The relationship between intuition and ethical decision-making has been researched extensively during the past two decades. This study aimed at exploring empirically observable associations between intuition and the moral intensity of ethical decision-making processes. A scenario-based quantitative approach was used to collect data from 157 practising professional spirit mediums. It was found that only collective universal intuition had a significant positive association with the moral intensity of ethical decision-making processes. Personal experience intuition and collective archetype intuition were not significantly associated (...) with moral intensity. This may explain why previous studies were unable to gauge the effects of intuition on ethical decision-making. The results suggest that a pure mind can improve one’s ability to make decisions. Thus, decision-makers would benefit by being more attuned to their sense of morality. (shrink)

One of the interpretive devices that Ch'eng-kuan (澄 觀) is famous for having employed to distill the essence of the vast Mahāvaipulya Buddhāvataṃsaka Sūtra (Tafang-kuang fo-hua-yen ching 《大方廣佛華嚴經》 was a series of variations on the contemplative theme (kuan-men 觀門) of the complete interfusion (yüan-jung 圓融) of the scripture's three chief protagonists (san-sheng 三聖) ── the Buddha Vairocana (Pi-lu-che-na 毘盧遮那) and the bodhisattvas Mañjuśrī (Wen-shu-shih-li 文殊師利) and Samantabhadra (P'u-hsien 普賢). By aligning these three powerful sacred persons with a number of (...) philosophical categories that he believed to be central to the sūtra ── categories like "cause" (yin 因 ), "fruition" (kuo 果 ), "faith" (hsin 信 ), "understanding" (chieh 解), "insight" (chih 智), "practice" (hsing 行), "principle" (li 理), etc. ── he provided a focal point at which the rich and vivid meditative and liturgical lives of Hua-yen devotees could be made to converge with their philosophical reflections. -/- Although Ch'eng-kuan invoked this device in several of his writings, his most concerted development of it is a short essay entitled San-sheng yüan-jung kuan-men, which appears to have been written relatively late in his long career. Like many important Hua-yen texts, this essay seems to have been lost in China not long after its author's death. However, it was preserved in Korea and Japan and from the latter country was reintroduced to China in the last years of nineteenth century. Neither in China nor in the West has it yet been adequately studied. -/- The core of the present article is a critical edition of the Chinese text of the essay based on a careful comparison of all available versions and presented together with a copiously annotated English translation. The edition translation are preceded by a brief interpretive introduction and followed by an appendix in which are given: a detailed discussion of the work's textual history, detailed accounts of its various editions, and descriptions of its several surviving paraphrases and commentaries. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Obtaining adequate informed consent from trauma patients is challenging and time-consuming. Healthcare providers must communicate complicated medical information to enable patients to make informed decisions. This study aimed to explore the challenges of obtaining valid consent and methods of improving the quality of the informed consent process for surgical procedures in trauma patients. We conducted a systematic review of relevant English-language full-text original articles retrieved from PubMed that had experimental or observational study design and involved adult trauma patients. Studies involving (...) informed consent in clinical or research trials were excluded. Titles and abstracts of searched articles were reviewed and relevant data were extracted with a structured form. Results were synthesized with a narrative approach. A total of 2044 articles were identified in the initial search. Only eight studies were included in the review for narrative synthesis. Six studies involved orthopedic surgeries, one involved nasal bone surgeries, and one involved trauma-related limb debridement. Only one study was conducted in an emergency department. Information recall was poor for trauma patients. Risk recall and comprehension were greater when written or video information was provided than when information was provided only verbally. Patient satisfaction was also greater when both written and verbal information were provided than when verbal information alone was provided; patients who received video information were more satisfied than patients who received written or verbal information. Many articles have been published on the subject of informed consent, but very few of these have focused on trauma patients. More empirical evidence is needed to support the success of informed consent for trauma patients in the emergency department, especially within the necessarily very limited time frame. To improve the informed consent process for trauma patients, developing a structured and standardized informed consent process may be necessary and achievable; its effectiveness would require evaluation. Adequately educating and training healthcare providers to deliver structured, comprehensive information to trauma patients is crucial. Institutions should give top priority to ensuring patient-centered health care and improved quality of care for trauma patients. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

This research adopted the unified theory of acceptance and use of technology to emphasize the use of the PX Pay mobile payment app for PX Mart, the most popular supermarket in Taiwan, and examine the degree of involvement as a moderator. The influence of factors related to PX Mart’s target customer groups on their shopping intentions and usage behaviors were discussed, with subsequent benefits and optimization directions. This study indicated the following results. First, performance expectations, ease-of-use expectations, and social impact (...) enhance consumers’ behavioral intention and behavioral intention significantly influence usage behavior. Second, gender has no significant moderating effect on the proposed model. Third, age has a moderating effect from performance expectations and ease-of-use expectations, social influence on behavioral intention. Fourth, use is more significantly affected by perceived stakeholders for customers over age 50 than for those age 30–39. Fifth, the degree of involvement significantly affects the relationship between behavioral intention and usage behavior in terms of social influence and facilitating conditions effects. Finally, we provided academic and practical implications and make contributions to both the online payment industry and academia. (shrink)

The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Remarks at Harvard University Memorial Service for Benjamin I. SchwartzYu-sheng LinAmong the eminent intellectual historians in the world after World War II, Ben Schwartz was one of the most subtle and profound. He was deeply rooted in—but not confined by—the humanist tradition of Montaigne and Pascal, and this provided him with insights into the wretchedness as well as the grandeur of the human condition and with a conscious (...) Socratic moral and intellectual drive toward self-examination as a prerequisite for any inquiry into human affairs. Indeed, the distinctivecharacter of Ben's scholarship lay in his integration of morality and intellect. These humanistic resources in combination with his outstanding intellectual endowment enabled Ben to reach great heights of scholarly endeavor.To mention just a few of his many enduring achievements: Ben's thesis, advanced as early as 1951 and based on a study of the inner history of the rise of the Chinese Communist movement from a comparative perspective, developed the idea that the trajectory of Marxism eastward to Russia and China was, in fact, "a steady process of decomposition." This powerful argument has stood the test of time, whereas both the notion, on the Right, of a monolithic world communism and the idea, on the Left, of the Chinese Communist movement as the embodiment of the intellectual and moral legitimacy of Marxism fell by the wayside.His In Search of Wealth and Power: Yen Fu and the West, which offers a double mirror, with modern China illuminated by the modern West and vice versa, is a trailblazing work in intercultural intellectual history. Furthermore, The World of Thought in Ancient China, Ben's prizewinning magnum opus, which treats the whole range of ancient Chinese thought from a world-historical perspective, has achieved a methodological, no less than a historiographical, breakthrough. Ben's discussion of the need to "descend from the level of total cultural orientations to the level of shared problématiques" advances boldly beyond Max Weber's ideal-typical analysis in comparative world history. Historiographically, Ben's study of the general orientations in ancient China and their dialectical relations with the problématiques manifested in different schools of thought is the most incisive and comprehensive treatment of ancient Chinese thought to date.These great achievements derived from his ability to combine deep insights into historical realities with a humane simplicity in holding onto what is central in life. Such a simplicity was manifest in his spontaneous humility, a quality that furnished him with the moral and intellectual resources by which to develop empathetic understanding of the various strands of thought in China as well as in the West. Ben's analyses of human problems from a world-historical perspective, while characteristically erudite, subtle, complex, and at times extraordinarily brilliant, were singularly free from any trace of the influence of intellectual fashions and from any sort of [End Page 187] posturing or self-exhibition. He always struggled at the center of life and history, making the best effort to enter into the depth of human reality, drawing out its significanceas fully as he could. These great attainments were, I submit, a natural outgrowth of the strength of his moral and intellectual character, which led him to be truly open-minded and thus acutely perceptive. It was because he was so seriously interested in the study of humanity that he so seriously studied the Chinese. His universalist concerns fused with his humanist humility and thus empowered him to lift the field of Chinese studies out of its various forms of parochialism.The Confucian philosopher Xun Zi once said that the genuine scholar "explains with a humane compassion, listens with a studious attitude, and engages in disputation with an impartial mind." I know no one other than Ben Schwartz to have attained this ideal. His absolute joy in intellectual give-and-take and his delight, with his eyes gently sparkling, in reaching an understanding of a complex issue were infectious. It was indeed my good fortune and great privilege to be able to sit at the feet of Professor Schwartz. He embodied most eloquently the very essence of humanistic scholarship; his spirit is and shall always be a... (shrink)

该书收入近20篇文章。即《法家之学源出儒家》、《儒家与中国早期政党政治》、《论屈原及其时代》、《汉武帝建元新政与失败》等。.

Catching a Feather on a Fan. A Zen Retreat with Master Sheng Yen. Interpreter Ming Yee Wang. Edited with an introduction and commentaries by John Crook. Element Books, Shaftesbury 1991. xi, 126 pp. £6.99.