BackgroundDecisions about limitations of life sustaining treatments are made for end-of-life patients in intensive care units. The aim of this research was to explore the professional and ethical attitudes and experiences of medical professionals on treatment of end-of-life patients in ICUs in the Republic of Croatia.MethodsA cross-sectional study was conducted among physicians and nurses working in surgical, medical, neurological, and multidisciplinary ICUs in the total of 9 hospitals throughout Croatia using a questionnaire with closed and open type questions. Exploratory factor (...) analysis was conducted to reduce data to a smaller set of summary variables. Mann–Whitney U test was used to analyse the differences between two groups and Kruskal–Wallis tests were used to analyse the differences between more than two groups.ResultsLess than third of participants stated they were included in the decision-making process, and physicians are much more included than nurses. Sixty two percent of participants stated that the decision-making process took place between physicians. Eighteen percent of participants stated that ‘do-not-attempt cardiopulmonary resuscitations’ orders were frequently made in their ICUs. A decision to withdraw inotropes and antibiotics was frequently made as stated by 22.4% and 19.9% of participants, respectively. Withholding/withdrawing of LST were ethically acceptable to 64.2% of participants. Thirty seven percent of participants thought there was a significant difference between withholding and withdrawing LST from an ethical standpoint. Seventy-nine percent of participants stated that a verbal or written decision made by a capable patient should be respected. Physicians were more inclined to respect patient’s wishes then nurses with high school education. Nurses were more included in the decision-making process in neurological than in surgical, medical, or multidisciplinary ICUs. Male participants in comparison to female, and physicians in comparison to nurses with high school and college education displayed more liberal attitudes about LST limitation.ConclusionsDNACPR orders are not commonly made in Croatian ICUs, even though limitations of LST were found ethically acceptable by most of the participants. Attitudes of paternalistic and conservative nature were expected considering Croatia’s geographical location in Southern Europe. (shrink)

Recent research has suggested that both the Honesty-Humility dimension, psychopathic traits and cheating attitudes are important predictors of academic dishonesty. The present study examined: a) the incremental role of triarchic psychopathic traits in academic cheating over the Honesty-Humility dimension; b) the incremental role of cheating attitudes over personality; c) the mediating role of cheating attitudes in the relationship between different psychopathic components and academic cheating. Two-hundred-and-ninty-seven students (59% female, 23 years on average) completed several questionnaires: the Triarchic Psychopathy Measure (TriPM), (...) The HEXACO-PI-R Honesty-Humility scale, Attitudes Toward Cheating Scale, and the Academic Cheating Behaviours Scale. As expected, triarchic psychopathy added incremental variance in explaining academic cheating, after controlling for Honesty-Humility. Cheating attitudes explained additional 24% after controlling for personality traits. Meanness lead to more lenient attitudes toward cheating, which lead to more academic cheating behaviours. On the other hand, the effects of boldness and disinhibition were not mediated by attitudes towards cheating. Overall, the results suggest that the psychopathic traits display the effects on the academic cheating via several different mechanisms. The findings have both important theoretical and practical implications. (shrink)

Developing countries need to reform legislation to ensure the global supply firms in ready-made garment industry is adequately addressing obligations of social responsibility. Literature typically focuses on strategies for raising responsible standards in global buying firms within the RMG industry, but fails to focus on implementing strategies for suppliers in developing countries. This article addresses this gap by specifically focusing on the RMG industry in Bangladesh, the home of the third largest RMG supplier in the world. It concentrates on analysing (...) how and to what extent the law can assist in developing social responsibility performance of the RMG manufacturing firms in developing countries. It ultimately concludes that a new governance approach in laws can effectively increase the social responsibility practice standards of an industry where global buying firms are profit-driven and governmental agencies are either inadequate or corrupt. (shrink)

Noir -- House -- Train -- Dead -- Ipseity -- Habeas corpus.

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...) aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

The semantic of the terms “sustainable development” and “corporate social responsibility” have changed over time to a point where these concepts have become two interrelated processes for ensuring the far‐reaching development of society. Their convergence has given dimension to the environmental and corporate regulation mechanisms in strong economies. This article deals with the question of how the ethos of this convergence could be incorporated into the self‐regulation of businesses in weak economies where nonlegal drivers are either inadequate or inefficient. It (...) proposes that the policies for this incorporation should be based on the precepts of meta‐regulation that have the potential to hold force majeure, economic incentives, and assistance‐related strategies to reach an objective from the perspective of weak economies. (shrink)

BackgroundThere is a lack of empirical research regarding the outcomes of such clinical ethics support methods as moral case deliberation. Empirical research in how healthcare professionals perceive potential outcomes is needed in order to evaluate the value and effectiveness of ethics support; and help to design future outcomes research. The aim was to use the European Moral Case Deliberation Outcome Instrument instrument to examine the importance of various MCD outcomes, according to healthcare professionals, prior to participation.MethodsA North European field survey (...) among healthcare professionals drawn from 73 workplaces in a variety of healthcare settings in the Netherlands, Norway and Sweden. The Euro-MCD instrument was used.ResultsAll outcomes regarding the domains of moral reflexivity, moral attitude, emotional support, collaboration, impact at organisational level and concrete results, were perceived as very or quite important by 76%–97% of the 703 respondents. Outcomes regarding collaboration and concrete results were perceived as most important. Outcomes assessed as least important were mostly about moral attitude. ‘Better interactions with patient/family’ emerged as a new domain from the qualitative analysis. Dutch respondents perceived most of the outcomes as significantly less important than the Scandinavians, especially regarding emotional support. Furthermore, men, those who were younger, and physician-respondents scored most of the outcomes as statistically significantly less important compared with the other respondents.ConclusionsThe findings indicate a need for a broad instrument such as the Euro-MCD. Outcomes related to better interactions between professionals and patients must also be included in the future. The empirical findings raise the normative question of whether outcomes that were perceived as less important, such as moral reflexivity and moral attitude outcomes, should still be included. In the future, a combination of empirical findings and normative reflection will contribute to the revision of the instrument. (shrink)

Much work on intellectual humility has focused on its epistemic benefits. We suggest that displaying (or failing to display) intellectual humility also has effects on how others perceive us and that, as a result, intellectual humility can serve reputation management purposes, in at least four ways: (i) Intellectual humility can be used to signal we are a good source of information; (ii) Intellectual humility can be used to signal we are competent through countersignaling; (iii) Intellectual humility can be used to (...) make sure others do not believe we are overclaiming superiority; (iv) lack of intellectual humility (or intellectual arrogance) can be used to signal dominance. The evidence suggests that intellectual humility (or lack thereof) can have each of these effects. Seeing intellectual humility as (inter alia) a reputation management tool predicts that people will be more or less likely to display intellectual humility in some contexts. For instance, people in a position of power might stand to lose less if they fail to be intellectual humble; accordingly, evidence suggests that they tend to display less intellectual humility. In conclusion, we speculate that understanding intellectual humility as reputation management could help construct environments more conducive to displays of intellectual humility. (shrink)

This paper provides frameworks for understanding how ethics might be expressed in gameplay situations, and how we can study the ethical frameworks that games offer to players. There are many ways to delve into such topics, and this paper considers only a few approaches. It briefly surveys some of the important ques-tions and critiques arising from audience studies, theories of play and games, and work on cheating, and begins to build a framework for considering ethics in relation to games and (...) players that transcends the “place apart” that games are often constructed as. (shrink)

The notion of harm has been a recurring and a significant notion in the characterization of mental disorder. It is present in eminent diagnostic manuals such as DSM and ICD, as well as in the discussion on mental disorders in philosophy of psychiatry. Recent demotion of harm in the definition of mental disorders in DSM-5 shows a general trend towards reducing the significance of harm when thinking about the nature of mental disorders. In this paper, we defend the relevance of (...) the notion of harm in the characterization of mental disorder against some of these attacks. We approach this issue by using the method of conceptual explication pioneered by Rudolf Carnap. Within this framework, we argue that keeping the notion of harm not only helps to discriminate what is pathological from the nonpathological but also prevents potential misuses of psychiatric authority. (shrink)

Even though Corporate Social Responsibility (CSR) has become a widely accepted concept promoted by different stakeholders, business corporations' internal strategies, known as corporate self-regulation in most of the weak economies, respond poorly to this responsibility. Major laws relating to corporate regulation and responsibilities of these economies do not possess adequate ongoing influence to insist on corporate self-regulation to create a socially responsible corporate culture. This book describes how the laws relating to CSR could contribute to the inclusion of CSR principles (...) at the core of the corporate self-regulation of these economies in general, without being intrusive in normal business practice. It formulates a meta-regulation approach to law, particularly by converging patterns of private ordering and state control in contemporary corporate law from the perspective of a weak economy. It proposes that this approach is suitable for alleviating regulators' limited access to information and expertise, inherent limitations of prescriptive rules, ensuring corporate commitment, and enhance the self-regulatory capacity of companies. This book describes various meta-regulation strategies for laws to link social values to economic incentives and disincentives, and to indirectly influence companies to incorporate CSR principles at the core of their self-regulation strategies. It investigates this phenomenon using Bangladesh as a case study. (shrink)

The convergence of corporate social responsibility (CSR) and corporate governance (CG) has changed the corporate accountability mechanism. This has developed a socially responsible ‘corporate self-regulation’, a synthesis of governance and responsibility in the companies of strong economies. However, unlike in the strong economies, this convergence has not been visible in the companies of weak economies, where the civil society groups are unorganised, regulatory agencies are either ineffective or corrupt and the media and non-governmental organisations do not mirror the corporate conscience. (...) Using the case of Bangladesh, this article investigates the convergence between CSR and CG in the self-regulation of companies in a less vigilant environment. (shrink)

Based on a case study of a large multinational group, this paper addresses the way in which social and environmental reporting systems were changed and the consequences and controversies associated with this change. Drawing on Power’s work on the processes by which things are made auditable via underlying systems, we focus on how and why a specific programme with auditability as its ultimate aim changed the basis on which the external social and environmental report was prepared. Our analysis demonstrates that (...) the perceived alignment with the financial report preparation and the explicit pursuit of auditability legitimized SER and paved the way for data systems to be changed. The programme borrowed authority from financial accounting technologies not only to make a system change but also to push SER internally, as we suggest that an intraorganizational group used the programme to ensure the existence and organizational status of SER. However, we also illustrate some of the practical challenges associated with this change, which include issues related to internal control and the establishment of organizational boundaries. (shrink)

It is often claimed that there is an explanatory divide between an expressivist account of normative discourse and a realist conception of normativity: more precisely, that expressivism and realism offer conflicting explanations of (i) the metaphysical structure of the normative realm, (ii) the connection between normative judgment and motivation, (iii) our normative beliefs and any convergence thereof, or (iv) the content of normative thoughts and claims. In this paper I argue that there need be no such explanatory conflict. Given a (...) minimalist approach to the relevant metaphysical and semantic notions, expressivism is compatible with any explanation that would be acceptable as a general criterion for realism. (shrink)

How can we distinguish between quasi-realist expressivism and normative realism? The most promising answer to this question is the “explanation” explanation proposed by Dreier (2004), Simpson (2018), and others: the two views might agree in their claims about truth and objectivity, or even in their attributions of semantic content to normative sentences, but they disagree about how to explain normative meaning. Realists explain meaning by invoking normative facts and properties, or representational relations between normative language and the world, the thought (...) goes, while expressivists appeal instead to desire-like mental states in their explanations of meaning. However, I argue that, if we adopt a deflationary approach to representation and other related notions, there need be no such explanatory divide between expressivism and anything recognizable as a plausible notion of normative realism. Any alleged explanatory criterion for realism will either be incompatible with deflationism, or it will fail to capture some standard versions of normative realism. I conclude that, in a deflationary framework, expressivism is compatible with genuine realism. (shrink)

Despite societal concerns about the welfare of commercial laying hens, little attention has been paid to the welfare implications of the choices made by the genetics companies involved with their breeding. These choices regarding trait selection and other aspects of breeding significantly affect living conditions for the more than 7 billion laying hens in the world. However, these companies must consider a number of different commercial and societal interests, beyond animal welfare concerns. In this article we map some of the (...) relevant dilemmas faced by genetics companies in order to outline the scope of opportunities to improve welfare under current market conditions. This includes identifying cases where different animal welfare concerns conflict. We discuss the moral responsibility of laying hen genetics companies and the welfare implications that derive from the choices they make and the policies they follow. In addition to evaluating a selection of predominant current practices and breeding goals, we outline different angles from where to assess the moral legitimacy of various industry practices and policies. We discuss specific issues such as injurious pecking, bone health, induced moulting, chick culling and the circumstances of breeding stock. (shrink)

We all could have had better lives, yet often do not wish that our lives had gone differently, especially when we contemplate alternatives that vastly diverge from our actual life course. What, if anything, accounts for such conservative retrospective attitudes? I argue that the right answer involves the significance of our personal attachments and our biographical identity. I also examine other options, such as the absence of self-to-self connections across possible worlds and a general conservatism about value.

BackgroundBesides balancing burdens and benefits of intensive care, ethical conflicts in the process of decision-making should also be recognised. This calls for an ethical analysis relevant to clinicians. The aim was to analyse ethically difficult situations in the process of deciding whether a patient is admitted to intensive care unit.MethodsAnalysis using the ‘Dilemma method’ and ‘wide reflective equilibrium’, on ethnographic data of 45 patient cases and 96 stakeholder interviews in six UK hospitals.Ethical analysisFour moral questions and associated value conflicts were (...) identified. Who should have the right to decide whether a patient needs to be reviewed? Conflicting perspectives on safety/security. Does the benefit to the patient of getting the decision right justify the cost to the patient of a delay in making the decision? Preventing longer-term suffering and understanding patient’s values conflicted with preventing short-term suffering and provision of security. To what extent should the intensivist gain others’ input? Professional independence versus a holistic approach to decision-making. Should the intensivist have an ongoing duty of care to patients not admitted to ICU? Short-term versus longer-term duty to protect patient safety. Safety and security were key values at stake in the ethical conflicts identified. The life-threatening nature of the situation meant that the principle of autonomy was overshadowed by the duty to protect patients from harm. The need to fairly balance obligations to the referred patient and to other patients was also recognised.ConclusionProactive decision-making including advance care planning and escalation of treatment decisions may support the inclusion of patient autonomy. However, our analysis invites binary choices, which may not sufficiently reflect reality. This calls for a complementary relational ethics analysis. (shrink)

Suppose that there are objective normative facts and our beliefs about such facts are by-and-large true. How did this come to happen? This is the reliability challenge to normative realism. As has been recently noted, the challenge also applies to expressivist “quasi-realism”. I argue that expressivism is useful in the face of this challenge, in a way that has not been yet properly articulated. In dealing with epistemological issues, quasi-realists typically invoke the desire-like nature of normative judgments. However, this is (...) not enough to prevent the reliability challenge from arising, given that quasi-realists also hold that normative judgments are truth-apt beliefs. To defuse this challenge, we need to isolate a deeper sense in which normative thought is not representational. I propose that we rely on the negative functional thesis of expressivism: normative thought does not have the function of tracking normative facts, or any other kind of facts. This thesis supports an argument to the effect that it is misguided to expect an explanation of our access to normative facts akin to the explanations available in regions of thought that have a tracking function. We should be content with explanations of our reliability that take for granted certain connections between our psychology and the normative truths. (shrink)

The aim of this study was to evaluate agreement between nurses’ and physicians’ opinions regarding aggressiveness of treatment and to investigate and compare the rationales on which their opinions were based. Structured interviews regarding 714 patients were performed on seven general wards of a university hospital. The data gathered were then subjected to qualitative and quantitative analyses. There was 86% agreement between nurses’ and physicians’ opinions regarding full or limited treatment when the answers given as ‘uncertain’ were excluded. Agreement was (...) less (77%) for patients with a life expectancy of less than one year. Disagreements were not associated with professional status because the physicians considered limiting life-sustaining treatment as often as the nurses. A broad spectrum of rationales was given but the results focus mostly on those for full treatment. The nurses and the physicians had similar bases for their opinions. For the majority of the patients, medical rationales were used, but age and quality of life were also expressed as important determinants. When considering full treatment, nurses used quality-of-life rationales for significantly more patients than the physicians. Respect for patients’ wishes had a minor influence. (shrink)

Cognitive models of social anxiety disorder suggest that memory biases for negative social information contribute to symptoms of social anxiety. However, it remains unclear whether memory bias...

Normative naturalism holds that normative properties are identical with, or reducible to, natural properties. Various challenges to naturalism focus on whether it can make good on the idea that normative concepts can be used in systematically different ways and yet have the same reference in all contexts of use. In response to such challenges, some naturalists have proposed that questions about the reference of normative terms should be understood, at least in part, as normative questions that can be settled through (...) normative inquiry. In this paper I have two goals. First, I argue that these naturalist proposals do not yet allow for radical disagreement on normative matters, or at least do not explain how such disagreement is possible. Secondly, I argue that, in order to account for radical disagreement, naturalists should not only treat normative reference as a normative issue but also adopt a non-representationalist account of normative concepts, on which such concepts are individuated through their practical role. I illustrate this point by showing how a view that combines naturalism and expressivism about normative discourse can vindicate the elasticity of normative concepts, their referential stability, and the objectivity of normative truths. (shrink)

The following scenario seems possible: a community uses concepts that play the same role in guiding actions and shaping social life as our normative concepts, and yet refer to something else. As Eklund argues, this apparent possibility poses a problem for any normative realist who aspires to vindicate the thought that reality itself favors our ways of valuing and acting. How can realists make good on this idea, given that anything they might say in support of the privileged status of (...) our normative concepts can be mirrored by the imagined community? E.g., the realist might claim that using our concepts is what we ought to do if we are to describe normative facts correctly, but members of the other community can claim the same about their concepts, using their own concept of ought. A promising approach to this challenge is to try to rule out the possibility of alternative normative concepts, by arguing that any concepts that have the same normative role must share a reference as well. In this paper I argue that normative quasi-naturalism, a view that combines expressivism about normative discourse with a naturalist metaphysics of normativity, supports referential normativity and solves the problem of alternative normative concepts. (shrink)

It has been argued that there is something morally objectionable about moral realism: for instance, according to realism, we are justified in believing that genocide is wrong only if a certain moral fact obtains, but it is objectionable to hold our moral commitments hostage to metaphysics in this way. In this paper, I argue that no version of this moral argument against realism is likely to succeed. More precisely, minimal realism―the kind of realism on which realist theses are understood as (...) internal to moral discourse―is immune to this challenge, contrary to what some proponents of the moral argument have suggested, while robust non-naturalist realists might have good answers to all versions of the argument as well, at least if they adopt a certain stance on how to form metaphysical beliefs in the moral domain. (shrink)

Mandalas in the Making: The Visual Culture of Esoteric Buddhism at Dunhuang, by Michelle C. Wang. Leiden: Brill, 2018. xviii + 318 pages. Hb. $147.00, ISBN-13: 9789004357655; Ebook $25.00, ISBN-13: 9789004360402.

Motivated by the increasing economic significance of investment advisory industries and the prevalence of wrongdoing in financial planning services, we examine whether, and to what extent, employee misconduct is shaped by their local corruption culture. Using novel data of more than 4.7 million adviser-year observations of financial advisers and the Department of Justice’s data on corruption, we find that financial advisers and advisory firms located in areas with higher levels of corruption are more likely to commit misconduct. These results hold (...) for both individual advisor and firm level analyses and are robust to the use of various fixed effects, model specifications, proxies for corruption and misconduct, and an instrumental variable approach. Using the passage of the Dodd-Frank Whistleblower Provision, which provides incentives for reporting corruption incidences and thereby reduces the incentives for fraud, we find that the relation between local corruption culture and adviser misconduct is attenuated after the provision enacted by the SEC. Overall, our study highlights the externalities of corruption culture on individual ethics and the essential role of whistleblowing laws in reducing corruption-prone norms. (shrink)

This paper, through a discussion of the IRA's proxy bomb campaigns, challenges the way martyrdom is and has been constructed and forces us to examine terrorist events without preconceived notions. It is important to note that when we witness an event that on the surface appears to be an instance of martyrdom, the reality might be far more complex. Part of the problem has been the current inductive logic associated with the study of terrorism in which attacks are a given (...) and experts will engage in a psychological autopsy to trace perpetrators' intentions and motives after the fact. If they are religious, we assume that this act was one of self-sacrifice for a religious cause. However, this is not always the case. We argue that we need to question the intent of the action rather than assume that the event is automatically an act of martyrdom. While attacks in Kabul or Baghdad may appear as deliberate jihadi operations by the Taliban or by Al Qaeda in Iraq, our investigation has determined that a portion of such attacks are the product of coercion and not martyrdom in the traditional sense although observers may understand them to be martyrdom operations. (shrink)

In inclusive dance settings, where people with different abilities and talents come together, the role of facilitators is essential in guiding the process of inclusion. Their behavior gives sensitive information to the individual about one’s status within the own-group affiliation. Even today, very little research on the motivation for facilitating inclusivity in dance contexts exists. This case study will examine the facilitator’s motivation by juxtaposing current theory next to experiences of seven experts of contemporary dance facilitation in Europe. Good opportunities (...) for meaningful interactions can be created in a dance setting: it promotes a deeper sense of community, gives us the feeling of belonging, generates respect and inclusion, and helps to prevent the feeling of loneliness. This research report sheds light on the motivation of being the facilitator of dance for heterogeneous groups and reveals three factors from the data. First, to be led by an artistic motivation, second, to have a vision in terms of changing the society, and third, to have another personal motivation. The motivation of the facilitator is regarded as highly important for inclusive work, as the person who facilitates plays a key role in these successful processes of inclusion. (shrink)

In June 1928, Captain Barnett W. Harris, an amateur naturalist from Indiana, arrived in Zululand to experiment on wild animals with his invention – the mercy bullet. This “bullet”consisted of a hypodermic needle filled with anesthetic drugs that could render an animal unconscious – an early model of what is now known as the tranquilizer gun. The history of this gun typically begins with Colin Murdoch, a New Zealand pharmacist and veterinarian, who patented the invention in 1959. While largely absent (...) in the archives, through tracing popular science publications and press, this article exposes a longer history of animal tranquilizers from an unlikely source. Tracing Harris’s story allows this article to speak to different historical discourses that influenced his rise as a celebrated inventor, and later to his disappearance from the scientific arena. This article argues that debates about pain relief (for both humans and nonhuman animals) and developments in military technology at the turn of the twentieth century resulted in experiments with narcotic bullets, a precursor to this “mercy bullet moment.” While hailed across the press as the man who might transform animal capturing into a humane practice, the workings of Harris’s bullet remained ambiguous. Despite this, he promoted his invention through several lecture series and radio presentations to the American public in the 1930s, where elements of scientific showmanship can be observed. Overall, Harris’s omission from the history of animal tranquilizing demonstrates the multiple contingencies that define a moment of scientific “success” – or, in this case, push some into relative obscurity. (shrink)