Introduction Understanding the views of the public is essential if generally acceptable policies are to be devised that balance research access to general practice patient records with protection of patients' privacy. However, few large studies have been conducted about public attitudes to research access to personal health information. Methods A mixed methods study was performed. Informed by focus groups and literature review, a questionnaire was designed which assessed attitudes to research access to personal health information and factors that (...) influence these. A postal survey was conducted of an electoral roll-based sample of the adult population of Ireland. Results Completed questionnaires were returned by 1575 (40.6%). Among the respondents, 67.5% were unwilling to allow GPs to decide when researchers could access identifiable personal health information. However, 89.5% said they would agree to ongoing consent arrangements, allowing the sharing by GPs of anonymous personal health information with researchers without the need for consent on a study-by-study basis. Increasing age (by each 10-year increment), being retired and primary level education only were significantly associated with an increased likelihood of agreeing that any personal health information could be shared on an ongoing basis: OR 1.39 (95% CI 1.18 to 1.63), 2.00 (95% CI 1.22 to 3.29) and 3.91 (95% CI 1.95 to 7.85), respectively. Conclusions Although survey data can be prone to response biases, this study suggests that prior consent agreements allowing the supply by GPs of anonymous personal health information to researchers may be widely supported, and that populations willing to opt in to such arrangements may be sufficiently representative to facilitate valid and robust consent-dependent observational research. (shrink)

Within the context of structural theories this paper examines what health professionals say about their clinical service structures. We firstly trace various conceptual perspectives on clinical service structures, discussing multiple theoretical axes. These theories question whether clinical service structures represent either superficial or more profound changes in hospitals. We secondly explore which view is supported though a content analysis of the free text responses of 111 health professionals (44 doctors, 45 nurses and 22 allied health practitioners) about (...) their clinical service structures in a questionnaire survey in two large hospitals that had implemented clinical service structures three years previously. Commentaries unfavourable toward clinical service structures were made by 47.7% of staff, favourable by 24.3%, mixed (both favourable and unfavourable) by 17.1% and non-evaluative statements were made by 10.8%. The most frequent criticisms were inefficient organisation of change (27%), poor management (24.3%), lack of cooperation between staff (15.9%) and failure to empower health practitioners (13.5%). All professions made more negative than positive evaluations of their clinical service structures but the ratio was highest for doctors and lowest for allied health. Ranking of nurses' and allied health staffs' specific evaluations were similar but both differed significantly from doctors.' Unfavourable or negative comments predominated, and change appears more superficial and less profound than advocates of structural contributions hope. Four types of belief systems about clinical service structures are apparent. Some study participants are disposed toward the status quo; others toward restructuring; yet others are team oriented; and a final group is tribally oriented. The implication of this paper for managers is that more work is needed if clinical service structures are to realise the promise of more multi-disciplinarity and less fragmentation across professional groups. For scholars, the implication is that marrying different theoretical frames with empirical data can serve to produce fresh perspectives and perhaps new insights. (shrink)

The aim of this study was to assess attitudes of intensive care nurses to selected ethical issues related to end-of-life decisions in paediatric intensive care units. A self-administered questionnaire was distributed in 2005 to intensive care nurses at two different scientific occasions in Turkey. Of the 155 intensive care nurse participants, 98% were women. Fifty-three percent of these had intensive care experience of more than four years. Most of the nurses failed to agree about withholding (65%) or withdrawing (60%) futile (...) treatment. In addition, 68% agreed that intravenous nutrition must continue at all costs. In futile treatment cases, the nurses tended to leave the decision to parents or act maternalistically. The results showed that intensive care nurses could ignore essential ethical duties in end-of-life care. We suggest that it is necessary to educate Turkish intensive care nurses about ethical issues at the end of life. (shrink)

The aim of this study was to reveal doctors' and nurses' attitudes to euthanasia in intensive care units and surgical, internal medicine and paediatric units in Turkey. A total of 205 doctors and 206 nurses working in several hospitals in Istanbul participated. Data were collected by questionnaire and analysed using SPSS v. 12.0. Significantly higher percentages of doctors (35.3%) and nurses (26.6%) working in intensive care units encountered euthanasia requests than those working in other units. Doctors and nurses caring for (...) terminally ill patients in intensive care units differed considerably in their attitudes to euthanasia and patient rights from other health care staff. Euthanasia should be investigated and put on the agenda for discussion in Turkey. (shrink)

This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual face-to-face interviews. Our study has two main findings: (1) In (...) the context of organ procurement, HPs believe that BD is a more reliable standard for determining death than circulatory death, and (2) While the vast majority of HPs consider it morally acceptable to retrieve organs from brain-dead donors, retrieving organs from DCD patients is much more controversial. We offer the following possible explanations. DCD introduces new conditions that deviate from standard medical practice, allow procurement of organs when donors’ loss of circulatory function could be reversed, and raises questions about “death” as a unified concept. Our results suggest that, for many HPs, these concerns seem related in part to the fact that a rigorous brain examination is neither clinically performed nor legally required in DCD. Their discomfort could also come from a belief that irreversible loss of circulatory function has not been adequately demonstrated. If DCD protocols are to achieve their full potential for increasing organ supply, the sources of HPs’ discomfort must be further identified and addressed. (shrink)

BackgroundDecisions about appropriate treatment at the end of life are common in modern healthcare. Non-treatment decisions (NTDs), comprising both withdrawal and withholding of (potentially) life-prolonging treatment are in principle accepted in Norway. However, in practice they may give rise to significant moral problems for health professionals, patients and next of kin. Here, patient values must be considered. It is relevant to study the moral views and intuitions of the general population on NTDs and special areas of contention such as (...) the role of next of kin in decision-making.MethodsElectronic survey to members of a nationally representative panel of Norwegian adults. Respondents were presented with vignettes describing patients with disorders of consciousness, dementia, and cancer where patient preferences varied. Respondents answered ten questions about the acceptability of non-treatment decision making and the role of next of kin.ResultsWe received 1035 complete responses (response rate 40.7%). A large majority, 88%, supported the right of competent patients to refuse treatment in general. When an NTD was in line with the patient’s previously expressed preferences, more respondents tended to find NTDs acceptable. More respondents would accept NTDs for themselves than for the vignette patients. In a scenario with an incompetent patient, clear majorities wanted the views of next of kin to be given some but not decisive weight, and more weight if concordant with the patient’s wishes. There were, however, large variations in the respondents’ views.ConclusionThis survey of a representative sample of the Norwegian adult population indicates that attitudes to NTDs are often in line with national laws and guidelines. However, the high variance among the respondents and relatively large weight given to next of kin’s views, indicate a need for appropriate dialogue among all stakeholders to prevent conflicts and extra burdens. Furthermore, the emphasis given to previously expressed opinions indicates that advance care planning may increase the legitimacy of NTDs and prevent challenging decision-making processes. (shrink)

Background: Dignity is a multidimensional construct that includes perception, knowledge, and emotions related to competence or respect. Attitudes to aging are a comprehensive personal view of the experience of aging over the course of life, which can be influenced by various factors, such as the levels of health and self-sufficiency and social, psychological, or demographic factors. Aim: The purpose of this study was to explore the attitudes to aging of home-dwelling and inpatient older adults, and whether dignity and other (...) selected factors belong among the predictors influencing attitudes to aging in these two different groups of older adults. Research design: Cross-sectional study using a set of questionnaires: Patient Dignity Inventory, Attitudes to Aging Questionnaire, and Barthel Index. Pearson and Spearman correlation analyses and multivariable linear regression were used for statistical processing. Participants and research context: 233 inpatients and 237 home-dwelling older adults participated in the research in two regions of the Czech Republic. Ethical considerations: Institutional Review Board approval was received from the authors’ university. Findings: The inpatients had more negative attitudes to aging. The predictors of their attitudes to aging were gender and dignity. Women and inpatients with poor dignity ratings had more negative attitudes to aging. The predictors for home-dwelling older adults were education, living arrangement, and dignity. More negative attitudes to aging were found in older adults with lower levels of education who lived alone and rated their dignity as low. Discussion and Conclusions: The results of this study add to the understanding that a sense of dignity is an important predictor of attitudes to aging for both home-dwelling older adults and inpatients. (shrink)

This integrative review aims to provide a synthesis of research findings of health-care professionals’ knowledge, attitudes and behaviours relating to patient capacity to consent to or refuse treatment within the general hospital setting. Search strategies included relevant health databases, hand searching of key journals, ‘snowballing’ and expert recommendations. The review identified various knowledge gaps and attitudinal dispositions of health-care professionals, which influence their behaviours and decision-making in relation to capacity to consent processes. The findings suggest that there (...) is tension between legal, ethical and professional standards relating to the assessment of capacity and consent within health care. Legislation and policy guidance concerning capacity assessment processes are lacking, and this may contribute to inconsistencies in practice. (shrink)

The purpose of this paper is to propose a critique of the prevailing attitude of human health, what I refer to as the will to health, using a Nietzschean perspective. First, I briefly discuss the purpose and manner of Nietzsche’s methodological approach to philosophy and his problem with modernity. Second, I explicate the two current ideological paradigms of health that, in my view, constitute the prevailing will to health. Third, Nietzsche’s general understanding of human (...) class='Hi'>health is presented and following this, a critique of some contemporary health matters from this perspective is undertaken. Strictly speaking, there is no specific thesis to be found in this paper. I do not presume to prove or disprove anything, rather I avail myself of Nietzsche’s unique insight into the human condition as a rubric from which to illuminate something of the nature of human health. (shrink)

We have investigated attitudes towards the use of health data among the Swedish population by analyzing data from a survey answered by 1645 persons. Health data are potentially useful for a variety of purposes. Yet information about health remains sensitive. A balance therefore has to be struck between these opposing considerations in a number of contexts. The attitudes among those whose data is concerned will influence the perceived legitimacy of policies regulating health data use. We aimed (...) to investigate what views are held by the general public, and what aspects matter for the willingness to let one’s data be used not only for one’s own care but also for other purposes. We found that while there is a broad willingness to let one’s data be used, the possibility to influence that use is considered important. The study also indicated that when respondents are required to balance different interests, priority is typically given to compulsory schemes ensuring that data are available where needed, rather than voluntary participation and data protection. The policy implications to be drawn from this are not self-evident, however, since the fact that a majority has a certain attitude does not by itself determine the most adequate policy. (shrink)

Acceptance of elderly or marginal health individuals as kidney donors is debated, with practices varying between centres. Transplant recipients, live kidney donors and health-care professionals caring for patients with renal failure were surveyed regarding their views on live donor kidney transplantation (LDKT) of marginal health (diabetes, hypertension, atherosclerosis, obesity, etc.) and elderly donors. Participants were recruited within a tertiary renal and transplant centre and invited to participate in focus groups and structured interviews. They also completed an anonymous (...) questionnaire. Of 464 participants who completed the questionnaire (36% health-care professionals and 64% patients), 49% and 64%, respectively, stated that marginal and elderly donors should be accepted for LDKT. In the structured interviews, emphasis was given to presenting to donor, recipient and their respective families a calculated risk regarding the effect that either a nephrectomy or transplant has on long-term quality of life. Participants stated that an independent third party in addition to the transplant team should discuss involved risks. Issues of ‘how desperate’ the recipient's situation is should also be considered. Health-care professionals stated that regardless of the strength of will of an individual to donate a kidney (despite age, health problems or personal risk), they should always have the right to say ‘no’ if performing a specific LDKT was against their professional and ethical values. About half of those surveyed considered that marginal health and elderly donors were acceptable for LDKT. Emphasis was given to the explanation to donors and recipients of the risks involved in such transplantation. (shrink)

The use of complementary and alternative medicine is increasing in the Western world. However, there is no clear evidence of effect of alternative therapies. Moreover, there is no consensus between practitioners and researchers as to the right way of assessing the efficacy of alternative therapies. To investigate practitioners’ perspective on evidence and ways of assessing efficacy twelve in-depth interviews were conducted in Denmark with acupuncturists, including physicians practising acupuncture, acupuncturists with a health-related background, and acupuncturists without a health-related (...) background. Two themes predominated the study, first, the interviewees’ general reflections on how it is possible to establish knowledge about an effect of acupuncture; and second the interviewees’ reflections on the use of randomized controlled trials in acupuncture, including obstacles and alternatives to conducting randomized controlled trials. Further, two conceptions of what constitutes evidence were identified: a biomedical conception and an experience-based conception. Most interviewees were sceptical about the use of randomized controlled trials in acupuncture. Two reasons, especially, were given for this scepticism. First, practical and instrumental reasons concerning the specific elements of the randomized controlled trial or relating to limited resources; and second, value-based reasons are concerning the nature of acupuncture. However, the interviewees were really opposed only to a certain kind of randomized controlled trial, the so-called explanatory trial. They would actually welcome a pragmatic trial. The study gives valuable insight into an under explored field and provide a platform for further investigation, and a better informed discussion of the subject. (shrink)

England and Wales are moving toward a model of ‘opt out’ for use of personal confidential data in health research. Existing research does not make clear how acceptable this move is to the public. While people are typically supportive of health research, when asked to describe the ideal level of control there is a marked lack of consensus over the preferred model of consent. This study sought to investigate a relatively unexplored difference between the consent model that people (...) prefer and that which they are willing to accept. It also sought to explore any reasons for such acceptance. (shrink)

A self-designed questionnaire was given to 634 health professionals in a large teaching hospital in Hubei Province in mainland China, to clarify the participants’ attitude towards information disclosure to cancer patients. Statistic description was used to analyze the data. The item ‘inappropriate information about cancer easily leads to medical disputes’ scored highest at 3.86, while the scores of such items as ‘advantages of fully informing patients outweigh disadvantages’, ‘if their family members demand nondisclosure, you will find it difficult (...) to cooperate in good faith with patients’, and ‘telling white lies to patients disturbs you a lot’ were less than 3. The health care staff placed a high value on both the desire and priority of patients to know the truth, though most of them did not think that patients had received enough information about their disease. In order to improve cancer patients’ current state of knowledge, health professionals should learn more about informed consent, and special methods and guidelines compatible with Chinese culture are urgently required in China. (shrink)

OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire with (...) a response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues. (shrink)

Background Interest in biobanking for collection of specimens for non-communicable diseases research has grown in recent times. This paper explores the perspectives of Nigerians on donation of specimen for the biobanking research. Methods We conducted 16 Focus Group Discussions (FGD) with individuals from different ethnic, age and socio-economic groups in Kano (North), Enugu (Southeast), Oyo States (Southwest) and Abuja, the Federal Capital Territory (Central) of Nigeria. We used topic guides and prompt statements to explore the knowledge and understanding of interviewees (...) to general issues about biobanking of biospecimens, their use and specifically about role of biobanking in non-communicable diseases research. Results A total of 123 individuals participated in 16 focus group discussions in 2011. Our participants had limited knowledge of the concept of biobanking but accepted it once they were educated about it and saw it as a worthwhile venture. Half of our study participants supported use of broad consent, a quarter supported restricted consent while the remaining quarter were in favour of tiered consent. Most discussants support shipment of their samples to other countries for further research, but they prefer those collaborations to be done only with competent, ethical researchers and they would like to receive feedback about such projects. The majority preferred health care as a benefit from participation, particularly for any unexpected condition that may be discovered during the course of the research instead of financial compensation. Participants emphasized the need to ensure that donated samples were not used for research that contradicts their religious beliefs. Conclusions Our study demonstrates that our participants accepted biobanking once they understand it but there were different attitudes to elements of biobanking such as type of consent. Our study highlights the need to carefully document population attitudes to elements of modern scientific research and the consenting process. (shrink)

BackgroundRespecting patients’ confidentiality is an ethical and legal responsibility for health professionals and the cornerstone of care excellence. This study aims to assess health professionals’ knowledge, attitudes, and associated factors towards patients’ confidentiality in a resource-limited setting.MethodsInstitutional based cross-sectional study was conducted among 423 health professionals. Stratified sampling methods were used to select the participants, and a structured self-administer questionnaire was used for data collection. The data was entered using Epi-data version 4.6 and analyzed using SPSS, version (...) 25. Bi-variable and multivariable binary logistic regression analyses were used to measure the association between the dependent and independent variables. Odds ratio with 95% confidence intervals and P value was calculated to determine the strength of association and to evaluate statistical significance.ResultOut of 410 participants, about 59.8% with [95% CI (54.8–68.8%)] and 49.5% with [95% CI (44.5–54.5%)] had good knowledge and favorable attitude towards patents confidentiality respectively. Being male (AOR = 1.63, 95% CI [1.03–2.59]), taking training on medical ethics (AOR = 1.73, 95% CI = [1.11–2.70]), facing ethical dilemmas (AOR = 3.07, 95% CI [1.07–8.79]) were significantly associated factors for health professional knowledge towards patients’ confidentiality. Likewise, taking training on medical ethics (AOR = 2.30, 95% CI [1.42–3.72]), having direct contact with the patients (AOR = 3.06, 95% CI [1.12–8.34]), visiting more patient (AOR = 4.38, 95% CI [2.46–7.80]), and facing ethical dilemma (AOR = 3.56, 95% CI [1.23–10.26]) were significant factors associated with attitude of health professionals towards patient confidentiality.ConclusionThe findings of this study revealed that health professionals have a limited attitude towards patient confidentiality but have relatively good knowledge. Providing a continuing medical ethics training package for health workers before joining the hospital and in between the working time could be recommended to enhance health professionals’ knowledge and attitude towards patient confidentiality. (shrink)

Previous studies investigating attitudes to genetically modified (GM) foods suggest a correlation between negative attitudes and low levels of science education, both of which are associated with women. In a qualitative focus group study of Australian women with diverse levels of education, we found attitudes to GM foods were part of a complex process of making “good” food decisions, which included other factors such as locally produced, fresh/natural, healthy and nutritious, and convenient. Women involved in GM crop development and those (...) with health science training differed in how they used evidence to categorize GM foods. Our findings contribute to a deeper understanding of how GM food, and the role of science and technology in food production and consumption more broadly, is understood and discussed amongst diverse “publics” and across different “sciences,” and to research related to deepening public engagement at the intersection of science and values. (shrink)

Critical thinking is a complex, dynamic process formed by attitudes and strategic skills, with the aim of achieving a specific goal or objective. The attitudes, including the critical thinking attitudes, constitute an important part of the idea of good care, of the good professional. It could be said that they become a virtue of the nursing profession. In this context, the ethics of virtue is a theoretical framework that becomes essential for analyse the critical thinking concept in nursing care and (...) nursing science. Because the ethics of virtue consider how cultivating virtues are necessary to understand and justify the decisions and guide the actions. Based on selective analysis of the descriptive and empirical literature that addresses conceptual review of critical thinking, we conducted an analysis of this topic in the settings of clinical practice, training and research from the virtue ethical framework. Following JBI critical appraisal checklist for text and opinion papers, we argue the need for critical thinking as an essential element for true excellence in care and that it should be encouraged among professionals. The importance of developing critical thinking skills in education is well substantiated; however, greater efforts are required to implement educational strategies directed at developing critical thinking in students and professionals undergoing training, along with measures that demonstrate their success. Lastly, we show that critical thinking constitutes a fundamental component in the research process, and can improve research competencies in nursing. We conclude that future research and actions must go further in the search for new evidence and open new horizons, to ensure a positive effect on clinical practice, patient health, student education and the growth of nursing science. (shrink)

In order to assure optimal care of patients with chronic illnesses, it is necessary to take into account the cultural factors that may influence health-related behaviors, health practices, and health-seeking behavior. Despite the increasing number of Romanian Roma, research regarding their beliefs and practices related to healthcare is rather poor. The aim of this paper is to present empirical evidence of specificities in the practice of healthcare among Romanian Roma patients and their caregivers. Using a qualitative exploratory (...) descriptive design, this study is based on data gathered through three focus groups with 30 health mediators in the counties of Iasi and Cluj (Romania). We identified various barriers to access to healthcare for Roma patients: lack of financial resources and health insurance coverage, lack of cognitive resources or lack of personal hygiene, but also important cultural issues, such as the shame of being ill, family function, disclosure of disease-related information, patient’s autonomy, attitudes towards illness and health practices, that should be considered in order to create a culturally sensitive environment in Romanian medical facilities:… The role of the health mediators within the context of cultural diversity is also discussed, as cultural brokers contributing to health care quality among Romanian Roma patients Bridging cultural differences may improve patient–healthcare provider relationships, but may have limited impact in reducing ethnic disparities, unless coupled with efforts of Roma communities to get involved in creating and implementing health policies. (shrink)

BackgroundResuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit, meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people regarding resource allocation decisions in the NICU.MethodsThe study design was a cross-sectional quantitative survey, consisting of 20 hypothetical rationing scenarios. There were (...) 119 respondents who entered the questionnaire, and 109 who completed it. The respondents were adult US and Indian participants of the online crowdsourcing platform Mechanical Turk. Respondents were asked to decide which of two infants to treat in a situation of scarce resources. Demographic characteristics, personality traits and political views were recorded. Respondents were also asked to respond to a widely cited thought experiment involving rationing.ResultsThe majority of respondents, in all except one scenario, chose the utilitarian option of directing treatment to the infant with the higher chance of survival, higher life expectancy, less severe disability, and less expensive treatment. As discrepancy between outcomes decreased, however, there was a statistically significant increase in egalitarian responses and decrease in utilitarian responses in scenarios involving chance of survival, life expectancy, and cost of treatment. In the classic ‘lifeboat’ scenario, all but two respondents were utilitarian.ConclusionsThis survey suggests that in situations of scarcity and equal clinical need, non-health professionals support rationing of life-saving treatment based on probability of survival, duration of survival, cost of treatment or quality of life. However, where the difference in prognosis or cost is very small, non-health professionals preferred to give infants an equal chance of receiving treatment. (shrink)

The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research published in March of 1983 its Report, Securing Access to Health Care: The Ethical Implications of Differences in the Availability of Health Services . Concluding that there are "ethical obligations" on behalf of society which are balanced by individual obligations, the Report provides an ethical framework for ensuring "ultimate responsibility" of the Federal government to arrange for equitable access to health and (...) to a fair share of cost. In doing so the Report neither makes justice nor beneficence the prime moral principle in public health care, it rather calls for a common sense approach in "approximating adequacy". But how to define equality without creating uniformity in a society rich in its diversity, including attitudes towards health? Keywords: justice, beneficence, right to health care, equality, distribution CiteULike Connotea Del.icio.us What's this? (shrink)

This article compares health promotion attitudes towards prostate cancer and Alzheimer’s disease. Our aim is to demonstrate that these two apparently distinct conditions of the aging body – one affecting the male reproductive system, the other primarily the brain – are addressed in similar fashion in recent public health activities because of a growing emphasis on a ‘cardiovascular logic’. We suggest that this is a form of reductionism, and argue that it leaves us with a dangerous paradox: while (...) re-transcending, at least partially, the conceptual separation of body and brain, it clouds much-needed discussion and research, such as contingent issues of socio-economic and socio-cultural disease disparities. (shrink)

BackgroundThe health sector aims to improve health outcomes and access to healthcare. At the same time, the sector relies on unsustainable environmental practices that are increasingly recognised to be catastrophic threats to human health and health inequities. As such, a moral imperative exists for the sector to address these practices. While strides are currently underway to mitigate the environmental impacts of healthcare, less is known about how health researchers are addressing these issues, if at all.MethodsThis (...) paper uses an interview methodology to explore the attitudes of UK health researchers using data-intensive methodologies about the adverse environmental impacts of their practices, and how they view the importance of these considerations within wider health goals.ResultsInterviews with 26 researchers showed that participants wanted to address the environmental and related health harms associated with their research and they reflected on how they could do so in alignment with their own research goals. However, when tensions emerged, their own research was prioritised. This was related to their own desires as researchers and driven by the broader socio-political context of their research endeavours.ConclusionTo help mitigate the environmental and health harms associated with data-intensive health research, the socio-political context of research culture must be addressed. (shrink)

We assessed the attitudes, perceptions, and stereotypes toward Latino immigrants among 247 mental health professionals across 32 U.S. states. We also randomly presented two versions of an attitude measure that varied in their references to immigrants. Participants reported that they did not agree with the anti-immigration law Arizona SB 1070 and other similar bills. Also, greater multicultural awareness was related to positive attitudes and fewer stereotypes toward immigrants. Furthermore, participants who were asked to think about “undocumented immigrants” viewed (...) Latino immigrants more positively than those who were asked think about “illegal aliens.” Findings show the continued need for multicultural awareness and competence training for mental health professionals, which align with the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. Limitations and future directions for research are discussed. (shrink)

AimTo explore new mothers' knowledge of newborn screening, and their attitudes towards issues surrounding sample retention and the potential for blood screening samples to be used for research.MethodsA self-administered mail survey was sent to women who gave birth in Perth, Western Australia during January 2005. A total of 600 women completed the survey.ResultsIt was found that women were aware of newborn screening, however desired further information in order to acquire a more comprehensive knowledge of the test. Further, women reported discomfort (...) with the long-term storage of cards, but they were supportive of using blood samples for medical research, contingent upon the samples being de-identified and parental consent provided.ConclusionsNew mothers need to be provided with comprehensive information about the newborn screening test at a time which is conducive for the assimilation of this information. In addition, whilst supporting health related research using newborn screening samples, new mothers are keen for ethical issues to be sufficiently addressed prior to samples being systematically stored for extended periods of time. (shrink)

The availability of free health care to all citizens has been regarded as a great achievement of the Soviet society. In recent decades, however, decreased funding of the state-run health care system has led to a deterioration in the quality and quantity of available medical equipment and services. More than 50 percent of the Russian population is dissatisfied with the health care system and the attitudes and moral standards of their health care providers. This article discusses (...) the degree, nature, and some of the causes of the public's dissatisfaction and concludes with a preliminary look toward the future of the Russian health care system. (shrink)

Explaining Attitudes offers an important challenge to the dominant conception of belief found in the work of such philosophers as Dretske and Fodor. According to this dominant view beliefs, if they exist at all, are constituted by states of the brain. Lynne Rudder Baker rejects this view and replaces it with a quite different approach - practical realism. Seen from the perspective of practical realism, any argument that interprets beliefs as either brain states or states of immaterial souls is a (...) 'non-starter'. Practical realism takes beliefs to be states of the whole persons, rather like states of health. What a person believes is determined by what a person would do, say and think in various circumstances. Thus beliefs and other attitudes are interwoven into an integrated, commonsensical conception of reality. (shrink)

A challenge of performing research in the paediatric emergency and acute care setting is obtaining valid prospective informed consent from parents. The ethical issues are complex, and it is important to consider the perspective of participants, health care workers and researchers on research without prospective informed consent while planning this type of research. We performed a systematic review according to PRISMA guidelines, of empirical evidence relating to the process, experiences and acceptability of alternatives to prospective informed consent, in the (...) paediatric emergency or acute care setting. Major medical databases and grey sources were searched and results were screened and assessed against eligibility criteria by 2 authors, and full text articles of relevant studies obtained. Data were extracted onto data collection forms and imported into data management software for analysis. Thirteen studies were included in the review consisting of nine full text articles and four abstracts. Given the heterogeneity of the methods, results could not be quantitatively combined for meta-analysis, and qualitative results are presented in narrative form, according to themes identified from the data. Major themes include capacity of parents to provide informed consent, feasibility of informed consent, support for alternatives to informed consent, process issues, modified consent process, child death, and community consultation. Our review demonstrated that children, their families, and health care staff recognise the requirement for research without prior consent, and are generally supportive of enrolling children in such research with the provisions of limiting risk, and informing parents as soon as possible. Australian data and perspectives of children are lacking and represent important knowledge gaps. (shrink)

Register-based research can provide important and valuable contributions to public health research, but involves ethical issues concerning the balance of public health benefits and individual autonomy. This study aimed to describe the opinions of the Finnish public about these issues.

This study aims at assessing the level of knowledge, attitudes, and practices (KAP) concerning reproductive health (RH) among adolescent college-going girls in the urban and rural areas of Chittagong District, Bangladesh. A college-based cross-sectional study was conducted among college-going girls (N = 792) of four colleges attending Higher Secondary Certificate (HSC) classes (eleven/twelve classes) in Chittagong District. Data were collected using a structured and self-administered questionnaire. Chi-square (χ2) and independent-samples t-test were conducted to make the comparison between urban and (...) rural participants. Data were analyzed using IBM SPSS version 24.0. The authors’ interpretation of the findings was also informed by anthropological as well as qualitative considerations. Mothers were reported to be the key informants of reproductive health for the adolescent girls of both urban and rural areas. Besides, urban respondents were more likely than rural respondents (p <.001) to feel comfortable during the discussion on RH with mother/sister/relative; to communicate frequently with their mothers; to discuss RH issues regularly; to have prior knowledge on menstruation. Moreover, this study also found significant differences (p <.05) regarding most of the items addressing RH knowledge, attitude, and practice between adolescent girls in urban and rural areas of Bangladesh due to the existing socio-cultural disparities between the areas of residence. (shrink)

When a patient with a serious mental illness expresses a desire for children, mental health professionals are faced with an ethical dilemma. To date, little research has been conducted into their strategies for dealing with these issues.

With dwindling support from governments toward universities, university–industry partnerships have increased. Ethical concerns over such partnerships have been documented, are particularly relevant when an institution receives money from a corporation whose products do harm and are intensified for academic public health institutions whose missions include promoting well-being. Academics in medicine and nutrition have often failed to recognize the potential conflicts of industry-sponsored research. It is unclear if research to date has explored attitudes of public health academics toward accepting (...) such funds. The objective of this research was to review systematically the attitudes of public health academics with respect to accepting funds from for-profit corporations. Four electronic databases were searched as well as the archives of the Chronicles of Higher Education. The search strategy was based on four main domains: for-profit organizations, funding, public health and academia. This search resulted in a total of 4017 articles reviewed. No articles were found that investigated the attitudes of public health academics toward accepting funds from industry. The lack of articles addressing public health academicians’ perspective toward accepting industry funds is striking. Research regarding this topic can guide development of policies that minimize the negative consequences of industry funding. (shrink)

BackgroundA growing number of studies show the potential of loyalty card data for use in health research. However, research into public perceptions of using this data is limited. This study aimed to investigate public attitudes towards donating loyalty card data for academic health research, and the safeguards the public would want to see implemented. The way in which participant attitudes varied according to whether loyalty card data would be used for either cancer or COVID-19 research was also examined.MethodsParticipants (...) were recruited via Prolific Academic to take part in semi-structured telephone interviews, with questions focused on data sharing related to either COVID-19 or ovarian/bowel cancer as the proposed health condition to be researched. Content analysis was used to identify sub-themes corresponding to the two a priori themes, attitudes and safeguards.ResultsParticipant attitudes were found to fall into two categories, either rational or emotional. Under rational, most participants were in favour of sharing loyalty card data. Support of health research was seen as an important reason to donate such data, with loyalty card logs being considered as already within the public domain. With increased understanding of research purpose, participants expressed higher willingness to donate data. Within the emotional category, participants shared fears about revealing location information and of third parties obtaining their data. With regards to safeguards, participants described the importance of anonymisation and the level of data detail; the control, convenience and choice they desired in sharing data; and the need for transparency and data security. The change in hypothetical purpose of the data sharing, from Covid-19 to cancer research, had no impact on participants’ decision to donate, although did affect their understanding of how loyalty card data could be used.ConclusionsBased on interviews with the public, this study contributes recommendations for those researchers and the wider policy community seeking to obtain loyalty card data for health research. Whilst participants were largely in favour of donating loyalty card data for academic health research, information, choice and appropriate safeguards are all exposed as prerequisites upon which decisions are made. (shrink)

OBJECTIVES: This study was designed to identify and compare the attitudes of patients and health care professionals towards advance directives. Advance directives promote recognition of the patient's autonomy, letting the individual exercise a certain measure of control over life-sustaining care and treatment in the eventuality of becoming incompetent. DESIGN: Attitudes to advance directives were evaluated using a 44-item self-reported questionnaire. It yields an overall score as well as five factor scores: autonomy, beneficence, justice, external norms, and the affective dimension. (...) SETTING: Health care institutions in the province of Québec, Canada. Survey sample: The sampling consisted of 921 subjects: 123 patients, 167 physicians, 340 nurses and 291 administrators of health care institutions. RESULTS: Although the general attitude of each population was favourable to the expression of autonomy, multivariate analysis of variance (MANOVA) indicated that physicians attached less importance to this subscale than did other populations (p < .001). Above all, they favoured legal external norms and beneficence. Physicians and administrators also attached less importance to the affective dimension than did patients and nurses. Specifically, physicians' attitudes towards advance directives were shown to be less positive than patients' attitudes. CONCLUSION: More attention should be given to the importance of adequately informing patients about advance directives because they may not represent an adequate means for patients to assert their autonomy. (shrink)

When considering the principle of medical confidentiality, disclosure of genetic information constitutes a special case because of the impact that this information can have on the health and the lives of relatives. The aim of this study is to explore the attitudes of Turkish physicians and patients about sharing information obtained from genetic tests.

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A (...) questionnaire analysis was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited (...) and somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

Every emerging technology has its pros and cons; health-conscious users pay more importance to healthy and environment-friendly technologies. Based on the UTAUT2 model, we proposed a comprehensive novel model to study the factors influencing consumers’ decision-making to adopt the technology. Compared to prior studies that focused on linear models to investigate consumers’ technology adoption intentions and use behavior. This study used a Structural Equation Modeling-fuzzy set qualitative comparative analysis approach to account for the complexity of customers’ decision-making processes in (...) adopting new technology. We collected valid responses from 830 consumers, analyzed them, and evaluated them using a deep learning SEM-fsQCA technique to capture symmetric and asymmetric relations between variables. We have extensively incorporated a health-consciousness attitude as a predictor and mediator to understand better the decision-making toward technology adoption, specifically 5G technology. All the factors tested in our model are statistically significant except the economic factors. Health-consciousness attitude and behavioral intention found significant predictors and valid mediators in the process of 5G technology adoption. FsQCA provided six configurations to achieve high 5G adoption. The findings have significant practical ramifications for telecom corporations, advertisers, government officials, and key policymakers. Additionally, the study added substantial theoretical literature to technology adoption, particularly the adoption of 5G technology. (shrink)

Abstract.“Dumpster diving” is a term generally used for obtaining items, in this case food for consumption, from dumpsters. This study evaluates the prevalence of dumpster diving in two low-income urban communities in Minneapolis, Minnesota. Additionally, attitudes and beliefs of adults who engage in this behavior are reported. Surveys (n=396) were used to collect data including individual dumpster diving behavior, food security, health, and demographic data. Nearly one-fifth of those surveyed had used dumpster diving as a means to obtain food. (...) Focus groups (n=17) were conducted to further evaluate dumpster divers’ attitudes and beliefs about dumpster diving, use of food assistance programs including benefits and barriers, and other strategies used to obtain food such as stealing. Focus group participants were primarily homeless and most were high school educated. Ways to improve delivery of food assistance are suggested. In conclusion, more research on the use of dumpsters as a source of food is needed. Utilizing more of the 96 billion pounds of food wasted each year in the US through food recovery and donation programs could help to provide socially acceptable means for low-income urban dwellers to obtain food. (shrink)

Background: This article describes the overall attitudes of children, their parents, and attending physicians toward including or excluding pediatric patients in medical communication and health care decision-making processes. Methods: Fifty-two interviews were carried out with pediatric patients (n = 17), their parents (n = 19), and attending oncologists (n = 16) in eight Swiss pediatric oncology centers. The interviews were analyzed using thematic coding. Results: Parenting styles, the child's personality, and maturity are factors that have a great impact upon (...) the inclusion of children in their health care processes. Children reported the desire to be heard and involved, but they did not want to dominate the decision-making process. Ensuring trust in the parent–child and physician–patient relationships and respecting the child as the affected person were important values determining children's involvement. These two considerations were closely connected with the concern that fantasies are often worse than reality. Seeking children's compliance with treatment was a practical but critical reason for informing them about their health care. The urge to protect them from upsetting news sometimes resulted in their (partial) exclusion. Conclusions: The ethical imperative for inclusion of children in their health care choices was not so much determined by the right for self-determination, but by the need to include them. If children are excluded, they imagine things, become more isolated, and are left alone with their fears. Nevertheless, the urge to protect children is innate, as adults often underestimate children's coping capacities. (shrink)

Moral case deliberation is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care (...) institutions to acquire expertise in dealing with moral questions independent of the expertise of an ethicist. Over the past 10 years, we developed a training program with a specific mix of theory and practice, aiming to foster the right attitude, skills and knowledge of the trainee. The content and the didactics of the training developed in line with the philosophy of MCD: pragmatic hermeneutics, dialogical ethics and Socratic epistemology. Central principles are: ‘learning by doing’, ‘reflection instead of ready made knowledge’, and ‘dialogue on dialogue’. This paper describes the theoretical background and the didactic content of the current training. Furthermore, we present didactic tools which we developed for stimulating active learning. We also go into lessons we learned in developing the training. Next, we provide some preliminary data from evaluation research of the training program by participants. The discussion highlights crucial aspects of educating professionals to become facilitators of MCD. The paper ends with concluding remarks and a plea for more evaluative evidence of the effectiveness and meaning of this training program for doing MCD in institutions. (shrink)

Population-based genomics studies have proven successful in identifying genetic variants associated with diseases. High-quality biospecimens linked with informative health data from diverse segments of the population have made such research possible. However, the success of biobank research depends on the willingness of the public to participate in this type of research. We aimed to explore the factors associated with the willingness of the public to participate in biobank research from four low- and middle-income countries in the Arab region (Egypt, (...) Jordan, Morocco, and Sudan). We used a previously validated questionnaire to assess several constructs that included the public’s perceptions, attitudes, and willingness to participate in biobank research. We recruited 967 participants. More than half did not have prior awareness of biobanks. Participants’ willingness to donate biospecimens and health data was less than 10%. Our results also showed that participants harbored concerns with trust, privacy, and with data-sharing involving international researchers. Predictors of willingness to participate in biobank research included no previous involvement in research and positive attitudes toward biobanks. Finally, our study showed several differences between the four countries regarding several of the investigated constructs. We conclude there should be additional efforts to raise public awareness and enhance perceptions of the public in biobanking research to enhance trust. We further recommend qualitative research to explore the underlying factors that contribute to the public’s concerns with international data sharing that would enhance global health. (shrink)

This paper reports the responses of 251 mental health care practitioners to a mail survey examining their views concerning ethical conflicts and practices within their work environments. Besides identifying the sources and types of conflicts they experience, respondents were asked how ethical standards have changed over the last 10 years as well as the factors influencing these changes. Conclusions and implications are outlined and future research needs are described.

An evaluation was made of theassociations between self-reported healthconscious consumerism, body-mass index (BMI),and consumer beliefs, attitudes, intentions,and behaviors regarding sustainably producedfoods. Self-administered surveys were completedby adult consumers (n = 550) in threemetropolitan Minnesota grocery stores. Selecteddemographic and psychographic differencesbetween health conscious consumers andnon-health conscious consumers were evaluated.Compared to non-health conscious consumers,health conscious consumers were more likely tobe female, older, more educated, higher incomeearners, more active, healthier, and possess ahealthier body mass index. They also held moresupportive beliefs, (...) attitudes, and intentionswith regard to sustainably produced foods. Inconclusion, some consumers are interested insupporting sustainable production practices andtheir support may be linked to improvedpersonal, environmental, and communityhealth. (shrink)

BackgroundFollowing the increased presence of the Right-to-Die Movement, improved end-of-life options, and the political and legal status of aid-in-dying around the globe, suicide tourism has become a promising alternative for individuals who wish to end their lives. Yet, little is known about this from the perspective of those who engage in the phenomenon.MethodsThis study applied the qualitative research approach, following the grounded theory tradition. It includes 11 in-depth semi-structured interviews with Israeli members of the Swiss non-profit Dignitas who contemplated traveling (...) to Switzerland for aid-in-dying.ResultsSeven themes emerged from the data analysis, including health and functioning; feelings regarding survivorship and existence; interacting with the health sector; attitudes regarding death and dying; suicide; choosing death; and choosing suicide tourism. A significant portion of the participants had experienced suicidal thoughts and had even previously attempted suicide, some more than once. Most of them referred to chronic illnesses, functional disability, and social isolation. They understand suffering within the subjective dimension, namely only by the person who is actually subjected to the disease, ailments, and disability. Participants regarded aid-in-dying in Switzerland as positive thanks to its guaranteed outcome: "beautiful death", compared to "disadvantaged dying" which places a burden on the participants' loved ones throughout the prolonged dying. Most of them do not necessarily want to have their loved ones beside them when they die, and they see no significant meaning in dying in a foreign country to which they have no emotional or civil attachment.ConclusionThe desirable approval or tragic refusal by Dignitas to participants' requests for suicide tourism enhances the paradox between the perception of aid-in-dying as a mechanism for fulfilling controlled death and its bureaucratic and materialistic characteristics specifically reflected in a paid, formalized approach to aid-in-dying that cultivate dependency and collaboration. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedThe Ahmadis: Community, Gender, and Politics in a Muslim Society. By Antonio Gualtieri. Montreal and Kingston: McGill-Queen's University Press, 2004. Pp. xvi + 192. Hardcover $65.00. Paper Cdn $24.95 / U.S. $19.95.American Knees. By Shawn Wong. Seattle and London: University of Washington Press, 2005. Pp. xxi + 229. Paper $14.95.The Art of Worldly Wisdom. By Baltasar Gracian and translated by Joseph Jacobs. Mineola, NY: Dover Publications, 2005. Pp. (...) xiii + 114. Paper $5.95.Bashō's Journey: The Literary Prose of Matsuo Bashō. Translated by David Landis Barnhill. Albany: State University of New York Press, 2005. Pp. xvii + 191. Hardcover $59.50. Paper $17.95.Bringing the Gods to Mind: Mantra and Ritual in Early Indian Sacrifice. By Laurie L. Patton. Berkeley: University of California Press, 2005. Pp. xv + 289. Hardcover $49.95/£32.50.Buddhist Inclusivism: Attitudes Towards Religious Others. By Kristin Beise Kiblinger. Burlington, VT: Ashgate Publishing Company, 2005. Pp. viii + 145. Hardcover $89.95.A Chinese Ethics for the New Century: The Ch'ien Mu Lectures in History and Culture, and Other Essays on Science and Confucian Ethics. By Donald J. Munro. Hong Kong: Chinese University Press, 2005. Pp. xlv + 158. Hardcover $33.00.Chinese Theories of Reading and Writing: A Route to Hermeneutics and Open Poetics. By Ming Dong Gu. Albany: State University of New York Press, 2005. Pp. xiv + 334. Hardcover $85.00.A Dictionary of Cantonese Slang: The Language of Hong Kong Movies, Street Gangs, and City Life. By Christopher Hutton and Kingsley Bolton. Honolulu: University of Hawai'i Press, 2005. Pp. xxiv + 492. Paper $28.00.Ghazālī and the Poetics of Imagination. By Ebrahim Moosa. Chapel Hill and London: University of North Carolina Press, 2005. Pp. xiii + 349. Hardcover $59.95. Paper $22.50.Going Forth: Visions of Buddhist Vinaya. Edited by William M. Bodiford. Honolulu: University of Hawai'i Press, 2005. Pp. x + 317. Hardcover $48.00.The Harem: Inside the Grand Seraglio of the Turkish Sultans. By N. M. Penzer. Mineola, NY: Dover Publications, 2005. Pp. 277. Paper $14.95.Ideals of the East: The Spirit of Japanese Art. By Kakuzo Okakura. Mineola, NY: Dover Publications, 2005. Pp. xiv + 106. Paper $5.95. [End Page 365]An Illustrated Chinese Materia Medica. By Jing-Nuan Wu. New York: Oxford University Press, 2005. Pp. 706. Price not given.Jews and Arabs: A Concise History of Their Social and Cultural Relations. By S. D. Goitein. Mineola, NY: Dover Publications, 2005. Pp. xv + 263. Paper $12.95.The Logic of Nothingness: A Study of Nishida Kitarō. By Robert J. J. Wargo. Honolulu: University of Hawai'i Press, 2005. Pp xi + 241. Paper $25.00.The Moral and Political Thought of Mahatma Gandhi. By Raghavan N. Iyer. New Delhi: Oxford University Press, 2000. Pp. xiii + 449. Paper Rs 520.00.Nietzsche's Epic of the Soul: Thus Spoke Zarathustra. By T. K. Seung. Lanham, MD: Lexington Books, 2005. Pp. xxviii + 370. Hardcover $83.00. Paper $27.95.Of Guilds, Companies, Corporations, and Governance: A Conceptual Sketch. By Leonardo R. Silos. Makati City, Philippines: Asian Institute of Management, 2005. Pp. xvi + 238. Price not given.The Path to Rome. By Hilaire Belloc. Mineola, NY: Dover Publications, 2005. Pp. ix + 251. Paper $12.95.The Philosophy of the Bhagavadgātā : A Study based on the Evaluation of the Commentaries of Śamkara, Rāmānuja and Madhva. By S. M. Srinivasa Chari. New Delhi: Munshiram Manoharlal Publishers, 2005. Pp. xxvi + 294. Hardcover Rs 575.00.The Philosophy of Rabindranath Tagore. By Kalyan Sen Gupta. Burlington, VT: Ash-gate Publishing Company, 2005. Pp. ix + 103. Hardcover $79.95.The Pristine Dao: Metaphysics in Early Daoist Discourse. By Thomas Michael. Albany: State University of New York Press, 2005. Pp. xi + 170. Hardcover $60.00. Paper $21.95.Three Mountains and Seven Rivers: Prof. Musashi Tachikawa's Felicitation Volume. Edited by Shoun Hino and Toshihiro Wada. Delhi: Motilal Banarsidass Publishers. 2004. Pp. xx + 903. Hardcover Rs. 1800.The Unity of Mystical Traditions: The Transformation of Consciousness in Tibetan and German Mysticism. By Randall Studstill. Leiden and Boston: Brill, 2005. Pp. xii + 304. Hardcover @89/$127.00.Writing the World: On Globalization. Edited by David... (shrink)