BackgroundMost medical schools in Japan have incorporated mandatory courses on medical ethics. To this date, however, there is no established means of evaluating medical ethics education in Japan. This study looks 1) To develop a brief, objective method of evaluation for moral sensitivity and reasoning; 2) To conduct a test battery for the PIT and the DIT on medical students who are either currently in school or who have recently graduated (residents); 3) To investigate changes in moral sensitivity and reasoning (...) between school years among medical students and residents.MethodsQuestionnaire survey: Two questionnaires were employed, the Problem Identification Test (PIT) for evaluation of moral sensitivity and a portion of the Defining Issues Test (DIT) for moral reasoning. Subjects consisted of 559 medical school students and 272 residents who recently graduated from the same medical school located in an urban area of Japan.ResultsPIT results showed an increase in moral sensitivity in 4th and 5th year students followed by a decrease in 6th year students and in residents. No change in moral development stage was observed. However, DIT results described a gradual rising shift in moral decision-making concerning euthanasia between school years. No valid correlation was observed between PIT and DIT questionnaires.ConclusionThis study's questionnaire survey, which incorporates both PIT and DIT, could be used as a brief and objective means of evaluating medical students' moral sensitivity and reasoning in Japan. (shrink)
BackgroundIn Japan, discussion concerning advance directives has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan.MethodA self-administered questionnaire was sent via mail to a (...) stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan . Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution.ResultsOf the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will.ConclusionsWritten ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of leeway to surrogates and/or caregivers, and/or 2) to ensure his or her directives in the cases of terminal illness, brain death, and pain treatment, as well as regarding information disclosure. (shrink)
Background Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance (...) directives policy and practice. Methods We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor). Conclusion This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy. (shrink)
Background In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. Method A self-administered questionnaire was sent (...) via mail to a stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan (n = 165,567). Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution. Results Of the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will. Conclusions Written ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of leeway to surrogates and/or caregivers, and/or 2) to ensure his or her directives in the cases of terminal illness, brain death, and pain treatment, as well as regarding information disclosure. (shrink)
SETTING: Medical ethics education has become common, and the integrated ethics curriculum has been recommended in Western countries. It should be questioned whether there is one, universal method of teaching ethics applicable worldwide to medical schools, especially those in non-Western developing countries. OBJECTIVE: To characterise the medical ethics curricula at Asian medical schools. DESIGN: Mailed survey of 206 medical schools in China, Hong Kong, Taiwan, Korea, Mongolia, Philippines, Thailand, Malaysia, Singapore, Indonesia, Sri Lanka, Australia and New Zealand. PARTICIPANTS: A total (...) of 100 medical schools responded, a response rate of 49%, ranging from 23%-100% by country. MAIN OUTCOME MEASURES: The degree of integration of the ethics programme into the formal medical curriculum was measured by lecture time; whether compulsory or elective; whether separate courses or unit of other courses; number of courses; schedule; total length, and diversity of teachers' specialties. RESULTS: A total of 89 medical schools (89%) reported offering some courses in which ethical topics were taught. Separate medical ethics courses were mostly offered in all countries, and the structure of vertical integration was divided into four patterns. Most deans reported that physicians' obligations and patients' rights were the most important topics for their students. However, the evaluation was diverse for more concrete topics. CONCLUSION: Offering formal medical ethics education is a widespread feature of medical curricula throughout the study area. However, the kinds of programmes, especially with regard to integration into clinical teaching, were greatly diverse. (shrink)
Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate (...) samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. (shrink)
Public satisfaction with policy process influences the legitimacy and acceptance of policies, and conditions the future political process, especially when contending ethical value judgments are involved. On the other hand, public involvement is required if effective policy is to be developed and accepted.
Wu Jiang was born in November 1917, in Zhuji county, Zhejiang Province. He began work in the theoretical field in the 1950s, and has worked at People's University, Red Flag, the Central Party School, and the Central Academy of Socialism . He has published the following works: Issues on the Reform of the Capitalist Economy in China, On the Proletarian Dictatorship, Collected Works on Historical Dialectics, Ten Lectures on Epistemology, Twenty Lectures on Philosophical Issues, Several Issues Relating to Contemporary Socialism, (...) and Origins and Development of the Theory of the Initial Stage of Socialism, and others. (shrink)
BackgroundThis study aimed to ask a sample of the general population about their preferences regarding doctors holding discretionary powers in relation to disclosing cancer diagnosis and prognosis.MethodsThe researchers mailed 443 questionnaires to registered voters in a ward of Tokyo which had a socio-demographic profile similar to greater Tokyo's average and received 246 responses . We describe and analysed respondents' attitudes toward doctors and family members holding discretionary powers in relation to cancer diagnoses disclose.ResultsAmongst respondents who wanted full disclosure about the (...) diagnosis without delay, 117 respondents agreed to follow the doctor's discretion, whilst 111 respondents agreed to follow the family member's decision. For respondents who preferred to have the diagnosis and prognosis withheld, 59 agreed to follow the doctor's decision, and 79 of respondents agreed with following family member's wishes.ConclusionsThe greater proportion of respondents wants or permits disclosure of cancer diagnosis and prognosis. In patients who reveal negative attitudes toward being given a cancer disclosure directly, alternative options exist such as telling the family ahead of the patient or having a discussion of the cancer diagnosis with the patient together with the family. It is recommended that health professionals become more aware about the need to provide patients with their cancer diagnosis and prognosis in a variety of ways. (shrink)
In 1997, after long social debates, the Japanese government enacted a law on organ transplantation from brain-dead bodies. Since 1993, on gene therapy, administrative agencies have issued a series of guidelines. This study seeks to elucidate when people became aware of the issues and when they formed their opinions on organ transplant and gene therapy. At the same time, it aims to examine at which point in time experts, those in university ethical committees and in academic societies, consider these technologies (...) became accepted among the public. A self-administered questionnaire was sent by mail to a stratified random sampling of 3000 people nationwide in Japan. Another questionnaire was sent both to the member societies of the Japanese Association of Medical Sciences and to the ethical committees of all the medical schools in Japan. Results of the surveys indicated that many of the public remained undecided on the desirability of organ transplant or gene therapy at the time of enactment of official guidelines. A substantial part of them formed their opinions in subsequent periods, especially around the time of first implementation and thereafter. Experts of the academic societies and of the university ethical committees regarded the time of implementation as an important factor in the acceptance of the technologies in society. Since many people formed their opinion during the period of technological implementation, communications efforts to facilitate public understanding of science and technology, as well as to advance practical discussion on policy alternatives in this period can play a key role in determining the fate of technological innovation and ethical debates in medicine. (shrink)
As denominadas filosofias do _hen kai pan_tiveram um papel determinante no pensamento alemão do século XVIII e XIX, em boa parte devido ao tratamento que lhes foi dado por F. H. Jacobi em _Sobre a doutrina de Espinosa em cartas ao senhor Moses Mendelssohn _. Espinosa e Giordano Bruno são os grandes representantes desse modo de pensar, e suas filosofias inauguram uma nova articulação entre causa e razão, mundo e Deus. Jacobi identifica em ambos o modelo da máxima coerência intelectual (...) que uma filosofia pode alcançar, um monismo imanente cuja consistência lógica não pode ser combatida no interior do sistema com as armas da metafísica pura. Por outro lado, é no princípio indeterminado, comum a essas doutrinas, que Jacobi verá a confirmação de uma danosa tendência da história da filosofia que culmina no idealismo de Fichte e na filosofia do jovem Schelling, isto é, na união entre natureza naturada e naturante no eu. (shrink)
Metaphilosophy is itself philosophy about philosophy. It is not something before or independent of philosophy. Both Kai Nielsen and Richard Rorty are deeply concerned (someone might say obsessively preoccupied) with metaphilosophy. They both are thoroughly historicist and contextualist resolutely rejecting any form of a transcendental or metaphysical turn. They argue against claims to absolute validity (as well as against absolutism in any form) and a natural order of reasons: some 'Reason' to which any rational agent must be committed. They both (...) see philosophy as a transitional genre first (historically speaking) from religion then metaphysics and more latterly from scientistic conceptions of the world. But they differ about what philosophy is transitional to. For Rorty it is historical narrative and utopian proposals; for Nielsen it is critical theory. Rorty claims this, Nielsen's intentions to the contrary notwithstanding, commits him to enlightenment rationalism. Nielsen replies that his form of critical theory is deeply historicist and contextual without being resolutely atheoretical. This plays out in political orientation to Nielsen's being a socialist while Rorty is a social democrat. (shrink)
I thought the paper by Kai-yee Wong and Chris Fraser was fascinating and insightful. Two things I especially appreciated are the clarity with which they summarize my views. I think they are quite fair and accurate. Second, I appreciate their suggestion that the way to deal with the practical problem of weakness of will has much to do with the role of the Background in shaping our actions. I think they are especially on the right track when they say that (...) the improvement of Background skills may actually narrow the range of real options for action, (p. 21) nonetheless, they do not decrease freedom. As they say, “It is a process of strengthening the self, and the agent is likely to experience the concomitant restriction of ‘live’ options not as a limitation but as strength of character.” (p. 21). That seems to me very much on the right track. What they are suggesting, and it is a powerful addition to my own writings, is that we should not just think of the Background as facilitating languages, games and social practices generally, but for morality as well (p. 23). (shrink)
This festschrift includes a dozen essays on issues that have been at the focus of Kai Nielsen's research, mainly issues in ethics and political philosophy. Among these are four essays on socialism and Marxism. There are also essays on philosophy of religion, epistemology, and meta-philosophy.
This meticulously constructed book is as hard to review as would be a comparably cerebral science fiction novel the plot and characters of which have few ties to its readers' lived world. Yet it is intended to apply straightforwardly to the world in which we live and move and fight our wars. For philosopher Kai Draper seeks no less lofty a goal than to lay out the standards whereby to determine what harm done to innocents in a war is ethical (...) and what harm done to them in war is not ethical. (shrink)
Playing an irreplaceable role for the whole speedy development in East Asia, Hong Kong is an example of a multicultural cosmopolitan urban centre in the Pacific Rim with strong ties with the Atlantic. However, with regards to mainland China, Hong Kong has always held a marginal position, carrying multiple marginal labels. In recent years, Hong Kong has been struggling to move beyond its Chinese/Western identities, simultaneously searching its own native insular self. This is shown in the way contemporary intellectuals approach (...) Hong Kong’s memory. As an example, this paper looks at Dung Kai-cheung’s novel Atlas: The Archaeology of an Imaginary City. Although Rey Chow describes the Hong Kong situation as namely, “the struggle between the dominant and the subdominant within the native culture itself”, I would like to argue that Dung Kai-Cheung does not engage in the sort of radical anti-colonial, nationalist discourse that could be read through the lens of The Empire Writes Back. Rather, he seeks a new form of anti-colonial discourse which advances a reconciliatory cosmopolitan vision of multicultural coexistence in a marginocentric city. (shrink)
- uneducated in the field authors who defend a consensus they are being TOLD when they enter offices of Ed-Sci, teaching and writing works on learning-theory - but never checked the facts, PART I and PART II.
In my Contemporary Critiques of Religion and in my Scepticism , I argue that non-anthropomorphic conceptions of God do not make sense. By this I mean that we do not have sound grounds for believing that the central truth-claims of Christianity are genuine truth-claims and that we do not have a religiously viable concept of God. I argue that this is so principally because of three interrelated features about God-talk. While purporting to be factual assertions, central bits of God-talk, e.g. (...) ‘God exists’ and ‘God loves man-kind’, are not even in principle verifiable in such a way that we can say what experienceable states of affairs would count for these putative assertions and against their denials, such that we could say what it would be like to have evidence which would make either their assertion or their denial more or less probably true. Personal predicates, e.g. ‘loves’, ‘creates’, are at least seemingly essential in the use of God-talk, yet they suffer from such an attenuation of meaning in their employment in religious linguistic environments that it at least appears to be the case that we have in such environments unwittingly emptied these predicates of all intelligible meaning so that we do not understand what we are asserting or denying when we utter ‘God loves mankind’ or ‘God created the heavens and the earth’ and the like. When we make well-formed assertions, it appears at least to be the case that a necessary condition for such wellformedness is that we should be able successfully to identify the subject of that putative statement so that we can understand what it is that we are talking about and thus understand that a genuine statement has actually been made. But, where God is conceived non-anthropomorphically, we have no even tolerably clear idea about how God, an infinite individual, occupying no particular place or existing at no particular time, and being utterly transcendent to the world, can be identified. Indeed we have no coherent idea of what it would be like to identify him and this means we have no coherent idea of what it would be like for God even to be a person or an it. He cannot be picked out and identified in the way persons and things can. (shrink)
Wang, Kai 王楷, Naturalistic Human Nature and Cultivation of the Self: The Spirit of Xunzi’s Virtue Philosophy 天然與修為—荀子道德哲學的精神. Beijing 北京: Peking University Press, 2011, 206 pages Content Type Journal Article Pages 115-118 DOI 10.1007/s11712-011-9252-z Authors Elizabeth Woo Li, Department of Philosophy, Peking University, Beijing, China Journal Dao Online ISSN 1569-7274 Print ISSN 1540-3009 Journal Volume Volume 11 Journal Issue Volume 11, Number 1.
This paper points out some of the weaknesses of the traditional account of the Homeric phrase androteta kai hében and suggests instead that the entire phrase is a relatively recent creation of the tradition on the model of an *an(b)roteta kai hében. This phrase in turn has a clear Avestan cognate hauruuatata ameretata.
Kai Nielsen is one of Canada’s most distinguished political philosophers. In a career spanning over 40 years, he has published more than 400 papers in political philosophy, ethics, meta-philosophy, and philosophy of religion. He has engaged much of the best work in Anglophone political philosophy, shedding light on many of the central debates and controversies of our time but throughout has remained a unique voice on the political left. _ Pessimism of the Intellect _presents a thoughtful collection of Nielsen’s essays (...) complemented by an extended reflective interview with Nielsen. This collection allows the reader to grasp the systematic scope of his thought and methodology. (shrink)
In attempting to address the heideggerian Seinsfrage, by way of situating it between the platonic conception of ̉όν in the Sophist and of χώρα in the Timaeus, this paper investigates the ontological possibilities that are opened up in terms of rethinking space. Asserting the intrinsic connection between the question of being and that of space, we argue that the maturation of ontology as phenomenology would not unfold in its furthermost potential unless the being of space gets clarified. This state of (...) affairs confronts us with the exacting ontological task to found a theory of space that contributes to an explication of the question of being beyond its associated temporocentric determinations. Consequently, our line of inquiry endeavors herein to constitute a prologmenon to the elucidation of the question of the being of space as “ontokhorology.”. (shrink)
The article first gives an exegesis of the famous passage in the "Republic", 505d11-506a2. Attention is drawn to the fact that the principle that every soul does everything for the Good can be translated in two ways: Every soul does everything for the sake of the Good, or goes to all lengths for the sake of the Good. Depending on the different translations, we have a different picture of the platonic Socrates in the Republic, an intellectualistic Socrates for whom irrational (...) desires do not exist, or a Socrates who also accepts irrational desires. The article favours the first one. Then it attempts to show that we can elucidate some dark points in the Socratic thesis that the Good is what every soul pursues and for which every soul does everything, with the help of Aquinas’s distinction between it actio hominis and actio humana. Finally, the article outlines three substantive answers to the question “What is the Good?” – the henological, the perfectionist and the structuralist. Instead of advancing a new answer, the article suggests an uncontroversial formal starting point for an answer to this question. (shrink)