Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

Guanxi is perceived as a major determinant for successful business in China. This research paper investigates the importance of Guanxi from the Hong Kong Businessmen's viewpoint. It confirms previous findings in this area and adds on new dimensions. Therefore, practitioners and academics may further refine their knowledge in this subject.

Drawing on the general ethics and social psychology literature, this study presents a model to delineate the major factors likely to affect consumers’ intentions to bring their own shopping bags when visiting a supermarket (called “bring your own bags” or “BYOB” intention). The model is empirically validated using a survey of 250 Chinese consumers. Overall, the findings support the hypothesized direct influence of teleological evaluation and habit on BYOB intention, as well as that of deontological evaluation and teleological evaluation on (...) ethical judgment about the BYOB practice. Teleological evaluation exerts a much stronger influence on ethical judgment than does deontological evaluation. In addition, the findings reveal that consumers who perceive the BYOB practice to be more important are more inclined to rely on their ethical judgment to derive their BYOB intention. Academically, these findings provide some encouraging evidence for the application of general ethics theories to explain green consumption-related practices. Practically, the findings also suggest that a utilitarian approach (i.e., emphasizing the consequences of BYOB) may represent an effective means for the Chinese government to promote BYOB practice among consumers. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general (...) custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms. (shrink)

Because sin is anything that turns our heart from God, sins are both voluntary and jnvoluntary. As a consequence, double effect can only be adequately understood in a Christian context in which it is recognized that, even when evil is not willed, our involvement in its causation can still mar our hearts. The acknowledgement of involuntary sins resituates double effect so that the traditional Christian concern with spiritual harm and healing can be maintained. In this way, one can overcome the (...) underdeveloped Western theological appreciation of double effect, which ignores the effect on the heart of causing evil. (shrink)

Rather than revealing itself as a single, unified, ecumenical faith, Christianity is sundered with Christians united neither in one communion nor in one baptism. Christian Bioethics seeks to examine the traditional content-full moral commitments which the Christian faiths bring to life, sexuality, suffering, illness and death within the contexts of medicine and health care. Seeking to understand the differences which separate the bioethics of Roman Catholics, Protestants, and the Orthodox, Christian Bioethics explores the manners in which the faiths diverge. The (...) failure of the Enlightenment project to disclose a content-full communality that would bind mankind has left much to be reconsidered by Christians who face new ethical dilemmas in the novel guise of advances in health care technologies. (shrink)

In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that (...) it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism. (shrink)

This paper presents four different understandings of the family and their concomitant views of the authority of the family in pediatric medical decision making. These different views are grounded in robustly developed, and conflicting, worldviews supported by disparate basic premises about the nature of morality. The traditional worldviews are often found within religious communities that embrace foundational metaphysical premises at odds with the commitments of the liberal account of the family dominant in the secular culture of the West. These disputes (...) are substantial and ultimately irresolvable by sound rational argument because of the failure to share common foundational premises and rules of evidence. It is in light of these fundamental disagreements that there is a need to evaluate critically the claims and agenda advanced by the Convention on the Rights of the Child. (shrink)

Generalized anxiety disorder is among the world’s most prevalent psychiatric disorders and often manifests as persistent and difficult to control apprehension. Despite its prevalence, there is no integrative, formal model of how anxiety and anxiety disorders arise. Here, we offer a perspective derived from the free energy principle; one that shares similarities with established constructs such as learned helplessness. Our account is simple: anxiety can be formalized as learned uncertainty. A biological system, having had persistent uncertainty in its past, will (...) expect uncertainty in its future, irrespective of whether uncertainty truly persists. Despite our account’s intuitive simplicity—which can be illustrated with the mere flip of a coin—it is grounded within the free energy principle and hence situates the formation of anxiety within a broader explanatory framework of biological self-organization and self-evidencing. We conclude that, through conceptualizing anxiety within a framework of working generative models, our perspective might afford novel approaches in the clinical treatment of anxiety and its key symptoms. (shrink)

Marx's critique of political economy as a problem-posing framework Political economy and its critique Writing in the late, Friedrich Engels drew attention ...

A re-examination of the anonymous Commentary on the Theaetetus, henceforth abbreviated K, is overdue. It may yet prove to be the most important document we possess for plotting the course of pre-Plotinian Platonism, and is by far the largest surviving portion of a pre-Plotinian commentary on a complete work of Plato. It offers us insights into the issues of the first century B.C. which are unparalleled in other extant Middle Platonist works, either because of the subject of the work and (...) its consequent tendency to bring to mind the epistemological debates between Philo of Larissa, Antiochus of Ascalon, and Aenesidemus, or because the author, whom we may call A, is writing at a time comparatively close to those debates. (shrink)

This essay provides evidence to support a promising conceptual and potentially practical set of ideas at once both principled and effective found in the work of Max Weber and Alfred Schutz addressed to the issue of ‘adequacy’ as a goal in social research. Efforts to achieve adequacy beyond the epistemological conditions required by Weber’s demand that evidence meet both causal adequacy and adequacy on the level of meaning were significantly refocused by Schutz’s later concern, responding specifically to Weber, that the (...) social sciences also address themselves to his postulate of adequacy. It states that “Each term used in a scientific system referring to human action must be so constructed that a human act performed within the life-world by an individual actor in the way indicated by the typical construction would be reasonable and understandable for the actor himself, as well as for his fellow men”. A serious attempt to implement a more expansive notion of adequacy by practically activating this postulate in the ways suggested can be beneficial not only for the social research situation but in everyday life as well. (shrink)