ABSTRACT This paper critically examines the liberal model of decision making for the terminally ill and contrasts it with the familial model that can be found in some Asian cultures. The contrast between the two models shows that the liberal model is excessively patient‐centred, and misconceives and marginalises the role of the family in the decision making process. The paper argues that the familial model is correct in conceiving the last journey of one's life as a sharing process rather than (...) a process of exercising one's prior or counterfactual choice, and concludes by suggesting a policy framework for the practice of familialism that can answer the liberal challenge that familialism cannot safeguard the patient from abuse and neglect. (shrink)

Richard Nisbett's The Geography of Thought is one of several recent works that have highlighted purported differences in thinking patterns between East Asians and Westerners on the basis of empirical research. This has implications for teaching and for other issues such as cultural integration. Based on a framework consisting of three distinct notions of rationality, this paper argues that some of the differences alleged by Nisbett are either not real or exaggerated, and that his geography of thought fails to provide (...) an adequate account of thinking styles across cultures. The paper concludes with a discussion of the implications for teaching and learning critical thinking that can be drawn from the framework developed. (shrink)

This paper examines the practice of informed consent in Hong Kong by drawing on structured interviews conducted with eleven physicians, three patients, and four family members primarily at a well-established public hospital in Hong Kong. The findings of this study show that the Hong Kong approach to medical decision-making lies somewhere between that of America on the one hand, and mainland China on the other. It is argued that the practice of medical decision-making in Hong Kong can be modeled by (...) a moderate familism that is directed towards achieving the best interests of the patient (1) as understood by the physician, (2) in consultation with the family, (3) under the prima facie presumption that consent is not required for disclosure of information to the family, (4) while aiming at an eventual albeit frequently partial and vague disclosure to the patient. (shrink)

Richard Nisbett's The Geography of Thought is one of several recent works that have highlighted purported differences in thinking patterns between East Asians and Westerners on the basis of empirical research. This has implications for teaching and for other issues such as cultural integration. Based on a framework consisting of three distinct notions of rationality, this paper argues that some of the differences alleged by Nisbett are either not real or exaggerated, and that his geography of thought fails to provide (...) an adequate account of thinking styles across cultures. The paper concludes with a discussion of the implications for teaching and learning critical thinking that can be drawn from the framework developed. (shrink)

The aims of this paper are threefold. The first aim is to provide a critique of the reform proposal of the Harvard School of Public Health for Hong Kong's health care system through privatization of the public sector services. The second aim is to argue for the duty of society to guarantee every member equal access to a basic level of health care based on the values of equity, care and free choice. The third aim is to explore some suggestions (...) about delivery structures and financial arrangements of a dual sector health care system which will better enable society to provide a basic level of health care that is sustainable and affordable, while being at the same time consistent with the values of care, equity and free choice. (shrink)

This article reveals the outcome of a study on the perceptions of elders, family members, and healthcare professionals and administration providing care in a range of different long-term care facilities in Hong Kong with primary focus on the concepts of autonomy and dignity of elders, quality and location of care, decision making, and financing of long term care. It was found that aging in place and family care were considered the best approaches to long term care insofar as procuring and (...) balancing the values of dignity, autonomy, family integrity and social sustainability were concerned. An elder having the final say was generally accepted. The results also initiated the importance of sharing of financial responsibility among elders, children and government albeit the emphasis was placed on individuals. Furthermore, dignity of elders was not considered purely a synonym of autonomy, but it had also to do with respect, family and social connections. (shrink)

This work examines the importance of distinguishing different levels of psychological explanation and the primacy of the computational level over implementational levels. The framework of levels allows us to recognize the role of formal theories as tools for specifying reasoning tasks at the computational level. It is shown that formal specifications of reasoning tasks allow us to analyze the complexity of the specified tasks and also serve to define reasoning competence and performance errors. Complexity analysis helps us identify tractable, practically (...) significant, subclasses of inference. The identification of these subclasses provides useful ante hoc and post hoc specifications for AI programming projects and psychological modeling. Formalization and complexity analysis also enable us to examine tradeoffs between tractability and range of applicability of implementations of a reasoning task. It is undesirable to obtain tractability at the expense of limiting the applicability of a cognitive mechanism to an unreal situation or a toy domain. It is argued that this undesirable result can be avoided if we examine the structure of the environment in which a mechanism is supposed to work and the environmental assumptions that make the computation tractable. Finally, it is demonstrated that many problems the human mind needs to solve in normal environments are indeed tractable and that the mind is equipped with adaptive mechanisms to solve them efficiently. This demonstration undermines a skeptical challenge to human rationality based on claims that many problems are intractable and that the capacity of the human mind is limited. (shrink)

This chapter gives an outline of the development of the human organ transplant system in Hong Kong, whose key features are a soft opt-in system and strict prohibitions on commercial dealings in human organs for transplant. It is argued that under such a system, there is a lack of incentives for either cadaveric or living organ donations and for family members to endorse deceased donation. This argument is followed by an investigation of the shortage of organ donations in Hong Kong, (...) the limited success of the government promotion to improve the number of donations, and a discussion of new alternatives for improvement that have been initiated or proposed. It is argued that the feasibility and effectiveness of these alternatives are limited and uncertain. More radical reform of the existing system in terms of honorary, compensationalist, and familist incentives is needed and they all need to be taken into consideration. (shrink)

This chapter contains sections titled: A Naturalistic Account of Human Rationality Geography of Thought: A Tale of Two Versions Nisbett on Logic and Contradiction How Radical are East‐West Differences in Thinking Style? Some Implications for the Education of Critical Thinking Acknowledgements Notes References.

This chapter discusses some legal implications of Hong Kong’s three types of organ donation incentive and presents further thoughts about their ethical and policy implications. It aims to transform the useful findings presented in previous chapters into legal solutions and policy innovations in practice. We argue that the Hong Kong law is able to incorporate mixed incentive measures and further suggest detailed legal rules regarding organ incentives for the government to consider. In terms of ethical and policy implications in a (...) wider context, we suggest a paradigm shift in incentive structure and the adoption of mixed incentive measures for the promotion of organ donation and procurement. However, we agree that the exact choice or combination of organ incentive measures ultimately depends on how each country or jurisdiction will assess their practical effectiveness, political legitimacy, and ethical justification. (shrink)

This book examines, through a multi-disciplinary lens, the possibilities offered by relationships and family forms that challenge the nuclear family ideal, and some of the arguments that recommend or disqualify these as legitimate units in our societies. That children should be conceived naturally, born to and raised by their two young, heterosexual, married to each other, genetic parents; that this relationship between parents is also the ideal relationship between romantic or sexual partners; and that romance and sexual intimacy ought to (...) be at the core of our closest personal relationships - all these elements converge towards the ideal of the nuclear family. The authors consider a range of relationship and family structures that depart from this ideal: polyamory and polygamy, single and polyparenting, parenting by gay and lesbian couples, as well as families created through current and prospective modes of assisted human reproduction such as surrogate motherhood, donor insemination, and reproductive cloning. (shrink)

Russellian monism – an influential doctrine proposed by Russell (1927/1992) – is roughly the view that the natural sciences can only ever tell us about the causal, dispositional, and structural properties of physical entities and not about their categorical properties, and, moreover, that our qualia are constituted by categorical properties. Recently, Stoljar (2001a, 2001b), Strawson (2008), Montero (2010, 2015), Alter and Nagasawa (2012), and Chalmers (2015) have attempted to develop this doctrine into a version of physicalism. Russellian monism faces the (...) so-called combination problem, according to which it is difficult to see how categorical properties could collectively constitute qualia. In this paper, I suggest that there is an insufficiently discussed aspect of the combination problem which I call the difference-maker problem. Taking the difference-maker problem into account, I argue that the combination problem – whether or not it can be solved – results in a dilemma for the project of developing Russellian physicalism. That is, Russellian monism is either physicalistically unacceptable or it is implausible; hence, Russellian monism and physicalism are incompatible. (shrink)

Background Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. Objective The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. (...) Research design A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. Participants and research context A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. Ethical consideration Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. Findings Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the ‘conflicts’ domain with increased clinical exposure. Conclusion Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings. (shrink)

Assume [Formula: see text]. Let [Formula: see text] be a [Formula: see text] equivalence relation coded in [Formula: see text]. [Formula: see text] has an ordinal definable equivalence class without any ordinal definable elements if and only if [Formula: see text] is unpinned. [Formula: see text] proves [Formula: see text]-class section uniformization when [Formula: see text] is a [Formula: see text] equivalence relation on [Formula: see text] which is pinned in every transitive model of [Formula: see text] containing the real (...) which codes [Formula: see text]: Suppose [Formula: see text] is a relation on [Formula: see text] such that each section [Formula: see text] is an [Formula: see text]-class, then there is a function [Formula: see text] such that for all [Formula: see text], [Formula: see text]. [Formula: see text] proves that [Formula: see text] is Jónsson whenever [Formula: see text] is an ordinal: For every function [Formula: see text], there is an [Formula: see text] with [Formula: see text] in bijection with [Formula: see text] and [Formula: see text]. (shrink)

Given a set of objects characterized by a number of attributes, hidden patterns can be discovered in them for the grouping of similar objects into clusters. If each of these clusters can be considered as exemplifying a certain concept, then the problem concerned can be referred to as a concept discovery problem. This concept discovery problem can be solved to some extent by existing data clustering techniques. However, they may not be applicable when the concept involved is vague in nature (...) or when the attributes characterizing the objects can be qualitative, quantitative, and fuzzy at the same time. To discover such concepts from objects with such characteristics, we propose a Genetic-Algorithm-based technique. By encoding a specific object grouping in a chromosome and a fitness measure to evaluate the cluster quality, the proposed technique is able to discover meaningful fuzzy clusters and assign membership degrees to objects that do not fully exemplify a certain concept. For evaluation, we tested the proposed technique with simulated and real data and the results are found to be very promising. (shrink)

Background eHealth was widely used during the COVID-19 pandemic. Much attention was given to the technical aspects of eHealth, such as infrastructure and cost, while the soft skill of compassion remained underexplored. The wide belief in compassionate care is more compatible with in-person interactions but difficult to deliver via e-platforms where personal and environmental clues were lacking urges studying this topic. Purpose to explore the experience of delivering compassionate care via an eHealth platform among healthcare professionals working to contain the (...) COVID-19 pandemic. Methods A qualitative study design with an interpretative phenomenological analysis approach was used. Twenty healthcare professionals (fifteen nurses and five physicians) who provided care using technology platforms, such as telephone hotlines, mobile apps, and social media, were interviewed individually. Ethical considerations Permission to conduct the study was obtained from the Institutional Review Board. Results Participants stated that “eHealth enabled compassionate care during the pandemic” by ensuring patient care availability and accessibility. They shared experiences of “communicating compassionate care via eHealth” with suggestions of addressing patients’ needs with empathy, adopting a structured protocol to guide eHealth communication, and using more advanced visual-media methods to promote human-to-human interaction. They recommended “setting realistic mutual expectations” considering the limitations of eHealth in handling complex health situations and staffing shortages. Participants considered “low eHealth literacy hinders compassion.” Additionally, they recommended the need for “institutional/system-level support to foster compassionate care.” Conclusion Participants recognized the importance of integrating compassion into eHealth services. Promotion of compassionate care requires standardization of eHealth services with institutional and system-level support. This also includes preparing adequate staffing who can communicate compassionate care via eHealth, set realistic expectation, and adjust communication to eHealth literacy level while meeting the needs of their patients. (shrink)

This paper is aimed at investigating the differences in ethical perception between Mainland China and Hong Kong through qualitative analysis. The level of idealism and relativism of the informants are measured quantitatively. The qualitative analysis of the viewpoints of participants from Hong Kong and other Chinese cities offers a profound understanding of ethical perception. Contradicting previous studies, our research offers a fresh perspective, indicating that those with high idealism are not always the ones who condemn misconduct or advocate for whistle-blowing. (...) Interestingly, we noted that individuals with high relativism frequently consider and emphasize alternative perspectives, rather than merely condemning or advocating misconduct and whistle-blowing. Conversely, those with low relativism frequently exhibit more anger, regardless of their stance. This discovery suggests that high relativism could be beneficial for facilitating communication between conflicting parties. (shrink)

Influential or frequently cited business ethics research does not appear in a vacuum; our study reveals its predominant sources and contributors by discipline. By examining citations from articles published in three top business ethics journals (Journal of Business Ethics, Business Ethics Quarterly and Business Ethics: A European Review) over the period 2004–2008, we document that the preponderance of influential business ethics research comes primarily from the management faculty. In addition, management journals and management books are the predominant sources for influential (...) business ethics research. Further, among the management fields, organizational behavior and organizational structure predominate leadership and strategy as the major subject areas for influential business ethics research, suggesting that this influential body of research is focused on a micro rather than on a macro context. These empirical results lend credence to the perception that there is a silo effect in influential business ethics research and suggest that business ethics research in a micro context might have permeated to the teaching of business ethics. (shrink)

On 25 May 2020, Officer Derek Chauvin asphyxiated George Floyd in Minneapolis — a murder that was captured in a confronting nine-minute bystander video that set off a firestorm of activity on online social networks, in the streets of the United States, and even worldwide. These protests captured the collective rage, dissatisfaction, and resentment personally and vicariously experienced towards the widespread systematic injustice and mistreatment of African Americans by police and vigilantes. The scale of these protests, both online and in (...) the streets, has been estimated to have far exceeded the civil rights marches of the 1960s (Buchanan et al. 2020). Considering the widespread extent of these protests, our research aims to analyse conflictual intergroup moral dynamics in terms of the reactive attitudes expressed by distinct online communities on Twitter. This paper examines the extent to which the Strawsonian (1962) reactive attitudes framework is applicable to the Twitter discourse around the Black Lives Matter protests reignited by the murder of George Floyd. In particular, we argue that the Strawsonian framework is inadequate to understand a range of prevalent attitudes expressed in this discourse — attitudes that we call reactionary as opposed to merely reactive. Reactionary attitudes include counter-indignation on behalf of the accused rather than Strawsonian indignation on behalf of the victim of a moral wrong. We document the expression of such attitudes among the right-wing participants in the online discourse about the Black Lives Matter movement. (shrink)

On November 26, 2018, the world awoke to the news that genome editing had for the first time been used to create genetically modified human beings. He Jiankui, a scientist then employed by Southern University of Science and Technology of China, Shenzhen, announced via social media and the popular press that he had performed genome editing on embryos with the aim of disrupting the CCR5 gene in order to induce immunity to HIV, implanted the embryos, and that twin girls had (...) been born.In the wake of this announcement, arguments, claims, and accusations flew. Most commentators declared He's actions "irresponsible," pointing to various statements by scientific organizations agreeing that human embryo genome editing was... (shrink)

New health technologies are rapidly emerging from various areas of bioscience research, such as gene editing, regenerative medicine and synthetic biology. These technologies raise promising medical possibilities but also a range of ethical considerations. Apart from the issues involved in considering whether novel health technologies can or should become part of mainstream medical treatment once established, the process of research translation to develop such therapies itself entails particular ethical concerns. In this paper I use synthetic biology as an example of (...) a new and largely unexplored area of health technology to consider the ways in which novel health technologies are likely to emerge and the ethical challenges these will present. I argue that such developments require us to rethink conventional attitudes towards clinical research, the roles of doctors/researchers and patients/participants with respect to research, and the relationship between science and society; and that a broader framework is required to address the plurality of stakeholder roles and interests involved in the development of treatments based on novel technologies. (shrink)

This essay introduces the main arguments in Lucia Rafanelli’s Promoting Justice Across Borders: The Ethics of Reform Intervention (Oxford University Press, 2021). I place the book within the context of literatures on foreign intervention and global justice more broadly, review the major arguments Rafanelli develops in her book, and foreshadow some of the main points of critique and appreciation put forth by four engaging responses from: Paulina Ochoa Espejo, David Owen, Jennifer Rubenstein, and Arash Abizadeh.

Some scientists or philosophers argue that multiverse theories are unfalsifiable and thus not scientific. However, some advocates of multiverse theories have recently argued that although the multiverse is not observable, multiverse theories are indeed falsifiable in principle. Therefore, they share similar features with a conventional scientific theory. On the other hand, the proposals of an epistemic shift and nonempirical theory assessment have possibly revived the discussions of the scientific nature of multiverse theories. In this article, I revisit the falsifiable arguments (...) made by the advocates of multiverse theories and show that these arguments do not justify arguing the scientific nature of such theories. Moreover, even if we accept the proposals of the epistemic shift and the nonempirical theory assessment, I argue that multiverse theories still cannot pass or satisfy the required assessments based on the new theoretical virtues and the nonempirical arguments. (shrink)

Ethical issues related to comparative effectiveness research, or research that compares existing standards of care, have recently received considerable attention. In this paper we focus on how Ethics Review Committees should evaluate the risks of comparative effectiveness research. We discuss what has been a prominent focus in the debate about comparative effectiveness research, namely that it is justified when “nothing is known” about the comparative effectiveness of the available alternatives. We argue that this focus may be misleading. Rather, we should (...) focus on the fact that some experts believe that the evidence points in favor of one intervention, whereas other experts believe that the evidence favors the alternative. We will then introduce a case that illustrates this point, and based on that, discuss how ERCs should deal with such cases of expert disagreement. We argue that ERCs have a duty to assess the range of expert opinions and based on that assessment arrive at a risk judgment about the study under consideration. We also argue that assessment of expert disagreement is important for the assignment of risk level to a clinical trial: what is the basis for expert opinions, how strong is the evidence appealed to by various experts, and how can clinical trial monitoring affect the possible increased risk of clinical trial participation. (shrink)

Shuilu fahui is a Buddhist rite for saving all sentient beings (pudu) with a complex layer of ritual activities incorporating elements of all schools of Chinese Buddhism, such as Tantric mantras, Tian Tai rituals of asking for forgiveness (chanfa), and Pure Land reciting of Amitabha’s name. The ritual can be dated to the Tang Dynasty (c. 670–673 CE) and has been one of the most spectacular and popular rituals in Chinese Buddhism. Shuilu fahui is still performed in China, Hong Kong, (...) Taiwan and Singapore, and continues to be very popular amongst such Chinese communities. This study is an aid to understanding how Chinese Buddhism is practised by monks and nuns in Hong Kong, and how they interact with lay Buddhists through Shuilu fahui. This rite constructs and represents a unified religious world that contains many important and profound religious meanings, and it continuous to ­develop in order to accommodate the various demands of people in Hong Kong. (shrink)

Tillich has been accused of being an atheist and pantheist. This study shows mainly that once one studies Tillich's work with care and with an open mind, one can see clearly that his existential ontology is quite consistent in form and theistic in content, and that the terms which he uses to express the idea of God are not unduly vague at all. ; There are six chapters in this thesis. In the first chapter, I argue that Tillich is not (...) an atheist; his God above the God of theism is a more adequate concept than most traditional concepts of God. I show that, for Tillich, God as our ultimate concern expresses the appropriateness of a worshipping attitude towards God, and that God as being-itself shows that God is the ground of being that gives us the moral courage to affirm our being in spite of the fact of nonbeing. God is thus the "power of being" which conquers anxieties. ;In the second chapter, I show more clearly what being-itself means for Tillich. God as being-itself is not a being among beings. Beings are bound to the structure of being and the categories of finitude, but God as being-itself is not bound by them. Being-itself transcends the world and everything within it. Being-itself is not the kind of immanent God that pantheism holds. Thus I once again argue against the accusation that Tillich is an atheist or pantheist. I also argue against the idea that the Platonic or Aristotelian universal is adequate as a model to interpret Tillich's idea of being-itself. Being-itself, for Tillich, cannot be identified with the Platonic or Aristotelian universal. ;The third chapter shows how Tillich gives a philosophical-theological interpretation of religious symbols. Except for the claim that "God is being-itself" is a direct non-symbolic statement about God, everything we say about God is interpreted by Tillich as symbolic. In chapter four, I show in some detail why, for Tillich, the word "existence" cannot be applied to God. But when Tillich claims that God does not exist, he does not mean that there is no God. He only rejects the misleading combination of the word "existence" and "God." "Existence" should be applied only to finite beings, not to being-itself. Therefore I also argue that arguments for God's existence cannot be constructed out of Tillich's system as some commentators have claimed. In fact, for Tillich, God is presupposed necessarily; any argument for God's reality is impossible and unnecessary. ;Chapter five is a discussion of Tillich's idea of freedom in relation to God's transcendence. Only things are determined. Human being has finite freedom which is rooted in his destiny. And God is absolute freedom. However, God's absolute freedom does not destroy man's finite freedom. For Tillich, the crucial theistic assertion of God's transcendence is rooted in this reality of both human and divine freedom. ;In the final chapter, I discuss Tillich's proposed solution to the problem of evil and omnipotence. For Tillich, to say that God is omnipotent does not mean that God can do everything; rather it is to express our trust in God. It is to assert that God as the power of being can conquer nonbeing in all its expressions. The existence of evil does not constitute a reason for a believer to abandon his belief in God; it simply constitutes one of the mysteries of existence reflected in religion. The existence of evil is inevitable because it is implied in the creaturely finitude. To believe in God's providence, according to Tillich, is the only answer to the question of theodicy. Thus Tillich shows us how to face suffering. (shrink)

Economic sanctions are a primary tool the US government and international organizations use to promote human rights abroad, yet they have proven to be largely ineffective and harmful to civilians. There is accumulating evidence that this paradox may be explained by the expressive purposes of sanctions and domestic politics. This article further explores these explanations by examining human rights sanction policy debates. Specifically, I analyzed 27 US Congressional hearings on human rights policy toward China. I argue that moral pressure enabled (...) support for human rights sanctions, high costs fueled opposition to them, and discussions of effectiveness were marginal to the debate. The findings contribute to past studies by identifying the psychological and sociological mechanisms by which legislators circumvent arguments of sanction ineffectiveness and harmfulness and delineating the role of business, human rights, and ethnic interest groups in enabling and constraining support for human rights sanctions. (shrink)

Given the recent call to strengthen collaboration between researchers and relevant practitioners, we consider participatory design as a way to advance Cognitive Science. Building on examples from the Learning Sciences and Human−Computer Interaction, we (a) explore what, why, who, when, and where researchers can collaborate with community members in Cognitive Science research; (b) examine the ways in which participatory‐design research can benefit the field; and (c) share ideas to incorporate participatory design into existing basic and applied research programs. Through this (...) article, we hope to spark deeper discussions on how cognitive scientists can collaborate with community members to benefit both research and practice. (shrink)