This paper elucidates and rationalizes the ethical governance system for healthcare AI research, as outlined in the ‘Research Ethics Guidelines for AI Researchers in Healthcare’ published by the South Korean government in August 2023. In developing the guidelines, a four-phase clinical trial process was expanded to six stages for healthcare AI research: preliminary ethics review (stage 1); creating datasets (stage 2); model development (stage 3); training, validation, and evaluation (stage 4); application (stage 5); and post-deployment monitoring (stage 6). Researchers identified (...) similarities between clinical trials and healthcare AI research, particularly in research subjects, management and regulations, and application of research results. In the step-by-step articulation of ethical requirements, this similarity benefits from a reliable and flexible use of existing research ethics governance resources, research management, and regulatory functions. In contrast to clinical trials, this procedural approach to healthcare AI research governance effectively highlights the distinct characteristics of healthcare AI research in research and development process, evaluation of results, and modifiability of findings. The model exhibits limitations, primarily in its reliance on self-regulation and lack of clear delineation of responsibilities. While formulated through multidisciplinary deliberations, its application in the research field remains untested. To overcome the limitations, the researchers’ ongoing efforts for educating AI researchers and public and the revision of the guidelines are expected to contribute to establish an ethical research governance framework for healthcare AI research in the South Korean context in the future. (shrink)

In the current era of the Sustainable Development Goals, many countries are attempting to strengthen their health system and achieving Universal Health Coverage. The Korean National Health Insurance system functions as a core element of health financing, contributing to achieving UHC by promoting public health and social security through insurance benefits for prevention, diagnosis, treatment, rehabilitation, childbirth, and health promotion. The Republic of Korea achieved 100% NHI coverage of the target population in 1989, 12 years after the introduction of the (...) social insurance system. However, poor coverage of health services and lack of financial protection are major obstacles to achieving UHC. Therefore, the Korean government announced and implemented ‘Moon Jae-in Care’ in August 2017 to enhance the coverage rate of NHI by 70%. First, this study reviews the existing health insurance system in Korea from the perspective of health financing and UHC. Second, it analyses ‘Moon Jae-in Care’, based on the main framework of UHC. Third, it considers the ethical implications of these developments, with focus on the principles of equity, fairness, autonomy, and solidarity. Although the NHI reform is expected to propel Korean health care closer to UHC, many ethical, social, and political issues remain. (shrink)

BackgroundAttention deficit hyperactivity disorder is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and (...) controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.MethodsThirty-seven children and adolescents with and without ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test was conducted under four conditions: control, no-cue, visual cue, and visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions using a head-mounted display in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.ResultsThe magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control groups.ConclusionChildren and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner. (shrink)

Background: An association between gaming disorder and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs.Methods: Five representative GD instruments were chosen based on recommendations by the previous systematic review study to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on (...) either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized.Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 and a mean test-retest estimate of 0.86. Estimated effect sizes of correlation between GD and the variables were as follows: 0.33 with depression, 0.29 with anxiety, 0.30 with aggression, –0.22 with quality of life, 0.29 with loneliness, 0.56 with internet addiction, and 0.40 with game playtime, respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented.Discussion and Conclusion: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies.Limitations: The current study did not include gray literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42020219781]. (shrink)

Generalized anxiety disorder can cause significant socioeconomic burden and daily life dysfunction; hence, therapeutic intervention through early detection is important. This study was the final stage of a 3-year anxiety screening tool development project that evaluated the psychometric properties and diagnostic screening utility of the Mental Health Screening Tool for Anxiety Disorders, which measures GAD. A total of 527 Koreans completed online and offline versions of the MHS: A, Beck Anxiety Inventory, Generalized Anxiety Disorder-7, and Penn State Worry Questionnaire. The (...) participants had an average age of 38.6 years and included 340 females. Participants were also administered the Mini-International Neuropsychiatric Interview. Internal consistency, convergent/criterion validity, item characteristics, and test information were assessed based on the item response theory, and a factor analysis and cut-off score analyses were conducted. The MHS: A had good internal consistency and good convergent validity with other anxiety scales. The two versions of the MHS: A were nearly identical. It had a one-factor structure and showed better diagnostic accuracy for GAD detection than the GAD-7 and BAI. The IRT analysis indicated that the MHS: A was most informative as a screening tool for GAD. The MHS: A can serve as a clinically useful screening tool for GAD in Korea. Furthermore, it can be administered both online and offline and can be flexibly used as a brief mental health screener, especially with the current rise in telehealth. (shrink)

This study examined the disability support offices websites of twelve US higher education institutions anchored in multimodal discourse analysis and genre analysis to examine how semiotic resources are deployed to describe DSO services on their websites and to determine the discursive functions of advertisement they perform. The DSO websites were within four clicks from HEI homepages but had inconsistent navigation paths, making it difficult to reach DSO websites. DSO websites were foregrounding promoting and branding the institutions rather than presenting the (...) information about the services offered. This is achieved by using multimodal promotional rhetoric such as: situating accessibility as central commodifiable attribute, promoting the value of accessibility, establishing the superiority of the institution, constructing images of students with disabilities as empowered but dependent upon the DSO, and situating students within a college community. Implications for DSO websites functioning as advertisements are also discussed. (shrink)

Korean biobanks are now adapting to integrate the new paradigm of precision medicine into their fundamental role of promoting health technology. Since the enactment of Bioethics and Safety Act in 2004, the Republic of Korea has developed a regulatory framework that reflects ethical principles. However, the existing regulation of biobanks has recently proven to be limited in responding to newer ethical and legal issues that have arisen. First, as there is an emerging trend for human biospecimens to be stored, managed (...) and distributed as digitalized data, the current role of the Distributive Review Committee may become less important compared to the Data Access Committee. Second, even if public health data is anonymized, the risk of identifiability is growing. This makes a third point relevant, informed consent is crucial to respect the autonomy of patients and research subjects, but current consent rules need to change to reflect the interactive and dynamic communication process, in which information and communication technology plays an increasingly prominent role. Fourth, even though data sharing for research is expected to be altruistic and the sale of human biospecimens and genome data remains prohibited, data sharing practices have become more complicated and are closer to commercial use and commercialization. Given these challenges, there is a pressing need for continuing and deeper deliberation in order to develop a more comprehensive and responsive governance framework. (shrink)

SignificanceElectrical burns can cause severe damage to the nervous system, resulting in autonomic dysfunction with reduced cerebral perfusion. However, few studies have investigated these consequences.AimTo elucidate changes in prefrontal cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS) during the head-up tilt table test (HUT) for patients with electrical burns.ApproachWe recruited 17 patients with acute electrical burns within 1 week after their accidents and 10 healthy volunteers. The NIRS parameters acquired using an fNIRS device attached to the forehead were analyzed in five (...) distinct HUT phases.ResultsBased on their HUT response patterns, patients with electrical burns were classified into the group with abnormal HUT results (APG, n = 4) or normal HUT results (NPG, n = 13) and compared with the healthy control (HC, n = 10) participants. We found trends in hemodynamic changes during the HUT that distinguished HC, NPG, and APG. Reduced cerebral perfusion and decreased blood oxygenation during the HUT were found in both the NPG and APG groups. Patients with electrical burns had autonomic dysfunction compared to the HC participants.ConclusionsUsing fNIRS, we observed that acute-stage electrical burn injuries could affect cerebral perfusion. (shrink)

SummaryThe trends of intermarriage, and the attitude to it, of Koreans in Japan were examined. About 47% of total marriages of Koreans during the period 1965–79 comprised a husband and wife of different nationality. The proportion of Korean–Japanese marriages was higher than that of Korean–Korean marriages in recent years. Attitudes of Koreans in Japan are likely to favour intermarriage with Japanese. The results suggest that mixed marriages of Koreans and Japanese will continue to increase and may influence the future fertility (...) of Koreans in Japan. (shrink)

This research examines how one’s construal level of a crisis differs by crisis type, and how the interplay of crisis type and apology appeal type impacts the effectiveness of apology messages in a corporate crisis context. Findings indicate that one’s mental construal toward a crisis varies by crisis type, with a self-threatening crisis leading to a lower level of construal than a society-threatening one. Findings further suggest that in a society-threatening crisis condition, an informational apology was more effective than an (...) emotional one. However, in a self-threatening crisis condition, there was no significant difference between two different message types. These findings offer valuable guidelines for developing effective crisis response strategy. (shrink)

An entangled pair of photons (1 and 2) are emitted in opposite directions. A narrow slit is placed in the path of photon 1 to provide the precise knowledge of its position on the y-axis and this also determines the precise y-position of its twin, photon 2, due to quantum entanglement. Is photon 2 going to experience a greater uncertainty in momentum, that is, a greater Δpy because of the precise knowledge of its position y? The experimental data show Δy (...) Δ py < h for photon 2. Can this recent realization of the thought experiment of Karl Popper signal a violation of the uncertainty principle? (shrink)

ObjectivesHostile attribution bias is reportedly common from non-clinical population to those with serious mental illness, such as schizophrenia, and is known to be closely related to theory of mind. This study aimed to investigate whether ToM skills mediate the relationship among neurocognitive ability, personality traits, and attribution bias.MethodsA total of 198 non-clinical youths were recruited. To assess their neurocognitive ability and ToM skills, the participants were asked to complete Raven’s Standard Progressive Matrices and the Korean version of the Reading the (...) Mind in Eyes Test. To determine their personality traits, the Eysenck Personality Questionnaire and interpersonal reactivity index were used. To evaluate hostile attribution bias, the Ambiguous Intentions Hostility Questionnaire was administered. Path analysis and bias-corrected percentile bootstrap methods were used to estimate model fit and the parameters of the mediating effects.ResultsBased on model comparison, the best model characterized two direct pathways from psychoticism and the K-RMET to hostility attribution bias and three indirect pathways, wherein SPM, perspective taking, and psychoticism influenced hostile attribution bias through K-RMET. The final model fit indices were good [x2/df = 1.126; comparative fit index = 0.996; root mean square error of approximation = 0.026; standard root mean square residual = 0.026 and Akaike information criterion = 28.251] and the K-RMET fully mediated the association between SPM, perspective taking, psychoticism, and hostile attribution bias.ConclusionThe main findings suggested that ToM skills, such as the RMET, play an important role in explaining the relationship among neurocognitive ability, personality traits, and hostile attribution bias. ToM skills and a remediation strategy may need to be developed to balance the enhanced hostility bias that underlies the paranoia. (shrink)

In this article, I present different characteristics of de jure coreference, including an epistemological one and a logical one. Then, I present the semantic relation of coordination as what explains or grounds the phenomenon of de jure coreference. And I compare two theories of relational semantics, Fine’s (2007) and Taschek’s (1995a, 1995b, 1998), with respect to two famous puzzles in the philosophy of language, Frege’s puzzle and Kripke’s puzzle about belief. Lastly, I briefly discuss coordination between empty terms.

This book, based on Jaegwon Kim's 1996 Townsend Lectures, presents the philosopher's current views on a variety of issues in the metaphysics of the mind...

A close reading of Simone Weil's philosophical and literary writings examining themes of ethical obligation, dispossession and vulnerability in relation to the works of Emmanuel Levinas, Maurice Blanchot and Judith Butler.

This work critically builds on James K. A. Smith's postmodern Pentecostal epistemology with the aid of Reformed epistemology. The resulting postmodern Christian epistemology retains the central postmodern characteristics of perspectivalism and embodiment while integrating the truth element of Reformed epistemology’s warrant criteria.

In the ultimate meeting of the sublime with the ridiculous" (London Evening Standard) My Beautiful Despair blends the existential philosophy of Søren Kierkegaard with the superficial musings of Kim Kardashian West, based on the popular Twitter feed @KimKierkegaard. The love child of Søren Kierkegaard and Kim Kardashian, the @KimKierkegaard Twitter account has been admired, praised, and adored in The New Yorker, The Washington Post, The New York Times, Financial Times, The Economist, New York, Buzzfeed, and more, and has amassed nearly (...) a quarter of a million Twitter followers, including J.K. Rowling and Anna Kendrick. A mash-up of Kim's tweets and observations with Kierkegaard's philosophy, Kim Kierkegaardashian shares their musings on fashion, beauty, brunch, and the relentless waves of existential dread that wash over us day after day. Now in a humorous, illustrated gift book, perfectly suited for our existential times, Kierkegaardashian's philosophical insights are juxtaposed for the first time with Dash Shaw's brilliant black-and-white illustrations. A sample of the revelations included in My Beautiful Despair include: - I have majorly fallen off my workout-eating plan! AND it's summer. But to despair over sin is to sink deeper into it. - Obsessed with protecting your skin, lips, hair & face from the sun? Close the cover of the coffin tight, really tight, and be at peace. - I like my men like I like my coffee: a momentary comfort in the midst of all my suffering. - What is the operation by which a self relates itself to its own self, transparently? Selfie. - What if everything in life were a misunderstanding, what if laughter were really tears? Scared LOL!! - Glamour, menswear, top hat. (shrink)

ABSTRACTAccording to some influential readings of the Groundwork of the Metaphysics of Morals, the view presented there of the kind of spontaneity we are conscious of through theoretical reason and...

The sustainability labeling on the front of a package featured in a print advertisement may influence consumers’ product evaluations and purchase decisions. The findings of this exploratory study suggest that consumers seem to evaluate the sustainability claim more favorably if the advertisement highlights the personal impact on them. Moreover, environmental involvement appears to further moderate the effects of sustainability claims and environmental impact framing. The interactions that emerged in this study suggest that sustainability labeling effects constitute a complex phenomenon that (...) warrants future research. (shrink)

In this paper, I offer a novel account of entrapment. This account suggests that the wrongness of pursuing punishment in cases of entrapment consists of two distinct components, one concerning the culpability of the entrapped defendant and the other concerning the legitimacy of the entrapping state to prosecute crimes that it has effectively created. Distinguishing these two components of entrapment, I explain, helps to clarify the moral issues at stake and to resolve some confusions and debates in existing legal analyses (...) of entrapment. (shrink)

ABSTRACTBy showing its organic linkage between theories of human nature and governance, this article illustrates that the Huainanzi is a scripture that holds a systematic and unique theory. The ideal governance of the Huainanzi is mystical transformation, i.e. the Daoist concept of non-action. Rule by simple Confucian rituals is not at odds with mystical transformation. However, mystical transformation does not include the rule by rituals. Moreover, excessively complicated rituals are incompatible with mystical transformation. Human nature in the Huainanzi does not (...) contradict humanity and righteousness. Human nature’s growth into humanity and righteousness is as natural as the approach of a butterfly to flowers. However, the humanity and righteousness of the Huainanzi are not innate to human nature. Likewise, unlike a flower, a butterfly is not part of a plant. Moreover, artificial flowers, which correspond to excessively complicated rituals, are incompatible wi... (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)

Background and objectives Conscientious refusal of abortion has been discussed widely by medical ethicists but little information on practitioners' opinions exists. The American College of Obstetricians and Gynecologists (ACOG) issued recommendations about conscientious refusal. We used a vignette experiment to examine obstetrician-gynecologists' (OB/GYN) support for the recommendations. Design A national survey of OB/GYN physicians contained a vignette experiment in which an OB/GYN doctor refused a requested elective abortion. The vignette varied two issues recently addressed by the ACOG ethics committee—whether the (...) doctor referred and whether the doctor disclosed their objection to the abortion. Participants and setting 1800 OB/GYN randomly selected physicians were asked to complete a mail survey containing the vignette. The response rate was 66% (n=1154) after excluding 40 ineligible cases. Measurement Physicians indicated their approval for the vignette doctor's decision. Main results Overall, 43% of OB/GYN physicians responded that the conscientious refusal exercised by the vignette physician was appropriate. 70% rated the vignette doctor as acting appropriately when a referral was made. This dropped to 51% when the doctor disclosed objections to the patient, and to 12% when the doctor disclosed objections and refused to make a referral. Consistent with previous research, males were more likely to support disclosure and refusal to refer. Highly religious physicians supported non-referral but not disclosure. Conclusion OB/GYN physicians are less likely to support conscientious refusal of abortion if physicians disclose their objections to patients. This is at odds with ACOG recommendations and with some models of the doctor–patient relationship. (shrink)

Although informed consent is important in clinical research, questions persist regarding when it is necessary, what it requires, and how it should be obtained. The standard view in research ethics is that the function of informed consent is to respect individual autonomy. However, consent processes are multidimensional and serve other ethical functions as well. These functions deserve particular attention when barriers to consent exist. We argue that consent serves seven ethically important and conceptually distinct functions. The first four functions pertain (...) principally to individual participants: (1) providing transparency; (2) allowing control and authorization; (3) promoting concordance with participants' values; and (4) protecting and promoting welfare interests. Three other functions are systemic or policy focused: (5) promoting trust; (6) satisfying regulatory requirements; and (7) promoting integrity in research. Reframing consent around these functions can guide approaches to consent that are context sensitive and that maximize achievable goals. (shrink)

Direction of fit theories usually claim that beliefs are such that they “aim at truth” or “ought to fit” the world and desires are such that they “aim at realization” or the world “ought to fit” them. This essay argues that no theory of direction of fit is correct. The two directions of fit are supposed to be determinations of one and the same determinable two-place relation, differing only in the ordering of favored terms. But there is no such determinable (...) because of ineliminable asymmetries between the way that beliefs “aim at truth” and the way that desires “aim at realization.” This essay traces the ills of direction of fit theory to a misunderstanding of Anscombe and proposes a cure that distinguishes theoretical and practical thought by appeal to a distinction between thought in the form of a state and thought in the form of an event. (shrink)