Background: Healthcare professionals follow codes of ethics, making them responsible for providing holistic care to all disaster victims. However, this often results in ethical dilemmas due to the need to provide rapid critical care while simultaneously attending to a complex spectrum of patient needs. These dilemmas can cause negative emotions to accumulate over time and impact physiological and psychological health, which can also threaten nurse–patient relationships. Aim: This study aimed to understand the experience of nurses who cared for burn victims (...) of the color-dust explosion and the meaning of ethical relationships between nurse and patient. Research design: A qualitative descriptive study using a phenomenological approach. Participants and research context: Clinical nurses who provided care to the patients of the Formosa color-dust explosion of 2015 were selected by purposive sampling from a medical center in Taiwan. Data were collected using individual in-depth semi-structured interviews. Audiotaped interviews were transcribed and analyzed using Colaizzi’s method. Ethical considerations: This study was approved by the institutional review board of the study hospital. All participants provided written informed consent. Findings Three main themes described the essence of the ethical dilemmas experienced by nurses who cared for the burn-injured patients: the calling must be answered, the calling provoked my feelings, and the calling called out my strengths. Conclusions: Healthcare providers should recognize that nurses believed they had an ethical responsibility to care for color-dust explosion burn victims. Understanding the feelings of nurses during the care of patients and encouraging them to differentiate between the self and the other by fostering patient–nurse relationships based on intersubjectivity could help nurses increase self-care and improve patient caregiving. (shrink)

Post-stroke depression is a serious complication of stroke that significantly restricts rehabilitation. The use of immersive virtual reality for stroke survivors is promising. Herein, we investigated the effects of a novel immersive virtual reality training system on PSD and explored induced effective connectivity alterations in emotional networks using multivariate Granger causality analysis. Forty-four patients with PSD were equally allocated into an immersive-virtual reality group and a control group. In addition to their usual rehabilitation treatments, the participants in the immersive-virtual reality (...) group participated in an immersive-virtual reality rehabilitation program, while the patients in the control group received 2D virtual reality rehabilitation training. The Hamilton Depression Rating Scale, modified Barthel Index, and resting-state functional magnetic resonance imaging data were collected before and after a 4-week intervention. rsfMRI data were analyzed using multivariate GCA. We found that the immersive virtual reality training was more effective in improving depression in patients with PSD but had no statistically significant improvement in MBI scores compared to the control group. The GCA showed that the following causal connectivities were strengthened after immersive virtual reality training: from the amygdala, insula, middle temporal gyrus, and caudate nucleus to the dorsolateral prefrontal cortex; from the insula to the medial prefrontal cortex; and from the thalamus to the posterior superior temporal sulcus. These causal connectivities were weakened after treatment in the control group. Our results indicated the neurotherapeutic use of immersive virtual reality rehabilitation as an effective non-pharmacological intervention for PSD; the alteration of causal connectivity in emotional networks might constitute the neural mechanisms underlying immersive-virtual reality rehabilitation in PSD. (shrink)

Evidence suggests divergent thinking is the cognitive basis of creative thoughts. Neuroimaging literature using resting-state functional connectivity has revealed network reorganizations during divergent thinking. Recent studies have revealed the changes of network organizations when performing creativity tasks, but such brain reconfigurations may be prolonged after task and be modulated by the trait of creativity. To investigate the dynamic reconfiguration, 40 young participants were recruited to perform consecutive Alternative Uses Tasks for divergent thinking and two resting-state scans were used for mapping (...) the brain reorganizations after AUT. We split participants into high- and low-creative groups based on creative achievement questionnaire and targeted on reconfigurations of the two brain networks: default-mode network and the network seeded at the left inferior frontal gyrus because the between-group difference of AUT-induced brain activation located at the left IFG. The changes of post-AUT RSFCs indicated the prolonged effect of divergent thinking. More specifically, the alterations of RSFCIFG−AG and RSFCIFG−IPL in the high-creative group had positive relationship with their AUT performances, but not found in the low-creative group. Furthermore, the RSFC changes of DMN did not present significant relationships with AUT performances. The findings not only confirmed the possibility of brain dynamic reconfiguration following divergent thinking, but also suggested the distinct IFGN reconfiguration between individuals with different creativity levels. (shrink)

Background Ethical dilemmas that arise in the clinical setting often require the collaboration of multiple disciplines to be resolved. However, medical and nursing curricula do not prioritize communication among disciplines regarding this issue. A common teaching strategy, problem-based learning, could be used to enhance communication among disciplines. Therefore, a university in southern Taiwan developed an interprofessional ethics education program based on problem-based learning strategies. This study described tutors’ experience teaching in this program. Aim To explore the phenomenon of teaching and (...) learning in interprofessional ethics education for medical and nursing students from the perspectives of tutors. Design Phenomenological qualitative research. Methods Medical and nursing students completed a 6-week interprofessional ethics education program moderated by either physician or nurse tutors. At the conclusion of the ethics education program, all 14 tutors were invited to participate in focus group interviews. Among them, six tutors (three nursing tutors and three physician tutors) participated in additional individual interviews. All of the contents from the focus group interviews and individual interviews were recorded and transcribed. Using the phenomenological approach, the phenomenon of teaching and learning in interprofessional ethics education were generated. Ethical consideration The study was approved by the Institutional Review Board. Findings Three themes emerged from the tutors' teaching perspectives, including the instructor’s motivation to teach, the use of narrative case scenarios, and the emphasis on improving interprofessional ethics communication. Discussion Problem-based learning creates an interprofessional communication platform in interprofessional ethics education. The phenomenon of value convergence between tutors and students, between different students’ professions, and between different students’ professional maturities is observed. Conclusion Problem-based learning is an effective teaching strategy for creating a communication platform for interprofessional ethics education. Ethic curriculum should emphasize motivating instructor, use narrative case scenarios, and focus on interprofessional communication. (shrink)

This paper examines the nature of friendship and the nature of exploitation, and the intersection of the two phenomena. It argues that because vulnerability is an essential aspect of friendship, the possibility of exploitation is ineliminable in friendship. Considers how we might, nonetheless, reduce our exposure to unfair treatment in friendships.

This book is an inquiry into the philosophical concern with truth as one joint subject in philosophy of language and metaphysics and presents a theory of truth, substantive perspectivism (SP). Emphasizing our basic pre-theoretic understanding of truth (i.e., what is captured by the axiomatic thesis of truth that the nature of truth consists in capturing the way things are), and in the deflationism vs. substantivism debate background, SP argues for the substantive nature of non-linguistic truth and its notion’s indispensable substantive (...) explanatory role, both of which are not only intrinsically beyond what the linguistic function of the truth predicate can tell but are fundamentally related to the raison d’être of the truth predicate. Taking a holistic approach, SP endeavors to do justice to various reasonable perspectives, which are somehow contained in many competing accounts of truth, through a coordinate system: SP interprets such perspectives as distinct but related perspective-elaboration principles that distinctively (regarding distinct dimensions of the truth concern and/or for the sake of distinct purposes) elaborate, but are also unified by, the truth axiom thesis. To look at the issue from a broader vision, the book also takes a cross-tradition approach exploring the relationship between Daoist thinking of truth and thinking about truth in analytic philosophy.This book will enhance our systematic understanding of the issue through its holistic approach, broaden our vision on the issue via its cross-tradition approach, and enrich the conceptual and explanatory resources in treating the issue. (shrink)

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy—the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius’ teachings. However, Confucius’ emphasis on the filial piety, family values, the “love of gradation”, altruism of people, and the “role specified relation oriented ethics” will (...) inevitably influence the “specification” and application of these bioethical principles and hence tend to grant “beneficence” a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of “first among equals” are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian “doctrine of Mean” and a balanced “two dimensional personhood” approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing “giving beneficence a priority” or “asserting autonomy must triumph”. (shrink)

People often make less risky decisions for themselves than others. We examined how people allocated risks (i.e., determining the ratio of uncertain outcomes to certain outcomes) between themselves and others. We also investigated gain (vs. loss) domain and social value orientation as predictors of risk allocations. The results of three experiments demonstrated that participants were more likely to share their risks equally between themselves and others than distribute risk unequally. In the gain (vs. loss) domain, participants allocated fewer risks to (...) themselves and more risks to the other person for unequal risk allocations. Compared to proselfs, prosocials were more likely to allocate risks equally. We also found stronger domain effects on unequal risk allocations for proselfs than for prosocials. Therefore, our findings clarify the effects of risk distribution, domain, and social value orientation on interpersonal allocation decisions and highlight equal risk distribution between oneself and others. (shrink)

In this paper, I give a metaphilosophical analysis of the core idea of deflationism by discussing some basic conceptual and methodological issues involved in the debate between deflationism and substantivism. In so doing, I argue for three positive points. First, the crux of the dispute between deflationism and substantivism is whether or not truth is substantive in its metaphysical nature and in its explanatory role in philosophical enterprises, rather than whether or not a minimal approach regarding conceptual resources is taken (...) to explain truth; a minimal approach itself is philosophically innocent. Second, there is no intrinsic connection between the core idea of deflationism and the Tarski-style equivalence thesis, which is often identified as implying or supporting the former. Third, there are some unbridged fundamental gaps between the core idea of deflationism and various redundancy theses; these redundancy theses cannot be identified as the former, nor can they be used to justify the former on their own. (shrink)

Despite the growing body of research on emotional labor, little has been known about the social consequences of emotional labor. Drawing on emotional dissonance theory, the authors investigate the relationship between the felt emotional dissonance and prosocial behavior (e.g., donation to a charity). Findings from multiple studies suggest that higher emotional dissonance serially influences perceived lack of control, emotional exhaustion, lowered sympathy for others’ feeling, and subsequently lower willingness to help others. when individuals are asked to recall their past experiences (...) of emotional dissonance, they expressed lack of control and emotional exhaustion (Study 3), lower sympathy for others’ feeling (Study 1, 3), and subsequently become less willing to help others both in their intention (Study 2A and 3) and with actual money (Study 2B). Further, this negative relationship is moderated by the display rules (i.e., surface acting vs. deep acting, Study 3). Managerial and public policy implications are discussed. (shrink)

A concise alphabetic guide to the main concepts, figures, topics and important movements of thought that have shaped Chinese philosophy over the last three thousand years. The entries are concisely written, terms are cross-referenced and transcriptions are typically given in the pinyin system while the Chinese originals for important concepts are also provided. Chinese Philosophy A-Z stresses philosophical relevance in choosing entries while paying due attention to historical links between relevant ideas and movements of thought. The volume also shows how (...) some of the central ideas under discussion contribute to the philosophical enterprise as a whole. The book is aimed at students, teachers of philosophy, and educated non-specialists who are interested in Chinese philosophy, particularly those readers new to Chinese philosophy. (shrink)

In response to recent debates on the need to abandon the Dead Donor Rule (DDR) to facilitate vital-organ transplantation, I claim that, through a detailed philosophical analysis of the Uniform Determination of Death Act (UDDA) and the DDR, some acts that seem to violate DDR in fact do not, thus DDR can be upheld. The paper consists of two parts. First, standard apparatuses of the philosophy of language, such as sense, referent, truth condition, and definite description are employed to show (...) that there exists an internally consistent and coherent interpretation of UDDA which resolves the Reduction Problem and the Ambiguity Problem that allegedly threaten the UDDA framework, and as a corollary, the practice of Donation after the Circulatory Determination of Death (DCDD) does not violate DDR. Second, an interpretation of the DDR, termed ‘No Hastening Death Rule’ (NHDR), is formulated so that, given that autonomy and non-maleficence principles are observed, the waiting time for organ procurement can be further shortened without DDR being violated. (shrink)

IntroductionClinical ethics committees (CECs) support and enhance communication and complex decision making, educate healthcare professionals and the public on ethical matters and maintain standards of care. However, a consistent approach to training members of CECs is lacking. A systematic scoping review was conducted to evaluate prevailing CEC training curricula to guide the design of an evidence-based approach.MethodsArksey and O’Malley’s methodological framework for conducting scoping reviews was used to evaluate prevailing accounts of CEC training published in six databases. Braun and Clarke’s (...) thematic analysis approach was adopted to thematically analyse data across different healthcare and educational settings.Results7370 abstracts were identified, 92 full-text articles were reviewed and 55 articles were thematically analysed to reveal four themes: the design, pedagogy, content and assessment of CEC curricula.ConclusionFew curricula employ consistent approaches to training. Many programmes fail to provide CEC trainees with sufficient knowledge, skills and experience to meet required competencies. Most programmes do not inculcate prevailing sociocultural, research, clinical and educational considerations into training processes nor provide longitudinal support for CEC trainees. Most CEC training programmes are not supported by host institutions threatening the sustainability of the programme and compromising effective assessment and longitudinal support of CEC trainees. While further reviews are required, this review underlines the need for host organisations to support and oversee a socioculturally appropriate ethically sensitive, clinically relevant longitudinal training, assessment and support process for CEC trainees if CECs are to meet their roles effectively. (shrink)

Human embryonic stem cell research can bring about major biomedical breakthroughs and thus contribute enormously to human welfare, yet it raises serious moral problems because it involves using human embryos for experiment. The “moral status of the human embryo” remains the core of such debates. Three different positions regarding the moral status of the human embryo can be categorised: the “all” position, the “none” position, and the “gradualist” position.The author proposes that the “gradualist” position is more plausible than the other (...) two positions. Confucius’s moral principle of jen, which proposes a unique theory of “love of gradation”, and the principle of yi, which advocates “due treatment for persons”, are then explored. The author then argues that our moral obligations to do good to other living organisms, persons, and our families are different.Putting together the “gradualist” position on the human embryo, and Confucius’s theories of “love of gradation” and “due treatment for persons”, the author concludes that the early embryo has less ethical significance than the later fetus and adult human. The moral obligation we have toward persons is clearer and stronger than that which we have toward human embryos. Embryo research is justifiable if it brings enormous welfare to human persons that cannot be otherwise achieved. The “love of gradation” requires us, however, to extend love and respect towards other entities according to their different status. We should therefore be very cautious in using human embryos for research, acknowledging the gradualist nature of their moral status. (shrink)

In July 2002, I had the honour to be invited to give a 15 minute presentation on behalf of my country, Taiwan, on the topic of “Current system of national guidance on human subject protection in medical research” in a panel discussion of the Forum for Ethical Review Committees in Asia and the Western Pacific , World Health Organization international conference held in Chin-Mai, Thailand. In that conference, four delegates from Taiwan had a rare and therefore very precious opportunity to (...) share Taiwan’s experience in establishing and promoting “human subject protection system” with delegates from 27 WHO member countries of the region. Through the vigorous exchanges of opinion in those four …. (shrink)