This study investigated the usefulness of the six-item Stress and Anxiety to Viral Epidemics scale and the Coronavirus Anxiety Scale as tools to assess anxiety related to coronavirus disease in cancer patients. A total of 221 patients with cancer responded to an anonymous online questionnaire between 15 July and 15 August 2020. The functional impairment of the patients was assessed using the Work and Social Adjustment Scale, and the SAVE-6 and CAS were also applied. Among these 221 cancer patients, 110 (...) had SAVE-6 scores ≥ 15 and 21 had CAS scores ≥ 5. Within the study population, 104 and 29 patients had WSAS scores ≥ 11 and ≥ 21, respectively. The correlations between the SAVE-6 and WSAS and CAS scores were statistically significant. The cut-off for the SAVE-6 was 15 points, while that for the WSAS was 11. Our results suggested that the SAVE-6 and CAS could be used to evaluate moderate and severe degrees of functional impairment related to mental health, respectively, in cancer patients during viral epidemics. (shrink)

Background Nurses providing care to patients with end-of-life or terminal illnesses often encounter ethically challenging situations leading to moral distress. However, existing quantitative studies have examined moral distress using instruments that address general clinical situations rather than those specific to end-of-life care. Furthermore, qualitative studies have often been limited to participants from a single unit or those experiencing moral distress-induced circumstances. A comprehensive and integrated understanding of the overarching process of moral distress is vital to discern the unique circumstances surrounding (...) end-of-life care and its consequential impacts. Research objectives To explore the moral distress experiences of nurses who are frequently involved in caring for patients with end-of-life or terminal illnesses and apply it to two existing theories: the model of moral distress and the ecological model. Research design A qualitative descriptive approach was employed. Participants and research context Seven focus group interviews involving 30 nurses were performed. The subsequent transcriptions underwent rigorous content analysis. Ethical considerations We obtained Institutional Review Board approval from a university. Focus group interviews were conducted with nurses who agreed to participate and signed the consent form. Findings The moral distress-inducing factors and nurses’ perceived impact of moral distress were identified and categorized based on moral distress theories and ecological models. A total of 15 categories and 30 subcategories across the following 4 domains were derived: (1) intrapersonal, (2) interpersonal, (3) organizational, and (4) structural factors. Conclusions End-of-life-specific circumstances induced moral distress among nurses, with both negative and positive impacts identified. Effective organizational and policy support is essential to manage conflicts, form a healthy organizational culture, provide training, and prevent unnecessary expenses due to the negative consequences of moral distress. (shrink)

BackgroundThis study aimed to identify the healthcare providers’ experience and perspectives toward end-of-life care decisions focusing on end-of-life discussion and physician’s order of life-sustaining treatment documentation in Korea which are major parts of the Life-Sustaining Treatment Act.MethodsA cross-sectional survey was conducted using a questionnaire developed by the authors. A total of 474 subjects—94 attending physicians, 87 resident physicians, and 293 nurses—participated in the survey, and the data analysis was performed in terms of frequency, percentage, mean and standard deviation using the (...) SPSS 24.0 program.ResultsStudy results showed that respondents were aware of terminal illness and physician’s order of life-sustaining treatment in Korea well enough except for some details. Physicians reported uncertainty in terminal state diagnosis and disease trajectory as the most challenging. Study participants regarded factors (related to relationships and communications) on the healthcare providers’ side as the major impediment to end-of-life discussion. Study respondents suggested that simplification of the process and more staff are required to facilitate end-of-life discussion and documentation.ConclusionBased on the study results, adequate education and training for better end-of-life discussion are required for future practice. Also, a simple and clear procedure for completing a physician’s order of life-sustaining treatment in Korea should be prepared and legal and ethical advice would be required. Since the enactment of the Life-Sustaining Treatment Act, several revisions already have been made including disease categories, thus continuous education to update and support clinicians is also called for. (shrink)

A dearth of literature focuses on the relationship between acculturation, power distance and liminality for migrant nurses entering foreign workplaces. Expectations are for migrant nurses to be practice‐ready swiftly. However, this aspiration is naïve given the complex shifts that occur in deeply held cultural beliefs and practices and is dependent on an organisational climate of reciprocal willingness to adapt and learn. This exploratory study identified that although a plethora of literature addresses challenges migrant nurses face, there are limited data that (...) link these transitional processes to concepts that might usefully guide transitions. This study draws from the overarching concept of acculturation, together with Hofstede's (2011) notion of power distance and the theory of liminality to explore the experiences of eight migrant nurses. Data highlighted that adjusting to altered hierarchical relationships took many months because negotiating power distance challenged deeply held beliefs and assumptions about professional and organisational hierarchies. Migrant nurses’ accounts indicated a paucity of organisational processes to address these difficulties; therefore, they navigated this liminal space of adjustment to power distance differences in an ad hoc manner. Their acculturation experiences, arguably unnecessarily prolonged, indicate the value in workplace commitment to exploring a collaborative, critically reflective approach to optimise transitions. (shrink)

La philosophie Ricœurienne de la religion suit l’anthropologie kantienne, la bonté originaire et le mal radical de la nature humaine. Ricœur, toutefois, considère le problème du mal plus profondément que Kant. Il cherche alors, dans le kérygme religieux, la motivation plus profonde que le motif autonome, alors que Kant, par l’interprétation allégorique, s’adonne à la démystication de la religion historique. Le Dieu nommé s’addresse, au-delà du Dieu conceptuel kantien, au sens super-abondant au millieu du non-sens de la vie et ouvre (...) l’horizon de théonomie. Celle-ci fait du commandement de l’amour un appel non-violent; l’amour qui réunit la forme universelle et la matière particulière de la norme morale. (shrink)

This article addresses the 2nd Korean consensus conference on cloning that was held by the Korean National commission for UNESCO in 1999. It notes that the citizens participated directly and handled the important social agenda through deliberative process. The consensus conference is another democratic form derived from preference aggregative democracy in the sense that it basically depends on public judgment of the citizens.Compared to other models (elitist or preference aggregative), it has some advantages: 1. It can solve the problem of (...) political legitimacy. 2. It can check the partiality of expert groups in biotechnology and ethics. 3. It enables us to make informed, responsible decisions. 4. It results in education of citizens’ preference.However, we need to expand the deliberative model. First, we need institutional efforts on behalf of future generations because cloning relates to them. Second, we should not confine deliberation to logical argument, but expand deliberation to include the value of life which cannot be expressed in the form of argument or discourse. (shrink)

This article analyses the relationship between rights and capabilities in order to get a better grasp of the kind of consequentialism that the capability theory represents. Capability rights have been defined as rights that have a capability as their object (rights to capabilities). Such a definition leaves the relationship between capabilities and rights to a great extent underspecified since nothing is said about the nature of those rights. Hence, it is not precluded that they are mere negative liberties, something that (...) capability theorists deny. On the other hand, to say that all capability rights are substantive in the sense that they themselves are capabilities (rights as capabilities) will in a significant number of cases fail to match well with our intuitions. This article presents an account of the relationship between rights and capabilities that avoids these problems of underspecification and of plausibility, respectively. First, it is argued that to take the idea of capability rights seriously, three new ‘list issues’ need to be addressed. Second, developing a point made by Nussbaum, it is argued that capability rights are to be defined as being purely instrumental. Whereas the resulting analysis of capability rights solves the problems of underspecification and plausibility, it raises doubts about the claim that the capability approach gives more importance to rights than do traditional forms of consequentialism. (shrink)

Learning to solve a class of problems can be characterized as a search through a space of hypotheses about the rules for solving these problems. A series of four experiments studied how different learning conditions affected the search among hypotheses about the solution rule for a simple computational problem. Experiment 1 showed that a problem property such as computational difficulty of the rules biased the search process and so affected learning. Experiment 2 examined the impact of examples as instructional tools (...) and found that their effectiveness was determined by whether they uniquely pointed to the correct rule. Experiment 3 compared verbal directions with examples and found that both could guide search. The final experiment tried to improve learning by using more explicit verbal directions or by adding scaffolding to the example. While both manipulations improved learning, learning still took the form of a search through a hypothesis space of possible rules. We describe a model that embodies two assumptions: the instruction can bias the rules participants hypothesize rather than directly be encoded into a rule; participants do not have memory for past wrong hypotheses and are likely to retry them. These assumptions are realized in a Markov model that fits all the data by estimating two sets of probabilities. First, the learning condition induced one set of Start probabilities of trying various rules. Second, should this first hypothesis prove wrong, the learning condition induced a second set of Choice probabilities of considering various rules. These findings broaden our understanding of effective instruction and provide implications for instructional design. (shrink)

This paper presents a non-preference-based approach to the analysis of negative freedom. It is argued that a proper understanding of (different conceptions of) negative freedom necessitates an examination of the consequences of changes in the set of feasible alternatives. For this reason the paper does not focus on freedom rankings of opportunity sets but on freedom rankings of opportunity situations, i.e., pairs consisting of a feasible set and an opportunity set. Three different freedom rankings of opportunity situations are axiomatically characterised. (...) Each of the three rankings forms a generalisation of the purely cardinality-based freedom ranking of opportunity sets presented by Pattanaik and Xu (1990). (shrink)

Recent theories of negative freedom see it as a value-neutral concept; the definition of freedom should not be in terms of specific moral values. Specifically, preferences or desires do not enter into the definition of freedom. If preferences should so enter then Berlin's problem that a person may enhance their freedom by changing their preferences emerges. This paper demonstrates that such a preference-free conception brings its own counter-intuitive problems. It concludes that these problems might be avoided if the description of (...) the constraints which specify an agent's lack of freedom include the intentions of those who constrain the agents. (Published Online July 31 2007) Footnotes1 Versions of this paper have been read to a diverse set of academics in Bayreuth, Germany; Groningen, Netherlands; LSE, UK; and in Dublin, Ireland. We would like to thank participants at those sessions for their comments. We also thank anonymous referees, Ian Carter and Luc Bovens for their help in improving the paper. (shrink)

Naturalism is a pan-Asian view of the world and way of life. Unlike the atheistic naturalism in the West, Asian naturalism, which rests upon an organic view of the world as represented by key concepts such as the Dao, Heaven, and Emptiness, is basically spiritual. Going beyond the traditional Western antithesis of naturalism and supernaturalism, matter and spirit, it can even be called “supernatural naturalism.” As a living example of Asian naturalism, this article examines the ethics of threefold reverence: reverence (...) toward Heaven, all human beings, and all beings, animate and inanimate. Threefold reverence constitutes the cardinal teaching of Cheondogyo or the Eastern Learning, a native Korean religio-philosophical movement which arose in the latter half of the nineteenth century. The ecological-environmental crisis of our age cannot be overcome without a fundamental change in our attitude toward nature. Recovering humanity’s primal sense of reverence toward all beings in nature is a vital part of this change. (shrink)

Dutch euthanasia legislation states that an act of euthanasia is only permissible if it is based on a voluntary request made in a situation of unbearable suffering to which there are no alternatives.The central question of this article is whether these criteria can be satisfied simultaneously. In an analysis of several (partly overlapping) definitions of voluntariness it is argued that there are circumstances in which this question should be answered negatively.The possible incompatibility of the criteria reveals a tension between different (...) defences of the permissibility of euthanasia. (shrink)

Luther’s beliefs provide three avenues of change for the Korean church and Korean society at large. First, Luther’s argument about two different kingdoms can help the Korean church set itself free from the deeply rooted political attachment stemming from the ideological conflict with North Korea over the past six decades. Second, Luther’s understanding of the individual’s inner mind as the locus of revelation of the divine truth is expected to enhance an autonomous self-determination that is independent of the collective mindset (...) of the multitude, which leads to the naissance of being truly individual. Lastly, Luther’s ethics of love will hopefully improve the public awareness concerning human rights of criminals and, through his vocation theory, give the vision of a unified organic society that Rises above the possessive individualism that spread widely during Korea’s rapid economic growth. (shrink)

This paper presents a formal framework that purports to capture some aspects of Kant's theory of freedom. In particular, we argue that the analysis sheds further light on Kant's distinction between a negative and a positive concept of freedom. The paper shows that the two concepts are not equivalent: we not only argue that in a Kantian perspective negative freedom need not entail positive freedom, but also that there are situations in which a person can be said to be positively (...) but not negatively free (in a Kantian sense). (shrink)