There is currently an evidentiary gap in the scholarship concerning medical tourism's impact on low- and middle-income destination countries (LMICs). This article reviews relevant evidence that exists and concludes that there are signs of correlation between medical tourism and the expansion of private, technology- intensive health care in LMICs, which has largely remained out of reach for the majority of the local patients. In light of this health care inequity between local residents and medical tourists in LMICs, we argue that (...) the presumption should not be in favor of medical tourism and that governments have a legitimate interest in seeking to regulate this industry to ensure that the net effects for their citizens is positive. Moreover, sending countries, particularly those in the developed world, have the responsibility to adopt public policies to diminish demand on the part of their citizens for medical tourism and to work with LMICs to ensure that the growth of medical tourism does not occur at the expense of the poorest of the poor. (shrink)

Travelling internationally to acquire medical treatments otherwise unavailable or inaccessible in one’s home country is not a novel concept. Conventionally, such medical travel largely entailed patients from developed countries or wealthy patients from the developing world seeking care in Western facilities like the Mayo Clinic in the U.S. and myriad private clinics along Harley Street in London, England. What is different about the topical phenomenon known as “medical tourism” is the growing trend of health services export in the opposite direction. (...) The number of patients travelling from the developed world to low- and middle-income countries for treatments has ballooned in recent years, primarily driven by difficulties with accessing affordable care at home. According to a liberal estimate by the Deloitte Center for Health Solutions, the number of Americans travelling abroad for care rose from 750,000 in 2007 to 1.6 million in 2012. On the flip side, Thailand reportedly treated a total of 1.3 million foreign nationals in 2007, which represented a 16% leap from 2001. (shrink)

Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

Venneman and colleagues argue that “do not resuscitate” (DNR) is problematic and should be replaced by “allow natural death” (AND). Their argument is flawed. First, while end-of-life discussions should be as positive as possible, they cannot and should not sidestep painful but necessary confrontations with morality. Second, while DNR can indeed be nonspecific and confusing, AND merely replaces one problematic term with another. Finally, the study’s results are not generalisable to the populations of physicians and working nurses and certainly do (...) not support the authors’ claim that there is a movement to replace DNR with AND. (shrink)

A system as complex as man can be viewed from many sides, and the one or the other axis can be selected to form a theoretical image. Partial truths will emerge, and their mutual intermeshing will gradually raise truth to higher levels. … It has always proven prejudicial to attribute general validity to a partial truth. Yet, a partial truth could not have been reached without overstating its value. Thus the history of truth is intimately interconnected with the history of (...) emotion, but the latter has remained in the dark.Robert Musil, The Man Without Qualities. (shrink)

Journal of Philosophy of Education, EarlyView.

Hong Kong’s Covid-19 epidemic circumstances have given us a valuable opportunity to reflect on Hong Kong’s elderly care policies. This essay argues that Hong Kong should learn from the West and provide a subsidy to family caregivers for proper elderly care. We rebut the social and moralistic reasons for not introducing such a subsidy in Hong Kong. We indicate that providing cash subsidy to family caregivers does not monetize or tarnish Confucian filial obligation to take care of elderly people, but (...) enable adult children from low-income families to undertake this obligation effectively. In addition, we contend that providing such a subsidy would not significantly affect the job market in Hong Kong and that incurred financial and manpower costs for monitoring family care are controllable. (shrink)

The East Asian family-oriented principle is defensible in theory as a shared decision making model and thus a viable alternative to individual-oriented decision making in bioethics. There are two crucial problems with the family-oriented principle, i.e., family-oriented paternalism and conflicts of interests between a patient and his family. These obstacles may appear formidable but they are not insurmountable in practice.

[1] Sefer Orḥot Ḥayim leha-Rosh ʻim beʼur "ha-Shem orḥotenu" ... 2. Ḳunṭres Be-Shaʻar ha-melekh ʻal haḳdamat ha-Rambam, kolel tsiyunim u-meḳorim u-veʼurim be-divre ha-Rambam ṿeha-Raʼabad ... 3. Ḳunṭres Tashlum yefeh ʻenayim ʻal Seder Zeraʻim u-Ṭehorot, ʻeduyot, Tamid, Midot, Ḳenim ṿe-ʻod ṿe-hu tsiyunim ʻal mas. elu mi-Yerushalmi u-midrashim ... 4. Ḳunṭres Marʼot maḳom, ṿe-hu tsiyunim ʻal ha-meḳomot she-Rashi ṿe-Tos. meviʼim mirdrash o Yerushalmi ṿe-Tosefta ṿe-khu. ṿe-lo tsuyan meḳoro ... 5. Ḳunṭres Ṭeʻama de-ḳara, ṿe-hu ḳetsat ḥidushim ʻal ha-Torah ṿe-ʻal Neviʼim u-Khetuvim -- ḥeleḳ (...) 3. Heʻarot ʻal seder ha-Shas (ṿe-kholel gam ezeh ḳunṭresim). (shrink)

PURPOSE:To report the localization of a gene causing drusen and macular degeneration in a previously undescribed North American family. METHODS:Genetic mapping studies were performed using linkage analysis in a single family with drusen and atrophic macular degeneration. RESULTS:The clinical manifestations in this family ranged from fine macular drusen in asymptomatic middle-aged individuals to atrophic macular lesions in two children and two elderly patients. We mapped the gene to chromosome 6q14 between markers D6S2258 and D6S1644. CONCLUSIONS:In a family with autosomal dominant (...) drusen and atrophic macular degeneration, the gene maps to a 3.2-cM region on chromosome 6q14. This locus appears to be distinct from, but adjacent to, the loci for cone-rod dystrophy 7 (CORD7) and North Carolina macular dystrophy (MCDR1). Future identification of the gene responsible for the disease in this family will provide a better understanding of macular degeneration. (shrink)

Nanotechnology shows great promise in a variety of applications with attractive economic and societal benefits. However, societal issues associated with nanotechnology are still a concern to the general public. While numerous technological advancements in nanotechnology have been achieved over the past decade, research into the broader societal issues of nanotechnology is still in its early phases. Based on the data from the Web of Science database, we applied the main path analysis, cluster analysis and text mining tools to explore the (...) main research fronts and hierarchical structure of these societal issues. We found that the research studies fell into four categories: "General Toxicity and EHS (Environment, Health and Safety)," "Medicine and Cytotoxicity," "Assessment and Regulation," and "Environment and Ecotoxicity." These research studies have disclosed much information about the potential effect of nanotechnology on public health and the environment. Relatively speaking, the studies on the assessment, regulation, preventive solutions, and environmental protection are just emerging. This finding indicates that an abundance of effort should be conducted on these emerging themes to maximize the benefits of nanotechnology while minimizing its potential harm. The implications for various parties in this domain are also presented. (shrink)

This study aimed to identify the learning and business incubation processes and their impact on developing the performance of business incubators in Gaza Strip, and the study relied on the descriptive analytical approach, and the study population consisted of all employees working in business incubators in Gaza Strip in addition to experts and consultants in incubators where their total number reached (62) individuals, and the researchers used the questionnaire as a main tool to collect data through the comprehensive survey method, (...) where (55) questionnaires were retrieved with a recovery rate of (88.7%). The results of the study showed that there is a high approval of the variables of the study, where the dimension of incubation operations came with a relative weight (84.89%), followed by the learning dimension which got a relative weight (82.50%), while the performance level of the incubators got a relative weight (80.12%) and as the study results showed There is a positive relationship statistically between the two dimensions of learning and business incubation processes and performance development in business incubators, and the linear regression analysis model showed that the main effect in improving the performance of business incubators is "after business incubation operations" while it showed weak effect after learning. The study came out with several recommendations, the most important of which is that business incubators seek to reinforce the learning process and incubation processes for business, and the need to periodically evaluate their performance, and that a more effective mechanism be designed to follow up with companies after the end of the incubation period and monitor the progress of these companies. (shrink)

"This concise, elegant essay on the roots and historical justification of philosophy marks a decisive step in posing the problem of what philosophy is. With consummate clarity and the charisma that distinguished him as a lecturer, Jos Ortega y Gasset re-creates ""that moment when Parmenides began talking about something exceptionally strange, which he called 'being.'"" How and why, he asks, did such a surprising adventure come about?Considering the human qualities that prompt a curiosity about existence and eternity, Ortega examines philosophy's (...) etymology, its connection to poetry, and its differentiation from religion and other modes of thought. He lucidly delineates radical differences of doctrine and style among early Greek thinkers, especially the ""madman of reason"" Parmenides and the ""absolute individual"" Heraclitus. He also considers philosophy's fundamental task of revealing the latent world poised behind the manifest world and discovering the relations between them.""Unable to find lodging among the philosophies of the past,"" Ortega observes, ""we have no choice but to attempt to construct one of our own."" The Origin of Philosophy argues for the vital importance of philosophy as a human endeavor, even while noting that each generation of thought reveals the past as ""a defunct world of errors.""". (shrink)

Fourteen essays by leading scholars from around the world explore the theological, philosophical, and historical connections between the three Abrahamic faiths and ethics. Timely reading for students of religion, philosophy, and ethics.

Originally published: Oxford: Clarendon Press, 1932.

Esta reedición de La deshumanización del arte incluye, además del ensayo que da título al volumen, una serie de artículos que Ortega no recogió en ninguno de sus libros. En ellos se comprueba la persistencia con que supo extraer de la experienca del arte notas relevantes para el curso de sus formulaciones filosóficas. En esta nueva edición -revisada conforme a los originales- se incluye el discurso " La verdad no es sencilla ", publicado recientemente con carácter póstumo, y un apéndice, (...) inédito hasta la fecha, al ensayo " Sobre el punto de vista en las artes ". (shrink)

The logical empiricists often appear as a foil for feminist theories. Their emphasis on the individualistic nature of knowledge and on the value-neutrality of science seems directly opposed to most feminist concerns. However, several recent works have highlighted aspects of Carnap's views that make him seem like much less of a straightforwardly positivist thinker. Certain of these aspects lend themselves to feminist concerns much more than the stereotypical picture would imply.

In his groundbreaking work of 1969, Spinoza's Metaphysics: An Essay in Interpretation, Edwin Curley attacked the traditional understanding of the substance-mode relation in Spinoza, which makes modes inhere in the substance. Curley argued that such an interpretation generates insurmountable problems, as had been already claimed by Pierre Bayle in his famous entry on Spinoza. Instead of having the modes inhere in the substance Curley suggested that the modes’ dependence upon the substance should be interpreted in terms of (efficient) causation, i.e., (...) as committing Spinoza to nothing over and above the claim that the substance is the (efficient) cause of the modes. These bold and fascinating claims generated one of the most important scholarly controversies in Spinoza scholarship of the past thirty-five years. In this chapter I argue against Curley’s interpretation and attempt to reestablish the traditional understanding of Spinozistic modes as inhering in God and as predicated of God. I also criticize Curley’s philosophical motivation for suggesting this interpretation. I do believe, however, that Curley is right about the existence of an intimate connection between the substance-mode relation and causation in Spinoza. In the next chapter I will study the notion of ‘immanent cause’, which merges efficient causality and inherence. I will clarify the relation between immanent, efficient and material causation, and show where precisely Spinoza diverged from the traditional Aristotelian taxonomy of causes. In the second chapter I also discuss the German Idealists’ view of Spinoza as an ‘acosmist’. Under this interpretation Spinoza was a modern reviver of Eleatic monism, who allegedly asserts the mere existence of God, and denies the reality of the world of particular things. Spinozistic modes - according to this reading - are nothing but passing and unreal phenomena. Though this view of Spinoza as an ‘acosmist’ can be supported by some lines in Spinoza’s thought, I believe it should be rejected since it is not consistent with some of the most central doctrines of the Ethics. In the final part of the second chapter I discuss the relation between modes and the attributes under which they fall, and suggest a terminological distinction between a ‘mode of God’ (i.e., a mode under all attributes) and a ‘mode of an attribute’ (i.e., a mode under a specific attribute), a distinction which can help us avoid some common confusions in the treatment of the issue. (shrink)