Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

Neurosurgery for psychiatric disorders, also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to (...) set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law, what types of regulations are required, and how to approach international harmonization given the potential migration of researchers and patients. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

Lachlan observed that any nonzero d.c.e. degree bounds a nonzero c.e. degree. In this paper, we study the c.e. predecessors of d.c.e. degrees, and prove that given a nonzero d.c.e. degree , there is a c.e. degree below and a high d.c.e. degree such that bounds all the c.e. degrees below . This result gives a unified approach to some seemingly unrelated results. In particular, it has the following two known theorems as corollaries: there is a low c.e. degree isolating (...) a high d.c.e. degree [S. Ishmukhametov, G. Wu, Isolation and the high/low hierarchy, Arch. Math. Logic 41 259–266]; there is a high d.c.e. degree bounding no minimal pairs [C.T. Chong, A. Li, Y. Yang, The existence of high nonbounding degrees in the difference hierarchy, Ann. Pure Appl. Logic 138 31–51]. (shrink)

In this study, we attempt to explain the divergent results found in the relationships between supervisor–subordinate guanxi and employee work outcomes. Specifically, we propose that the relationships between supervisor–subordinate guanxi and participatory management, turnover intentions, and organizational commitment are mediated by job satisfaction. Based on the data collected from a sample of 196 employees of three local manufacturing firms in Zhejiang Province, China, we found that job satisfaction fully mediated the effects of supervisor–subordinate guanxi on participatory management and intentions to (...) leave, but partially mediated the relationship between supervisor–subordinate guanxi and organizational commitment. Theoretical and practical implications are discussed. (shrink)

The concept of rectifying names [cheng-ming] is a familiar one in the Confucian Analects. It occupies an important, if not central, position in the political philosophy of Confucius. Since, according to Confucius, the rectification of names is the basis of the establishment of social harmony and political order, one might suspect that later political theories of Confucian-ists should be traced back to the Confucian doctrine of rectifying names. It need not be added that the theory of rectifying names, as developed (...) by Hsün Tzu in the third century B. C., served the double purpose of strengthening his political doctrine of government on the one hand and repudiating doctrines of names on the other. (shrink)

This book transforms phenomenology, music, technology, and the cultural arts from within. Gathering contributions by performing artists, media technology designers, nomadic composers, and distinguished musicological scholars, it explores a rich array of concepts such as embodiment, art and technology, mindfulness meditation, time and space in music, self and emptiness, as well as cultural heritage preservation. It does so via close studies on music phenomenology theory, works involving experimental music and technology, and related cultural and historical issues. This book will be (...) of considerable interest to readers from the fields of sound studies, science and technology studies, phenomenology, cultural studies, media studies, and sound art theory. This book is equally relevant and insightful for musicians, composers, media artists, sound artists, technology designers, and curators and arts administrators from the performing and visual arts. (shrink)

This paper compares some key concepts from Buddhism with ideas from different traditions of systems thinking. There appear to be many similarities, suggesting that there is significant potential for dialogue and mutual learning. The similarities also indicate that it may be possible to develop a Buddhist systems methodology to help guide exploration and change within Buddhist organisations.

Three experiments examined repetition priming for meaningful environmental sounds in a sound stem identification paradigm using brief sound cues. Prior encoding of target sounds together with their associated names facilitated subsequent identification of sound stems relative to nonstudied controls. In contrast, prior exposure to names alone in the absence of the environmental sounds did not prime subsequent sound stem identification performance at all . Explicit and implicit memory were dissociated such that sound stem cued recall was higher following semantic than (...) nonsemantic encoding, whereas sound priming was insensitive to manipulations of depth encoding . These results extend the findings of long-term repetition priming into the auditory nonverbal domain and suggest that priming for environmental sounds is mediated primarily by perceptual processes. (shrink)

This paper proposes a novel account of why intertemporal decisions tend to display impatience: People pay more attention to the opportunity costs of choosing larger, later rewards than to the opportunity costs of choosing smaller, sooner ones. Eight studies show that when the opportunity costs of choosing smaller, sooner rewards are subtly highlighted, people become more patient, whereas highlighting the opportunity costs of choosing larger, later rewards has no effect. This pattern is robust to variations in the choice task, to (...) the participant population, and is observed for both incentivized and hypothetical choices. We argue that people are naturally aware of the opportunity costs associated with delayed rewards, but pay less attention to those associated with taking smaller, sooner ones. We conclude by discussing implications for theory and policy. (shrink)

While environmental claims are increasingly used by companies to appeal consumers, they also attract greater scrutiny from independent parties interested in consumer protection. Consumers are now able to compare corporate environmental claims against external, often disconfirming, information to form their brand attitudes and purchase intentions. What remains unclear is how the level of information specificity of both the environmental claims and external disconfirming information interact to influence consumer reactions. Two experiments address this gap in the CSR communication literature. When specific (...) claims are countered by specific external information, consumers report more negative brand attitudes and lower purchase intentions. The effect is serially mediated by skepticism toward the claims and lack of corporate credibility. We conclude by discussing strategies that firms can utilize to avoid information dilution and ensure that external disconfirming information percolates to consumers as specific. (shrink)

The effectiveness of complaint handling and service recovery policies in customer retention has been the focus of both scholars and service organizations. In the past decade, Justice Theory has provided the basis of the dominant theoretical framework for complaint management and service recovery. However, it does not explicitly address unfair trade practices, which constitute an ethical issue. Favorable outcomes in complaint handling may not be able to restore the reputation of a company and the potential harm perceived by consumers. Using (...) face-to-face interviews, this study applies Fairness Theory to explore the psychological responses of consumers in the post-complaint phase, particularly in ethical judgment. The findings suggest that an unfavorable outcome in the post-complaint stage leads to counterfactual thinking by the consumer about the consumer's state of well-being. The complaint must be due to the discretionary actions of the service provider whose accountability is assessed. Those harmful actions are then judged against an ethical standard. Explanations can reduce blame, and their effectiveness is moderated by outcome favorability but not ethical judgment. Favorable outcome, captured by "Would Perception," has only limited influence on Perceived Potential Harm (PPH), which is an important determinant of ethical judgment. This study makes both theoretical and practical contributions. It is the first study to validate Fairness Theory empirically and apply it to complaint handling as a complement of Justice Theory in the information and communication technology (ICT) service context. The study indicates that customers may condemn a service provider because of PPH even though the outcome is favorable. Unfair trade practices are what make customers hate ICT service providers. (shrink)

We extend research on the effects of local audit office characteristics on audit quality by investigating whether audit offices in highly religious U.S. Metropolitan Statistical Areas exhibit going concern decisions that reflect heightened professional skepticism relative to audit offices in less religious MSAs. Prior research links religiosity to risk aversion and ethical development and suggests audit practice offices in more religious MSAs are more likely to issue going concern opinions because they will assess the effects of mitigating factors in a (...) more skeptical manner. Our results indicate that audit practice offices located in highly religious MSAs are more likely to issue going concern audit opinions, consistent with a more skeptical assessment of mitigating factors. Additional tests provide direct evidence consistent with the argument that these audit offices are more risk averse in issuing going concern opinions. Our findings are relevant to auditors, audit clients, researchers, and regulators. (shrink)