BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

The physician’s duty of confidentiality is based on the observance of the patient’s privacy and intimacy and on the importance of respecting both of these rights, thus creating a relationship of confidence and collaboration between doctor and patient. The main objective of this work consists of analyzing the aspects that are related to the confidentiality of patients’ data with respect to the training, conduct and opinions of doctors from different Clinical Management Units of a third-level hospital via a questionnaire. The (...) present study aimed to define the problem and determine whether the opinions of these professionals correspond to those observed in a previous work conducted at the same center. Of the 200 questionnaires that were collected, 62.5% were from consultants and the rest were from residents with an average of 14.4 ± 12.5 years in professional practice. The respondents noted habitual situations in which confidentiality was breached in the reference hospital. The section on their attitudes and behaviors towards situations related to confidentiality showed a slightly lower average score than that of their medical knowledge; significant differences in these scores were observed between the consultants and residents as well as between the extreme age groups and years of professional practice, thus more inadequate attitudes were consistently noted in younger doctors who had fewer years of experience. Finally, the respondents answered that the training of doctors in the aspects of healthcare law and ethics was the most important measure that the hospital could adopt regarding confidentiality practices. (shrink)

This study tests the hypothesis that university professors (lecturers) (in the U.S. and Spain) with different money profiles (based on Factors Success, Budget, Motivator, Equity, and Evil of the Love of Money Scale) will differ in work-related attitudes and satisfaction. Results suggested that Achieving Money Worshipers (with high scores on Factors Success, Motivator, Equity, and Budget) had high income, Work Ethic, and high satisfaction with pay level, pay administration, and internal equity comparison but low satisfaction with external equity comparison. Careless (...) Money Admirers (high Success but low Budget) had low intrinsic job satisfaction and low satisfaction with pay level and life. Apathetic Money Managers (low Evil and low Motivator) had the highest intrinsic job satisfaction and life satisfaction. Money Repellent Individuals (high Evil and low Success) had low income, work experience, Work Ethic, and low satisfaction with pay administration. Money does not provide the same motivation for people in all four money profiles. Results are discussed in light of the effectiveness of using money to reward people with different money profiles, intrinsic motivation, and unethical behavior. (shrink)

Orphan drug policy often gives ‘special treatment’ to rare diseases, by giving additional priority or making exceptions to specific drugs, based on the rarity of the conditions they aim to treat. This essay argues that the goal of orphan drug policy should be to make prevalence irrelevant to funding decisions. It aims to demonstrate that it is severity, not prevalence, which drives our judgments that important claims are being overlooked when treatments for severe rare diseases are not funded. It shows (...) that prioritising severity avoids problems caused by prioritising rarity, and that it is compatible with a range of normative frameworks. The implications of a severity-based view for drug development are then derived. The severity-based view also accounts for what is wrong with how the current system of drug development unfairly neglects common diseases that burden the developing world. Lastly, the implications of a severity-based view for current orphan drug policies are discussed. There are no data in this work. (shrink)

Ethical leadership matters in the context of organizational change due to the need for followers to trust the integrity of their leaders. Yet, there have been no studies investigating ethical leadership and organizational change. To fill this gap, we introduce a model of the moderating role of involvement in change. Organizational change and involvement in change are proposed as context-level moderators in the relationships of ethical leadership and work-related attitudes and performance. We employ a sample of 199 supervisor–subordinate pairs from (...) a wide variety of organizations. Results support a three-way interaction (ethical leadership, organizational change, and involvement in change) for performance and OCBs. Our results have important implications for organizational change since ethical leadership appears to complement follower involvement when change is happening. (shrink)

This text, commissioned by the OSUN Global Observatory of Academic Freedom, discusses how the concept of academic freedom is codified in Colombian Law and regulations of public and private higher education institutions. It also explores common conceptions of academic freedom among Colombian scholars, as well as commonly observed threats to it.

Blockchain is an open digital ledger technology that has the capability of significantly altering the way that people operations operate in organizations. This research takes a first step in proposing several ways in which the blockchain technology can be used to improve current organizational practices, while also considering the ethical implications. Specifically, the paper examines the role that blockchain technology plays in three primary areas of people operations: entry to the organization, intraorganizational processes, and exit. In each section, the paper (...) reviews the ethical implications from the lenses of virtue ethics, utilitarianism, deontology and contractarianism. The paper concludes that in whole the implementation of blockchain technology in people operations processes can create a more ethical work environment. However, careful implementation is necessary and requires extensive examination of ethical implications in advance. (shrink)

Through cultural transmission, repeated learning by new individuals transforms cultural information, which tends to become increasingly compressible . Existing diffusion chain studies include in their design two processes that could be responsible for this tendency: learning and reproducing . This paper manipulates the presence of learning in a simple iterated drawing design experiment. We find that learning seems to be the causal factor behind the increase in compressibility observed in the transmitted information, while reproducing is a source of random heritable (...) innovations. Only a theory invoking these two aspects of cultural learning will be able to explain human culture's fundamental balance between stability and innovation. (shrink)

This paper examines folk theories of algorithmic recommendations on Spotify in order to make visible the cultural specificities of data assemblages in the global South. The study was conducted in Costa Rica and draws on triangulated data from 30 interviews, 4 focus groups with 22 users, and the study of “rich pictures” made by individuals to graphically represent their understanding of algorithmic recommendations. We found two main folk theories: one that personifies Spotify and another one that envisions it as a (...) system full of resources. Whereas the first theory emphasizes local conceptions of social relations to make sense of algorithms, the second one stresses the role of algorithms in providing a global experience of music and technology. We analyze why people espouse either one of these theories and how these theories provide users with resources to enact different modalities of power and resistance in relation to recommendation algorithms. We argue that folk theories thus offer a productive way to broaden understanding of what agency means in relation to algorithms. (shrink)

We investigate the emergence of iconicity, specifically a bouba-kiki effect in miniature artificial languages under different functional constraints: when the languages are reproduced and when they are used communicatively. We ran transmission chains of participant dyads who played an interactive communicative game and individual participants who played a matched learning game. An analysis of the languages over six generations in an iterated learning experiment revealed that in the Communication condition, but not in the Reproduction condition, words for spiky shapes tend (...) to be rated by naive judges as more spiky than the words for round shapes. This suggests that iconicity may not only be the outcome of innovations introduced by individuals, but, crucially, the result of interlocutor negotiation of new communicative conventions. We interpret our results as an illustration of cultural evolution by random mutation and selection. (shrink)

Gratitude is both expected and problematic in live organ donation. Are there grounds to require it, and to forbid access to live donor transplantation to a recipient who fails to signal that he feels any form of gratitude? Recipient gratitude is not currently required for organ donation, but it is expected and may be a moral requirement. Despite this, we argue that making it a condition for live organ transplantation would be unjustified. It would constitute a problematic and disproportionate punishment (...) for perceived immoral behaviour on the part of the recipient. It would also bar the donor from positive aspects of organ donation that remain even in the absence of recipient gratitude. A potential recipient's lack of gratitude should be explored as a possible symptom of other morally problematic issues and integrated into the information provided to the potential donor. Recognition of the donor's gift and gratitude for it may also need to be expressed in part by others. This last aspect is relevant even in cases where the recipient feels and expresses gratitude. (shrink)

The issues involved in deciding whether to use artificial methods of delivering hydration and nutrition are often very difficult for patients, families, and health care providers. Once private and personal matters, these decisions now frequently involve the judicial system. Five years ago, Hospice of Washington recognized the need for a written policy and wrote the one published here. Its goal is to respect individual preferences and family concerns while addressing the nutrition and hydration needs of dying patients. The policy sets (...) parameters on the issue, provides basic information, and encourages crafting the most fitting resolution to each situation. (shrink)

This _Handbook_ provides a comprehensive guide to the practice and principles of child and adolescent psychotherapy around the world. Contents include: * a brief introduction to the child psychotherapy profession, its history and development * a review of the theory underlying therapeutic practice * an overview of the varied settings in which child psychotherapists work * analysis of the growth of the profession internationally * an examination of areas of expertise around the world * a summary of current research Contributors (...) are experienced practitioners from within a diverse range of schools and approaches and so provide a well-rounded picture of child and adolescent psychotherapy today. _The Handbook of Child and Adolescent Psychotherapy_ will be an essential resource for professional psychotherapists, students of psychotherapy, social workers and all professionals working with disturbed children. (shrink)

The employment of mythological language and imagery by an Epicurean poet - an adherent of a system not only materialist, but overtly hostile to myth and poetry - is highly paradoxical. This apparent contradiction has often been ascribed to a conflict in the poet between reason and intellect, or to a desire to enliven his philosophical material with mythological digressions. This book attempts to provide a more positive assessment of Lucretius' aims and methodology by considering the poet's attitude to myth, (...) and the role which it plays in the De Rerum Natura, against the background of earlier and contemporary views. The author suggests that Lucretius was not only aware of the tension between his two roles as philosopher and poet, but attempted to resolve it by developing his own, Epicurean poetic, together with a bold and innovative theory of the origins and meaning of myth. (shrink)

In the paper “Categoricity in abstract elementary classes with no maximal models”, we address gaps in Saharon Shelah and Andrés Villavecesʼ proof in [4] of the uniqueness of limit models of cardinality μ in λ-categorical abstract elementary classes with no maximal models, where λ is some cardinal larger than μ. Both [4] and [5] employ set theoretic assumptions, namely GCH and Φμ+μ+).Recently, Tapani Hyttinen pointed out a problem in an early draft of [3] to Villaveces. This problem stems from the (...) proof in Shelah and Villavecesʼ [4] that reduced towers are continuous. Residues of this problem also infect the proof of Proposition II.7.2 in VanDieren [5]. We respond to the issues in Shelah and Villaveces [4] and VanDieren [5] with alternative proofs under the strengthened assumption that the abstract elementary class is categorical in μ+. (shrink)

Introduction Previous research has explored euthanasia’s ethical dimensions, primarily focusing on general practice and, to a lesser extent, psychiatry, mainly from the viewpoints of physicians and nurses. However, a gap exists in understanding the comprehensive value-based perspectives of other professionals involved in both somatic and psychiatric euthanasia. This paper aims to analyze the interplay among legal, medical, and ethical factors to clarify how foundational values shape the ethical discourse surrounding euthanasia in both somatic and psychiatric contexts. It seeks to explore (...) these dynamics among all healthcare professionals and volunteers in Belgium. Methods Semi-structured interviews were conducted with 30 Dutch-speaking healthcare workers who had encountered patients requesting euthanasia for psychiatric conditions, in Belgium, from August 2019 to August 2020. Qualitative thematic analysis was applied to the interview transcripts. Findings Participants identified three pivotal values and virtues: religious values, professional values, and fundamental medical values encompassing autonomy, beneficence, and non-maleficence, linked to compassion, quality care, and justice. These values interwove across four tiers: the patient, the patient’s inner circle, the medical realm, and society at large. Irrespective of their euthanasia stance, participants generally displayed a blend of ethical values across these tiers. Their euthanasia perspective was primarily shaped by value interpretation, significance allocation to key components, and tier weighting. Explicit mention of varying ethical values, potentially indicating distinct stances in favor of or against euthanasia, was infrequent. Conclusion The study underscores ethical discourse’s central role in navigating euthanasia’s intricate landscape. Fostering inclusive dialogue, bridging diverse values, supports informed decision-making, nurturing justice, and empathy. Tailored end-of-life healthcare in psychiatry is essential, acknowledging all involved actors’ needs. The study calls for interdisciplinary research to comprehensively grasp euthanasia’s multifaceted dimensions, and guiding policy evolution. While contextualized in Belgium, the implications extend to the broader euthanasia discourse, suggesting avenues for further inquiry and cross-cultural exploration. (shrink)

Innovation in medieval studies is the creative ability to go back to sources. Digging, exploring, and connecting material pieces of evidence, facts, and individuals uncover new knowledge. One of the most significant sources for the medieval textual production is the university. Understanding the writings stemming from different faculties of medieval universities requires skills, curiosity, and tools. Among such instruments, the statutes of universities help researchers not only to decipher the organization of the academic institutions and interpret the rules that apply (...) to scholars and to their professors, but also to decode how and why texts were produced. The faculty of theology represents the highest level where education led during the Middle Ages and delivers the highest degree such as the master in theology. All over Europe, such faculties become the impetus that drives the intelligentsia to produce a textual heritage that today generates inspiration for magisterial carriers. Among them, Professor Maarten Hoenen is one to praise today. Taking as a point of departure a recent publication of Maarten Hoenen, 1 I will propose to investigate the relation between the statute of universities and of intellectual practices within medieval academia-more precisely, how a researcher should dig for complementary sources when the main documentation depicting an intellectual practice, such as the protestatio and gratiarum actio, is missing. I do not intend to be exhaustive, but simply to focus on how we should understand these two actions, protestatio and gratiarum actio, in connection with the Sentences commentaries. 2 The paradox is that we have traces of these two practices in the surviving manuscripts stemming from the university, but we do not always have a description of these actions in their statutes. Protestatio represents an oath that bachelors take at the beginning of an academic exercise, and the gratiarum actio is the final paragraph that closes the same exercise by thanks addressed to the public. The span of time I will focus on is between the fourteenth and fifteenth centuries, since this is the period from which some testimonies survived that today help to better clarify how these actions were performed in medieval academia. It is also the period of naissance of the new faculties of theology all around Europe, as it is the case with Bologna, Vienna, Cracow, or Prague. They all embraced the model disseminated in Paris and Oxford on reading on the Sentences of Peter Lombard to obtain the degree of doctor in theology, and they contribute to building tradition, and therefore to produce sources for us today. (shrink)

A serious problem confronting discourses on recognition is that of showing equal respect for citizens’ diverse cultural identities whilst at the same time attending to feminist concerns. This article focuses on the complex issues emerging from the recent legislation prohibiting the Muslim veil in French state schools. I respond to these problems by defending two conditions of a postcolonial and feminist approach to the politics of recognition. This approach should be, first, transformative, in the sense of widening its conception of (...) core values through an engagement with cultural difference. Second, it should be critical in its orientation to practices affecting women adversely within any social group. An integration of these concerns is proposed in terms of ‘affective citizenship’. This approach supports the different components of women’s autonomous functioning, through a universalistic commitment to the creative expression of their hybrid identities. (shrink)

As a neonatal neurologist, I serve families facing tragic decisions in which they must balance trade-offs between death and life with profound disability. I often find myself in complex discussions about future outcome, in which families sort through in real-time what information they value most in making such a choice. Will he laugh? Will he be in pain? Will he know how much he’s loved? In this month’s feature article, Brick et al share the results of an online survey aimed (...) at assessing public views on when a life is not worth living, in an effort to inform ongoing legal and clinical debates about withdrawal of life-sustaining treatment for children. These findings raise important questions about how we define and measure outcomes that matter to parents as they make these tragic decisions. It is challenging to interpret these findings in the absence of context of how decision-making for infants occurs in real-time. The nature of this study and its objective required that cases be substantially simplified. As the authors acknowledge, the prognoses and function of the children involved in these cases were often deeply contested. Prognostic uncertainty is common for children with significant …. (shrink)

This article offers a comparative analysis of experimental fetal surgery and fetal tissue research. The author argues that fetuses are positioned differently across each set of practices, with significant implications for actors in these domains. By empirically charting the ways in which humanity is or is not attributed to fetal work objects, the author's argument challenges contemporary debates in science studies that tend to conceptualize human and nonhuman in dualistic terms. This analysis instead shows the heterogeneous attribution of these categories, (...) as well as the spaces, margins, and positions, which constitute them as distinct. (shrink)

This article brings insights from feminist science and technology studies to bear on recent public debates over the human papillomavirus vaccine, which prevents many cervical cancers, and male circumcision as potential HIV preventive. In the United States, attempts to mandate HPV vaccination have activated intense concerns about female “promiscuity,” whereas talk of promoting circumcision against HIV has triggered scant anxiety about American boys’ sexuality. The authors show how intersections among gender, sexuality, race, and age have shaped responses to these two (...) containment technologies—and how the technologies’ deployment both relies on and reproduces meanings of gender and sexuality that constitute the omnipresent “double standard.” The analysis develops an original feminist sociology of containment, explicating how social relations shape the innovation, reinvention, and use of technologies to contain particular sorts of bodies, fluids, and sexual practices—by whom, under what conditions, and for what purposes. (shrink)

Autonomy is conceptualized as the need for agency, self-actualization and independence. Nowadays, financial independence and academic achievement for young populations may be considered as key aspects in the transition to adulthood in response to some contextual demands of different cultural environments. By means of a multi-level model, the present study aims to determine the influence and contribution of factors at individual-level (e.g. sex, age, socioeconomic status, family financial support, awarded scholarships, personal finance, student loans) and school-level (e.g. programme quality, online (...) programs, face to face programs) on the academic achievement of young higher education Colombian students. Data come from the scores of the national standardized academic achievement test administered in 2018 in Colombia. The sample included 234,386 students enrolled in 3,389 higher education institutions in Colombia. After controlling the effects of program quality, and the student's previous academic abilities and socio-economic conditions, results showed that students with scholarships had higher scores than financially-dependent students (those who had students loans) and financially-independent students (those who self-funded their studies or who worked during the week) who had low-scores in the national standardized academic achievement test. (shrink)

A interdisciplinaridade constitui-se, atualmente, como uma das posturas imprescindíveis de existência nas intervenções realizadas junto às demandas que se colocam. Face a esta constatação é evidente que também a postura profissional do assistente social seja orientada por esta perspectiva para que desta forma possa inserir- se junto às demais categorias profissionais e, mesmo, junto à sociedade em geral de forma mais efetiva. Investigar a utilização da Teoria da Ação Comunicativa de Jürgen Habermas como referencial de análise da configuração da interdisciplinaridade (...) nas ações do Serviço Social, constitui-se no tema central deste texto. (shrink)

The results in this paper are in a context of abstract elementary classes identified by Shelah and Villaveces in which the amalgamation property is not assumed. The long-term goal is to solve Shelah’s Categoricity Conjecture in this context. Here we tackle a problem of Shelah and Villaveces by proving that in their context, the uniqueness of limit models follows from categoricity under the assumption that the subclass of amalgamation bases is closed under unions of bounded, -increasing chains.

Cada día, la guerra, la persecución ideológica y la violencia en las calles obligan a millones de familias a abandonar sus hogares.La literatura infantil y juvenil y, en concreto, los álbumes ilustrados, se convierten en un instrumento didáctico fundamental para abordar temáticas complejas como la guerra y los desplazamientos forzosos en las aulas.Teniendo en cuenta esto, ¿existen álbumes ilustrados dedicados a estas temáticas?¿Cómo podemos aprovecharlos en el aula? El presente trabajo pretende dar respuesta a estas preguntas a partir de una (...) propuesta práctica concreta y de una aproximación teórica a los conceptos que la conciernen. (shrink)