The ethical and social implications of data mining, algorithmic curation and automation in the context of social media have been of heightened concern for a range of researchers with interests in digital media in recent years, with particular concerns about privacy arising in the context of mobile and locative media. Despite their wide adoption and economic importance, mobile dating apps have received little scholarly attention from this perspective – but they are intense sites of data generation, algorithmic processing, and cross-platform (...) data-sharing; bound up with competing cultures of production, exploitation and use. In this paper, we describe the ways various forms of data are incorporated into, and emerge from, hook-up apps’ business logics, socio-technical arrangements, and cultures of use to produce multiple and intersecting data cultures. We propose a multi-layered research agenda for critical and empirical inquiry into this field, and suggest appropriate conceptual and methodological frameworks for exploring the social and political challenges of data cultures. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Although work tasks often address substantive social issues, the effects of issue characteristics on task motivation are little understood. This study explores this topic by examining how the moral characteristics of an issue (moral intensity) affect motivation in tasks intended to address the issue (task motivation). Adopting the lens of work design theory, I hypothesize that moral intensity increases task motivation through the mediation of perceived task impacts on the community (perceived community impacts), and that this effect will (...) occur after controlling for the effects of perceived task impact on the worker and their organization. In two studies in the context of volunteering I find that, rather than acting in parallel with other task impacts, the effect of moral intensity through perceived community impacts is fully mediated by perceived organization and self impacts in a three-stage mediation. These findings demonstrate the potential relevance of issue characteristics such as moral intensity to work design theory and shed new light on the psychological mechanisms through which perceived prosocial impacts promote task motivation. I discuss implications for research and practice. (shrink)

The aim of the paper is to investigate the effects of the corporate governance model on social and environmental disclosure (SED). We analyze the disclosures of the 100 U.S. Best Corporate Citizens in the period 2005–2007, and we posit a series of simultaneous relationships between different attributes of the governance system and a multidimensional construct of corporate social performance (CSP). We consider both the extent and the quality of SED, with the purpose of identifying increasing levels of corporate commitment to (...) stakeholders and shedding some light on whether SED is used as a signal or rather as a legitimacy tool. Our empirical evidence shows that the stakeholders’ orientation of corporate governance is positively associated with CSP and SED. On the other hand, we do not find support for the monitoring intensity of corporate governance being negatively associated with social performance. We also find that CSP in the “product” dimension is positively associated with the extent and quality of SED whilst CSP in the “people” dimension is negatively associated with the extent and quality of SED. At a time when shareholders and stakeholders share more common aspects in their relationships with firms, this is a significant area to explore and this research fills an important lacuna in this respect. (shrink)

This paper develops a response to the ethical conception of the human Other formulated by Gilles Deleuze in his review of Michel Tournier’s 1967 novel Friday. The central contention here is that although Deleuze develops a compelling notion of intensive ethics in response to Tournier’s novel, that ethics also remains deeply problematic in refusing to ascribe a positive role to the human Other. My wager is that some of these problems can be brought to light by placing Deleuze’s philosophy (...) in dialogue with that of Emmanuel Levinas. As I seek to show, Levinas’s philosophy of alterity not only reveals that Deleuze is mistaken in failing to ascribe a positive ethical role to the human Other, but also begins to point the way toward a more positive conception of ethics that does not oppose the Other to the intensive realm that Deleuze so much values. (shrink)

This paper reports the results of a systematic review conducted on articles examining the effects of daytime electric light exposure on alertness and higher cognitive functions. For this, we selected 59 quantitative research articles from 11 online databases. The review protocol was registered with PROSPERO. The results showed that both short-wavelength dominant light exposure and higher intensity white light exposure induced alertness. However, those influences depended on factors like the participants’ homeostatic sleep drive and the time (...) of day the participants received the light exposure. The relationship between light exposure and higher cognitive functions was not as straightforward as the alerting effect. The optimal light property for higher cognitive functions was reported dependent on other factors, such as task complexity and properties of control light. Among the studies with short-wavelength dominant light exposure, ten studies reported beneficial effects on simple task performances, and four studies on complex task performances. Four studies with higher intensity white light exposure reported beneficial effects on simple task performance and nine studies on complex task performance. Short-wavelength dominant light exposure with higher light intensity induced a beneficial effect on alertness and simple task performances. However, those effects did not hold for complex task performances. The results indicate the need for further studies to understand the influence of short-wavelength dominant light exposure with higher illuminance on alertness and higher cognitive functions. (shrink)

Some intentional attitudes (beliefs, fears, desires, etc.) have a common focus in spite of there being no object at that focus. For example, two beliefs may be about the same witch even when there are no witches, different astronomers had beliefs directed at Vulcan, even though there is no such planet. This relation of having a common focus, whether or not there is an actual concrete object at that focus, is called intentional identity. In the first part of this thesis (...) I develop a new theory of intentional identity, the triangulation theory, and argue that it has significant advantages over the extant theories of intentional identity in the literature. Empty attitudes (attitudes that are not, prima facie, about anything that exists) will serve as useful cases for testing theories of intentional identity. -/- In the second part, I put the theory developed in the first part to work. I use triangulation theoretic tools to shed light on other debates about intentional attitudes. Some issues to which intentional identity are relevant are the debate about the content of intentional attitudes, the issue of whether or not we need to appeal to external constraints on the content of intentional attitudes, how we should understand the agreement and disagreement of attitudes, how we should construe communication and how we ought to solve Kripke’s puzzle about belief. The second part of this thesis also motivates a broadly internalist and individualistic approach to the con-tent of intentional attitudes; it turns out that if we take a closer look at the narrowly construed psychological states of agents we find materials that allow us to make sense of phenomena usually associated with externalist constraints on the content of attitudes (such as causal constraints and eligibility constraints) in a new way. (shrink)

Many countries have adopted new triage recommendations for use in the event that intensive care beds become scarce during the COVID‐19 pandemic. In addition to establishing the exact criteria regarding whether treatment for a newly arriving patient shows a sufficient likelihood of success, it is also necessary to ask whether patients already undergoing treatment whose prospects are low should be moved into palliative care if new patients with better prospects arrive. This question has led to divergent ethical guidelines. This paper (...) explores the distinction between withholding and withdrawing medical treatment during times of scarcity. As a first central point, the paper argues that a revival of the ethical distinction between doing and allowing would have a revisionary impact on cases of voluntary treatment withdrawal. A second systematic focus lies in the concern that withdrawal due to scarcity might be considered a physical transgression and therefore more problematic than not treating someone in the first place. In light of the persistent disagreement, especially concerning the second issue, the paper concludes with two pragmatic proposals for how to handle the ethical uncertainty: (1) triage protocols should explicitly require that intensive care attempts are designed as time‐limited trials based on specified treatment goals, and this intent should be documented very clearly at the beginning of each treatment; and (2) lower survival prospects can be accepted for treatments that have already begun, compared with the respective triage rules for the initial access of patients to intensive care. (shrink)

Today's computers are becoming ever more versatile. They are used in various applications, such as for education, entertainment, and information services. In other words, computers are often required to not only inform users of information but also communicate with them socially. Previous studies explored the design of ambient light displays and suggested that such systems can convey information to people in the periphery of their attention without distracting them from their primary work. However, they mainly focused on using ambient (...) lights to convey certain information. It is still unclear whether and how the lights can influence people's perception and decision-making. To explore this, we performed three experiments using a ping-pong game, Ultimatum game, and Give-Some game, in which we attached an LED strip to the front-bottom of a computer monitor and had it display a set of light expressions. Our evaluation of the results suggested that expressive lights do affect human perception and decision-making. Participants liked and anthropomorphized the computer more when it displayed light animations. Particularly, they perceived the computer as positive and friendlier when it displayed green and low intensity light animation, while red and high intensity light animation was perceived as negative and more hostile. They consequently behaved with more tolerance and cooperation to the computer when it was positive compared with when it was negative. The findings can open up possibilities for the design of ambient light systems for various applications where human-machine interaction is needed. (shrink)

Poultry production makes a substantial contribution to global food security, providing energy, protein, and essential micro-nutrients to humans. Modern intensive poultry farming systems are challenged by the evolution of Highly Pathogenic Avian Influenza strains. The presence of avian influenza in poultry flocks poses a significant risk of an avian origin influenza that is easily transmittable between human beings evolving. By reducing contact between humans and fowl, the use of automation in poultry production has the potential to improve biosecurity and thus (...) reduce the risk of pandemic influenza. Many poultry facilities are already highly automated. The rapid rate of progress in robotics and AI suggests that “lights out”—fully automated—poultry production systems may soon be possible. In this paper we consider the ethical and policy issues that would be raised by lights-out poultry production. There is a strong animal and human welfare case for reducing the risk of pandemic influenza via increased use of automation. However, lights-out farming looks to be the ultimate endpoint of dynamics already present in industrial agriculture, which led to the dangers of zoonotic infection from animal agriculture in the first place. Whether nations should respond to that risk by doubling down on industrial models of animal production and embracing fully automated farms or by reconsidering the current model of animal agriculture altogether is, we suggest, both the most important, and the most difficult, question posed by the prospect of lights out farms. (shrink)

BackgroundThe need for an ethical debate about the use of coercion in intensive care units (ICU) may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their (...) ICU stay will shed different light on intensive care management. Patients' experiences of loss of control, dependency and abandonment may lead to a new approach towards a broader approach to the concept of coercion in intensive care. The aim of our research is to explore the experiences of patients and relatives in the ICU and to determine when it might be possible to reduce feelings and memories of coercion.MethodsWe conducted and analysed 29 semi-structured interviews with patients and relatives who had been in the ICU a few months previously. Following a coding and categorisation process in MAXQDA™, a rigorous qualitative methodology was used to identify themes relevant to our research.ResultsFive main themes emerged: memory issues; interviewees’ experiences of restricting measures and coercive treatment; patients’ negative perception of situational and relational dependency with the risk of informal coercion; patients’ perceptions of good care in a context of perceived dependency; progression from perception of coercion and dependency to respect for the person. All patients were grateful to have survived. However, coercion in the form of restraint, restriction of movement, and coercive treatment in the ICU was also acknowledged by patients and relatives. These included elements of informal coercion beyond restraints, such as a perceived negative sense of dependence, surrender, and asymmetrical interaction between the patient and health providers.ConclusionsTo capture the full range of patients' experiences of coercion, it is necessary to expand the concept of coercion to include less obvious forms of informal coercion that may occur in dependency situations. This will help identify solutions to avoid or reduce negative recollections that may persist long after discharge and negatively affect the patients' quality of life. (shrink)

Health care providers are expected both to relieve pain and to provide anticipatory guidance regarding how much a procedure is going to hurt. Fulfilling those expectations is complicated by the cognitive modulation of pain perception. Warning people to expect pain or setting expectations for pain relief not only influences their subjective experience, but it also alters how nociceptive stimuli are processed throughout the sensory and discriminative pathways in the brain. In light of this, I reconsider the characterization of placebo (...) analgesia as pharmacologically inert and the use of it as deceptive. I show that placebo analgesia exploits the same physical mechanisms as proven analgesics and argue that it should be utilized to relieve pain. Additionally, I describe factors to help identify situations in which clinicians have the obligation to disclose the potential for pain coupled with ways of mitigating the risk of high-intensity pain by setting positive expectations. (shrink)

This article aims to clarify the question of speed and intensity in the thoughts of Simondon and Deleuze, in order to shed light on the recent debates regarding accelerationism and its politics. Instead of starting with speed, we propose to look into the notion of intensity and how it serves as a new ontological ground in Simondon's and Deleuze's philosophy and politics. Simondon mobilises the concept of intensity to criticise hylomorphism and substantialism; Deleuze, taking up Simondon's (...) conceptual framework, repurposes it for his ontology of difference, elevating intensity to the rank of generic concept of being, thus bypassing notions of negativity and individuals as base, in favour of the productive and universal character of difference. In Deleuze, the correlation between intensity and speed is fraught with ambiguities, with each term threatening to subsume the other; this rampant tension becomes explicitly antagonistic when taken up by the diverse strands of contemporary accelerationism, resulting in two extreme cases in the posthuman discourse: either a pure becoming, achieved through destruction, or through abstraction that does away with intensity altogether; or an intensity without movement or speed, that remains a pure jouissance. Both cases appear to stumble over the problem of individuation, if not disindividuation. Hence, we wish to raise the following question: in what way can one think of an accelerationist politics with intensity, or an intensive politics without the fetishisation of speed? We consider this question central to the interrogation of the limits of acceleration and posthuman discourse, thus requiring a new philosophical thought on intensity and speed. (shrink)

This study, presenting a history of the measurement of light intensity from its first hesitant emergence to its gradual definition as a scientific subject, explores two major themes. The first concerns the adoption by the evolving physics and engineering communities of quantitative measures of light intensity around the turn of the twentieth century. The mathematisation of light measurement was a contentious process that hinged on finding an acceptable relationship between the mutable response of the human (...) eye and the more easily stabilised, but less encompassing, techniques of physical measurement. -/- A second theme is the exploration of light measurement as an example of ‘peripheral science’. Among the characteristics of such a science, I identify the lack of a coherent research tradition and the persistent partitioning of the subject between disparate groups of practitioners. Light measurement straddled the conventional categories of ‘science’ and ‘technology’, and was influenced by such distinct factors as utilitarian requirements, technological innovation, human perception and bureaucratisation. Peripheral fields such as this, which may be typical of much of modern science and technology, have hitherto received little attention from historians. -/- These themes are pursued with reference to the social and technological factors which were combined inextricably in the development of the subject. The intensity of light gained only sporadic attention until the late nineteenth century. Measured for the utilitarian needs of the gas lighting industry from the second half of the century, light intensity was appropriated by members of the nascent electric lighting industry, too, in their search for a standard of illumination. By the turn of the century the ‘illuminating engineering movement’ was becoming an organised, if eclectic, community which promoted research into and standards for the measurement of light intensity. -/- The twentieth-century development of the subject was moulded by organisation and institutionalisation. Between 1900 and 1920, the new national and industrial laboratories in Britain, America and Germany were crucial in stabilising the subject. In the inter-war period, committees and international commissions sought to standardise light measurement and to promote research. Such government- and industry-supported delegations, rather than academic institutions, were primarily responsible for the ‘construction’ of the subject. Practitioners increasingly came to interpret the three topics of photometry (visible light measurement), colorimetry (the measurement of colour) and radiometry (the measurement of invisible radiations) as aspects of a broader study, and enthusiastically applied them to industrial and scientific problems. -/- From the 1920s, the long-established visual methods of observation were increasingly replaced by physical means of light measurement, a process initially contingent on scientific fashion more than demonstrated superiority. New photoelectric techniques for measuring light intensity engendered new commercial instruments, a trend which accelerated in the following decade when photometric measurement was applied with limited success to a range of industrial problems. Seeds sowed in the 1920s – namely commercialisation and industrial application, the transition from visual to ‘physical’ methods, and the search for fundamental limitations in light measurement – gave the subject substantially the form it was to retain over the next half-century. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

Considerable effort has been devoted over the last fifteen years by faculty and administrators in numerous colleges and universities, and by organizations such as the Aspen Institute and Teagle Foundation, to enhancing business education through broad infusion of the perspectives and content of the liberal arts. The emphasis has been on integration of the social sciences and especially the humanities. The author—a natural scientist—recounts a seminal experience that motivated him to work more intensively on this initiative with his colleagues across (...) academic divisions at his home institution and beyond. He also argues for more engagement by natural science faculty in this process and examines the transdisciplinary re-visioning required to transform business teaching, learning, and practice into a new paradigm consistent with ecological reality. (shrink)

This study investigates the association of a broad set of variables with the ethical decision making of management accountants in Libya. Adopting a cross-sectional methodology, a questionnaire including four different ethical scenarios was used to gather data from 229 participants. For each scenario, ethical decision making was examined in terms of the recognition, judgment and intention stages of Rest’s model. A significant relationship was found between ethical recognition and ethical judgment and also between ethical judgment and ethical intention, but ethical (...) recognition did not significantly predict ethical intention—thus providing support for Rest’s model. Organizational variables, age and educational level yielded few significant results. The lack of significance for codes of ethics might reflect their relative lack of development in Libya, in which case Libyan companies should pay attention to their content and how they are supported, especially in the light of the under-development of the accounting profession in Libya. Few significant results were also found for gender, but where they were found, males showed more ethical characteristics than females. This unusual result reinforces the dangers of gender stereotyping in business. Personal moral philosophy and moral intensity dimensions were generally found to be significant predictors of the three stages of ethical decision making studied. One implication of this is to give more attention to ethics in accounting education, making the connections between accounting practice and Islam. Overall, this study not only adds to the available empirical evidence on factors affecting ethical decision making, notably examining three stages of Rest’s model, but also offers rare insights into the ethical views of practising management accountants and provides a benchmark for future studies of ethical decision making in Muslim majority countries and other parts of the developing world. (shrink)

This paper will explore the possibility of a creative philosophy of history in the work of Gilles Deleuze. It will do so by focusing on Deleuze’s concepts of ‘intensity’ and ‘depth’, as discussed in his seminal work Difference and Repetition . By analysing these concepts in light of several historical thinkers whom Deleuze significantly draws upon (Bergson, Péguy and Braudel), I will show in this paper how Deleuze promotes a theory of history that is not opposed to his (...) philosophy of becoming and creativity, but in concert with it. (shrink)

2003 Paul Bunge Prize of the Hans R. Jenemann Foundation for the History of Scientific Instruments Judging the brightness and color of light has long been contentious. Alternately described as impossible and routine, it was beset by problems both technical and social. How trustworthy could such measurements be? Was the best standard of intensity a gas lamp, an incandescent bulb, or a glowing pool of molten metal? And how much did the answers depend on the background of the (...) specialist? A History of Light and Colour Measurement: Science in the Shadows is a history of the hidden workings of physical science-a technical endeavor embedded in a social context. It argues that this "undisciplined" subject, straddling academia, commerce, and regulation, may be typical not only of 20th century science, but of its future. Attracting scientists, engineers, industrialists, and artists, the developing subject produced a new breed of practitioners having mixed provenance. The new measurers of light had to decide the shape not only of their specialism but of their careers: were they to be a part of physics, engineering, or psychology? The physical scientists who dominated the subject into the early 20th century made their central aim the replacement of the problematic human eye with physical detectors of light. For psychologists between the wars, though, describing the complexity of color was more important than quantifying a handful of its dimensions. And after WWII, military designers shaped the subject of radiometry and subsumed photometry and colorimetry within it. Never attaining a professional cachet, these various specialists moved fluidly between science and technology; through government, industry, and administration. (shrink)

A simple geometry utilizing a laser-excited atomic beam as light source, and a nearby oscillating mirror, would permit the observation of a two-channel optical interference effect involving photons which can be localized predominantly in one channel by coincidence observations of the recoiling source atom. A sacrifice of the optimum conditions for photon interference is necessary even when photon localization in one channel is accomplished by an observation of the recoil atom. This necessity arises because the width of the slit (...) defining the atomic beam, and with it the important optical source dimension, must be comparable to the optical wavelength to obtain the small uncertainty in initial total momentum needed for significant localization. Quantum mechanical calculations of the coincidence intensity and singles intensity as a function of mirror position are made for a source width of five quarter wavelengths and are compared to a classical optics calculation of the singles intensity. The coincidence intensity calculation, as expected, predicts a smaller interference effect than classical optics due to the photon localization. The singles intensity calculation also predicts the same reduction in the classical interference effect, as a consequence of the orthoganality of the final atom states. (shrink)

New light is shed on Leibniz’s commitment to the metaphysical priority of the intensional interpretation of logic by considering the arithmetical and graphical representations of syllogistic inference that Leibniz studied. Crucial to understanding this connection is the idea that concepts can be intensionally represented in terms of properties of geometric extension, though significantly not the simple geometric property of part-whole inclusion. I go on to provide an explanation for how Leibniz could maintain the metaphysical priority of the intensional interpretation (...) while holding that logically the intensional and the extensional stand in strictly inverse relation to each other. (shrink)

Drawing on the behavioral theory, this study examines how the misalignment between a firm's environmental effort and the level of subsidies received from the government in affecting the firm's investment in non-environmental R&D. Based on a sample of Chinese A-share listed firms from 2008 to 2019 and using polynomial regression techniques, our findings reveal that firms in the “low effort-high subsidies” group exhibit lower non-environmental R&D intensity compared to firms in the “high effort-low subsidies” group. This study contributes to (...) the literature by shedding light on the interplay between corporate environmental efforts, government subsidies, and non-environmental R&D investment. The findings suggest the importance of aligning the environmental efforts of firms with subsidy levels from the government to effectively allocate resources for different types of R&D. The implications of this research suggest that firms should carefully consider aligning their environmental efforts with government subsidies to optimize their investment in non-environmental R&D and overall innovation strategy. Furthermore, the study indicates that firms and governments should prudently balance the relationship between environmental R&D and non-environmental R&D to avoid any negative impact on the latter. (shrink)

Background: ICU patients’ family members are in a new, uncertain, and vulnerable situation due to the patient’s critical illness and complete dependence on the ICU nurses and physicians. Family members’ feeling of being cared for is closely linked to clinicians’ attitudes and behavior. Aim: To explore ICU nurses’ and physicians’ bedside interaction with critically ill ICU patients´ families and discuss this in light of the ethics of care. Research design: A qualitative study using participant observation, focus groups, and thematic (...) narrative analysis. Participants and research context: Data were gathered from July 2017 to August 2019, in four ICUs in Norway through 270 h of fieldwork and seven focus groups with ICU nurses and physicians. Ethical considerations: The Regional Committee for Medical and Health Research Ethics and the Norwegian Centre for Research Data approved the study. Findings: Quality of ICU family care depends on nurses’ and physicians’ attitudes, behavior, and personality traits. Three main themes were identified: being attentive, an active approach, and degree of tolerance. Discussion: The findings are discussed in light of the ethics of care and empirical research from the intensive care environment. Conclusions: This study shows that attentive, active, and tolerant clinicians represent a culture of ethical care that gives families greater freedom of action and active participation in patient care. Clinicians must not bear sole responsibility for this culture; it must have a firm basis in the hospital and ICU and be established through training, interprofessional reflection, and support of clinicians. (shrink)

Research questions and backgroundThis study explores a highly controversial issue of medical care in Germany: the decision to withhold or withdraw mechanical ventilation in critically ill patients. It analyzes difficulties in making these decisions and the physicians’ uncertainty in understanding the German terminology of Sterbehilfe, which is used in the context of treatment limitation. Used in everyday language, the word Sterbehilfe carries connotations such as helping the patient in the dying process or helping the patient to enter the dying process. (...) Yet, in the legal and ethical discourse Sterbehilfe indicates several concepts: (1) treatment limitation, i.e., withholding or withdrawing life-sustaining treatment (passive Sterbehilfe), (2) the use of medication for symptom control while taking into account the risk of hastening the patient’s death (indirekte Sterbehilfe), and (3) measures to deliberately terminate the patient’s life (aktive Sterbehilfe). The terminology of Sterbehilfe has been criticized for being too complex and misleading, particularly for practical purposes. Materials and methods An exploratory study based on qualitative interviews was conducted with 28 physicians from nine medical intensive care units in tertiary care hospitals in the German federal state of Baden-Wuerttemberg. The method of data collection was a problem-centered, semi-structured interview using two authentic clinical case examples. In order to shed light on the relation between the physicians’ concepts and the ethical and legal frames of reference, we analyzed their way of using the terms passive and aktive Sterbehilfe. Results Generally, the physicians were more hesitant in making decisions to withdraw rather than withhold mechanical ventilation. Almost half of them assumed a categorical prohibition to withdraw any mechanical ventilation and more than one third felt that treatment ought not to be withdrawn at all. Physicians showed specific uncertainty about classifying the withdrawal of mechanical ventilation as passive Sterbehilfe, and had difficulties understanding that terminating ventilation is not basically illegal, but the permissibility of withdrawal depends on the situation. Conclusions The physicians’ knowledge and skills in interpreting clinical ethical dilemmas require specific improvement on the one hand; on the other hand, the terms passive and aktive Sterbehilfe are less clear than desirable and not as easy to use in clinical practice. Fear of making unjustified or illegal decisions may motivate physicians to continue (even futile) treatment. Physicians strongly opt for more open discussion about end-of-life care to allow for discontinuation of futile treatment and to reduce conflict. (shrink)

The problem of the intensification and remission of qualities was a crux for philosophical, theological, and scientific thought in the Middle Ages. It was raised in Antiquity with this remark of Aristotle: some qualities, as accidental beings, admit the more and the less. Admitting more and less is not a trivial property, since it belongs neither to every category of being, nor to every quality. Rather it applies only to states and dispositions such as virtue, to affections of bodies such (...) as heat and sweetness, and to affections of soul such as anger. However, the property of admitting more and less was a matter of importance for the qualitative physics that had reigned up to about the time of Descartes, a physics which was concerned with concepts such as heat, coldness, lightness, heaviness, and so on. (shrink)

What should be the role of an institutional ethics committee in resolving conflict concerning patient care decisions in the neonatal intensive care unit? This question takes on added importance in light of recent court decisions which suggest that IEC deliberations may serve as persuasive evidence in court, of proposed state regulations that would establish an IEC as an alternative to judicial review, and of recent Joint Commission on Accreditation of Healthcare Organizations guidelines that require an institutional policy on limitation (...) or withdrawal of treatment to include a specified mechanism for resolving conflict. Unfortunately, despite these developments, prospective case consultation remains one of the most controversial and poorly understood aspects of IEC functions. Questions and concerns persist about the relation the IEC has and should have to actual decisions in specific cases.We briefly examine the clinical, organizational, and regulatory complexity of the NICU environment and suggest five potential sources of uncertainty, disagreement, and conflict among parent and NICU staff. (shrink)

This paper inquires into how the new techniques of 14th-century physics, especially the doctrines of the maxima and minima of powers and the latitudes of forms, were applied to the issue of propagation of light. The focus is on several Prague disputed questions, originating between 1377 and 1409, dealing with whether illumination has infinite or finite reach and whether illumination’s intensity remains constant (uniformis) or is rather uniformly decreasing (uniformiter difformis). These questions are contextualised through examination of Oxford, (...) Paris, and Prague sources of the era (John Dumbleton, John Buridan, Nicole Oresme, Albert of Saxony, Henry of Langenstein, John of Holland) to construct a fresh survey of late medieval theories of light. Along the way, the discovery of a hitherto unknown Prague disputation from the 1370s is announced, and new evidence for the dating and Central European dissemination of Jacobus de Sancto Martino’s De latitudinibus formarum and Nicole Oresme’s Questiones super Geometriam is uncovered. (shrink)