This article examines the (bio) ethical and professionalism issues that may arise in the context of medical practice in low and middle income countries (LAMIC), and the challenges this poses for medical regulatory bodies in the regions, in upholding ethics in professional practice. A quadrangle of source of the problems given rise to the breach of ethics in medical practice is identified, and suggested steps, based on ethical principles and concept, is proposed towards the resolution of the problems presented. As (...) LAMIC progress to improve the health of its population, this endeavour should occur hand in hand with contemporary medical ethics theories, taking in context the region’s ethnographic and cultural beliefs and practices. (shrink)

For more than 20 years, both here and abroad, significant efforts have been undertaken to provide equal access to nutritional food for all citizens. Yet, the numbers of under-nourished continue to rise, as do those afflicted with non-communicable diseases (NCDs) such as obesity, diabetes, hypertension, and heart disease. Clearly, current efforts are not working. Relying on the psychological phenomena of learned helplessness and fundamental attribution error, it is argued that certain individuals may not be willing, or able, to take actions (...) that are currently prescribed regarding access to nutritious food. The water is muddied regarding potential solutions as the various actors involved (e.g., corporations, governments, individuals) cannot agree on a starting point and continue to point fingers regarding responsibility. It is posited that emphasis needs to shift from the current “one-size-fits-all” approach to one that is more tailored to the various actors, specifically the individuals. Within the group of individuals (consumers), based on Wenar’s Least Cost Theory, even further distinction must be made between those who see themselves as capable actors and those who do not. In this conceptual piece intended to refocus the discussion surrounding food access, we propose that future research should approach these issues from a unit of analysis perspective in an attempt to identify the solutions most likely to succeed at various participating levels. (shrink)

Adverse events that harm patients can also have a harmful impact on health care workers. A few health care organizations have begun to provide psychological support to these Second Victims, but there is uncertainty over whether these discussions are admissible as evidence in malpractice litigation or disciplinary proceedings. We examined the laws governing the admissibility of these communications in 5 states, and address how the laws might affect participation in programs designed to support health care workers involved in adverse events. (...) We found that privilege is uneven from stateto- state, and also unclear. Ambiguity alone could have a chilling effect on Second Victim programs. We propose legislation to protect volunteer and health care worker communications provided by peer counselors, or failing this, updating of statutory provisions to explicitly include these communications within the ambit of existing protections. Enhancing protections could help to foster an environment of healing for both patients and caregivers. (shrink)

The harmful impact of an adverse event ripples beyond injured patients and their families to affect physicians, nurses, and other health care staff that are involved. These “Second Victims” may experience intense feelings of anxiety, guilt, and fear. They may doubt their clinical competence or ability to continue working at all. Some go on to suffer post-traumatic stress disorder and depression.Medical institutions long ignored this problem, preferring to believe that adverse events, or “errors,” occur due to incompetence — the unfortunate (...) work of a few “bad” practitioners who deserve, if anything, a reprimand for their negligence. Study after study has rejected this attribution and shown that adverse events in health care stem primarily from systemic flaws, not “bad apples.” Devastating errors, in other words, can, do, and always will happen in the care of competent, well-trained, and caring practitioners. (shrink)

According to Brentano, mentality is essentially intentional in nature. Other philosophers have emphasized the phenomenal-qualitative aspect of conscious experiences as core to the mind. A recent philosophical wave – the ‘phenomenal intentionality programme’ – seeks to unite these conceptions in the idea that mental content is grounded in phenomenal qualities. However, a philosophical and scientific current, which includes Freud and contemporary cognitive science, makes widespread use of the posit of unconscious mentality/mental content. I aim to reconcile these disparate, influential strands (...) of thought concerning mentality’s essence, by defending a conception of the mark of the mental as consisting in content-carrying qualitative character (or mental qualities) – but understood as properties that can exist both in conscious (i.e. phenomenal) form and unconsciously. I describe this conception, deal with major historical objections to the notions of unconscious qualitative character and mentality, and explain the virtues of construing the mark of the mental in this way. (shrink)

As a sort of intellectual provocation and as a lateral thinking strategy for creativity, this chapter seeks to determine what the study of the dynamics of biodiversity can offer linguists. In recent years, the analogical equation "language = biological species" has become more widespread as a metaphorical source for conceptual renovation, and, at the same time, as a justification for the defense of language diversity. Language diversity would be protected in a way similar to the mobilization that has taken place (...) to protect endangered species. Nevertheless, one must be careful when uncritically transferring conceptualizations and theoretical frameworks from one field to another, since obviously, these two phenomena are quite different in the real world. The dialogue with bioecologists starts by asking about the formation of diversity, i.e., about specialization. Here, one can observe the similarity between the processes of linguistic and genetic fragmentation, in the sense that both phenomena have a (socio)geographical basis for dispersion and consequently, for the loss of their original compact nature and their intercommunication. The self-organizing and creative properties of human beings favor the development of specific varieties for each subset, varieties that continue to evolve constantly, through the unceasing "languaging" of humanity. Regarding the continuity of species or languages, one can also observe the decisive role of intragroup relations. The staying power of linguistic varieties will increase in direct proportion to the intensity of the relationship among the components of the subset. On the other hand, if exotic elements are introduced, especially if these elements are aggressive in nature, the alteration of the ecological niche may turn out to be fatal for the continuity of the previously existing forms. This suggests to us the need to make an in-depth study of what the minimal contextual conditions would be so that a set linguistic group could be assured a sustainable continuity within a framework of linguistic contact. What type of minimum (socio-)ecological niche would a language have to have if we wished to ensure its habitual reproduction? A proposal is made here to explore the ideas of "exclusive functions" and "non-hierarchical functional distribution" for codes in situations where there is high contact and a danger of disuse. As regards change, this phenomenon is seen as an inherent element in the tendency of life to create new developments, which may or not be accompanied by an adaptation to changing environmental conditions. It is pointed out that, similar to what happens in biology, much of linguistic innovation stems from a systemically reorganized mixture of solutions from different codes. An important research question would be, however, to determine why some of these innovations disappear and others survive and extend throughout the community. The big question mark, as Mufwene points out, is, then how to manage to understand how "the evolution of language proceeds by naturally selecting from among the competing alternatives available through the idiolects of individual speakers". Extinction, whether it be of languages or of species, is caused in most cases "by a combination of demographic processes and environmental changes", as Brown points out. Thus, the environment plays a fundamental role in the direction of evolution, since the "the survival of the fittest is, in actuality, the survival of those who fit into the context (Allen and Hoekstra)". This allows us to see the great degree of importance of political-economic contexts in the case of languages. In the same way, migratory movements are also one of the major variables determining the extinction of biodiversity and language diversity. Species and habitat form the basic unit of existence, and this is the major point of departure for understanding the problem of the preservation and recovery of species or languages. Given the increase in the degree of linguistic contact, the continuity of language diversity depends on determining, as exactly as possible, as Prigogine, the physicist, would say, what precise conditions of imbalance may prove to be stable. The great challenge is not so much avoiding contact but managing it. And "restorative ecology" can also be of help to us here. Being able to reach sustainable solutions for language diversity implies a profound knowledge of the dynamics for determining the ways in which language is used in contact situations. The general conclusion is that linguistics is still terminologically and conceptually ill prepared to deal with the dynamic character of human languages. The world and our objects must be conceived of as elements in a state of flux, as changing systems in an unstable equilibrium. With respect to language policy, it would be necessary to make an effort to manage to establish some general principles regarding the linguistic organization of the human species that would make it possible for local linguistic diversity and communication on a planetary scale, which must necessarily take place, to be compatible with each other. To succeed, it will be necessary to continue promoting an autonomous socio-ecological perspective devoted to the comprehension of language phenomena. Such a perspective would be based on a paradigm of complexity, and would, at the same time, place human beings at the center of its theoretical underpinnings. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

In this paper we interpret a characterization of the Gödel speed-up phenomenon as providing support for the ‘Nagel-Newman thesis’ that human theorem recognizers differ from mechanical theorem recognizers in that the former do not seem to be limited by Gödel's incompleteness theorems whereas the latter do seem to be thus limited.However, we also maintain that (currently non-existent) programs which are open systems in that they continuously interact with, and are thus inseparable from, their environment, are not covered by the above (...) (or probably any other recursion-theoretic) argument. (shrink)

This volume celebrates the remarkable career of Dr. Preston King, an African American political philosopher with an international reputation. King's first degree was from Fisk University (1956). He moved directly to the London School of Economics (LSE), completing his M.Sc. (Econ) in 1958 with a Mark of Distinction. He taught at LSE for the next two years. A scrap with Jim Crow America kept him in exile for the next 40 years. Major friends and influences at LSE were Professors (...) Sir Karl Popper, Michael Oakeshott, and Dr Bernard Crick. King took up subsequent lectureships at the Universities of Keele, Ghana, and Sheffield. He was Senior Research Assistant at the Acton Society Trust (London), then professor at the Universities of Nairobi, New South Wales (Sydney), Lancaster, returning at last to the USA as joint Woodruff Professor at Emory and Distinguished Professor at Morehouse. The essays comprising this volume are by internationally renowned figures. They creatively explore History, Toleration, and Friendship, as three seminal themes running through Preston King's sizeable oeuvre. This book's first third consists of essays on Time and History, with brilliant contributions by Professors Browning, Lawson, Moore, and Cherribi. The second third consists of essays on Time and Toleration, with memorable and penetrating analyses by Professors Jones, Read, Modood/Dobbernak, and Brown. The third part consists of essays on Time and Friendship, with offerings - both charming and insightful - by Professors Devere, Smith, and Coleman. The book concludes with a novel and captivating chapter by King himself, on the philosophy of time, which constitutes the substratum of so much of his work and reflection. (shrink)

Background: Bioethics consultations are conducted in varied settings, including hospitals, universities, and other research institutions, but there is sparse information about bioethics consultations conducted in corporate settings such as pharmaceutical companies. The purpose of this article is to describe a bioethics consultation service at a pharmaceutical company, to report characteristics of consultations completed by the service over a 6-year period, and to share results of a consultation feedback survey. Methods: Data on the descriptive characteristics of bioethics consultations were collected from (...) 2008 to 2013 and analyzed in Excel 2007. Categorical data were analyzed via the pivot table function, and time-based variables were analyzed via formulas. The feedback survey was administered to consultation requesters from 2009 to 2012 and also analyzed in Excel 2007. Results: Over the 6-year period, 189 bioethics consultations were conducted. The number of consultations increased from five per year in 2008 to approximately one per week in 2013. During this time, the format of the consultation service was changed from a committee-only approach to a tiered approach (tailored to the needs of the case). The five most frequent topics were informed consent, early termination of a clinical trial, benefits and risks, human biological samples, and patient rights. The feedback survey results suggest the consultation service is well regarded overall and viewed as approachable, helpful, and responsive. Conclusions: Pharmaceutical bioethics consultation is a unique category of bioethics consultation that primarily focuses on pharmaceutical research and development but also touches on aspects of clinical ethics, business ethics, and organizational ethics. Results indicate there is a demand for a tiered bioethics consultation service within this pharmaceutical company and that advice was valued. This company's experience indicates that a bioethics consultation service raises awareness about bioethics, empowers employees to raise bioethical concerns, and helps them reason through challenging issues. (shrink)

A key and continuing concern within the pragma-dialectical theory of argumentation is how to account for effective persuasion disciplined by dialectical rationality. Currently, van Eemeren and Houtlosser offer one response to this concern in the form of strategic manoeuvring. This paper offers a prior/passing theory of communicative interaction as a supplement to the strategic manoeuvring approach. Our use of a prior/passing model investigates how a difference of opinion can be resolved while both dialectic obligations of reasonableness and rhetorical ambitions of (...) argumentative success are simultaneously accommodated. The paper explores the model with particular reference to the pragma-dialectical rules of critical discussion, strategic manoeuvring and fallacious reasoning. (shrink)

Business ethics education is most effective when students take an active approach and must respond to various demands and feedback. In this paper we describe a classroom exercise in which students are tasked with delivering an ethics briefing to “executive teams”. Through a combination of individual analysis and group work, students become immersed in real-world ethics problem-solving, in which there are no easy solutions. Students must defend their ethical recommendations as well as challenge those from other groups. The exercise concerns (...) an existing controversial business called Seeking Arrangement. Survey results from graduate students who have participated in the exercise reveal that it is effective in producing better ethics problem solving, as well as greater confidence in addressing ethical issues. (shrink)

This user-friendly companion to the comprehensive Guidelines for the Systematic Treatment of the Depressed Patient outlines psycho-behavioral interventions to help practicing clinicians select the appropriate therapeutic procedure for various patients. This brief reference book for professional psychotherapists is intended to help practicing clinicians select the appropriate therapeutic procedure for various patients.

Stigma can influence the prevention and identification of fetal alcohol spectrum disorder, a leading cause of developmental delay in North America. Understanding the effects of public health practices and policies on stigma is imperative. We reviewed social science and biomedical literatures to understand the nature of stigma in FASD and its relevance from an ethics standpoint in matters of health practices and policies. We propose a descriptive model of stigma in FASD and note current knowledge gaps; discuss the ethical implications (...) of stigma based on two distinct criteria ; and describe two cases and the concerns associated with inadvertent stigmatization by public health initiatives for FASD. We recommend further empirical and ethical analyses to examine whether public health policies and practices inadvertently stigmatize and impact the success of public health initiatives and programs for FASD. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Despite worldwide attention given to food access, very little progress has been made under the current model. Recognizing that individual engagement is likely based on individual experiences and perceptions, this research study investigated whether or not a correlation exists between one’s socioeconomic status (SES) and perceived personal responsibility for food access. Discussion of results and implications provide fresh insight into the ongoing global debate surrounding food access. Outcomes also provide insight into willing and able participants and point to least-cost solutions (...) which may be better suited to implement and initiate change. Results indicate that the issue of food access is more complex than simply lobbying for better decision-making among individuals and populations, highlighting the importance of unit of analysis considerations. (shrink)

A fundamental fact about human minds is that they are never truly alone: all minds are steeped in situated interaction. That social interaction matters is recognized by any experimentalist who seeks to exclude its influence by studying individuals in isolation. On this view, interaction complicates cognition. Here, we explore the more radical stance that interaction co-constitutes cognition: that we benefit from looking beyond single minds toward cognition as a process involving interacting minds. All around the cognitive sciences, there are approaches (...) that put interaction center stage. Their diverse and pluralistic origins may obscure the fact that collectively, they harbor insights and methods that can respecify foundational assumptions and fuel novel interdisciplinary work. What might the cognitive sciences gain from stronger interactional foundations? This represents, we believe, one of the key questions for the future. Writing as a transdisciplinary collective assembled from across the classic cognitive science hexagon and beyond, we highlight the opportunity for a figure-ground reversal that puts interaction at the heart of cognition. The interactive stance is a way of seeing that deserves to be a key part of the conceptual toolkit of cognitive scientists. (shrink)

Soft X‐ray tomography (SXT) is an imaging technique capable of characterizing and quantifying the structural phenotype of cells. In particular, SXT is used to visualize the internal architecture of fully hydrated, intact eukaryotic and prokaryotic cells at high spatial resolution (50 nm or better). Image contrast in SXT is derived from the biochemical composition of the cell, and obtained without the need to use potentially damaging contrast‐enhancing agents, such as heavy metals. The cells are simply cryopreserved prior to imaging, and (...) are therefore imaged in a near‐native state. As a complement to structural imaging by SXT, the same specimen can now be imaged by correlated cryo‐light microscopy. By combining data from these two modalities specific molecules can be localized directly within the framework of a high‐resolution, three‐dimensional reconstruction of the cell. This combination of data types allows sophisticated analyses to be carried out on the impact of environmental and/or genetic factors on cell phenotypes. (shrink)

High-frequency oscillations emerged as a neural code for both positive affect and fluent attentional processing from evolutionary simulations with artificial neural networks. Visual 50 Hz flicker, which entrains neural oscillations in the gamma band, has been shown to foster attentional switching, but can it also elicit positive affect? A three-faces display was preceded by a 50, 25, or 0 Hz flicker on the position of the odd-one-out . Participants decided on the gender or on the subjective valence of this neutral (...) target in an approach-avoidance task, which served as an implicit affective measure. Only the detection of 25 Hz flicker, but not of 50 Hz flicker, was above chance . Faces primed by invisible 50 Hz flicker were explicitly evaluated more positively than with 25 Hz or 0 Hz. This gamma flicker also facilitated approach reactions, and inhibited avoidance reactions relative to 25 Hz and 0 Hz flicker in Blocks 1 and 2. Attentional switching was, moreover, enhanced by the 50 Hz flicker. According to the Affect–Gamma hypothesis, also in biological neural networks, high-frequency gamma oscillations may code for positive affect. (shrink)

Purpose: Our aim was to determine if self-determined motivation (SDM) in elite, men’s soccer changes over time and differs as a function of age, skill-grouping, and engagement in soccer play and practice. We tested predictions from the Developmental Model of Sport Participation (DMSP) regarding relations between practice and play and SDM among both elite and non-elite samples. Methods: Elite youth soccer players in the UK (n = 31; from the Under 13/U13 yr and U15 yr age groups) completed practice history (...) and motivation questionnaires at time1 (T1) and ~2 years later (T2: now U15 yr & U17 yr). Non-elite players (n = 32; from U15 yr and U17 yr) completed the same questionnaires at T2 only. Results: For the elite groups, global SDM decreased over time for the current U17 group (from U15), but no change was seen for the current U15 group (from U13). Age group differences at T2 mirrored these data, with U17 players showing lower global SDM and higher controlled motivation than U15 elites. The non-elite players did not show age group differences, but elites scored higher for global SDM and autonomous motivation than non-elites. The recent hours accumulated in practice negatively correlated with global SDM in elite and non-elite groups, but play was unrelated to measures of motivation. Conclusions: Differences in SDM as a function of age and skill point towards the dynamic nature of these motivations over time, likely a result of proximity to external rewards related to professional status. Although high volumes of practice are related to lower global SDM in both skill groups, the absence of any relations between SDM and soccer play does not support a key prediction related to the DMSP. (shrink)

Is it possible to advance democracy by empowering ordinary citizens to make key decisions about the design of political institutions and policies? In 2004, the government of British Columbia embarked on a bold democratic experiment: it created an assembly of 160 near-randomly selected citizens to assess and redesign the province's electoral system. The British Columbia Citizens' Assembly represents the first time a citizen body has had the power to reform fundamental political institutions. It was an innovative gamble that has been (...) replicated elsewhere in Canada and in the Netherlands, and is gaining increasing attention in Europe as a democratic alternative for constitution-making and constitutional reform. In the USA, advocates view citizens' assemblies as a means for reforming referendum processes. This book investigates the citizens' assembly in British Columbia to test and refine key propositions of democratic theory and practice. (shrink)

Miscreants, in the form of deviants and dark personalities, impact organizations more than we realize. Most management instruction on ethics issues focuses on helping students to understand how to evaluate difficult situations, make ethical decisions, and engage in ethical actions. While this approach works well for the individual decision maker, it fails to help students learn how to anticipate and proactively prevent the unethical actions of others. Using ethical codes as a backdrop, “Thinking Like a Bad Guy” is a provocative (...) classroom activity to elicit critical and creative thinking among business students. The goal of this exercise is to facilitate student learning so they can anticipate the behaviors of bad actors and alter organizational processes and procedures to mitigate the ability of others to violate organizational ethical standards. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.