Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design, development and deployment of AI systems to support decision-making around (...) cardiopulmonary resuscitation and the determination of a patient’s Do Not Attempt to Resuscitate status (also known as code status). The COVID-19 pandemic has made us keenly aware of the difficulties physicians encounter when they have to act quickly in stressful situations without knowing what their patient would have wanted. We discuss the results of an interview study conducted with healthcare professionals in a university hospital aimed at understanding the status quo of resuscitation decision processes while exploring a potential role for AI systems in decision-making around code status. Our data suggest that (1) current practices are fraught with challenges such as insufficient knowledge regarding patient preferences, time pressure and personal bias guiding care considerations and (2) there is considerable openness among clinicians to consider the use of AI-based decision support. We suggest a model for how AI can contribute to improve decision-making around resuscitation and propose a set of ethically relevant preconditions—conceptual, methodological and procedural—that need to be considered in further development and implementation efforts. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

Im Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

Contemporary organizations often reciprocate to society for using resources and for affecting stakeholders by engaging in corporate social responsibility. It has been shown that CSR has a positive impact on employee attitudes. However, not all employees may react equally strongly to CSR practices. Based on socio-emotional selectivity theory, we contend that the effect of CSR on employee satisfaction will be more pronounced for older than for younger employees, because CSR practices address those emotional needs and goals that are prioritized when (...) people’s future time perspective decreases. In one multi-source field study and one experimental study, we demonstrate that CSR indeed has a stronger positive effect on employee satisfaction for older relative to younger employees. Accordingly, engaging in CSR can be an attractive tool for organizations that aim to keep their aging workforce satisfied with their job. (shrink)

The aim of the article is to introduce a new concept of “pain-related bodily doubt,” which complements current concepts currently in use, such as pain-related fear, pain catastrophizing, and pain self-efficacy. This new concept, adapted from recent philosophical work on illness experience, has the potential to positively contribute to pain research and clinical practice by providing a vocabulary for clinicians and patients to discuss implicit or tacit dimensions of pain-related experiences.

BackgroundThe need for an ethical debate about the use of coercion in intensive care units (ICU) may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their (...) ICU stay will shed different light on intensive care management. Patients' experiences of loss of control, dependency and abandonment may lead to a new approach towards a broader approach to the concept of coercion in intensive care. The aim of our research is to explore the experiences of patients and relatives in the ICU and to determine when it might be possible to reduce feelings and memories of coercion.MethodsWe conducted and analysed 29 semi-structured interviews with patients and relatives who had been in the ICU a few months previously. Following a coding and categorisation process in MAXQDA™, a rigorous qualitative methodology was used to identify themes relevant to our research.ResultsFive main themes emerged: memory issues; interviewees’ experiences of restricting measures and coercive treatment; patients’ negative perception of situational and relational dependency with the risk of informal coercion; patients’ perceptions of good care in a context of perceived dependency; progression from perception of coercion and dependency to respect for the person. All patients were grateful to have survived. However, coercion in the form of restraint, restriction of movement, and coercive treatment in the ICU was also acknowledged by patients and relatives. These included elements of informal coercion beyond restraints, such as a perceived negative sense of dependence, surrender, and asymmetrical interaction between the patient and health providers.ConclusionsTo capture the full range of patients' experiences of coercion, it is necessary to expand the concept of coercion to include less obvious forms of informal coercion that may occur in dependency situations. This will help identify solutions to avoid or reduce negative recollections that may persist long after discharge and negatively affect the patients' quality of life. (shrink)

Emotions are a core factor of learning. Studies have shown that multiple emotions are co-experienced during learning and have a significant impact on learning outcomes. The present study investigated the importance of multiple, co-occurring emotions during learning about human biology with MetaTutor, a hypermedia-based intelligent tutoring system. Person-centered as well as variable-centered approaches of cluster analyses were used to identify emotion clusters. The person-centered clustering analyses indicated three emotion profiles: a positive, negative and neutral profile. Students with a negative profile (...) learned less than those with other profiles and also reported less usage of emotion regulation strategies. Emotion clusters identified through spectral co-clustering confirmed these results. Throughout the learning activity, emotions built a stable correlational structure of a positive, a negative, a neutral and a boredom emotion cluster. Positive emotion cluster scores before the learning activity and negative emotion cluster scores during the learning activity predicted learning, but not consistently. These results reveal the importance of negative emotions during learning with MetaTutor. Potential moderating factors and implications for the design and development of educational interventions that target emotions and emotion regulation with digital learning environments are discussed. (shrink)

Rooftop gardens, rooftop greenhouses and indoor farms have been established or planned by activists and private companies in Berlin. These projects promise to produce a range of goods that could have positive impacts on the urban setting but also carry a number of risks and uncertainties. In this early innovation phase, the relevant stakeholders’ perceptions and social acceptance of ZFarming represent important preconditions for success or failure of the further diffusion of this practice. We used the framework of acceptance to (...) investigate the stakeholders’ attitudes and to identify the key factors that might hinder or promote the introduction of ZFarming. The results are based on an analysis of 38 qualitative interviews conducted with key stakeholders in Berlin. As the results show, major perceived benefits of ZFarming include improved consumer awareness, education, and the creation of experimental spaces. Stakeholders further perceive opportunities for resource savings, new business models, repurposing of abandoned buildings and improved aesthetics. Major perceived risks are associated with growing techniques that are considered “unnatural”, health risks, conflicts with images of traditional agriculture, the rejection of animal production in urban areas, the risk of projects being too expensive and too complex or being implemented too early, i.e. before the mechanisms are fully understood. The analysis further reveals which contextual factors—political, legal, market-related, spatial or societal—might negatively or positively influence ZFarming acceptance. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. (shrink)

ZusammenfassungIm Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

ObjectiveBreast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time.MethodsWomen with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses (...) were stratified for couples’ sexual activity status at baseline.ResultsA total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline.ConclusionSexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality. (shrink)

This edited volume traces cultural appearances of disgust and investigates the varied forms and functions disgust takes and is given in both established and vernacular cultural practises. Contributors focus on the socio-cultural creation, consumption, reception and experiencing of disgust, a visceral emotion whose cultural situatedness and circulation has historically been overlooked in academic scholarship. Chapters challenge and supplement the biological understanding of disgust as a danger reaction and as a base emotion evoked by the lower senses, touch, taste and smell, (...) through a wealth of original case studies in which disgust is analyzed in its aesthetic qualities, and in its cultural and artistic appearances and uses, featuring visual and aural media. Because it is interdisciplinary, the book will be of interest to scholars in a wide range of fields, including visual studies, philosophy, aesthetics, sociology, history, literature, and musicology. (shrink)

Human–robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human–robot interaction experiments. For that, we analyzed 201 videos of five human–robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social (...) norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, but they often smile, when in an error situation with the robot. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human–robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

Michael A. PetersBeijing Normal UniversityMy deepest condolences to Pepe, Dom and Marcus and to Jim’s grandchildren. Tina and I spent a lot of time at the Marshall family home, often attending dinn...

The current informal practice of pharmacometrics as a combination art and science makes it hard to appreciate the role that informatics can and should play in the future of the discipline and to comprehend the gaps that exist because of its absence. The development of pharmacometric informatics has important implications for expediting decision making and for improving the reliability of decisions made in model-based development. We argue that well-defined informatics for pharmacometrics can lead to much needed improvements in the efficiency, (...) effectiveness, and reliability of the pharmacometrics process. The purpose of this paper is to provide a description of the pervasive yet often poorly appreciated role of informatics in improving the process of data assembly, a critical task in the delivery of pharmacometric analysis results. First, we provide a brief description of the pharmacometric analysis process. Second, we describe the business processes required to create analysis-ready data sets for the pharmacometrician. Third, we describe selected informatic elements required to support the pharmacometrics and data assembly processes. Finally, we offer specific suggestions for performing a systematic analysis of existing challenges as an approach to defi ning the next generation of pharmacometric informatics. (shrink)

This study investigates the increased commercialization of African indigenous vegetables (AIV)—former subsistence crops such as African nightshade, cowpea leaves and amaranth species grown mainly by women—from a feminist economics perspective. The study aims to answer the following research question: How does AIV commercialization affect the gendered division of labor, women’s participation in agricultural labor, their decision-making power, and their access to resources? We analyze commercialization’s effects on gender relations in labor and decision-making power and also highlight women’s agency. Based on (...) a mixed method design and analyzing household-level panel data and qualitative focus groups from Kenya, we observe an economic empowerment of women that we relate to women’s individual and collective strategies as well as their retention of control over AIV selling and profits. Yet, while we see economic empowerment of women through commercialization—how they broaden their scope of action and are empowered by generating revenue—that does not contribute to a redistribution of labor or land rights, which are key for gender equality, instead it increases women’s labor burden. (shrink)

Experiences of discrimination such as everyday racism can negatively affect the mental and physical health of children and adolescents with an immigrant background and impair their integration process in the host societies. Although experiences of racism are part of the everyday life of many minors affected by the process of “Othering”, an overview of empirical findings is missing for this age group worldwide. A systematic review was conducted to identify and analyze international research on the impact of discrimination on the (...) developmental outcomes and integration of immigrant children and adolescents. Three scientific databases were systematically searched up to June 11, 2021. A total of k = 4,769 identified publications were reviewed based on inclusion and exclusion criteria in terms of the PICOS format by independent reviewers. Thirty-four primary studies published between 1998 and 2021 met all inclusion criteria. The samples examined were mainly migrant youth, with only k = 2 studies assessing refugee youth and k = 1 study assessing both migrant and refugee youth. The majority of included studies assessed perceived discrimination, with only k = 1 study directly assessing experiences of racism. The association between discrimination or racism and developmental outcomes was assessed by the included studies within the three main topics of mental and physical health-related outcomes, school-related outcomes, and other developmental outcomes. Data collection procedures were implemented, and findings on minors’ developmental outcomes and integration process who experience discrimination and racism were summarized and discussed. The current review suggests experienced discrimination as a negative predictor of children and adolescents’ health-related outcomes, while no clear results could be found for the association between discrimination and school-related outcomes. A need for more empirical research focusing on the path and indirect link between discrimination and children and adolescents’ school-related outcomes as well as resulting school recommendations and the chosen career path was derived.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=260291], identifier [CRD42021260291]. (shrink)

Through the ages, many thinkers have worried that our death fears mar our lives. Sharing this worry, the Epicureans have argued that we can live well only if we see death for what it is: a mere “nothing” that it is ill-fitting to fear. I show how this argument depends on the assumption that a mental state theory of well-being is correct. If we give up this assumption, it can be fitting to fear death. Using my philosophical discussion of when (...) and how it is fitting to fear death, I formulate three strategies for keeping our death-related fears in check. In this way, my paper follows the therapeutic tradition in philosophy, whose potential I urge effective altruists to explore. (shrink)

Due to the societal dissemination of digital technology, people are increasingly experiencing environmental topics through digital media channels such as social networks. Several researchers therefore have proposed these channels as a possibility to strengthen sustainable development based on their cost-efficient nature. But while prior studies have investigated isolated factors for understanding environmental social media behavior, there is still scarce understanding of the relevant underlying motivational factors and possible connections with more traditional environmental behaviors. Therefore, the present study applied the established (...) socio-psychological model of goal-directed behavior (MGB) and compared the desires for liking as a fundamental form of digital social media behavior with the desires for two traditional environmental behaviors (money donation and volunteering) in a cross-sectional research design. Within the biodiversity conservation case of the Andean bear (Tremarctos ornatus) in Ecuador, we compared the antecedents for the desires for the corresponding environmental behaviors (RQ1) as well as their connections between each other (RQ2). Within a sample of 407 Ecuadorian students (Mage = 20.94 years, SD = 2.25, 61.2 % female), we found the marginal effect of perceived behavioral control on the desires for liking on social media as the main difference concerning the antecedents of the behaviors because money donation and volunteering largely depended on personal resources such as time or money. Furthermore, gender emerged as the second main difference between the behaviors due to it only being predictive for the liking motivation. Enjoyment was the only variable that coherently predicted all three behaviors. Finally, desires for liking on social media predicted both other behaviors in robust regression analyses, but were only predictive for volunteering in corresponding path models. The results illustrate how cost-efficient digital environmental behaviors such as liking may be suitable for sparking low-level environmental action, which may entail more pronounced forms of environmental activism, at least when they involve feasible personal costs. Overall, the findings are in line with prior research regarding the less demanding nature of liking, but further elaborate on the importance of gender for digital environmental behavior and correlates between digital and classical environmental behaviors. (shrink)

Critical reasoning (CR) when confronted with contradictory information from multiple sources is a crucial ability in a knowledge-based society and digital world. Using information without critically reflecting on the content and its quality may lead to the acceptance of information based on unwarranted claims. Previous personal beliefs are assumed to play a decisive role when it comes to critically differentiating between assertions and claims and warranted knowledge and facts. The role of generic epistemic beliefs on critical stance and attitude in (...) reflectively dealing with information is well researched. Relatively few studies have been conducted on the influence of domain-specific beliefs, i.e. beliefs in relation to specific content encountered in a piece of information or task, on the reasoning process, and on how these beliefs may affect the information-processing and decision-making processes. This study focuses on students’ task- and topic-related beliefs that may influence their reasoning when dealing with multiple and partly contradictory sources of information. To validly assess CR among university students, we used a newly developed computer-based performance assessment in which the students were confronted with an authentic task which contains theoretically defined psychological stimuli for measuring CR. To investigate the particular role of task- and topic-related beliefs on CR, a purposeful sample of 30 university students took part in a performance assessment and then were interviewed immediately afterwards. In the semi-structured cognitive interviews, the participants’ task-related beliefs were assessed. Based on qualitative analyses of the interview transcripts, three distinct profiles of decision-making among students have been identified. More specifically, the different types of students’ beliefs and attitudes derived from the cognitive interview data suggest their influence on information processing, reasoning approaches and decision-making. The results indicated that the students’ beliefs had an influence on their selection, critical evaluation and use of information as well as on their reasoning processes and final decisions. (shrink)

Cofactor squelching is the term used to describe competition between transcription factors (TFs) for a limited amount of cofactors in a cell with the functional consequence that TFs in a given cell interfere with the activity of each other. Since cofactor squelching was proposed based primarily on reporter assays some 30 years ago, it has remained controversial, and the idea that it could be a physiologically relevant mechanism for transcriptional repression has not received much support. However, recent genome‐wide studies have (...) demonstrated that signal‐dependent TFs are very often absent from the enhancers that are acutely repressed by those signals, which is consistent with an indirect mechanism of repression such as squelching. Here we review these recent studies in the light of the classical studies of cofactor squelching, and we discuss how TF cooperativity in so‐called hotspots and super‐enhancers may sensitize these to cofactor squelching. (shrink)

If few authors have paid much attention to the feminine concerns in new reproductive technologies, actually it is mainly some feminist authors, who, to a great extent, have allowed these concerns to enter into public debate. On the other hand, the preoccupation about women's interests and points of view is a feature in common of all feminist approaches, independently of their other philosophical concepts. Nevertheless, another feature of feminist discourses is their plurality and heterogeneity. So, we have not find back (...) answers to the questions we have analysed in this paper, because there is not only one answer. This is not an inconvenience but an incentive to continue the democratic debate within the framework of plurality and tolerance. We must incorporate to this debate the, often forgotten, women's own interests, and a critical view of the underlying assumptions and biases. These two points of view are common to the majority of feminist approaches, and should be seriously considered as worthy to be incorporated to our discourses when debating the issues linked to the new reproductive technologies. (shrink)

Providing high-quality education for students with emergent proficiency in the language of instruction (referred to here as multilingual students) presents a challenge to inclusion for educational systems the world over. In Austria, a new German language support model was implemented in the school year 2018/19 which provides language support in separate classrooms up to 20 h a week. Since its implementation, the model has been strongly criticized for excluding multilingual students from the mainstream classroom, which is argued to reinforce the (...) educational disadvantages that they face. The study presented here provides unprecedented qualitative insight into how schooling for students within the so-called German language support classes (GLSC) was organized during the COVID-19 pandemic. It builds on results of a previous large-scale quantitative study (n= 3,400 teachers), which was conducted during the first lockdown (spring 2020) and indicated a high risk of exclusion for marginalized students, especially for multilingual students in GLSC. To gain deeper insights into the situation of these students during school closures, 37 teachers who work in these classes at both primary and lower-secondary schools in Vienna were interviewed, of which 18 interviews were considered for analysis. The interviews focus on the situation during the first and second school closures in the city of Vienna. A thematic analysis of the interview data reveals teachers’ perceptions of aspects which harmed or promoted inclusion for students in GLSC during these periods of school closure. Teachers’ perceptions of the most harming factors for students included strong language barriers between teachers and students, restricted access to technical equipment and supportive learning spaces, and low parental engagement. A development that promoted inclusion of these students was the option to allow them to come to school during the second school closure. Since existing studies on the schooling of students during school closures have hardly addressed the situation of students in GLSC, this study contributes to closing this research gap. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

Business leaders are increasingly responsible for the societal and environmental impacts of their actions. Yet conceptual views on responsible leadership differ in their definitions and theoretical foundations. This study attempts to reconcile these diverse views and uncover the phenomenon from a business leader’s point of view. Based on rational egoism theory, this article proposes a formal mathematical model of responsible leadership that considers different types of incentives for stakeholder engagement. The analyses reveal that monetary and instrumental incentives are neither sufficient (...) nor necessary for business leaders to consider societal and environmental stakeholder needs. Non-monetary and non-instrumental incentives, such as leaders’ values and authenticity, as well as their planning horizons, counterbalance pure monetary and instrumental orientations. The model in this article complements the growing body of research on responsible leadership by reconciling its various conceptual views and providing a foundation for future theory development and testing. (shrink)

Many apps request access to users’ contacts or photos and many consumers agree to these requests. However, agreeing is ethically questionable as it also gives apps access to others’ data. People thus regularly infringe each other’s information privacy. This behavior is at odds with offline practices and still poorly understood. Introducing a novel application of the theory of neutralization, we explore how people justify the giving away of others’ data and the emerging norms surrounding this behavior. To obtain a deeper (...) understanding of the potentially ambiguous norms surrounding the behavior, we investigate how people justify, i.e., neutralize, the behavior from both offender and victim perspectives. Across four studies, offenders appear more likely to admit to moral wrongdoing than victims assume. This suggests moral disagreement between offenders and victims. The discrepancy appears to be reasonably robust across different samples, apps and whether the other is identified, but diminishes when people learn how easily others’ data could be protected. These insights offer suggestions for businesses, consumers and public policy. (shrink)

This book offers a new account of what it is to act for a normative reason. The first part of the book examines the problems of causal accounts of acting for reasons and suggests to solve them by a dispositional approach. The author argues for a dispositional account which unites epistemic, volitional, and executional dispositions in a complex normative competence. This ‘Normative Competence Account’ allows for more and less reflective ways of acting for normative reasons. The second part of the (...) book clarifies the relation between the normative reason that an agent acts for and his or her motivating reasons. It refutes the widely held ‘identity view’ that acting for a normative reason requires the normative reason to be identical with a motivating reason. The author describes how normative reasons are related to motivating reasons by a relation of correspondence, and proposes a new understanding of how normative reasons explain those actions that are performed for them. Determined by Reasons engages with current debates from a wide range of different philosophical areas, including action theory, metaethics, moral psychology, epistemology, and ontology, to develop a new account of acting for normative reasons. (shrink)