In many jurisdictions, legal frameworks afford patients the opportunity to make prospective medical decisions or to create directives that contain a special provision forfeiting their own ability to object to those decisions at a future time point, should they lose decision‐making capacity. These agreements have been described with widely varying nomenclatures, including Ulysses Contracts, Odysseus Transfers, Psychiatric Advance Directives with Ulysses Clauses, and Powers of Attorney with Special Provisions. As a consequence of this terminological heterogeneity, it is challenging for healthcare (...) providers to understand the terms and uses of these agreements and for ethicists to engage with the nuances of clinical decision‐making with such unique provisions surrounding patient autonomy. In theory, prospective self‐binding agreements may safeguard patient's “authentic” wishes from future “inauthentic” changes of mind. In practice, it is unclear what may be comprised within these agreements or how—and to what effect—they are used. The primary focus of this integrative review is to curate the existing literature describing Ulysses Contracts (and analogous decisions) used in the clinical arena, in order to empirically synthesize their shared essence and provide insights into the traditional components of these agreements when used in practice, the requirements of their consent processes, and the outcomes of their utilization. (shrink)

In their forthcoming article, ‘What makes a medical intervention invasive?’ De Marco, Simons, and colleagues explore the meaning and usage of the term ‘invasive’ in medical contexts. They describe a ‘Standard Account’, drawn from dictionary definitions, which defines invasiveness as ‘incision of the skin or insertion of an object into the body’. They then highlight cases wherein invasiveness is employed in a manner that is inconsistent with this account (eg, in describing psychotherapy) to argue that the term invasiveness is often (...) used to explicitly or implicitly reference interventions that do not fall under the standard account. The authors offer an alternative ‘schematic’ definition of invasiveness, whereby medical interventions entail an underlying context-independent property of ‘basic invasiveness’ and may be understood both relative to each other and to a context-specific threshold of what is ‘invasive’. 1 We propose that the meaning of terms such as ‘invasiveness’ is necessarily heterogeneous,... (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

This paper examines how people anticipate negative emotion when faced with an uncertain outcome and try to manage their expectation. While extant research streams remain equivocal on whether managing expectation always succeeds, this research examines situations in which setting a low expectation can have an adverse emotional impact and ways to alleviate this negative emotional consequence. Using goal setting and false-feedback paradigm, we show that those who set low goals to manage expectation can end up feeling more disappointed than those (...) who set high goals (study 1), but this negative impact can be avoided when goals are reminded at feedback and when individuals are made aware of the inaccuracies in forecasting affect or are reminded of their initial goal (studies 1 and 2). (shrink)

Tasan Chong Yagyong (1762-1836) is one of the most creative thinkers Korea has ever produced, one of the country's first Christians, and a leading scholar in Confucian philosophy. Born in a staunchly Neo-Confucian society, in his early twenties he encountered writings by Catholic missionaries in China and was fascinated. However, when he later learned that the Catholic Church condemned the Confucian practice of placing a spirit tablet on a family altar to honor past generations, he left the small Catholic community (...) he had helped found and ostensibly returned to the Neo-Confucian fold. Nevertheless, the Christian ideas he studied in his youth influenced his thinking for the rest of his life, stimulating him to look at Neo-Confucianism with a critical eye and suggest new solutions to problems Confucian scholars had been addressing for centuries. A Korean Confucian's Advice on How to Be Moral is an annotated translation of Tasan's commentaries on the Confucian classic Zhongyong (usually translated as The Doctrine of the Mean) in which he applies both Confucianism and Christianity to the question of how to best develop a moral character. Written as a dialogue with King Chongjo, (r. 1776-1800) these texts reveal how Tasan interpreted his Confucian tradition, particularly its understanding of how human beings could cultivate morality, while the king's questions illustrate the mainstream Neo-Confucianism Tasan was reacting against. Tasan challenged the non-theistic standard, insisting that living a moral life is not easy and that we need to be motivated to exert the effort necessary to overcome our selfish tendencies. He had abandoned his faith by the time he wrote these commentaries but, influenced by Catholic works and determined to find a more effective way to live a moral life than non-theistic Neo-Confucianism provided, Tasan constructed a Confucian philosophy of moral improvement centered on belief in God. This translation, helpfully annotated for context and analysis, is an exploration of early Korean engagement with the West and a powerful guide to all those interested in Confucianism, Christianity, and morality. (shrink)

No consensus yet exists on how to handle incidental fnd-ings in human subjects research. Yet empirical studies document IFs in a wide range of research studies, where IFs are fndings beyond the aims of the study that are of potential health or reproductive importance to the individual research participant. This paper reports recommendations of a two-year project group funded by NIH to study how to manage IFs in genetic and genomic research, as well as imaging research. We conclude that researchers (...) have an obligation to address the possibility of discovering IFs in their protocol and communications with the IRB, and in their consent forms and communications with research participants. Researchers should establish a pathway for handling IFs and communicate that to the IRB and research participants. We recommend a pathway and categorize IFs into those that must be disclosed to research participants, those that may be disclosed, and those that should not be disclosed. (shrink)

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

In 2011, the Department of Health and Human Services proposed changes to the regulations that govern human subjects protection in federally funded research. The proposed changes involve modifying inclusion standards for minimal-risk research and removing the necessity of review from certain categories of noninvasive research. All studies would instead be required to comply with privacy protections as initiated by the Health Information Portability and Accountability Act . We argue that relying on HIPAA to protect participants from participation-related risks in noninvasive (...) research is insufficient to protect the autonomy and psychological health of potential research participants. Instead, we suggest a streamlined review format for these categories of research. (shrink)

This article examines the church as a trinitarian hermeneutical community through the insights of Vanhoozer and the speech act theory. Vanhoozer explained that through the speech act theory, the church should accept the Bible as a communication act of the Triune God and interpret the Triune God in it, and the church should live a life representing the Triune God. This article agrees with his argument, but as there is a point to revise and supplement his discussion from the speech (...) act theory, it re-examines the church as a trinitarian interpretive community. This explains the unification of the epistemological (revelational), ontological and relational perspectives of the Triune God by not separating the immanent Trinity from the economic Trinity. Also, Trinitarianism as a communicator is used to account for the relationship and activity of the Triune God’s perichoresis in the church community and the church in the interpretive community.Contribution: This article engages the church as a trinitarian hermeneutical community of Vanhoozer, and it redeems and reconsiders his argument in the speech act theory. By explaining the communication behaviour of the Trinity and the church, it describes the activities of the Triune God and the appearance of the church, living and working in the church community. (shrink)

A collection of Chogyam Trungpa's early teachings in North America--on buddha nature, emptiness, the feminine principle, and the three bodies of enlightenment. At the beginning of a North American teaching career that would span seventeen years, the meditation master Chogyam Trungpa conducted five pivotal seminars covering various dharmic topics. The transcripts from these seminars are collected here so that readers can experience them right at home. Comprising twenty-six talks in total, each one followed by a Q&A, Glimpses of the Profound (...) is sure to provoke glimpses of all kinds: glimpses that inspire you to look further, glimpses that give you confidence, glimpses that upset the apple cart, glimpses that open your heart, glimpses that undermine falsity, glimpses that awaken you to your boundless potential. This book was originally published as four separate volumes by Vajradhatu Publications. Judith L. Lief has written a new introduction. (shrink)

In the current study, we examine the changes in disclosure practices on compliance and the fight against corruption at Siemens AG, a large German multinational corporation, over the period 2000–2011 during which a major corruption scandal was revealed. More specifically, we conduct a content analysis of the company’s annual reports and sustainability reports during that period to investigate the changes of Siemens’ corruption and compliance disclosure using both quantitative and qualitative methods. Through the lens of legitimacy theory, stakeholder analysis, and (...) organizational façades, we find evidence that Siemens changed its compliance and corruption disclosure practices to repair its legitimacy in the wake of the 2006 corruption scandal. We analyze these strategies more closely by using the rational, progressive, and reputation façades framework. Our primary findings suggest that the annual reports show peaks of disclosure amounts on corruption and compliance disclosures earlier than sustainability reports, which can be partly explained by analyzing the disclosures made about—and to—the different stakeholder groups. We find that the annual report focuses more on internal stakeholders such as employees, while the sustainability report focuses more on external stakeholders such as suppliers. We also find that the company uses the façades differently depending on which report is being analyzed. (shrink)

The Great Synthesis of Wang Yangming Neo-Confucianism in Korea, a pioneering study of Chŏng Chedu (Hagok, 1649-1736) and Korean Yangming Neo-Confucianism, includes an annotated translation of the Chonŏn, Hagok's most important work on self-cultivation, and a comprehensive introduction to his life, scholarship, and thought.

The emergence of environmental governance practices raises a fundamental question as to whether they are substantive or symbolic. Toward that end, we analyze the relationship between a firm’s environmental governance and its environmental management as reflected in its ultimate outcome, environmental performance. We posit that substantive practices would bring changes in organizations, most notably in terms of improved environmental performance, whereas symbolic practices would portray organizations as environmentally committed without making meaningful changes to their operations. Focusing on a sample of (...) environmentally sensitive firms, results are consistent with environmental governance mechanisms being predominantly part of a symbolic approach to manage stakeholder perceptions on environmental management, having little substantial impact on organizations. Statistical analyses show mostly that there is no relation between environmental governance mechanisms and environmental performance, measured in terms of regulatory compliance, pollution prevention, and environmental capital expenditures. However, there is some indication that environmental incentives are associated with pollution prevention. Interviews with corporate directors shed further light on these results by underlining that environmental governance mechanisms are employed at the board level to protect the organization from reputational and/or regulatory harm, but are not necessarily intended to proactively improve environmental performance. (shrink)

Selection of author's works on Svātantrika Madhyamika philosophy and logic.

The notion of ‘wise mother and good wife (WMGW)’ (Hyonmo Yangcho) is the traditional idealized image of Korean womanhood as one who serves her country and others through her roles as a mother and wife. This ideology may continue to have some significance in the lives of many first‐generation Korean immigrant women, but its potential role in the adjustment challenges these women may face while acculturating to the immigrant context in the United States has received little attention. In this paper, (...) we briefly review the historical background of the WMGW ideology and discussed the significance of focusing research attention on the role of this notion in contemporary first‐generation Korean immigrant women in the United States. We focus on the intersecting influences of gender, ethnicity, and immigrants’ generation status, which may further marginalize some first‐generation Korean immigrant mothers. We then outline possible unique challenges faced by some of these mothers due to the WMGW gender ideology, highlighting potential immigration‐related difficulties including changes in their social support networks, parenting burden, mental health, and language issues. Finally, we provide suggestions for researchers and practitioners working with U.S. Korean immigrant women. (shrink)

A newly designed reissue of Pema Chodron's Always Maintain a Joyful Mind--featuring everday inspiration drawn from the classic Buddhist practice of lojong and instructive commentaries by Pema for making the lojong teachings a practical part of everyday life. This uniquely accessible presentation of lojong, one of Tibetan Buddhism's most renowned practices, gets at the heart of compassion as only Pema Chodron can. Featuring the 59 pithy lojong slogans and Pema's commentary for everyday practice on each facing page, The Compassion Bookwill (...) serve as a go-to handbook for anyone seeking to instill more love and joy in their lives. In addition, the book will offer readers access to a 45-minute audio download on the related meditation practice of tonglen ("sending and taking") taught by Pema. (shrink)

By making Korea a central part of comparative history of East Asian religion and society, this book traces the evolution of Korean religion from the oldest representation to that of the current day by utilizing wide-ranging interdisciplinary and comparative resources. This book presents a holistic view of the enduring religious tradition of Korea and its cultural and social significance within the wider horizons of modern and globalizing changes. Reflecting nearly five decades of the author s work on the subject, it (...) presents an understanding of the main current in Korean religion and social thought throughout history. It then goes on to examine discourses on values and morality involving the relationship between religion and society, in particular the human meaning of economy and society, which is one of the most central and practical problems in the contemporary world with global relevance beyond Korea and Asia. Addressing the overview of the Korean religious tradition in the context of its impact on the making of modern society and economy, this book will appeal to students and scholars of Religious Studies, Korean Studies and Asian Studies. ". (shrink)

Annotations to the pedagogical exegesis of Mādhyamika philosophy.

We respond to Moseley and Wilkinson's defense of inner speech models of AVH.

This article intends to identify and construct a Wesleyan perspective of business and entrepreneurship, drawing on how Wesley viewed and used business and entrepreneurship in relation to poverty in England, in order to identify helpful implications for the church which seeks to engage with poverty-related issues. Wesley did not repudiate or underestimate business and entrepreneurship in believers’ lives; rather, he provided believers with practical guidance and theological foundations for business and entrepreneurship particularly in the context of poverty. We argue that (...) Wesley should be viewed as a compassionate entrepreneur—with the compassion of a liberator and the practice of an entrepreneur, as he encouraged believers to actively participate in economic activities, and recognized entrepreneurship as a sustainable and significant way to empower the poor. Wesley’s example challenges the church today as his case study serves as a radical and faithful application of biblical economic teachings on business and entrepreneurship. (shrink)

Marcuse’s Challenge to Education, a collection of essays by scholars who have explicated his theories accompanied by unpublished lecture notes by Marcuse himself, examines his ground-breaking critique of education as well as his own pedagogical alternatives. This compilation provides an overview of the various themes of Marcuse's challenges to traditional education and connections with ideas of other radical thinkers ranging from Bloch and Freire to Freud and Lacan.

Collection of Kagyudpa scholar's texts on Buddhist logics.