Bioethics has made remarkable progress as a scholarly and applied field. A mere fledgling in the 1960s, it is now firmly established in hospitals, medical schools, and government agencies and boasts a number of professional associations and a handsome collection of journals.

In this paper I focus on a major aspect of the later Wittgenstein’s investigation of thinking – his discussion of the idea of thinking as a process or an activity. I shall show that Wittgenstein’s remarks, apart from some concerning the methodology and conception of philosophy, are grammatical remarks, meaning that they describe the use of the word “thinking” and can be agreed to by every competent speaker. I thus show that Wittgenstein’s investigation of thinking is a grammatical one, and (...) hence that there is no inconsistency between his conception of philosophy and his philosophical practice. In the process of doing so, I shall also review previous studies on this topic and point out their deficiencies. (shrink)

Originating in a 1983 Mexican Government Program, the term ‘food sovereignty’ was coined in 1996 by La Via Campesina—a global peasant network—to address concerns within the civil society for food security. Rather than to accept the neoliberal framework of mainstream food security definition and governance, the food sovereignty movement seeks to view food security as the right of peoples to define their own food and agriculture systems with limited corporation intervention. As a result, food production should be geared toward the (...) domestic and local markets and not toward international trade that only benefits corporations. This food sovereignty movement was inducted into China in 2013 just as China’s agricultural systems were shifting toward a more corporate-centric structure that increasingly exploits the small-scale farmers. A question was hence raised: How have the global civil society networks influenced the Chinese civil society and promoted China’s local food sovereignty movement? Through the world society theory, the author has identified social forums, such as international conferences and social media channels, as an expedient means for interactions. However, as the Chinese government continues to develop a corporate-centric food security governance system and tighten its civil society space, the impacts of China’s food sovereignty movement remain unclear. (shrink)

Los objetivos del presente estudio son evaluar la aceptabilidad de los estudiantes del modelo de portafolio electrónico de casos clínicos virtuales, lineales e integradores y su percepción sobre la metodología de aula invertida y aprendizaje en equipo modificado.El modelo de enseñanza mixta del portafolio electrónico, aula invertida y del aprendizaje en equipo modificado para estudiantes de pregrado permitió mejorar la satisfacción de los estudiantes al promover el aprendizaje activo y reflexivo. Los alumnos encontraron el modelo útil para una variedad de (...) propósitos en su educación de ciencias clínicas en el periodo de brote pandémico COVID-19. (shrink)

Nanotechnology shows great promise in a variety of applications with attractive economic and societal benefits. However, societal issues associated with nanotechnology are still a concern to the general public. While numerous technological advancements in nanotechnology have been achieved over the past decade, research into the broader societal issues of nanotechnology is still in its early phases. Based on the data from the Web of Science database, we applied the main path analysis, cluster analysis and text mining tools to explore the (...) main research fronts and hierarchical structure of these societal issues. We found that the research studies fell into four categories: "General Toxicity and EHS (Environment, Health and Safety)," "Medicine and Cytotoxicity," "Assessment and Regulation," and "Environment and Ecotoxicity." These research studies have disclosed much information about the potential effect of nanotechnology on public health and the environment. Relatively speaking, the studies on the assessment, regulation, preventive solutions, and environmental protection are just emerging. This finding indicates that an abundance of effort should be conducted on these emerging themes to maximize the benefits of nanotechnology while minimizing its potential harm. The implications for various parties in this domain are also presented. (shrink)

We applaud Ray and Cooper (2024) for emphasizing environmental health as a bioethics issue. As a team of interdisciplinary pediatric researchers and providers who are part of an institutional clima...

A cross-sectional study to ascertain what the Singapore population would regard as material risk in the anaesthesia consent-taking process and identify demographic factors that predict patient preferences in medical decision-making to tailor a more patient-centered informed consent. A survey was performed involving patients 21 years old and above who attended the pre-operative evaluation clinic over a 1-month period in Singapore General Hospital. Questionnaires were administered to assess patients’ perception of material risks, by trained interviewers. Patients’ demographics were obtained. Mann–Whitney U (...) test and Kruskal-Wallis one-way analysis of variance was used. Statistical significance was taken at p < 0.05. Four hundred fourteen patients were eligible of which 26 refused to participate and 24 were excluded due to language barrier. 364 patients were recruited. A higher level of education, being employed and younger age group are factors identified in patients who wanted greater participation in medical decisions. Gender, marital status, type of surgery, and previous surgical history did not affect their level of participation. The complications most patients knew about were Nausea, Drowsiness and Surgical Wound Pain. Patients ranked Heart Attack, Death and Stroke as the most significant risks that they wanted to be informed about in greater detail. Most patients wanted to make a joint decision with the anaesthetist, instead of letting the doctor decide or deciding for themselves. Discussion with the anaesthetist is the preferred medium of communication compared to reading a pamphlet or watching a video. Age and educational level can influence medical decision-making. Despite the digital age, most patients still prefer a clinic consult instead of audio-visual multimedia for pre-operative anaesthetic counselling. The local population appears to place greater importance on rare but serious complications compared to common complications. This illustrates the need to contextualize information provided during informed consent to strengthen the doctor-patient relationship. (shrink)

In this chapter, we argue that Du Châtelet’s account of motion is an important contribution to the history of the absolute versus relative motion debate. The arguments we lay out have two main strands. First, we clarify Du Châtelet’s threefold taxonomy of motion, using Musschenbroek as a useful Newtonian foil and showing that the terminological affinity between the two is only apparent. Then, we assess Du Châtelet’s account in light of the conceptual, epistemological, and ontological challenges posed by Newton to (...) any relational theory of motion. What we find is that, although Du Châtelet does not meet all the challenges to their full extent, her account of motion is adequate for the goal of the Principia: determining the true motions in our planetary system. (shrink)

El presente artículo busca proponer un acercamiento a la influencia del pensamiento de Thomas Hobbes y su obra en el pensamiento económico. En especial en las escuelas marxista, neoclásica y keynesiana. El influjo de su pensamiento puede evidenciarse en el abordaje metodológico, antropológico e institucional. Se ofrece una Mirada sobre la sociedad civil (comercial), el Mercado y el Estado al mismo tiempo. Hobbes ha sido la inspiración de un concepto de Estado monolítico en lo político, en este sentido, la mirada (...) de la economía bajo el concepto de un gran planificador centralizado, tiene importantes antecedentes en este autor. El ejercicio del control social del individuo como propuesta institucional, en varias escuelas de la economía comparten con Hobbes, varios antecedentes que merecen ser analizados. (shrink)

There are numerous occasions on which we need to reason about a finite number of events. And we often need to consider only those events which are given or which we perceive. These give rise to the Criteria of Finiteness and Closedness. Allen's logic provides a way of reasoning about events. In this paper I examine Allen and Hayes' axiomatisation of this logic, and develop two other axiomatisations based on the work by Russell and Thomason. I shall show that these (...) three axiomatisations are weakly equivalent, and that only the last two meet the Criteria of Finiteness and Closedness (to different degrees). I shall then examine two ways of constructing instants of time in a finite and closed world, i.e. the Russell construction and the Thomason construction. I shall prove that these two constructions are equivalent under certain conditions. (shrink)

ABSTRACTWittgenstein’s remark that one cannot follow a rule only once has generated two puzzles: how can everyone accept it to be true? and why does Wittgenstein advance it? These two puzzles have tormented commentators for decades. In this paper I put forward a new interpretation and explain away the two puzzles. I shall show that Wittgenstein’s remark is plain truth and that his motivation behind making it is to dissolve the picture theory of meaning propounded in the Tractatus. This interpretation (...) also helps us to see that Wittgenstein’s other remark, that to follow a rule is a custom, is also a grammatical one. (shrink)

In this paper, I first review previous interpretations of Wittgenstein's remarks on private language, revealing their inadequacies, and then present my own interpretation. Basing mainly on Wittgenstein's notes for lectures on private sensations, I establish the following points: ‘remembering the connection right’ means ‘reidentifying sensation-types’; the reason for ‘no criterion of correctness’ is that nothing, especially no inner mechanisms nor external devices, can be utilised by the private speaker to tell whether some sensations are of one type or different types; (...) and private names are not really names, private language is not really a language, therefore, private language is a grammatical illusion. My interpretation has the advantage of being able to reconcile Wittgenstein's conception of philosophy, which is to dissolve philosophical problems by rearranging grammatical facts, with his actual philosophical practice, at least in the case of private language. (shrink)

In this paper, I first review previous interpretations of Wittgenstein's remarks on private language, revealing their inadequacies, and then present my own interpretation. Basing mainly on Wittgenstein's notes for lectures on private sensations, I establish the following points: ‘remembering the connection right’ means ‘reidentifying sensation-types’; the reason for ‘no criterion of correctness’ is that nothing, especially no inner mechanisms nor external devices, can be utilised by the private speaker to tell whether some sensations are of one type or different types; (...) and private names are not really names, private language is not really a language, therefore, private language is a grammatical illusion. My interpretation has the advantage of being able to reconcile Wittgenstein's conception of philosophy, which is to dissolve philosophical problems by rearranging grammatical facts, with his actual philosophical practice, at least in the case of private language. (shrink)

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

In trying to make clear whether understanding is a mental state Wittgenstein asks a series of questions about the timing and duration of understanding. These questions are awkward, and they have posed a great challenge for commentators. In this paper I review the interpretations by Mole and by Baker and Hacker, and point out their problems. I then offer a new interpretation which shows (1) that a “mental state” in this context means a state of consciousness, (2) that Wittgenstein's questions (...) are intended to elicit the grammars of the words “understand” and a “state of consciousness”, (3) that, in this way, he clearly shows that understanding is not a state of consciousness and (4) that he also provides a therapy to dissolve the problem. (shrink)

This article does not intend to actually valuate intangible assets but focuses to investigate the relative value distribution of corporate intangible assets, and this links closely to the concept and application of value drivers. This is because we believe that drivers or attributes of the value significantly determine how the virtual value of these intangibles can be created for companies. We apply the analytic hierarchy process (AHP) to the appraising process of intangible assets. The AHP method can mainly sort the (...) non-financial value drivers in order according to their weighted contributions. Therefore, the key purpose of this article is to develop a tentative model for the evaluation of intangible assets, which helps business to correctly appraise corporate value ratios and avoid bias due to mainly relying on financial statements when measuring an entity’s value. In addition, in view of the significant proportion of intangible assets over total assets in high-technology industries, this research, then, uses six industries in Hsinchu Science Park, Taiwan, as its research objects in order to test the applicability of its model, as well as exploring the value weights of intangible assets and its evaluation among different technology industries. Besides, the empirical result of this article is mainly to support business appraisal and thus improves the effectiveness of value-based management. (shrink)

Philosophical Investigations, EarlyView.

Originating in a 1983 Mexican Government Program, the term ‘food sovereignty’ was coined in 1996 by La Via Campesina—a global peasant network—to address concerns within the civil society for food security. Rather than to accept the neoliberal framework of mainstream food security definition and governance, the food sovereignty movement seeks to view food security as the right of peoples to define their own food and agriculture systems with limited corporation intervention. As a result, food production should be geared toward the (...) domestic and local markets and not toward international trade that only benefits corporations. This food sovereignty movement was inducted into China in 2013 just as China’s agricultural systems were shifting toward a more corporate-centric structure that increasingly exploits the small-scale farmers. A question was hence raised: How have the global civil society networks influenced the Chinese civil society and promoted China’s local food sovereignty movement? Through the world society theory, the author has identified social forums, such as international conferences and social media channels, as an expedient means for interactions. However, as the Chinese government continues to develop a corporate-centric food security governance system and tighten its civil society space, the impacts of China’s food sovereignty movement remain unclear. (shrink)

In this paper, I examine the grammatical nature of Wittgenstein's private language argument (PLA). On my interpretation, the definition of private language implies that the private speaker has no natural expressions for his sensations. This in turn implies that he has no criterion of correctness for using his sensation‐words. This then implies, together with the grammatical rule that a word is senseless without a criterion of correctness for its use, that private sensation‐words are senseless, and hence also that private language (...) is senseless. So in my analysis, Wittgenstein succeeds in dissolving the problem of private language through a grammatical investigation, and therefore, his treatment of private language is consistent with his metaphilosophy. I further explain that Wittgenstein provides a diagnosis of the error of the philosopher who thinks that private language is possible and that he also offers a therapy consisting of analogies or objects of comparison. I also make a comparison with previous studies on the PLA and discuss a number of novelties in my interpretation. (shrink)

There is a common-sense view of language, which is held by Wittgenstein, Strawson Dummett, Searle, Putnam, Lewis, Wiggins, and others. According to this view a language consists of conventions, it is rule-governed, rules are conventionalised, a language is learnt, there are general learning mechanisms in the brain, and so on. I shall call this view the ‘ ordinary language ’ view of language. Chomsky’s attitude towards this view of language has been rather negative, and his rejection of it is a (...) major motivation for the development of his own theory. In this paper I shall review Chomsky’s long-standing criticisms. I shall show that Chomsky’s argument does not constitute a dismissal of the ‘ordinarylanguage’ view of language, Chomsky’s conclusions about language do not follow from his argument, and the ‘ ordinary language ’ view actually points to a promising way for us to understand the true nature of language and mind. (shrink)

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)

BackgroundResearchers worry that patients in early-phase research experience unrealistic optimism about benefits and risks of participation. The standard measure of unrealistic optimism is the Comparative Risk/Benefit Assessment questionnaire, which asks people to estimate their chances of an outcome relative to others in similar situations. Such a comparative framework may not be a natural way for research participants to think about their chances.ObjectiveTo examine how people interpret questions measuring unrealistic optimism and how their interpretations are associated with their responses.MethodsUsing an early-phase (...) cancer trial vignette, we administered the CRBA to 297 adults from the general public. They estimated their comparative chances of risk and benefit, then provided rationales for their estimates.ResultsFor both CRBA benefit and risk questions, about 50% of respondents chose 0, and 50% chose a non-0 response. Respondents’ rationales for their estimates showed that overall only about 40%–44% gave comparative rationales, indicating that they interpreted the CRBA as intended. 68.7% of respondents who gave the ‘correct’ 0 rating gave comparative rationales, whereas only 11.6% of respondents who gave non-0 ratings did so. A similar trend was seen for chances of risk.ConclusionResearch participants may not understand comparative benefit and risk questions as intended; attributions of unrealistic optimism may require additional evidence that the respondents’ estimates are intended to be comparative. (shrink)

Over the past two decades, Victor and Cullen's (Adm Sci Q 33:101-125, 1988) typology of ethical climates has been employed by many academics in research on issues of ethical climates. However, little is known about how managerial practices such as communication and empowerment influence ethical climates, especially from a functional perspective. The current study used a survey of employees from Taiwan's top 100 patent-owning companies to examine how communication and empowerment affect organizational ethical climates. The results confirm the relationship between (...) these two managerial practices and organizational ethical climates. We discuss our results and their implications for both future academic research and practice. (shrink)

OBJECTIVE: To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients. DESIGN: Retrospective descriptive study. SETTING: A cancer clinical trials unit in a large teaching hospital. PATIENTS: From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied. MAIN MEASUREMENT: Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated. RESULTS: (...) DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge. CONCLUSIONS: DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom. (shrink)

Structured interviews were held with 149 registered nurses in seven countries in America, Asia, Australia and Europe concerning the feeding of severely demented patients who do not accept food. The most common reasons for nurses being willing to change their decision to feed or not to feed were an order from the medical head, a request from the patient's husband and/or the staff meeting. There was a connection between the willingness to feed and the ranking of ethical principles. Nurses who (...) were most prone to feed the patient most often gave a high rank to the ethical principle of sanctity of life, while those who primarily chose not to feed the patient gave a high rank to the ethical principle of autonomy. All nurses stressed the ethical principle of beneficence. Des interviews structurés ont eu lieu avec 149 infirmiers/ères dans sept pays en Amérique, Asie, Australie et Europe concernant l'alimentation des malades gravement dément qui refusent de manger. La raison la plus générale pour des infirmiers/ères d'être prêt à changer leures décisions de donner à manger ou non sont: un ordre du médecin, la demande du mari de la malade ou de la réunion du personnel. Il y avait un lien entre la volonté de nourir et le rang des principes éthiques. Les infirmiers/ères les plus enclins de nourir la malade le plus souvent donnaient un rang supérieur au principe éthique de la sainteté de vie, pendant que ceux et celles qui choisissaient de ne pas nourrir la malade donnaient un rang supérieur au principe éthique de l'autonomie. Tous insistaient sur l'importance du principe éthique de la bienfaisance. Konstruktive Interviews wurden mit 149 ausgebildeten Krankenschwestern und Pfleger in sieben Ländern in Amerika, Asien, Australien und Europa gehalten über die Ernährung von schwer von Dementia praecox leidenden Patienten, die das Essen verweigern. Die gewöhnlichsten Gründe des Pflegepersonals für die Bereitwilligkeit, ihre Entscheidung, zu ernähren oder nicht, zu ändern, waren Anordnungen vom medizinischen Chef, Anfragen vom Ehemann der Patientin und/oder einer Personalsitzung. Es bestand ein Zusammenhang zwischen der Bereitwilligkeit zur Ernährung und dem Rang der ethischen Prinzipien. Die Pflegenden, die sich am meisten neigten, die Patientin zu ernähren, gaben dem ethischen Prinzip der Heiligkeit des Lebens einen hohen Rang, während die, die meistens vorzogen, die Patientin nicht zu ernähren, gaben dem ethischen Prinzip der Autonomie einen hohen Rang. Alle Pflegenden legten grossen Wert auf das ethische Prinzip der Wohltätigkeit. (shrink)

It is necessary to educate citizens so that they consider themselves to be the subjects of rights and duties. In order to defend this thesis, all deficiencies present on the current concept of citizenship are hereby presented. Victoria Camps’ proposal about public virtues is outlined next, allowing the proposition of an understanding of the citizenship from an ethical and political sense. Finally, it is concluded that it is important to consider the education of citizens as an objective to reach in (...) the current society. Everything previously mentioned makes up a debate that must take place in order to determine the course of any society nowadays. (shrink)

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)

This paper seeks to show the proximity between the phenomenologicalreflection that Merleau-Ponty presents in the article “The War Has Taken Place”, and the stories of Jose Carlos Agüero, in his book, Los rendidos. From a phenomenological perspective, both authors describe the experience of pain, shame and forgiveness as the pursuit of freedom and justice. The text is divided into two parts. In the first part, we present discourses of justice which were established after the Peruvian armed conflict and the need (...) of exercising the phenomenological “epochè” in order to describe the feelings of terror and shame that underlie as background of this shared experience. In the second part, supported by Merleau Ponty’s concepts of intersubjectivity and historicity, we define freedom as the pursuit of justice, which can only be understood at the primordialaction of being in relation with others, from which we give meaning to the past. (shrink)