The World Medical Association (WMA), the global representation of the medical profession, first adopted the International Code of Medical Ethics (ICoME) in 1949 to outline the professional duties of physicians to patients, other physicians and health professionals, themselves and society as a whole. The ICoME recently underwent a major 4-year revision process, culminating in its unanimous adoption by the WMA General Assembly in October 2022 in Berlin. This article describes and discusses the ICoME, its revision process, the controversial and uncontroversial (...) issues, and the broad consensus achieved among WMA constituent members, representing over 10 million physicians worldwide. The authors analyse the ICoME, including its response to contemporary changes and challenges like ethical plurality and globalisation, in light of ethical theories and approaches, reaching the conclusion that the document is a good example of international ethical professional self-regulation. (shrink)

Sedlakova and Trachsel (2023) argue that on the one hand, conversational artificial intelligence (CAI) does not fulfill the necessary conditions for full attribution of agency, such as having consc...

We present algebraic semantics for the classical logic of proofs based on Boolean algebras. We also extend the language of the logic of proofs in order to have a Boolean structure on proof terms and equality predicate on terms. Moreover, the completeness theorem and certain generalizations of Stone’s representation theorem are obtained for all proposed algebras.

Name der Zeitschrift: Der Islam Jahrgang: 91 Heft: 2 Seiten: 374-409.

Patients have the right to refuse their treatment; however, this refusal should be informed. We evaluated the quality of the informed refusal process in Iranian hospitals from patients' viewpoints. To this end, we developed a questionnaire that covered four key aspects of the informed refusal process including; information disclosure, voluntariness, comprehension, and provider-patient relationship. A total of 284 patients who refused their treatment from 12 teaching hospitals in the Isfahan Province, Iran, were recruited and surveyed to produce a convenience sample. (...) Patients' perceptions about the informed refusal process were scored and the mean scores of the four components were calculated. The findings showed that the practice of information disclosure was perceived to be moderate, however, comprehension, voluntariness and provider–patient relationship were perceived to be relatively good. We found that patients, who refused their care before any treatment had commenced, reported a lower quality of information disclosure and voluntariness. Patients informed by nurses and those who had not had a previous related admission, reported lower scores for comprehension and relationship. In conclusion, the process of obtaining informed refusal was relatively satisfactory except for levels of information disclosure. To improve current practices, Iranian patients need to be better informed about; different treatment options, consequences of treatment refusal, costs of not continuing treatment and follow-ups after refusal. Developing more informative refusal forms is needed. (shrink)

Organ donation is a life-saving process for patients suffering from an advanced organ failure. A disparity between donated organs and required organs for transplantation is one of the major problems in Iran. Since personal attitudes about organ donation is a main factor influencing willingness to donate organ, the present study sought to provide a deeper understanding of the attitudes of university students in Iran regarding organ donation. This qualitative study was conducted in 2016. Semi-structured interviews were held for collecting data (...) from eighty five students from various universities in Hamadan city, Iran. Using a purposive sampling method, the students were selected based on the maximum variation. The content analysis method was used for data analysis by the research team and criteria for the study’s rigor was considered. Overall, the students had positive attitudes toward organ donation by brain-dead patients. Nevertheless, not of them stated that they would become an organ donor. During the data analysis, 376 primary codes, 13 categories, and 6 themes were developed. Themes were “cognitive readiness”, “mediators of decision making”, “beliefs and motivations”, “interactions with the health system”, “dependency”, and “integrity of the body”. Also, thirteen sub-themes were developed. Many factors influence the students’ attitudes toward organ donation. Identification and explanation of these factors can help healthcare managers and policymakers for planning and improving the organ donation culture in the society. (shrink)

While the existing literature focuses on the disclosure of social information mainly by large companies, this paper concentrates on the disclosure of social information by small- and medium-sized companies (SME) listed on the Alternative Investment Market (AIM) in the U.K. The paper investigates the prevalent view that SMEs are unlikely to report social information due to their financial constraints and the perception that they have very little social conduct on which to report. Our overall evidence illustrates that, contrary to this (...) view, SMEs report social information regardless of their financial constraints, most likely in the same manner as large companies do, because they realise the significance of social reporting in establishing and retaining their corporate reputation. (shrink)

We thank our commentators for their thoughtful responses to our paper1 covering among other issues the relationships of ethics law and professional codes, the tensions between ethical universalism and cultural relativism and the phenomenon of moral judgement required when ethical norms conflict, including the norms of patient care versus obligations to others both now and in the future. Although the comments deserve more extensive discussion, in what follows we respond briefly to specific aspects of each commentary and remind readers that (...) professional codes of ethics are necessarily brief and that the International Code of Medical Ethics (ICoME) explicitly refers to the World Medical Association’s (WMA) mutually concordant and far more extensive ‘body of policies’.2 Sarela raises a fundamental and, as stated in the commentary, unresolved debate: ‘should ethics shape law or is it the converse’?3 We understand the ‘global medical ethos’ represented in the WMA’s revised ICoME to be firmly embedded in the assumption that ethics should shape law and that only where laws are so shaped do people governed by them have an ethical obligation to obey them. For the medical profession, laws permitting participation in torture or other cruel, inhuman or degrading practices and punishments are categorically unethical, and therefore, doctors must not facilitate or participate in them—difficult as it may be for some doctors in some regions or environments to act accordingly. Schantz and Mansoori claim that ‘if a code of ethics is an act of professional self-regulation and professional self-regulation is community-dependent, then a code of ethics cannot be …. (shrink)

This paper endeavors to argue that Derrida’s deconstructionist ethics can be construed as an embodiment of immanent ethics. To achieve this goal, it commences with Friedrich Nietzsche’s articulation of immanent ethics, drawing a contrast with formalist and conformist accounts of morality, exemplified in Kant. Following that, the paper explores the ethical thoughts of Michel Foucault and Gilles Deleuze to establish a connection between immanent ethics and the problem of life. In this context, we observe how immanent ethics redirects ethical concerns (...) from human consciousness to the domain of life, modes of existence, the unconscious desire and its exteriority. Within this framework, the paper characterizes Derrida’s ethics of deconstruction as a convergence of the immanence of deconstruction and deconstruction as a creative mode of life. As a result, Derrida’s formulation of ethical challenges within the context of aporias, impossibility, and responsibility can be understood as a call for resistance against conformity to established forms of life. This imbues deconstruction with an intrinsic ethical-political character. (shrink)

Theoretically, corporate social responsibility should be embedded in corporate governance structures. This paper presents evidence that this is not the case for listed UK companies. Our evidence shows that in the presence of less stringent regulatory requirements, companies tend to disclose less social information in comparison to mandatory governance information. The observed positive association between social and governance information disclosure levels provides supporting evidence that companies with more transparent governance structures tend to be socially conscientious. The paper also empirically shows (...) that the level of social information disclosure tends to vary with the size and industrial affiliation of companies, providing further evidence that listed UK companies are still treating social information as a tool to project a legitimate image. (shrink)

Today is an official holiday. It is Thursday the 11th of Ordibehesht or the 1st of May and it is a public holiday here. But this isn't because it's International Worker's Day, but because of the anniversary of the death of the prophet Mohammed. But for those of us who are second-class citizens (or to use the term that Mesbah Yazdi has coined for us merely 'ambulant pieces of flesh attached to legs', for those of us who are of no (...) use to the 'Islamic regime' -- which should in truth be referred to as 'the greatest human tragedy in the memory of recent human civilization') it makes no difference what day it is. I was up all night glued to the computer screen 'to earn my daily bread'. (Here I use the hackneyed expression 'to earn my bread' to mean precisely that and nothing more). At about 6:30 or 7:00am I fell sleep and managed briefly to flee the weight of my troubles, the totality of which I am now used to, knowing all the while that they will one day spell my end: exhaustion, back aches, eye strain, headaches, heart palpitations, and the thousand other terrible things. I was shattered. What do Mullahs know about such things? (shrink)

Legal tech is growing, and its growth provokes anxieties about the future of the legal profession as such. In this article, we examine the impact of legal tech on the central role of lawyers at law firms in crafting an imagined ‘right legal answer’ by drawing on Duncan Kennedy’s suggestion that a claim to the rightness of one’s legal propositions is a central characteristic of the legal profession. We first ask how changes in the organisation of legal services affect the (...) ability of lawyers at law firms to produce that ‘right legal answer’. While legal tech only exacerbates already ongoing processes of eradication of routine tasks, we find that it continues to mask the role of ideology in arriving at a right legal answer under a new layer of technological projection. Second, we ask how lawyers’ ability to produce ‘the right legal answer’ is affected by, first, expert systems and, second, a legal tech application named Bryter, representing a no-code system. We find that expert systems do not permit to uphold the unity of the lawyer required for Kennedy’s model of the right legal answer, but that no-code systems as Bryter do so. No-code systems can be reduced to a slogan: Have the lawyer, but evict her ideological temptations more efficiently than before! (shrink)

In Western literatures, "conflict" is a general term that refers to discord between two or more entities. In Islamic jurisprudence, however, in addition to the term "conflict", there is another term which is called tazāhum. The two terms, however, have different definitions. Conflict between two concepts, for instance, indicates that one is right and the other is wrong, while tazāhum does not necessarily have to be between right and wrong, and may appear between two equally right concepts. Moreover, conflict exists (...) on a legislative level, while tazāhum is a matter of obedience and adherence, meaning that in practice, both sides cannot continue to coexist. Conflict of interest is a known term in Western literatures, and according to D.F. Thompson, it refers to a situation where professional judgment regarding a primary interest is improperly and unjustifiably influenced by a secondary interest. Taking into account Thompson's definition and the distinction between "conflict" and "tazāhum", the English term "conflict of interest" translates to "tazāhum of interest" in Islamic jurisprudence as it refers to a person's action without reflecting right or wrong, and simply concerns priority of one interest over another. The resolution to tazāhum in Islamic jurisprudence lies in two principles: the principle of significance and the principle of choice. For instance, in case of conflict or tazāhum between the interests of patient and physician, the patient's interest should be the main concern based on the principle of significance. Although Western literatures propose methods such as disclosure or prohibition in order to resolve conflict of interest, the foundation for these solutions seems to have been the principle of significance. (shrink)

This is a reading of Gilles Deleuze’s masterpiece Logic of Sense. It provides a thorough and systematic reading of Deleuze’s book by focusing on the aspects that are neglected in the existing literature. Specifically, the claim that Deleuze’s Logic of Sense provides a convincing answer for the most important question of the history of philosophy regarding the relation between thought and existence as well as the relation between logic and ontology is defended. The answer is that if thought is related (...) to existence, logic is supposed to be, not the logic of essence, but rather the logic of sense. This analysis s pursued respectively through Deleuze’s readings of Frege, the ancient Stoics, Lewis Carroll, Kant, Lautman, Leibniz, and Melanie Klein. (shrink)

In “Iteration, Reiteration, Repetition”, Quentin Meillassoux accuses Deleuze of forming a subjectalist philosophical system, that is to say, despite his critiques of subjectivism and representationalism, Deleuze absolutizes the correlation between thought and being, while failing to grasp absolute exteriority. Meillassoux’s main argument in support of this claim is his interpretation of Deleuze’s ideas of “intensity” and “intensive difference” as a “difference of degree” instead of a “difference in nature”. In this paper, I argue against Meillassoux’s reading, and claim that, in (...) his early works, Deleuze constructs a transcendental philosophy very different from Kantian transcendentalism, in which exteriority is graspable through the evental aspects of our experience. Meillassoux accuses Deleuze of being a philosopher of continuity and homogeneity, and believes that the only way to evade subjectalism is by establishing a Cartesian dualism of subjective and objective realms. I claim, however, that Deleuze is the true philosopher of heterogeneity, and that continuity in Deleuze’s thought is simply a means of inducing heterogeneity everywhere. In order to reach the absolute, we do not need to establish a sharp dualism; what we need is a Deleuzian version of transcendental realism, which induces transcendental/empirical distinction everywhere, into both the inorganic and organic realms. (shrink)

The Declaration of Geneva is one of the core documents of medical ethics. A revision process was started by the World Medical Association in 2016. The WMA has also used this occasion to examine how the Declaration of Geneva is used in countries throughout the world by conducting a survey of all WMA constituent members. The findings are highly important and raise urgent questions for the World Medical Association and its National Medical Associations : The Declaration of Geneva is only (...) rarely used as an oath text despite the fact that physicians’ oaths are generally widespread. This is not consistent with the intention and claim of the Declaration of Geneva. The article then discusses three questions. Should there be one single binding oath? Which organization should be responsible for such an oath? Which oath is the most obvious candidate? In a globalized world and despite all cultural diversity, the medical profession should have one core moral basis which is binding for physicians all over the world. The most obvious candidate for an oath incorporating this moral basis is the Declaration of Geneva. (shrink)

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have (...) genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. (shrink)

A discussion of what operates from "within" formal agency as irreal surplus to artworks and how otherwise discursive systems become abstracted by the artwork. Text by Gavin Keeney. Images by Parsa Khalili.

Name der Zeitschrift: Jahrbuch für Wissenschaft und Ethik Jahrgang: 19 Heft: 1 Seiten: 253-276.

Today, health systems around the world are under pressure to create greater value for patients and society [81, p. 1, 119]; increasing access, improving client orientation and responsiveness, reducing medical errors and safety, restraining utilization via managed care, and implementing priority allocation of resources for high-burden health problems are examples of strategies towards this end. The quality paradigm by virtue of its strategic consumer focus and its methods for achieving operational excellence has proved an effective approach for creating higher value (...) in many sectors. If applied in a deliberate and holistic manner, the quality paradigm can bring about a more cost-effective organization of the health systems. In this article, we apply quality concepts to healthcare in a conceptual format; we characterize the health system’s customers and outputs with their quality dimensions. The product of this effort is a blueprint for a customer-driven health system which identifies six types of customers, nine types of outputs and the associated operations. As a preliminary step, a new analysis and definition of health and disease is provided. Rethinking the structure of health system in this manner and the related conceptual model can guide medical research, health sciences education, and health services policy, and help the practitioner to integrate all modern trends in healthcare delivery. (shrink)

We investigate variations of the Zitterbewegung frequency of electron due to an external static and uniform magnetic field employing the expectation value quantum approach, and compare our results with the classical model of spinning particles. We demonstrate that these two so far compatible approaches are not in agreement in the presence of an external uniform static magnetic field, in which the classical approach breaks the usual symmetry of free particles and antiparticles states, i.e. it leads to CP violation. Hence, regarding (...) the Zitterbewegung frequency of electron, the classical approach in the presence of an external magnetic field is unlikely to correctly describe the spin of electron, while the quantum approach does, as expected. We also show that the results obtained via the expectation value are in close agreement with the quantum approach of the Heisenberg picture derived in the literature. However, the method we use is capable of being compared with the classical approach regarding the spin aspects. The classical interpretation of spin produced by the altered Zitterbewegung frequency, in the presence of an external magnetic field, are discussed. (shrink)

Publication date: 11 June 2018 Source: Author: Fatemeh Nemati Sogolitappeh, Amjad Hedayat, Mehrdad Rezaee Arjmand, Mohamad Khaledian The purpose of the present study is to investigate the relationship between spiritual intelligence and emotional intelligence with resilience in undergraduate students. The population of the study included all students of Payam Noor University in Ghorveh during 2016-2017 academic years. According to the principles of statistical methodology for correlational studies, 100 students from different disciplines were selected as sample of the study using (...) simple random sampling method. In this research, King's Spiritual Intelligence Questionnaire, Bar-Ann 90-questions Emotional Intelligence Questionnaire, and Conner and Davison resilience questionnaire were used. Descriptive statistics and inferential statistics were used to analyze the data. The results of this study showed that there is a significant positive correlation between spiritual intelligence and emotional intelligence and resilience. Regression coefficients showed that spiritual intelligence and emotional intelligence predict 53.9% of the variation in resiliency. (shrink)

The aim of this phenomenological research study carried out in Iran was to capture the meaning of patients' rights from the lived experiences of patients and their companions. To achieve this, 12 semistructured interviews were conducted during 2005 in a teaching hospital in Tehran with patients and/or their companions. In addition, extensive field notes were compiled during the interviews. The data were analyzed using Benner's thematic analysis. The themes captured were classified into three main categories, with certain themes identified within (...) each category. The categories were: (1) the concept of patients' rights; (2) barriers to patients' rights; and (3) facilitators of patients' rights. The distinctive themes within each of the categories were identified as: (1a) receiving real care, (1b) focus on the patient, and (1c) equality and accessibility; (2a) dissatisfaction with caregivers, and (2b) specific work environment limitations; (3a) the patient's companion, (3b) a responsible system, and (3c) the public's awareness of rights. Although certain themes identified closely resemble those identified in international patients' bills of rights, the current study focused on themes that are particularly relevant to the Iranian sociocultural context. (shrink)

Today, the US pursues the global capture of data (understood as a significant engine of growth) by way of bi- and plurilateral trade agreements. However, the project of securing the global free flow of data has been pursued ever since the dawn of digital telecommunication in the 1960s and the US has made significant legal efforts to institutionalise it. These efforts have two phases: In the first 1970s and 80s “freedom of information” phase, the legal justification (and contestation) of the (...) global free flow of data hinged on imagining data as information, and its exchange as a practice of liberty. The second phase began in the late 1990s and continues today. In this phase, the free flow of data is aligned with a free-trade agenda in the context of first e-commerce and, starting in the 2000s, through attempts at creating a global public domain of personal data for the platform economy. The global free flow of data is an intrinsic aspect of informational capitalism. Assuming a constitutive, but not commanding role for law in informational capitalism, we conclude that the US attempt at ensuring free flow for its informational corporations is neither an entirely contingent nor a necessary outcome. It is a product of legal imagination. (shrink)

The present study aims at proposing a time series-based network public opinion emergency management decision support algorithm for the problems of low decision accuracy and long decision time in traditional similar algorithms. In this proposed algorithm, after the time series data are preprocessed, the association rules of the original indicator data of network public opinion emergencies are mined, the original indicator data matrix of NPOEs will be constructed, and the improved local linear embedding approach will be employed to obtain the (...) original indicator data of NPOEs. After carrying out the preprocessing according to the preprocessing results, the objective weight of the emergency decision index is calculated through the interval value fuzzy information entropy measurement of the emergency decision index, the emergency management decision support model is constructed, and the emergency management decision support of the NPOE is realized. The simulation experiment results show that the proposed algorithm has a better effect on the decision-making effect of the management of NPOEs, and a higher decision-making efficiency is achieved. (shrink)

Muḥammad Amīn b. Mīrzā Muḥammad Zamān Bukhārī, Muḥīṭ al-Tavārīkh. Edited by Mehrdad Fallahzadeh and Forogh Hashabeiky. Studies in Persian Cultural History, vol. 4. Leiden: Brill, 2014. Pp. ix + 112 + 388. $216, €167.

Parsa-Parsi et al systematically discuss and elucidate contentious and non-controversial ethical issues that emerged during the ICoME (International Code of Medical Ethics) revision process and the consensus they achieved. The ethical issues discussed include the physician’s duty to act in the best interests of patients and to ensure they are protected from the unjustifiable risk of harm, respect for patient autonomy and the duties of physicians during emergencies, among others. This paper examines paragraph 26, which requires doctors to provide (...) only medically justified remote treatment, ensure patients offer informed consent and adequately protect their confidentiality.1 At the peak of the COVID-19 pandemic, many countries in Europe and America implemented remote-by-default healthcare policies. At that time, the policy aimed to ensure that patients enjoyed continued access to care while protecting healthcare professionals’ health and well-being. After the COVID-19 pandemic, this policy remained in place. Regardless of the nature of their ailment, patients have consistently preferred in-person care out of concern that their health issues might not be accurately diagnosed and that they may not receive quality care …. (shrink)

Parsa-Parsi et al bring attention to the World Medical Association (WMA) and transparency to its International Code of Medical Ethics (ICoME) revisions.1 We value their report and the revised ICoME but explain here that the ICoME cannot reflect consensus among all WMA members, or the wider medical profession, given structural and epistemic injustices that restrain low-income and middle-income country (LMIC) physicians from participating in activities such as WMA revisions. Such injustices overlook experiences and contributions of those from LMICs and (...) marginalised groups, hindering their access to and influence within medicine.2 They also undermine access to information about, and from, the WMA. Recruiting new members from, and better engaging members in, LMICs would strengthen the WMA and its influence across the medical profession, and better elevate environmental sustainability as a biomedical and bioethical concern. This would be beneficial because there is controversy among physicians, bioethicists and other stakeholders about the relevance of environmental sustainability to medicine.3 4 That its addition to the ICoME was ‘uncontentious’ hints at structural and epistemic injustices in the revision process and homogeneity of those most involved in the revisions. Based on our observations as medical educators, it appears that few medical students and physicians at our institution, and few across the Caribbean and …. (shrink)

Parsa-Parsi et al assert that the International Code of Medical Ethics (ICoME) provides a professional standard that overrides conflicting national legal norms.1 While this claim is made in the context of laws that require doctors to participate in ‘acts of torture, or other cruel, inhuman, or degrading practices and punishments’ (para10 of ICoME), the underlying premise that medical ethics supersedes law requires scrutiny. It is clear that medical ethics and law are linked inextricably, but there is unresolved debate about (...) the sequence of this interaction: should ethics shape law; or is it the converse? Important principles, notably respect for patients’ autonomy, have arisen from case law and subsequently been adopted into medical ethics. As pointed out by Beauchamp and Childress, it is only ‘since the mid-1970s (that) the primary justification advanced for requirements of informed consent has been to protect autonomous choice’ (pg.118).2 Whereas, the legal obligation to respect autonomy can be traced to the early 1900s, in the landmark US case of Schloendorff v Society of New York Hospital : ‘Every human being of adult years and sound mind has a right to determine what shall be done with his own body’.1 Moreover, the term informed consent was born in law: it was coined …. (shrink)

After an intensive 4-year process, the World Medical Association (WMA) has revised its International Code of Medical Ethics (ICoME). In their report outlining this process, Parsa-Parsi et al not only describe how the WMA sought to ‘cultivat[e] international agreement’ on a ‘global medical ethos’, but also outline the philosophical framework of the ICoME: how the WMA, as the ‘global representation of the medical profession’, created and revised the ICoME through the process of international professional self-regulation.1 However, there is a (...) significant tension to be found in this framework—one which contrasts the international scope of the ICoME with the supposed source of its legitimacy. Here, we seek to characterise this tension and the doubt which it casts on the legitimacy of the ICoME. (shrink)

Paragraph 12 of the revised International Code of Medical Ethics (ICoME) states that ‘the physician should strive to practise medicine in ways that are environmentally sustainable with a view to minimising environmental health risks to current and future generations.’1 This emphasis on environmental sustainability is in line with popular discourse as well growing scholarly attention in medical ethics for healthcare’s contribution to climate change. Recent research analyses, for instance, the ‘greening’ of informed consent and related bioethical principles.2 3 It is (...) unclear what the duty of practising sustainable healthcare means at the level of doctor–patient interaction. Parsa-Parsi et al flag the potential conflict in the ICoME’s provisions if ‘the actions of physicians are influenced by environmental considerations to the detriment of patients’ (p. 2), noting that the ICoME does not provide a handhold to improve understanding of such tensions. The code ‘does not go into extensive detail, does not include comprehensive explanations nor any rules or guidance on how to reconcile its principles when they conflict’ (p. 4). For Parsa-Parsi et al, not codes, but textbooks have a crucial role to play in resolving this conflict. It is rife that professional codes can lead to internal inconsistencies and …. (shrink)