embrace evolution sometimes err in their interpretation of historical writings. Indeed, there are texts written by famous historical scholars of Islam who seem to suggest that humans have evolved from lower forms of species. These include Ibn Khaldūn, Jalāl ad‐Dīn Rūmī, al‐Jāhiz, and The Brethren of Purity (Ikhwān al Safā). Although this may be true, such (...) readings are a mistaken interpretation of the aforementioned authors who are actually referring to some form of the scalae naturae (the Great Chain of Being). This reference to the Great Chain of Being is unknown to some contemporary readers who mistakenly believe these writers to be discussing an evolutionary or a proto‐evolutionary theory. This article demonstrates how and why these historical records do not actually represent any notion of evolution as it is currently understood, in the hope of avoiding any further erroneous claims that seem to be proliferating among modern thinkers. (shrink)

In this work, Kenan Malik explores the history of moral thought as it has developed over three millennia, from Homer's Greece to Mao's China, from ancient India to modern America. It tells the stories of the great philosophers, and breathes life into their ideas, while also challenging many of our most cherished moral beliefs.

Drawing on 2 years of field research conducted between 2008 and 2010 in London’s Kurdish community, I discuss the practical and ethical challenges that confront researchers dealing with violence against women committed in the name of ‘honour’. In examining how feminist methodologies and principles inform my research, I address issues of researcher positioning and the importance of speaking with, rather than for, marginalised groups. I then explore the difficulties of operationalising this position when dealing with honour-based violence. Using the interview (...) data from the 2008–2010 study and a case study of the trial of Mehmet Goren (who was convicted in 2009 of murdering his daughter Tulay for supposedly dishonouring their family), I discuss the socio-cultural norms and values underlying honour codes, examining both the position of men and women in relation to the maintenance of family honour and the regulation of women’s sexuality and conduct. In particular, I explore the difficulties inherent in obtaining and understanding victims’ own personal narratives, especially in legal settings, while simultaneously showing how it is only through empowering women to speak for themselves that we will be able to bring about the deep societal changes needed to eradicate honour-based violence. (shrink)

This paper examines the problematisation of sex-selective abortion (SSA) in UK parliamentary debates on Fiona Bruce's Abortion (Sex-Selection) Bill 2014–15 and on the subsequent proposed amendment to the Serious Crime Bill 2014–15. On the basis of close textual analysis, we argue that a discursive framing of SSA as a form of cultural oppression of minority women in need of protection underpinned Bruce's Bill; in contrast, by highlighting issues more commonly articulated in defence of women's reproductive rights, the second set of (...) debates displaced this framing in favour of a broader understanding, drawing on postcolonial feminist critiques, of how socio-economic factors constrain all women in this regard. We argue that the problematisation of SSA explains the original cross-party support for, and subsequent defeat of, the policies proposed to restrict SSA. Our analysis also highlights the central role of ideology in the policy process, thus making politics visible in policymaking. (shrink)

The article ‘Understanding Racism’ by Kwame Anthony Appiah is a revised version of The Annual Examen Philosophicum Lecture held on 29 September 2023 at the University of Oslo, with comments by Anna...

Communication between road users is a major key to coordinate movement and increase roadway safety. The aim of this work was to grasp how pedestrians, cyclists, and kick scooter users sought to visually communicate with drivengers when they would face autonomous vehicles. In each experiment, participants were asked to imagine themselves in described situations of encounters between a specific type of vulnerable road user and a human driver in an approaching car. The human driver state and the communicative means of (...) the approaching car through an external Human-Machine Interface were manipulated between the scenarios. The participants were prompted to rate from “never” to “always” the frequency with which they would seek eye contact with the human driver either in order to express their willingness to cross or to make their effective decision to cross. Our findings revealed that a passive human driver in an AV with no visual checking on the road triggered a decline in vulnerable road users’ desire to communicate by eye contact. Moreover, the results of Experiment C demonstrated that the speed screen, the text message screen, and the vibrating mobile app eHMI signals diminished kick scooter users’ desire to communicate visually with the human driver, with some age-based differences. This suggested a better comprehension of the approaching car’s intentions by the kick scooter users, driven by the features of the eHMI. (shrink)

An examination of case law on forced marriage reveals that in addition to physical force, the role of emotional pressure is now taken into consideration. However, in both legal and policy discourse, the difference between arranged and forced marriage continues to be framed in binary terms and hinges on the concept of consent: the context in which consent is constructed largely remains unexplored. By examining the socio-cultural construction of personhood, especially womanhood, and the intersecting structural inequalities that constrain particular groups (...) of South Asian women in the UK, we argue that consent and coercion in relation to marriage can be better understood as two ends of a continuum, between which lie degrees of socio-cultural expectation, control, persuasion, pressure, threat and force. Women who face these constraints exercise their agency in complex and contradictory ways that are not always recognised by the existing exit-centred state initiatives designed to tackle this problem. (shrink)

For much of the past half century, politicians and scientists have largely spoken with a single voice on the issue of race. The experience of Nazism and the Holocaust made racial science politically unacceptable. It also shaped the scientific consensus that race was a social myth, not a biological reality. Today, however, that scientific consensus is beginning to crack.

In this paper, we define the regular and totally regular bipolar single valued neutrosophic hypergraphs, and discuss the order and size along with properties of regular and totally regular bipolar single valued neutrosophic hypergraphs. We extend work on completeness of bipolar single valued neutrosophic hypergraphs.

What is photography? -- Rethinking the political -- The photograph as the source of civil knowledge -- Civil uses of photography.

V tomto článku se zabývám konceptem SI (superinteligence) a s ní spojeným problémem kontroly. Podle určité skupiny teoretiků umělé inteligence stojíme na prahu události, která může radikálně změnit povahu technologického pokroku a lidské společnosti obecně. Touto událostí má být takzvaná technologická singularita, která je často spojována se vznikem první větší než lidské inteligence. Lidé jako Nick Bostrom varují před nebezpečím, které pro nás vznik SI znamená a upozorňují, že musíme co nejdříve najít metody kontroly této inteligence. Podle Bostroma a dalších (...) nebezpečí SI vyplývá z její povahy. Já na jedné straně posuzuji, jak SI může vzniknout, a na druhé straně soudím smysluplnost problému kontroly. Vznik SI vyplývá ze vzniku umělé inteligence. Proto soustřeďuji podstatnou část textu argumentům pro její vznik. Ukazují jak se Bostrom a další nechávají unést jedním problematickým argumentem. Dále podrobuji jejich pozici klasické kritice umělé inteligence. Prezentuji, jak stále lpí na problematických domněnkách svých předchůdců. Zejména soustřeďuji svoji kritiku na tvrzení, že SI bude mít jeden konečný cíl, který bude interpretovat. Toto tvrzení označuji jako antitetické, a to představě, že SI bude obecnou inteligencí. V závěru z mojí argumentace vyvozuji, že problém kontroly zaměňuje dva jiné různé problémy „kontroly.“. (shrink)

Our objective is to examine the effects of Big Five personality traits on ethical ideologies using a time-lagged design of 406 employees of higher education institutions in Pakistan. Based on low/high idealism versus relativism, we investigate the conceptual linkage between each of the personality traits and moral philosophy. The results illustrate that extraversion and openness to experience believed on subjectivism moral philosophy, agreeableness believed on situationism, and neuroticism believed on absolutism moral philosophies. In addition, contentiousness believed on exceptionism moral philosophy. (...) Furthermore, managerial implications and future research directions are suggested. (shrink)

The quality of the products coming from different lines of production requires some tests called comparative life tests. For lines having the same facility, the lifetime of the product is distributed by Burr XII, the lifetime distribution, and units are tested under type-I generalized hybrid censoring scheme. The observed censoring data are used under maximum likelihood and the Bayes method to estimate the model parameters. The theoretical results are discussed and assessed through data analysis and Monte Carlo simulation study. Finally, (...) we reported some brief comments obtained from numerical computation. (shrink)

Drawing on Conservation of resources (COR) theory, this study examined the underlying mechanism through which workplace bullying (WB) affects employees’ life satisfaction via job- related anxiety and insomnia. Time-lagged data were collected at two points in time from 211 doctor interns working in various hospitals in Pakistan. Results fully support a proposed serial multiple-mediator model. Workplace bullying is indirectly related to life satisfaction via job-related anxiety and insomnia. This study provides evidence of a spillover effect as to how workplace bullying (...) increases employees’ job-related anxiety which in turn leads to insomnia resulting in reduced employees’ life satisfaction. The present study extends research on workplace bullying to display its theoretical as well as empirical effects on life satisfaction. It demonstrates that workplace bullying as an occupational and psychological stressor has multiple effects on employees’ life satisfaction through a serial mediation model in the context of a developing country. It further explains that workplace bullying not only affects an employee’s workplace behaviors but also extends to the employee’s over-all life satisfaction. Keywords: Workplace bullying, job-related anxiety, insomnia, life satisfaction. (shrink)

On 3 August 2012, Shafilea Ahmed’s parents were convicted of her murder, nine years after the brutal ‘honour’ killing. The case offers important insights into how ‘honour’-based violence might be tackled without constructing non-Western cultures as inherently uncivilised. Critiquing the framing devices that structure British debates about ‘honour’-based violence demonstrates the prevalence of Orientalist tropes, revealing the need for new ways of thinking about culture that do not reify it or treat it as a singular entity that can only be (...) tackled in its entirety; instead, it is important to recognise that cultures consist of multiple, intersecting signifying practices that are continually ‘creolising’. Thus, rather than talking purely about culture, debates on ‘honour’-based violence should explore the intersection of culture with gender and other axes of differentiation and inequality. (shrink)

Realism Materialism Art (RMA) introduces a diverse selection of new realist and materialist philosophies and examines their ramifications in the arts. Encompassing neo-materialist theories, object-oriented ontologies, and neo-rationalist philosophies, RMA serves as a primer on “speculative realism,” considering its conceptual innovations as spurs to artistic thinking and practice and beyond. Despite their differences, these philosophical positions propose that thought can and does think outside itself, and that reality can be known without its being shaped by and for human comprehension. Today’s (...) realisms and materialisms explicitly challenge many of the dominant assumptions of cultural practice and theoretical inquiry, opening up new domains of research and artistic inquiry. -/- Cutting across diverse thematic interests and modes of investigation, the 35 essays in RMA offer a snapshot of the emerging and rapidly changing set of ideas and practices proposed by contemporary realisms and materialisms. The book demonstrates the broad challenge of realist and materialist approaches to received disciplinary categories and forms of practice, capturing their nascent reworking of art, philosophy, culture, theory, and science, among other fields. As such, RMA expands beyond the primarily philosophical context in which realism and materialism have developed. (shrink)

"This volume provides a long-needed anthology of major writings related to the subject of violence.

_Misapprehensions of culture and religion are used for the early marriages of women in Pakistan, which generates few significant challenges for women to pursue their higher education. The present study identifies such challenges for married women in higher education. These challenges are relevant to women’s post-marriage lifespan in rural Pakistan. Building upon Fredrickson’s (2001) and Hobfoll’s (2001) theories focused on post marriages issues, the study has developed open-ended questions for collecting in-depth information. Therefore, 43 in-depth interviews with married women were (...) conducted and through qualitative data analysis using NVIVO software, the study has highlighted that early marriages of girls have become a cultural norm, and education priorities of the girls are insignificant for parents to decide the marriage date. Married women pursuing education at marriage do not get any support from husbands and in-laws as the patriarchal norms prohibit women from stepping out from home. In these circumstances, women may get subject to the victim of many unlawful practices, including intimate partner violence (IPV). Thus, the present study findings imply that married women's participation in higher education is negligible due to weak legislation on women’s rights and strong illegitimate tribal practices._. (shrink)

This examines the six drivers and twelve detailed practices of sustainable human resource development (S-HRD) before and during the COVID-19 pandemic across different organizations in Poland. The empirical strategy is based on explorative research conducted using surveys in Poland between 2020 and 2021. The results confirm that the surveyed organizations implemented S-HRD practices driven mainly by the expectations of external stakeholders. They neglected the areas of caring for employees’ well-being and developing environmental awareness before the COVID-19 pandemic. During the pandemic, (...) most companies maintained their approach to S-HRD. This research is unique because it adds to the body of literature advocating the significance of S-HRD for organizational resilience before, during, and after extreme events. Generalizing the results is challenging because the snowball sample has significant restrictions. However, future research may overcome these shortcomings by using larger samples based on probability or random sampling techniques. (shrink)