Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

In this paper, we show that non-well-founded sets can be defined constructively by formalizing Hallnäs' limit definition of these within Martin-Löf's theory of types. A system is a type W together with an assignment of ᾱ ∈ U and α̃ ∈ ᾱ → W to each α ∈ W. We show that for any system W we can define an equivalence relation = w such that α = w β ∈ U and = w is the maximal bisimulation. Aczel's proof (...) that CZF can be interpreted in the type V of iterative sets shows that if the system W satisfies an additional condition (*), then we can interpret CZF minus the set induction scheme in W. W is then extended to a complete system W * by taking limits of approximation chains. We show that in W * the antifoundation axiom AFA holds as well as the axioms of CFZ -. (shrink)

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

Journal of Economic Methodology, Volume 19, Issue 2, Page 159-163, June 2012.

Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

Background: Studies from Western countries show that doctors working in neonatal intensive care units find withdrawal of treatment to be their most difficult ethical dilemma. There is less knowledge of how this is experienced in other economic, cultural, religious and educational contexts.Objectives: To explore and describe how Indian doctors experience ethical dilemmas concerning the withdrawal of treatment among critically sick and/or premature neonates.Method: Qualitative data from interviews was analysed according to Giorgi's phenomenological approach. The subjects were 14 doctors with various (...) levels of neonatal experience, recruited from two state‐owned NICUs in India. Main outcome measures: description reflecting the nature of ethical dilemmas and how they are experienced.Results: All doctors reported situations where the question of withdrawal of treatment was experienced as the worst part of their job. They felt that they lacked training in how to handle such dilemmas, and some had never talked about ethics before. They were especially concerned about non‐medical considerations that do not feature in current treatment guidelines. In describing their personal experiences, the informants mentioned their sense of responsibility in situations where they were aware that their decisions would influence a family's economy and reputation, availability of food and education for siblings, other children's access to equipment in the unit, and the use of resources in an underprivileged population. Sometimes lack of resources, usually ventilators, forced them to make decisions about which babies should get the chance to live. Other reported dilemmas included difficulties co‐operating with uneducated and poor parents.Conclusion: While Western doctors seem to focus on the rights and problems of the individual child, Indian doctors tend to refer to consequences for other children, for parents and society. There is a need for further research in this field, and for the development of guidelines on how to cope with differences in resources, and how to handle different patient groups’ cultural and religious concerns. (shrink)

Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wandering the Magnetosphere*Ingrid Koenig (bio)Navigation notes: These emergent drawings–excerpts from a visual essay–take up the complex network of impacts across physical forces entangled with bio-geo-political time. A key element for this work is a living cosmography to depict movement across time, and to visualize wandering on a planet, in the magnetosphere, and between the internal energy of Earth and the solar energy of the cosmos. Physicists say there (...) are no things, there are only relations between things.Q: Hello ancient stone - may I unfold you like a book? Do you carry a message from deep time? A: Yes, what you’re holding is not a thing, but a process. Click for larger view View full resolutionDrawing from Svalbard, Day 17 expedition, 2019[End Page 97]Drifting on a rocky planet, between the internal energy of Earth and the solar energy of the cosmos–we live within a “cosmo-tectonic circulation” —Jerome Gaillardet, geo-chemist. Click for larger view View full resolutionGeocosmic Logic[End Page 98] Click for larger view View full resolutionHow Entropy is Time (detail) Click for larger view View full resolutionMagnetic Story[End Page 99] Click for larger view View full resolutionMessage From Deep Time 3 Click for larger view View full resolutionMessage From Deep Time 1[End Page 100] Click for larger view View full resolutionLooping Matters 1 (Litli-Hrutur, Iceland) Click for larger view View full resolutionLooping Matters 2[End Page 101] Click for larger view View full resolutionMother Rock Waves (Miradalir Valley, Iceland) Click for larger view View full resolutionMother Rock in Time[End Page 102] Click for larger view View full resolutionVolcanic Logic (Miradalir Valley, Iceland) Click for larger view View full resolutionSonic Lava (Miradalir Valley, Iceland)[End Page 103] Click for larger view View full resolutionWaves Across Time (Miradalir Valley, Iceland) Click for larger view View full resolutionDisorientations[End Page 104] Click for larger view View full resolutionMessage From Deep Time 2 Click for larger view View full resolutionGravitational Thought[End Page 105] Click for larger view View full resolutionMagnetic Thought (Miradalir Valley, Iceland) Click for larger view View full resolutionDistance Ladder Collapse[End Page 106] Click for larger view View full resolutionMattering Logic 3 Click for larger view View full resolutionMattering Logic 4[End Page 107] Click for larger view View full resolutionHow We Make Time into Space Click for larger view View full resolutionHow Entropy is Time (detail 2–Svalbard)[End Page 108]Ingrid Koenig Ingrid Koenig is Associate Professor at Emily Carr University of Art + Design, Vancouver, Canada. She was the inaugural Artist in Residence (2011 to 2021) at TRIUMF, Canada’s particle accelerator center, and co-organizes processes of collaboration between artists and physicists in a project called Leaning Out of Windows. Her studio and research practices traverse the fields of physics, social history, feminist theory, and narratives of science. Her drawings explore the complex phenomena of physics and involve intuitive responses to specific sites through fieldwork in Canada’s Rocky Mountains, Germany, Iceland, Arctic Circle art + science expeditions, and through collaborations with physicists. She has received grants from the Canada Council for the Arts, the Goethe Institute, and the Social Science and Humanities Research Council. She co-edited the recently published book, Leaning Out of Windows: An Art and Physics Collaboration (Figure 1 Publishing, 2023).Footnotes* Excerpts from Wandering the Magnetosphere–drawings by Ingrid Koenig, 2019 to 2023, and ongoingCopyright © 2023 Johns Hopkins University Press and SubStance, Inc... (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

here has been a large number of studies in neurological sciences on how human brain works, especially in reading and parallel information processing. So I think this statement is really sweeping. Perhaps it is better to knowledge the abilities of human brains and to comment on the limitations of the human brain. The book “Adapt” by Tim Hartford advocates micro-step changes. An important aspect in this area is to understand the processes involved behind the scenes so that it gives us (...) a better formulation of the creativity algorithms involved. I will try to put in some pointers on the depths to which higher level intelligence has been simulated by AI in the past years. Some of the higher level intelligence mechanisms such as creativity, dreams and logical thinking have been implemented in machines in certain ways. However, they are still not implemented in the way humans do the same. The exact mechanism in which these intelligence mechanisms are used by human brains is still way ahead of that done by computers. However, we now look at other aspects in them as well as other functions which might be explored in the years ahead in AI. (shrink)

Jaina-Onomasticon. By Johannes Klatt. Edited by Peter Flügel and Kornelius Krümpelmann. Jaina Studies, vol. 1. Wiesbaden: Otto Harrassowitz, 2017. Pp. 1012. €178.

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (shrink)

Are global poverty and inequality on the rise or are they declining? And is the quality of life of the world's poorest people getting worse or better? These questions are often given conflicting answers by economists, the World Bank, and social activists. One reason for this is that assessments of quality of life can be made in terms of people's income, their resources, or their functionings and capabilities. This essay discusses the pros and cons of these evaluative approaches, and it (...) argues that all approaches have complementary strengths and should therefore in principle all be considered. Moreover, being aware that assessments of poverty and inequality can be made using these different frameworks helps us to understand the conflicting claims. (shrink)

Against the background of high demand for protein-rich feed in the EU and the environmental degradation associated with intensive livestock farming, insect-based feed is discussed as a potential sustainable alternative to conventional feed. However, the establishment of such an innovation depends not only upon technical and economic feasibility, but also on social factors impacting acceptability. The aim of this paper was to determine the acceptability of different social actor groups towards the use of insects as livestock feed, and to gain (...) insights into value-based arguments leading to positive or negative attitudes and perceived benefits and risks. By means of qualitative content analysis, we analysed responses of an EU public consultation process linked to the authorization of insect protein in pig and poultry feed. We found a broad range of value-based arguments that influence the complex judgement process of acceptability that have been neglected in prior quantitative surveys. In particular, our results bring forward more critical voices, such as animal welfare concerns and scepticism that insect-based feed can contribute to a more sustainable livestock system. Based on these findings, we discuss whether insects as feed are a viable contribution to a sustainability-oriented transformation of the agri-food system. We conclude that under certain conditions (when raised on low-value organic side streams such as manure) insect-based livestock feed may contribute to incremental sustainability improvements. Overall, however, the innovation has limitations, not only in terms of regulatory conditions but especially with regard to ethical concerns. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

From the co-founder and president of PETA, Ingrid Newkirk, and bestselling author Gene Stone comes Animalkind, a book that offers both a tour of the wonderful world of animals and a guide to simple ways in which we can reduce the harm we cause them in our everyday lives.

With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)

A IMPORTÂNCIA DE TRATAMENTO DE ÁGUAS RESIDUAIS ATRAVÉS DA BIORREMEDIAÇÃO: UMA ANÁLISE PRINCIPIOLÓGICA.

In the philosophy of well-being, there is hardly anything written on the lives of people with autism or on the question whether existing philosophical theories of well-being are suited for understanding how well the lives of autistic persons are going. This paper tries to make some progress towards filling this gap. I start by giving a concise account of autism, which highlights the huge heterogeneity among autistics. I discuss some basic features of autism, ask whether there are good reasons why (...) we would need an account of well-being specifically for autistics and what philosophical well-being research could learn from being informed by autistic experiences and phenomenology. I then investigate to what extent the capability approach gives us a helpful theory of well-being for autistics, and what looking through an autism-lens can contribute to the further development of the capabilitarian well-being. In particular, I show that some capabilities that are crucially relevant for autistics are also relevant for the lives of non-autistic people. The final part of the paper looks at an important difficulty in using the capabilitarian account of well-being for autistics, namely: should the normative focus be on achievements (functionings) or real opportunities (capabilities)? (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used and the (...) responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)

Now in its seventh edition, Ingrid Rima's classic textbook charts the development of the discipline from the classical age of Plato and Aristotle, through the middle ages to the first flowering of economics as a distinct discipline - the age of Petty, Quesnay and Smith - to the era of classical economics and the marginalist revolution. The book then goes on to offer extensive coverage of the twentieth century - the rise of Keynesianism, econometrics, the Chicago School and the (...) neoclassical paradigm. The concluding chapters analyze the birth of late twentieth century developments such as game theory, experimental economics and competing schools of economic thought. This text includes a number of practical features: a "family tree" at the beginning of each section, illustrating how the different developments within economics are interlinked the inclusion of readings from the original key texts a summary and questions to discuss, along with glossaries and suggestions for further reading This book provides the clearest, most readable guide to economic thought that exists and encourages students to examine the relevance of the discipline's history to contemporary theory. (shrink)

Social-emotional competences are critical for positive development and significantly predict educational and occupational attainment, health, and well-being. There is however a lack of consensus about the number of core competences, and how these are defined and operationalized. This divergence in approach challenges future research as well as the scientific usefulness of the construct. In an effort to create an integrative framework, this focused review evaluates different approaches of conceptualizing and assessing social-emotional competences. Building on shared conceptions, an integrative taxonomy “DOMASEC” (...) is introduced, specifying core domains and manifestations of social-emotional competences that bridge across frameworks focusing on social and emotional learning, personality traits and self-determination theory. Core domains include intrapersonal, interpersonal and task-oriented competencies, differentiating between affective, cognitive, and behavioral manifestations of competences across these domains. It is argued that the integrative taxonomy facilitates the conceptual specification of key constructs, that it helps to better organize the multitude of terms and definitions used, and to guide the conceptualization and operationalization of social-emotional competences and their various facets. (shrink)

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

People with dementia have previously not been active participants in research, with ethical difficulties often being cited as the reason for this. A wider inclusion of people with dementia in research raises several ethical and methodological challenges. This article adds to the emerging debate by reflecting on the ethical and methodological issues raised during an interview study involving people with dementia and their spouses. The study sought to explore the impact of living with dementia. We argue that there is support (...) for the inclusion of people with dementia in research and that the benefits of participation usually far outweigh the risks, particularly when a `safe context' has been created. The role of gatekeepers as potentially responsible for excluding people with dementia needs further consideration, with particular reference to the appropriateness of viewing consent as a primarily cognitive, universalistic and exclusionary event as opposed to a more particularistic, inclusive and context relevant process. (shrink)

La universidad adecuó la formación profesional hacia la virtualidad, adaptando con ello la teoría y la practica de las distintas materias, en ese nuevo contexto el objetivo de este estudio fue desarrollar un juego de simulación de selección de talento humano y describir la experiencia de juego en pandemia. Con un enfoque metodológico cuantitativo, diseño descriptivo no experimental transeccional, aplicado a estudiantes del VIII ciclo del curso de Gestión de Recursos Humanos. Se concluye que el juego simulado es una herramienta (...) que facilita el aprendizaje de forma virtual, asimismo contribuye con el aprendizaje del tema propuesto, de una forma organizada, dinámica y divertida. (shrink)