Discussions of patient-centred care and patient autonomy in bioethics have tended to focus on the decision-making context and the process of obtaining informed consent, leaving open the question of how patients ought to be counselled in the daily maintenance of their health and management of chronic disease. Patient activation is an increasingly prominent counselling approach and measurement tool that aims to improve patients’ confidence and skills in managing their own health conditions. The strategy, which has received little conceptual or ethical (...) analysis, raises important questions about how clinicians ought to foster confidence and a sense of control in their patients without exposing them to blame, stigma and other harms. In this paper, we describe patient activation, discuss its relationship to personal responsibility, autonomy and health disparities, and make recommendations regarding its use and measurement. (shrink)

Hundreds of millions of rare biospecimens are stored in laboratories and biobanks around the world. Often, the researchers who possess these specimens do not plan to use them, while other researchers limit the scope of their work because they cannot acquire biospecimens that meet their needs. This situation raises an important and underexplored question: how should scientists allocate biospecimens that they do not intend to use? We argue that allocators should aim to maximise the social value of the research enterprise (...) when allocating scarce biospecimens. We provide an ethical framework for assessing the social value of proposed research projects and describe how the framework could be implemented. (shrink)

It seems certain that one day we will allow the genetic technology which will enhance our offspring. A highly effective new tool, called CRISPR, which allows for carving out genes, is already being used to edit the genomes of animals. In July 2017, the FDA legalized that germline drugs for therapeutic purposes could be sold in the market. It is a high time, now, that we need engage in discussions about the ethics of germline intervention. To contribute to the discussion (...) by showing our thought and to educate the public, we write this paper. (shrink)

We conjecture that corporate social responsibility can be indicative of managerial ethics and integrity and examine whether equity investors and financial analysts consider CSR performance when they assess firms’ disclosures of actual and forecasted earnings. We find that only adverse CSR performance affects investors’ assessments of these disclosures. In contrast, we find that both positive and adverse CSR performance affect analysts’ forecast revisions in response to firms’ disclosures. We also find that firms with adverse CSR performance exhibit lower disclosure quality (...) and earnings persistence, but do not find that firms with positive CSR performance exhibit higher levels of both measures. This asymmetric result is consistent with investors’, but not analysts’, assessments of the effect of CSR performance on corporate disclosures. Our results are robust to using a three-stage least squares approach to address endogeneity concerns and to a battery of robustness and sensitivity analyses. Overall, our findings suggest that investors and analysts consider CSR when assessing the information in earnings-related corporate disclosures. (shrink)

ObjectivesMany older adults with visual impairment also have significant hearing loss. The aim was to investigate the effectiveness of a newly developed Dual Sensory Loss protocol on communication and wellbeing of older persons with DSL and their communication partners in the Netherlands and Belgium.MethodsParticipants and their communication partners were randomized in the “DSL-protocol” intervention group or a waiting-list control group. The intervention took 3 to 5 weeks. Occupational therapists focused on optimal use of hearing aids, home-environment modifications and effective communication (...) strategies. The primary outcome was the Communication Strategies domain of the Communication Profile for the Hearing Impaired. Secondary outcomes measured in participants were the Low Vision Quality Of Life Adjustment subscale, the Center for Epidemiological Studies - Depression Scale, De Jong Gierveld Loneliness Scale and the Fatigue Assessment Scale. The Hearing Handicap and Disability Inventory - Reaction of Others subscale and the Care-related Quality of Life - 7 Dimensions was measured in communication partners. Measurements were taken at baseline and 3-month follow-up. Linear mixed models were used to analyze effects between groups over time for every outcome measure.ResultsIntention-to-treat analyses showed a significant effect of the DSL-protocol on the use of verbal strategies in favor of the control group, however, this effect was non-significant after adjustment for confounding. Effect sizes of other outcomes varied between −0.23 [−0.57, 0.12] and 0.30 [−0.05, 0.64]. The LMM showed a significant effect on the HHDI-Reaction of others scale in favor of communication partners in the treatment group, however, the effect did not remain significant at a 0.01 significance level and the effect size was very small and non-significant 0.12, 95% CI [−0.27 to 0.51]. Adjusted analyses did not reveal treatment effects.ConclusionThe DSL-protocol did not clearly contribute to the enhancement of communication and wellbeing in DSL-patients. Possible reasons for the lack of effects are OTs not being comfortable giving advice on communication and psychosocial issues or the short-term treatment and follow-up period. Further study is warranted to find out how the protocol may be adapted or whether it is necessary to involve mental healthcare professionals.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier NTR2843. (shrink)

Both unipolar and bipolar depression have been linked with impairments in executive functioning. In particular, mood symptom severity is associated with differences in common EF, a latent measure of general EF abilities. The relationship between mood disorders and EF is particularly salient in adolescence and young adulthood when the ongoing development of EF intersects with a higher risk of mood disorder onset. However, it remains unclear if common EF impairments have associations with specific symptom dimensions of mood pathology such as (...) blunted positive affect, mood instability, or physiological arousal, or if differences in common EF more broadly relate to what is shared across various symptom domains, such as general negative affect or distress. To address this question, bifactor models can be applied to simultaneously examine the shared and unique contributions of particular mood symptom dimensions. However, no studies to our knowledge have examined bifactor models of mood symptoms in relation to measures of common EF. This study examined associations between common EF and general vs. specific symptom dimensions using structural equation modeling in adolescents and young adults with varying severity of mood symptoms. A General Depression factor capturing shared variance across symptoms statistically predicted lower Common EF. Additionally, a factor specific to physiological arousal was associated with lower Common EF. Anhedonia-specific and Mania-specific factors were not significantly related to Common EF. Altogether, these results indicate that deficits in common EF are driven by, or reflect, general features of mood pathology that are shared across symptom dimensions but are also specifically associated with physiological arousal. (shrink)

Bear Suppression Inventory (WBSI), was I'ound to correlate with n>casurcs of obsessional thinking and depressive and anxious al'lect, t pridic( signs «I' clinical «hscssion ainong individuals prone (oward «h»c»»i«n >I (hi>>king, (« predict depression tive (h (», and to predict I''iilurc «I' electr«dermal responses to habituate am«ng pci>pic having emotional thoughts. The WBSI was inversely correlated with repression as assessed by the Repression-Sensitization Scale, and so tap» a trait that i» itc unlike rcprc»si«n:is traditi«n;illy c«nccivcd.

The National Library of Finland and the Von Wright and Wittgenstein Archives at the University of Helsinki keep the collected correspondence of Georg Henrik von Wright, Wittgenstein’s friend and successor at Cambridge and one of the three literary executors of Wittgenstein’s Nachlass. Among von Wright’s correspondence partners, Elizabeth Anscombe and Rush Rhees are of special interest to Wittgenstein scholars as the two other trustees of the Wittgenstein papers. Thus, von Wright’s collections held in Finland promise to shed light on the (...) context of decades of editorial work that made Wittgenstein’s later philosophy available to all interested readers. In this text, we present the letters which von Wright received from Anscombe and Rhees during the first nine months after Wittgenstein’s death. This correspondence provides a vivid picture of the literary executors as persons and of their developing relationships. The presented letters are beautiful examples of what the correspondence as a whole has to offer; it depicts – besides facts of editing – the story of three philosophers, whose conversing voices unfold the human aspects of inheriting Wittgenstein’s Nachlass. Their story does not only deal with editing the papers of an eminent philosopher, but with the attempt to do justice to the man they knew, to his philosophy and to his wishes for publication. (shrink)

It is difficult to reconcile claims about the Father's role as the progenitor of Trinitarian Persons with commitment to the equality of the persons, a problem that is especially acute for Social Trinitarians. I propose a metatheological account of the doctrine of the Trinity that facilitates the reconciliation of these two claims. On the proposed account, ‘Father’ is systematically ambiguous. Within economic contexts, those which characterize God's relation to the world, ‘Father’ refers to the First Person of the Trinity; within (...) theological contexts, which purport to describe intra-Trinitarian relations, it refers to the Trinity in toto-thus in holding that the Son and Holy Spirit proceed from the Father we affirm that the Trinity is the source and unifying principle of Trinitarian Persons. While this account is solves a nagging problem for Social Trinitarians it is theologically minimalist to the extent that it is compatible with both Social Trinitarianism and Latin Trinitarianism, and with heterodox Modalist and Tri-theist doctrines as well. Its only theological cost is incompatibility with the Filioque Clause, the doctrine that the Holy Spirit proceeds from both the Father and the Son—and arguably that may be a benefit. (shrink)

Introduction: Probationers, offenders with less serious and non-violent offences, and under statutory supervision, have low levels of self-esteem and physical health, and high level of family conflict, and poorer quality of family relationships. This study examined the effectiveness of the existing probation service and the additional use of a positive family holistic health intervention to enhance physical, psychological, and family well-being in probationers and relationships with probation officers.Methods: Probationers under the care of the Hong Kong Social Welfare Department were randomized (...) into a care-as-usual control group, a brief intervention group receiving two 1-h individual sessions [of a brief theory-based positive family holistic health intervention integrating Zero-time Exercise and positive psychology themes of “Praise and Gratitude” in the existing probation service], or a combined intervention group receiving BI and a 1-day group activity with family members. The outcomes were physical activity, fitness performance, self-esteem, happiness, anxiety and depression symptoms, life satisfaction, quality of life, family communication and well-being, and relationships with probation officers. Self-administered questionnaires and simple fitness tests were used at baseline, 1-month and 3-month follow-up. Linear mixed model analysis was used to compare difference in the changes of outcome variables among groups, adjusted of sex, age, and baseline values. Focus group interviews were conducted. Thematic content analysis was used.Results: 318 probationers were randomized into CAU, BI, or CI group. CAU showed enhanced physical activity, fitness performance and psychological health, and family communication with small effect sizes. BI and CI showed further improved physical activity, family communication and family well-being. Additionally, CI reported greater improvements in the relationships with probation officers than CAU with a small effect size. CI also reported greater increases in physical activity and family communication than BI with small to moderate effect sizes. Qualitative feedbacks corroborated the quantitative findings.Conclusion: Our trial provided the first evidence of the effectiveness of probation service and the additional use of an innovative, relatively low-cost, theory-based brief positive family holistic health intervention. This intervention may offer a new model for enhancing probation service.Trial Registration: The research protocol was registered at the National Institutes of Health. (shrink)

We can clarify a certain difficulty with regard to the phrase ‘the best and most perfect virtue’ in Aristotle’s definition of the human good in Nicomachean Ethics I 7 if we make use of two related distinctions: Donnellan’s attributive–referential distinction and Kripke’s distinction between speaker’s reference and semantic reference. I suggest that Aristotle is using the phrase ‘the best and most perfect virtue’ attributively, not referentially, and further that even though the phrase may refer to a specific virtue (semantic reference), (...) Aristotle is not using the phrase to refer to a specific virtue (speaker’s reference). (shrink)

In an anthology on panentheism, Keith Ward assesses the appropriateness of the metaphor of embodiment for God, as well as the viability of the concept of panentheism itself, as he considers the theologies of Ramanuja, Hegel, and process thought. Ward frames polar problems with respect to the analogy of self-body/God-world and to the concept of panentheism. Ramanuja and Hegel’s theologies ultimately deny the freedom and compromise the independence and otherness of the creatures. Process theology compromises divine sovereignty and perfection, making (...) God too passible to the world’s evils. This article attempts to transcend such one-sided approaches as it develops a balanced concept of panentheism and a metaphor of divine embodiment that provide for mutual influence between God and the world, wherein both the suffering and happiness of the world affect God, while maintaining sole divine causal ultimacy with respect to the world. (shrink)

The purpose of this article is to expose a basic flaw at the root of perennialism as a method for studying mysticism—its distinction between ‘exoteric’ and ‘esoteric’ components of mysticism and religion. Rather than being distinct, the specific ‘exoteric’ doctrines of a given mystic’s tradition penetrate the mystics’ knowledge-claims. Thus, the ‘esoteric’ dimension in a mystical tradition is permeated by that mystical tradition’s ‘exoteric’ doctrines, not by the transcultural and ahistorical perennial spine that perennialists postulate. Contrary to what the perennialists (...) suggest, there is no one underlying esoteric set of beliefs embedded in all traditional religions that all mystics share. Rather, in the different religious traditions of the world, there are genuinely different mysticisms with different beliefs, practices, values, and goals. Thus, the perennialist approach distorts the history of mysticism. It is better seen as a theology of religions than as an alleged discernment of timeless truths presented throughout the history of mysticism. (shrink)

Richard Dawkins has a dilemma when it comes to design arguments. On the one hand, he maintains that it was Darwin who killed off design and so implies that his rejection of design depends upon the findings of modern science. On the other hand, he follows Hume when he claims that appealing to a designer does not explain anything and so implies that rejection of design need not be based on the findings of modern science. These contrasting approaches lead to (...) the following dilemma: if he claims that Darwinism is necessary for rejecting design, he has no satisfactory response to design arguments based on the order in the laws of physics or the fine-tuning of the physical constants; alternatively, if Humean arguments are doing most of the work, this would undermine one of his main contentions, that atheism is justified by science and especially by evolution. In any case, his Humean arguments do not provide a more secure basis for his atheism because they are seriously flawed. A particular problem is that his argument for the improbability of theism rests on a highly questionable application of probability theory since, even if it were sound, it would only establish that the prior probability of God’s existence is low, a conclusion which is compatible with the posterior probability of God’s existence being high. (shrink)

In this essay, we set out to survey and critically assess various attitudes and understandings of reductionism as it appears in discussions regarding the scientific study of religion. Our objective in the essay is twofold. First, we articulate what we will refer to as three ‘meta-interpretative’ frameworks, which summarize the distinct positions one can witness in response to the explanations coming out of research within the new science of religion. Second, and more importantly, we seek to demonstrate that under no (...) sensible interpretation of the notion of ‘reduction’ do the explanations provide a basis for defending one of the meta-interpretative frameworks rather than another. (shrink)

The present study focuses on furthering the theoretical foundations of the field of spirituality and religiosity in the workplace by providing a parsimonious definition, and multi-dimensional model for the construct of spirituality grounded in a pluralistic and historically authentic framework using the Sophia Perennis or Perennial Philosophy. In this process, the study addresses the dilemma of religiosity versus spirituality faced by researchers in this area, 175). It also addresses concerns regarding the potential conflicts related to spirituality and religiosity that (...) could arise in a secular workplace, which emphasizes inclusiveness and equality. A three factor model of spirituality is developed using the grounded theory approach, 3–21) and is corroborated by factor analysis of multiple samples, and participants representing three major world faith traditions. (shrink)

Alvin Plantinga, in the ninth chapter ofThe Nature of Necessity, sets out a defence of the Free Will Defence (FWD)2. In what follows, I shall set out, to begin with, a statement of the main line of his argument3. I shall, then, set out a number of minor criticisms of the ninth chapter. Finally, I shall set out a criticism of Plantinga’s argument.

Under the general tutelage of Kant, Charles Sanders Peirce (1839–1914) introduced American pragmatism to yet another philosophical dialectic: between a neglected transcendental instinct and earthly authorities. The dialectic became Peirce’s response to various evolutionary schemes in the 19th century. Guided by the recollected voices of Socrates, Jesus, St. John, Anselm, and Kant, as well as his own brand of pragmatism, Peirce eventually developed a “Neglected Argument for the Reality of God” a century ago, in 1908. Here, Peirce endorsed a more (...) adventurous god than ecclesiastical or theological authorities could imagine, a god of love (agapism) and chance (tychism), but still rife with fallibility. (shrink)

This paper is a review of the influence that lógos has had on ancient Greek, Jewish, and Christian writings. During the philosophical era known as Middle Platonism, the concept/ontology of the lógos played a unique role in enabling Pagan, Jewish, and Christian intellectuals to communicate on a small space of common ground.

This paper examines a political theory implict in Kierkegaard's critique of the novel Two Ages. To achieve that aim, it views Kierkegaard as a political radical relative to modern liberalism and aristocratic conservatism of the 1840's in Denmark, by juxtaposing him to Locke. Basic to the theory is a notion of individuality which relies on three interlocking concepts: will, equality, and autonomy. That notion in turn supports ideas of authority and leadership that throw further light on Kierkegaard's understanding of the (...) relation between religion and politics and suggests what is central to the political logic operative in the critique in his publication Literary Review. (shrink)