Resumen: En el marco del estudio de los discursos gerenciales, se destacan en el presente texto algunas de las aportaciones de Medina-Vicent, especialmente el análisis de los procesos de individualización y despolitización de mensajes que entroncarían con las reivindicaciones del feminismo. En este contexto, se propone la incorporación del concepto foucaultiano de dispositivo para el estudio de los elementos que contribuyen a la difusión de los discursos gerenciales. Este concepto podría ser de utilidad en la investigación empírica, proporcionando una (...) herramienta conceptual para estudiar como un sistema homogéneo de relaciones de saber y poder los distintos elementos que conformarían el dispositivo gerencial.: Within the framework of the study of managerial discourses, this text highlights some of the contributions of Medina-Vicent, especially the analysis of the processes of individualization and depoliticization of messages that are linked to the claims of feminism. In this context, the incorporation of the Foucauldian concept of dispositif is proposed for the study of the elements that contribute to the diffusion of managerial discourses. This concept could be useful in the empirical analysis, as well as providing a conceptual tool to study the different elements that make up the managerial dispositif as a homogeneous system of knowledge and power relations. Palabras clave: gerencialismo, dispositivo, herramientas disciplinarias. Keywords: managerialism, dispositif, disciplinary instruments. (shrink)

Resumen En este trabajo se realiza un análisis exploratorio sobre lo que se ha venido concibiendo como un nuevo campo del saber científico desde hace algunas décadas, nos referimos a la neuroteología. También se pretende entender hasta qué punto la filosofía naturalista contemporánea puede estar vinculada con la neuroteología -sobre todo cuando el naturalismo implica, en la mayoría de los casos, un reduccionismo que conduce al materialismo-, teniendo en conside ración que en las distintas áreas neurocientíficas tiene lugar un fisicalismo, (...) esto es, una reducción de las propiedades o procesos cognitivos a meros procesos cerebrales e interacciones neuronales, que, gracias a la tecnología, hoy pueden ser visualizados por distintos instrumentos y técnicas.In this work an exploratory analysis is carried out on what has been conceived as a new field of scientific knowledge for some decades, we refer to neurotheology. It is also intended to under- stand to what extent contemporary naturalistic philosophy can be linked to neurotheology - especially when naturalism implies, in most cases, a reductionism that leads to materialism -, taking into account that in the different neuroscientific areas it has instead a physicalism, that is, a reduction of cognitive properties or processes to mere brain processes and neural interactions, which, thanks to technology, can now be visualized by different instruments and techniques. (shrink)

Integrated approaches in the ethical decision-making (EDM) and practically wise decision-making literature are emerging as alternative perspectives to management theories that conceptualize decision-making in a rationalist and value-free manner. However, more dialogue between both perspectives and qualitative research that applies them is required. In addition, there is a need for empirical analysis on business engagement in the face of grand challenges in developing countries. This paper proposes an integrated practically wise EDM framework to study how Colombian councilors who, in 2013, (...) voted for or against the merger between the Colombian state-owned company UNE and the Swedish multinational Millicom interpret this decision and its public impact. Qualitative semi-structured interviews were conducted with a voluntary sample of 18 of 21 councilors. Supporters of the UNE-Millicom merger expressed open-mindedness, seeing the merger as a means to achieve justice. On the contrary, the merger’s opponents expressed circumspection, doubting that Millicom’s intentions really leaned toward justice. We conclude that practical wisdom—embodied by both supporters and detractors—fosters an understanding of EDM beyond what leaders should not do. It also includes a democratic and balanced deliberation on what leaders think they should do to promote the common good. (shrink)

Resumen: Este texto es una respuesta abierta a las apreciaciones planteadas por las profesoras María Ávila Bravo-Villasante y Lydia de Tienda Palop, y los profesores Carlos Jesús Fernández Rodríguez y David Muñoz Rodríguez a la obra Mujeres y discursos gerenciales. Hacia la autogestión feminista. A lo largo de las presentes páginas se busca articular un diálogo entre miradas procedentes de diferentes disciplinas que contribuya a enriquecer la reflexión elaborada en dicha obra y abrir nuevos interrogantes sobre la (...) misma. A su vez, dicho diálogo permitirá seguir ampliando el campo de los estudios del management desde la perspectiva feminista.: This is an open response to the comments of professors María Ávila Bravo-Villasante, Lydia de Tienda Palop, Carlos Jesús Fernández Rodríguez, and David Muñoz Rodríguez to the book Mujeres y discursos gerenciales. Hacia la autogestión feminista. The aim is to articulate a dialogue among views from different disciplines that can contribute to enrich the reflection elaborated in the book and to open new questions about it, with the hope that this dialogue will help to expand the field of management studies from a feminist perspective. Palabras clave: postfeminismo, mujeres, liderazgo, gestión. Keywords: postfeminism, women, leadership, management. (shrink)

Families play an essential role in deceased organ procurement. As the person cannot directly communicate his or her wishes regarding donation, the family is often the only source of information regarding consent or refusal. We provide a systematic description and analysis of the different roles the family can play, and actions the family can take, in the organ procurement process across different jurisdictions and consent systems. First, families can inform or update healthcare professionals about a person’s donation wishes. Second, families (...) can authorize organ procurement in the absence of deceased’s preferences and the default is not to remove organs, and oppose donation where there is no evidence of preference but the default is to presume consent; in both cases, the decision could be based on their own wishes or what they think the deceased would have wanted. Finally, families can overrule the known wishes of the deceased, which can mean preventing donation, or permitting donation when the deceased refused it. We propose a schema of 4 levels on which to map these possible family roles: no role, witness, surrogate, and full decisional authority. We conclude by mapping different jurisdictions onto this schema to provide a more comprehensive understanding of the consent system for organ donation and some important nuances about the role of families. This classificatory model aims to account for the majority of the world’s consent systems. It provides conceptual and methodological guidance that can be useful to researchers, professionals, and policymakers involved in organ procurement. (shrink)

Background: Several countries have recently changed their model of consent for organ donation from opt-in to opt-out. We undertook a systematic review to determine public knowledge and attitudes towards these models in Europe. Methods: Six databases were explored between 1 January 2008 and 15 December 2017. We selected empirical studies addressing either knowledge or attitudes towards the systems of consent for deceased organ donation by lay people in Europe, including students. Study selection, data extraction, and quality assessment were conducted by (...) two or more reviewers independently. Findings: Awareness of the consent model was lower in opt-out countries than in opt-in countries. A majority of the public agrees with opt-in, regardless of the law in their own country. There are ambivalent attitudes regarding the opt-out system. The public tend to prefer opt-in and mandatory choice over opt-out when several options are offered. Interpretation: The assumption that people in opt-out countries are aware of the legal requirements to be excluded from the pool of potential donors is not supported by the results of this review. This is a concern, since ignorance hinders people's autonomy regarding organ donation decision-making. Higher awareness of consent model in opt-in countries may reflect greater efforts to inform the public through campaigns to motivate donation. Legal moves towards opt-out are at odds with people's expressed preferences. Main limitations of this review are the lack of data from some countries, study population heterogeneity, and methodological shortcomings. (shrink)

Background The COVID-19 pandemic has influenced the approach to the health-disease system, raising the question about the principles of bioethics present in physician–patient relations. The principles while widely accepted may not be sufficient for a comprehensive ethical analysis. Therefore, the aim of this study was to explore the perception of these principles and the physician–patient relationship during a hospital stay through a qualitative approach. Method Sixteen semi-structured interviews took place to know the patients’ perception during their 2020 hospitalization for COVID-19. (...) The data was analyzed through the constant comparison method, creating categories and comparing them. In the end, seven categories were established and were grouped in three: bioethical principles (dignity, charity, vulnerability, autonomy), doctor-patient relationship (participant commitment, informed consent, health staff-patient relationship) and the experience of the disease (illness, the role of the family). Results The research found that most patients described a positive experience, with the feeling of having been well cared for with no sense of discrimination or injustice done. The majority also reported that their autonomy was respected in the treatment decisions. The evaluation of these attitudes is an area of opportunity, especially when the patients' vulnerability is at risk. Conclusions The ethics of virtue offers a better reflection of how human beings manifest themselves by emphasizing the development of virtuous character and behaviors that allow them to realize their values in life. Authorized by the Research Ethics Committee with registration: DI/18/105-B/3/308. (shrink)

This article explores the philosophy of Alain Badiou from the vantage point of the concepts of the localization, delocalization, and relocalization of the void as thematized through literary arts, religion, emancipatory politics, and the subject of psychoanalysis. In short, these moments around the void characterize the processes through which truth is processed and seen through their full realization by a philosophical engagement across the various conditions in which these truths occur. The localization of a void is the naming of an (...) indiscernible element that is incommensurable to the rubric of constructible knowledge, sense and meaning which could saturate the space of truth. Thus, the naming that localizes the void acts as a subtraction of the invariant in the variance of situation such that across various points in space and time, we are still able to subtract the universal as the invariant not just as the fidelity to the localized truth but also as the resurrection of truth upon its relocalization at a different place and a different time. At its core, this article is concerned with truth, why truth is persistent, and why we have to struggle to articulate the truth that we are trying to be faithful to again and again with each instance that truth risks being covered-over and obscured. (shrink)

El presente monográfico de Recerca titulado «Los nuevos discursos del management: contribuciones desde una perspectiva crítica», se compone de siete artículos de investigación y dos recensiones. A través de los diferentes escritos se pretende realizar un recorrido por el estado actual de los discursos del management y sus repercusiones no solo en el mundo del trabajo, sino en el grueso de la sociedad desde una perspectiva crítica. Así pues, a lo largo de las siguientes páginas el/la lector/a podrá transitar por (...) los diferentes discursos que hoy en día caracterizan el espacio social. Nos referimos a marcos generales de sentido como el individualismo y la descolectivización de lo social, pero también a cuestiones más concretas como el emprendimiento y la precariedad; todos ellos componentes que conforman el escenario al que nos estamos remitiendo en todo momento, esto es, el del discurso neoliberal o el «nuevo espíritu del capitalismo» (Boltanski y Chiapello, 2002). (shrink)

Status anxiety, the constant concern about individuals’ position on the social ladder, negatively affects social cohesion, health, and wellbeing. Given previous findings showing that status anxiety is associated with economic inequality, we aimed in this research to test this association experimentally. A cross-sectional study was run in order to discard confounding effects of the relationship between perceived economic inequality and status anxiety, and to explore the mediating role of a competitive climate. Then we predicted that people assigned to a condition (...) of high inequality would perceive more status anxiety in their social context, and they would themselves report higher status anxiety. Thus, in an experimental study PEI was manipulated. In Study 1, PEI uniquely predicted status anxiety, and perceived competitiveness mediated the relationship. In Study 2 PEI increased perceived contextual status anxiety, a specific form of perceived competitiveness based on socioeconomic status. Moreover, preliminary evidence of an indirect effect was found from PEI to personal status anxiety, through perceived contextual status anxiety. These preliminary findings provide experimental evidence for the effects of economic inequality on status anxiety and the mechanism involved. Economic inequality makes people feel that they live in a society where they are constantly concerned and competing with each other for their SES. These results could have important implications as health and wellbeing could be promoted by reducing economic inequalities and the competitive and materialistic environments of our societies. (shrink)

El presente texto nace del proyecto de investigación en gestión empresarial que se adelanta en el programa de administración de empresas donde están vinculados los autores. Se presenta la persecución del éxito empresarial y la ética sindical como la finalidad de consolidar el desarrollo sustentable latinoamericano. En ese sentido las nuevas realidades laborales se han estado enfocando recientemente en la productividad, en la eliminación del trabajo estático dando lugar al trabajo remoto y la formación de equipos de trabajo sinérgicos, que (...) respondan a las inclinaciones de esta nueva descendencia de subalternos, afectando así a las organizaciones sindicales que dependen del claustro de trabajo. (shrink)

Este artículo es producto de una reflexión etnográfica sobre el proceso de cambio sufrido por una cultura del trabajo asociada a la explotación del carbón y su vinculación con la ciudad de Lota, ubicada en el centro sur de Chile, la que se constituye comohabitacional y de servicios junto con el desarrollo de la monoindustria desde la segunda mitad del siglo XIX. Por una parte, se analiza cómo, desde la condición laboral, social y de vida de los trabajadores y la (...) población, se configura un sujeto histórico con identidad laboral y de clase, el que genera un discurso teleológico que da paso a una visión utópica durante el ciclo de vida de la explotación del mineral. Por otra, se analiza cómo el fin de la explotación del mineral en 1997, tras el cierre de los yacimientos, hace que los sujetos transformen su utopía en ucronía; es decir, cómo el fin de la narrativa que movilizaba las acciones genera una temporalidad alternativa que no tiene tiempo real, lo que revela las dificultades para reestructurar la biografía y memoria de una comunidad especializada. This article is the result of an ethnographic observation of the process of change undergone by a labor culture associated to the coal mining and its relationship with the city of Lota, located in the center South of Chile a city that has been constituted as a residential and services center along with the development of the monoindustry, from the second half of the nineteenth century. On one hand, it analyzes how this has shaped an historical subject with labor and class identity considering the working, social and living conditions of the mining workers and the population. This historical subject generates a teleological discourse that leads to a utopianist vision during the service life of the mineral´s exploitation. On the other hand, we analyze how the end of the mining activity in 1997, after the coal mine´s closing, causes the subjects to transform their utopia into uchronia; that is to say, how the aim of the narrative that addressed the actions generates an alternative temporality that has no real time, which reveals the difficulties to reconstruct the biography and memory of a specialized community. (shrink)

Business Ethics: A European Review, EarlyView.

En los últimos treinta años se ha transitado desde una concepción del capital humano como una macromagnitud económica a una idea de capital humano corporeizada en el individuo. Hemos asistido a una progresiva infiltración de dicha ideología del capital humano también en la vida de la juventud precaria. Nos centramos aquí en los jóvenes universitarios, para quienes el capital humano, ya de forma hegemónica, dirige y marca sus recorridos laborales y vitales. El análisis de los discursos de estos jóvenes nos (...) permitirá explorar desde la imposición de la lógica de la movilidad laboral, a la sujeción a las formas de "emprendedor de sí mismo" y a la normalización, como parte del proceso de incorporación de capital humano, de formas de empleo progresivamente al margen de los derechos y garantías laborales clásicas del trabajo salariado.In the last thirty years it has been gone from a conception of the human capital as an economic macro magnitude to an idea of human capital embodied in the individuals. We have been witnesses of the progressive infiltration of this ideology of the human capital also in the life of precarious youth. We focus in the university young people, for those who the human capital, already of hegemonic form, directs and marks its labour and vital routes. The analysis of the discourses of these young people will allow us to explore the imposition of the logic of labour mobility, the subjection to the forms of «entrepreneur of itself» and also the normalization of forms of work progressively excluded from the rights and classic labour guarantees as a part of the process of incorporation of human capital. (shrink)

Este artículo explora el concepto de trauma colectivo y su aplicación en el contexto histórico y social de las sociedades latinoamericanas. La transferencia del término «trauma colectivo» desde el campo del conocimiento psicológico a la esfera social e histórica plantea preguntas sobre su legitimidad y marco conceptual. El estudio examina la fidelidad de esta transferencia conceptual y su relación con la comprensión psicoanalítica temprana de los fenómenos traumáticos. El contexto cultural europeo de finales del siglo xix y principios del siglo (...) xx proporcionó la base para teorizar las consecuencias de experiencias intensas y violentas, lo que resultó en el concepto de «neurosis traumática», influenciado significativamente por el trabajo de Freud. El artículo discute la apropiación de herramientas psicoanalíticas en la crítica histórica y cultural para comprender eventos que desafían marcos tradicionales y la inteligibilidad social, como el Holocausto. La noción del trauma como una fuerza enigmática y recurrente en la experiencia histórica se explora a través del enfoque de los estudios del trauma. El artículo pone de relieve a destacados y destacadas académicas en este campo y su uso de conceptos psicoanalíticos, demostrando la preservación y aplicación significativa de estas nociones en la comprensión de fenómenos históricos y colectivos. Al acortar la brecha entre las experiencias psicológicas individuales y los traumas colectivos, los estudios del trauma ofrecen un enfoque único para interpretar y representar eventos que resisten las narrativas históricas tradicionales. (shrink)

In this work, we present a new approach to solve the location management problem by using the reporting cells strategy. Location management is a very important and complex problem in mobile computing which aims to minimize the costs involved. In the reporting cells location management scheme, some cells in the network are designated as reporting cells . The choice of these cells is not trivial because they affect directly to the cost of the mobile network. This article is focused on (...) the use of high performance computing to execute a parallel heuristic that places optimally the RCs in a mobile network, minimizing its total cost. The main goal of this work is to demonstrate that the collaborative work of different evolutionary algorithms can obtain very good results. For this reason, we have implemented a parallel heuristic and six evolutionary algorithms that works in a parallel way on a cluster to solve the RCs problem. (shrink)

Since 1968, the irreversible loss of functioning of the whole brain, called brain death, is assimilated to individual’s death. The almost universal acceptance of this neurological criterion of death had decisive consequences for the contemporary medicine, such as the withdrawal of mechanical ventilation in these patients and organ retrieval for transplantation. The new criterion was successfully accepted in part because the assimilation of brain death state to death was presented by medicine --and acritically assumed by most of societies-- as a (...) scientific and objective fact. Nevertheless, many people do not think that the patients suffering brain death are actually dead. We show here that those people are not necessarily wrong. It can be argued that, in fact, the justification of the neurological criterion is not scientific but moral. We outline the thesis that the problem surrounding the vital status of brain dead patients is due to a confusion between factual and normative questions. Furthermore, we claim that the donation of organs and the withdrawal of life-support could be ethically acceptable even if the patients suffering brain death are considered as alive. As an alternative to the dead donor rule, we propose a justification for organ donation of brain-dead patients based on the (moral) concepts of harm and consent : what truly justifies the procurement of organs on those patients is not that they are dead, but that they wish to donate their organs and that, since they have irreversibly lost their brain, they cannot be harmed. (shrink)

The search for a systems‐level picture of metabolism as a web of molecular interactions provides a paradigmatic example of how the methods used to characterize a system can bias the interpretation of its functional meaning. Metabolic maps have been analyzed using novel techniques from network theory, revealing some non‐trivial, functionally relevant properties. These include a small‐world structure and hierarchical modularity. However, as discussed here, some of these properties might actually result from an inappropriate way of defining network interactions. Starting from (...) the so‐called bipartite organization of metabolism, where the two meaningful subsets (reactions and metabolites) are considered, most current works use only one of the subsets by means of so‐called graph projections. Unfortunately, projected graphs often ignore relevant biological and chemical constraints, thus leading to statistical artifacts. Some of these drawbacks and alternative approaches need to be properly addressed. (shrink)

El libro Las generaciones que llegaron tarde presenta los resultados de un trabajo sobre los usos, las estrategias y las percepciones de las generaciones mayores en relación a las tecnologías de la información y de la comunicación. Las apropiaciones de los y las mayores en los ámbitos laboral, relacional y familiar, así como en el ocio, son objeto de análisis a partir de entrevistas en profundidad. Entre los principales resultados destaca el que, a pesar de la gran capacidad de adaptación (...) de las personas mayores a los nuevos entornos digitales, la sociedad informacional sigue avanzando a ritmos desiguales: mientras penetra y media en buena parte de las dinámicas sociales, sigue dejando en los márgenes a una parte de la población perteneciente a las generaciones de más edad. (shrink)

Este estudio tiene como objetivo analizar la relación que existe entre el aprendizaje de inglés, los empleadores y las formas en las que se está abordando la enseñanza de inglés y aprendizaje de lenguas en el estado de Baja California. Esta investigación se enfocó a atender los siguientes objetivos: 1. Identificar las principales competencias profesionales que requiere el sector empresarial en Baja California de sus prospectos empleados en términos de contratación y ascenso laboral. 2. Analizar el tipo de habilidades de (...) comunicación que requiere el sector empresarial en términos del dominio del inglés de sus egresados en la competencia comunicativa, escrita y oral y las nuevas formas de aprendizaje que se encuentran disponibles a través de la tecnología. (shrink)

(2013). Standards for Academic and Professional Instruction in Foundations of Education, Educational Studies, and Educational Policy Studies Third Edition, 2012, Draft Presented to the Educational Community by the American Educational Studies Association's Committee on Academic Standards and Accreditation. Educational Studies: Vol. 49, Critical, Interpretive, and Normative Perspectives of Educational Foundations: Contributions for the 21st Century, pp. 107-118.

Setting the stage with a selection of readings from important nineteenth century philosophers, this reader on truth puts in conversation some of the main philosophical figures from the twentieth century in the analytic, continental, and pragmatist traditions. Focuses on the value or normativity of truth through exposing the dialogues between different schools of thought Features philosophical figures from the twentieth century in the analytic, continental, and pragmatist traditions Topics addressed include the normative relation between truth and subjectivity, consensus, art, testimony, (...) power, and critique Includes essays by Kierkegaard, Nietzsche, James, Heidegger, Merleau-Ponty, Wittgenstein, Levinas, Arendt, Foucault, Rorty, Davidson, Habermas, Derrida, and many others. (shrink)

Alireza Bagheri supports a policy on organ procurement where individuals could choose their own definition of death between two or more socially accepted alternatives. First, we claim that such a policy, without any criterion to distinguish accepted from acceptable definitions, easily leads to the slippery slope that Bagheri tries to avoid. Second, we suggest that a public discussion about the circumstances under which the dead donor rule could be violated is more productive of social trust than constantly moving the line (...) between life and death. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

In this commentary, we criticize the argument that allowing euthanasia for people with disabilities is ableist. We analyze the distinction between facts and values in medical assistance in dying, the expressivist objection, and the problem of crypwashing.

Since the 1960s, scientists, engineers, and healthcare professionals have developed brain–computer interface (BCI) technologies, connecting the user’s brain activity to communication or motor devices. This new technology has also captured the imagination of publics, industry, and ethicists. Academic ethics has highlighted the ethical challenges of BCIs, although these conclusions often rely on speculative or conceptual methods rather than empirical evidence or public engagement. From a social science or empirical ethics perspective, this tendency could be considered problematic and even technocratic because (...) of its disconnect from publics. In response, our trinational survey (Germany, Canada, and Spain) reports public attitudes toward BCIs (N = 1,403) on ethical issues that were carefully derived from academic ethics literature. The results show moderately high levels of concern toward agent-related issues (e.g., changing the user’s self) and consequence-related issues (e.g., new forms of hacking). Both facets of concern were higher among respondents who reported as female or as religious, while education, age, own and peer disability, and country of residence were associated with either agent-related or consequence-related concerns. These findings provide a first look at BCI attitudes across three national contexts, suggesting that the language and content of academic BCI ethics may resonate with some publics and their values. (shrink)

Two main types of philosophical arguments have been given in support of the claim that the citizens of affluent societies have stringent moral duties to aid the global poor: “positive duty” arguments based on the notion of beneficence and “negative duty” arguments based on noninterference. Peter Singer’s positive duty argument (Singer 1972) and Thomas Pogge’s negative duty argument (Pogge 2002) are among the most prominent examples. Philosophers have made speculative claims about the relative effectiveness of these arguments in promoting attitudes (...) and behaviors that could lead to the alleviation of poverty. In this article we present the results of two empirical studies that evaluate these claims, and suggest that both arguments have a modest effect on people’s attitudes and behaviors regarding global poverty. In a replication of the second study, the negative duty argument, in particular, had a statistically significant effect on donations. We discuss the theoretical and practical significance of these results and suggest directions for further research on the role that philosophical arguments can play in engendering concern and action on pressing moral problems. (shrink)

Despite continuing controversies regarding the vital status of both brain-dead donors and individuals who undergo donation after circulatory death (DCD), respecting the dead donor rule (DDR) remains the standard moral framework for organ procurement. The DDR increases organ supply without jeopardizing trust in transplantation systems, reassuring society that donors will not experience harm during organ procurement. While the assumption that individuals cannot be harmed once they are dead is reasonable in the case of brain-dead protocols, we argue that the DDR (...) is not an acceptable strategy to protect donors from harm in DCD protocols. We propose a threefold alternative to justify organ procurement practices: (1) ensuring that donors are sufficiently protected from harm; (2) ensuring that they are respected through informed consent; and (3) ensuring that society is fully informed of the inherently debatable nature of any criterion to declare death. (shrink)

Bioethicists involved in end‐of‐life debates routinely distinguish between ‘killing’ and ‘letting die’. Meanwhile, previous work in cognitive science has revealed that when people characterize behaviour as either actively ‘doing’ or passively ‘allowing’, they do so not purely on descriptive grounds, but also as a function of the behaviour’s perceived morality. In the present report, we extend this line of research by examining how medical students and professionals (N = 184) and laypeople (N = 122) describe physicians’ behaviour in end‐of‐life scenarios. (...) We show that the distinction between ‘ending’ a patient’s life and ‘allowing’ it to end arises from morally motivated causal selection. That is, when a patient wishes to die, her illness is treated as the cause of death and the doctor is seen as merely allowing her life to end. In contrast, when a patient does not wish to die, the doctor’s behaviour is treated as the cause of death and, consequently, the doctor is described as ending the patient’s life. This effect emerged regardless of whether the doctor’s behaviour was omissive (as in withholding treatment) or commissive (as in applying a lethal injection). In other words, patient consent shapes causal selection in end‐of‐life situations, and in turn determines whether physicians are seen as ‘killing’ patients, or merely as ‘enabling’ their death. (shrink)

The multiobjective optimization on the basis of ratio analysis method captures diverse features such as the criteria and alternatives of appraising a multiple criteria decision-making problem. At the same time, the multiple criteria problem includes a set of decision makers with diverse expertise and preferences. In fact, the literature lists numerous approaches to aid in this problematic task of choosing the best alternative. Nevertheless, in the MCDM field, there is a challenge regarding intangible information which is commonly involved in multiple (...) criteria decision-making problem; hence, it is substantial in order to advance beyond the research related to this field. Thus, the objective of this paper is to present a fused method between multiobjective optimization on the basis of ratio analysis and Pythagorean fuzzy sets for the choice of an alternative. Besides, multiobjective optimization on the basis of ratio analysis is utilized to choose the best alternatives. Finally, two decision-making problems are applied to illustrate the feasibility and practicality of the proposed method. (shrink)

The ever‐increasing demand for organs led Spain, France, and other European countries to promote uncontrolled donation after circulatory determination of death (uDCDD). For the same reason, New York City has recently developed its own uDCDD protocol, which differs from European programs in some key ways. The New York protocol incorporates a series of technical and management improvements that address some practical problems identified in response to European uDCDD protocols. However, the more fundamental issue of whether uDCDD donors are dead when (...) organs are procured remains problematic for the New York City protocol and, indeed, for all uDCDD protocols. In the United States, two amendments to the legal criteria of death have been suggested to avoid a formal violation of the dead donor rule in DCDD protocols: first, replacing the requirement “irreversible” with the weaker term “permanent,” and second, using the term “circulatory” instead of “cardiac” to identify the key function that must be lost to declare death. While intended to facilitate controlled DCDD, these modifications create a problem for uDCDD protocols: if extracorporeal membrane oxygenation is introduced to preserve the organs, then circulation is restored after death is declared. In this issue of the Hastings Center Report, Kevin Munjal and colleagues call for a new ethical construct and policy so that uncontrolled and controlled DCDD can coexist. (shrink)

Background Consent policies for post-mortem organ procurement (OP) vary throughout Europe, and yet no studies have empirically evaluated the ethical implications of contrasting consent models. To fill this gap, we introduce a novel indicator of governance quality based on the ideal of informed support, and examine national differences on this measure through a quantitative survey of OP policy informedness and preferences in seven European countries. -/- Methods Between 2017–2019, we conducted a convenience sample survey of students (n = 2006) in (...) Austria (AT), Belgium (BE), Denmark (DK), Germany (DE), Greece (GR), Slovenia (SI) and Spain (ES), asking participants about their donation preferences, as well as their beliefs and views about the policy in place. From these measures, we computed indices of informedness, policy support, and fulfilment of unexpressed preferences, which we compared across countries and consent systems. -/- Results Our study introduces a tool for analyzing policy governance in the context of OP. Wide variation in policy awareness was observed: Most respondents in DK, DE, AT and BE correctly identified the policy in place, while those in SI, GR and ES did not. Respondents in opt-out countries (AT, BE, ES and GR) tended to support the policy in place (with one exception, i.e., SI), whereas those in opt-in countries (DE and DK) overwhelmingly opposed it. These results reveal stark differences in governance quality across countries and consent policies: We found a preponderance of informed opposition in opt-in countries and a general tendency towards support–either informed or uninformed–in opt-out countries. We also found informed divergence in opt-in countries and a tendency for convergence–either informed or uninformed–among opt-out countries. -/- Conclusion Our study offers a novel tool for analyzing governance quality and illustrates, in the context of OP, how the strengths and weaknesses of different policy implementations can be estimated and compared using quantitative survey data. (shrink)

In this issue of the Report, James L. Bernat proposes an innovative and sophisticated distinction to justify the introduction of permanent cessation as a valid substitute standard for irreversible cessation in death determination. He differentiates two approaches to conceptualizing and determining death: the biological concept and the prevailing medical practice standard. While irreversibility is required by the biological concept, the weaker criterion of permanence, he claims, has always sufficed in the accepted standard medical practice to declare death. Bernat argues that (...) the medical practice standard may be acceptable on the ground that proving circulatory or brain permanence is sufficient to assure complete accuracy for death diagnosis. -/- The topic requires public deliberation: processes to survey people's opinions and mechanisms to channel their opinions into policy-making. What is at stake is the nature of our society. Do we want an expertocracy, in which an enlightened few design policies for the greater good of the majority and exploit the lack of public knowledge to achieve compliance? (shrink)

Objectives To increase postmortem organ donation rates, several countries are adopting an opt-out (presumed consent) policy, meaning that individuals are deemed donors unless they expressly refused so. Although opt-out countries tend to have higher donation rates, there is no conclusive evidence that this is caused by the policy itself. The main objective of this study is to better assess the direct impact of consent policy defaults per se on deceased organ recovery rates when considering the role of the family in (...) the decision-making process. This study does not take into account any indirect effects of defaults, such as potential psychological and behavioural effects on individuals and their relatives. -/- Design Based on previous work regarding consent policies, we created a conceptual model of the decision-making process for deceased organ recovery that included any scenario that could be directly influenced by opt-in or opt-out policies. We then applied this model to internationally published data of the consent process to determine how frequently policy defaults could apply. -/- Main outcome measures We measure the direct impact that opt-in and opt-out policies have per se on deceased organ recovery. -/- Results Our analysis shows that opt-in and opt-out have strictly identical outcomes in eight out of nine situations. They only differ when neither the deceased nor the family have expressed a preference and defaults therefore apply. The direct impact of consent policy defaults is typically circumscribed to a range of 0%–5% of all opportunities for organ recovery. Our study also shows that the intervention of the family improves organ retrieval under opt-in but hinders it under opt-out. -/- Conclusions This study may warn policy makers that, by emphasising the need to introduce presumed consent to increase organ recovery rates, they might be overestimating the influence of the default and underestimating the power granted to families. (shrink)

This paper analyses the arguments for and against what we have called automatic organ procurement model in relation to the organs of the deceased. For this purpose, this work provides empirical evidence to assess the potential impact of this model on donation rates and on public opinion. Specifically, we examine first the reasons supporting this model, with special reference to utilitarian and justice arguments. On the other hand, we analyse both the approaches based on the violation of pre mortem and (...) post mortem interests opposing this theoretical model and the rejection the model would generate in the population. Finally, we point out the aspects that, in our opinion, should be exhaustively regulated if this model were implemented. In particular, we refer to the legal status of the human body, the treatments for end-of-life patients, the incentives for health professionals and the recognition of the right to conscientious objection. (shrink)

La normalización de la precariedad entre las personas jóvenes está entrando en lo que parece una nueva fase. De la mano de, entre otros factores, los discursos empresariales y la teoría del capital humano, estamos asistiendo a una vuelta de tuerca en la presión sobre la juventud: ya no basta con la búsqueda «activa» de empleo, ahora hay que invertir en uno mismo como «empresario de sí mismo» y, en esta lógica, si es preciso hay que optar por la «movilidad (...) internacional». Presentamos una revisión teórica y conceptual alrededor de lo que se conoce como fuga de cerebros y su justificación discursiva. Estamos ante un proceso que probablemente dejará una marca importante en una generación que ha visto truncadas sus posibilidades de transición a situaciones estables, idealmente identificadas con el mundo adulto.Normalization of precariousness among young people is entering in a new phase. Led by, among other factors, the human capital theory, we are witnessing a twist in pressure on young people: it is no longer enough with «active» job search, now you have to invest in yourself as entrepreneur of yourself’ and in this logic, maybe young people must choose for the «international mobility», which is represented as a cosmopolitan option. We present a theoretical and conceptual review around what is known as brain drain and its discursive justification. We are facing a process that will probably leave a significant mark on a generation whose chances of transition to stable situations have been truncated, ideally identified with the adult world. (shrink)

Since the 1960s, organ procurement policies have relied on the boundary of death—advertised as though it were a factual, value‐free, and unobjectionable event—to foster organ donation while minimizing controversy. Death determination, however, involves both discoveries of facts and events and decisions about their meaning (whether the facts and events are relevant to establish a vital status), the latter being subjected to legitimate disagreements requiring deliberation. By revisiting the historical origin of the dead donor rule, including some events that took place (...) in France prior to the report by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, I want to recall that those who first promoted the DDR did not take into account any scientific rationale to support the new proposed criteria to determine death. Rather, through a process of factual re‐semantization, they authorized themselves to decide about the meaning of death in order to implicitly prioritize the interests of organ recipients over those of dying people. (shrink)

El presente estudio propone un enfoque crítico de la cuestión del mal y del sufrimiento humano. En el marco del pensamiento ético de Levinas y desde una nueva perspectiva respecto de la concepción actual del lenguaje y del cuerpo, pretendemos cuestionar todas las formas de racionalismo y comprensión metafísica acerca del dolor y del sufrimiento humano. El propósito del presente estudio consiste en delinear una nueva forma de comportamiento en torno a la cuestión del mal y la debilidad humana, buscando (...) alternativas conceptuales para esclarecer este complejo problema ético. (shrink)

To assess—from a qualitative perspective—the perceptions and attitudes of Spanish rehabilitation professionals (e.g. rehabilitation doctors, speech therapists, physical therapists) about Brain–Computer Interface (BCI) technology. A qualitative, exploratory and descriptive study was carried out by means of interviews and analysis of textual content with mixed generation of categories and segmentation into frequency of topics. We present the results of three in-depth interviews that were conducted with Spanish speaking individuals who had previously completed a survey as part of a larger, 3-country/language, survey (...) on BCI perceptions. 11 out of 15 of these Spanish respondents (survey) either strongly or somewhat accept the use of BCI in rehabilitation therapy. However, the results of our three in-depth interviews show how, due to a strong inertia of attitudes and perceptions about BCI technology, most professionals feel reluctant to use BCI technology in their daily practice (interview). (shrink)