BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

Cognitive Science, Volume 46, Issue 2, February 2022.

Sustainability has become a major goal of domestic and international development. This essay analyzes the transitions of normative ideas embedded in the notion of sustainability by reviewing the discourses in the representative reports and literature from different periods. Three sets of ideas are proposed: inter- and intra-generational equity, stability of public systems, and a sense of solidarity, which confirms the scope of community and functions as a precondition for the previous two ideas. This essay uses the case of a health (...) system in a hypothetical country to illustrate that, besides securing financial sustainability, a genuinely sustainable public system must also meet the three normative ideas of sustainability. This essay also finds that these three ideas may create intrinsic tensions within the prevalent policy-making model—democracy. The pursuit of sustainability is not only the responsibility of a democratic government, but also a shared moral obligation of the body politic. (shrink)

Under the influence of concerns about sustainability, health system reforms have targeted institutional designs and have overlooked the role of socio-political factors like solidarity—a concept that is generally assumed to underpin the redistributive health system. The purpose of this research is to investigate users’ perceptions of the National Health Insurance as a system, their senses of solidarity and their views on the sustainability of the system in Taiwan. Using the descriptive ethics approach, qualitative in-depth interviews were conducted with typical case (...) sampling of 17 participants in the Taipei Metropolitan. The framework approach was used to analyze the interview transcripts. The research finds that despite great differences between users’ perceptions of the NHI, most users could share a notion of mutual relationship among each other. Three types of reasons are used to justify the obligations of mutual aid imposed by the NHI. These reasons are embedded within divergent conceptions of solidarity. The research also finds that government’s performance, the stability of decision-making and users’ personal experiences engaging with the system are important conditions for the users’ supportive attitude toward the system. Solidarity is a plausible concept in sustaining a non-Western social health insurance such as Taiwan’s NHI. (shrink)

Publicly-funded health systems, including those national health services and social or National Health Insurances, are institutionalized solidarity in health. In Europe, solidarity originated from the legacies of labor movements, the Judeo-Christian traditions, and nationalist sentiments in the re-construction Era after the WWII. In middle-to-high income East Asian countries, such as Japan, Taiwan, Korea, the health systems were built on different grounds and do not have such ethical origins of solidarity. As health systems in Europe and East Asia are both facing (...) sustainability crises due to aging population, stagnant economy, changing boundaries, and advancing medical technologies, how those systems with the European solidaristic ethical traditions can be revived and how those without the European traditions could survive become a matter of theoretical interests and an urgent policy problem to be addressed. Drawing on contemporary theories of solidarity, this essay analyzes the boundary problem and its impact on the sustainability of the health system in Taiwan. It then considers two plausible origins of solidarity in Taiwan. One is the re-emerged civic nationalism, and the other is an ethos of common life. It is argued that after years of implementation, the National Health Insurance in Taiwan might have shaped the social values and people’s habits and formed an ethos of common life. Such ethos could be an ethical origin of solidarity in non-western societies and help the health systems endure the prolonged sustainability crises. (shrink)

As the assumptions of perpetual economic and population growth no longer stand, the welfare systems built on such promises are in peril. Policymakers must reallocate the responsibility for providing care between generations. Democratic theories can help establish procedures for finding solutions, particularly in ageing democratic countries. By analysing existing representative and deliberative democratic theories, this paper explores how the interests of future generations could be included in such procedures. A hypothetical social health insurance scheme with the pay-as-you-go financial arrangement is (...) selected as an illustrative case. This paper argues that due to the intrinsic bias towards the current generation, both representative and deliberative democratic health policymaking are limited in making decisions that account for future generations. Instead, their interests could be at best represented by benevolent representatives. (shrink)

Unwanted children are carried, born, and reluctantly raised each year; they are prone to abortion, abandonment, neglect, and abuse. Meanwhile, many developed societies are suffering from depopulation. To address these two issues concurrently, I propose that governments should grant pregnant women and mothers an irreversible and unconditional one-time chance to relinquish all their legal rights and obligations associated with each of their children under a specific age to a National Rearing Institute that adopts the children and rears them to the (...) age when they can fully exercise their rights as adult citizens. I call this set of policy arrangements “Project New Republicans.” This project aims to (1) protect and support the best interests of unwanted children, (2) maximize the health outcomes of the mothers who gave birth to these children and help the mothers to achieve self-realization, and (3) preserve an influx to the population from procreation against depopulation. The project is primarily grounded on both the utilitarian and intra- / inter-generational accounts of justice. It also ameliorates the oppression and domination of women by unjust social structures in alignment with the human rights-based approach. (shrink)

Solidarity is presumed to underpin the redistributive health and welfare systems in modern democracies; however, it is often considered a Western—or more specifically, European—concept. While health and welfare systems have been transplanted successfully to many non-Western developed countries, whether the solidarity necessary for such systems exists or is intellectually available remains under debate. Using an East Asian country with the Confucian tradition as an illustrative case, I first argue that the Confucian tradition has special theoretical and sociological importance for health (...) and welfare solidarity. Then, through investigating the classic Confucian writings, I propose transformed interpretations of the essential concepts of Confucian thought, namely filial piety, benevolent governance and the mandate of heaven. With these interpretations, the differentiated family-based solidarity and the people-rooted thought in Confucianism could be reimagined to fit with the modern liberal-democratic political regime and welfare arrangements. I call this model Confucian welfarism, which I argue could form the intellectual origins of solidarity for people who believe in or have an affinity to Confucian ethos. (shrink)

Population policy has taken two divergent trajectories. In the developing part of the world, controlling population growth has been a major tune of the debate more than a half-century ago. In the more developed part of the world, an inverse pattern results in the discussion over the facilitation of population growth. The ethical debates on population policy have primarily focused on the former and ignored the latter. This paper proposes a more comprehensive account that justifies states’ population policy interventions. We (...) first consider the reasons that support pro-natalist policies to enhance fertility rates and argue that these policies are ethically problematic. We then establish an ethics of population policy grounded on account of self-sustaining the body politic, which consists of four criteria: survival, replacement, accountability, and solidarity. We discuss the implications of this account regarding birth-control and pro-natalist policies, as well as non-procreative policies such as immigration, adoption, and unintended baby-saving strategies. (shrink)

The workers’ compensation system in Taiwan cannot provide sufficient coverage for all workers. This essay adopts a solidaristic approach to address this issue by analyzing the reasons why workers’ compensation is underdeveloped in Taiwan and what could be done to persuade more key actors to support the reform for a more just policy arrangement. First, through comparison with the healthcare system, it is argued that the lack of solidarity and the perception of relevant similarities could explain the underdevelopment of workers’ (...) compensation. Second, the essay turns to the normative aspect of the issue. Compared with other normative political theories, Iris M. Young’s social connection model provides specific normative guidance that is useful for justifying the allocation of responsibility for a more just workers’ compensation reform. (shrink)

Among measures tackling the impacts of the COVID‐19 pandemic, the selling of private insurance policies covering individual infection is overlooked by the ethics literature. To record the “COVID Claimania” in Taiwan and to assess its ethical implications, we collected 38 policies from 10 insurers sold between January 2020 and May 2022 and found that their risk calculation of the COVID‐19 prevalence ranged from 0.5% to 11.08%. In reality, the prevalence by the end of 2022 was 37% in Taiwan. Selling private (...) insurance policies is ethically problematic in three ways. First, it represents the insurance industry's irresponsible risk‐taking profit‐seeking behaviors. Second, it would jeopardize the effectiveness of the disease‐prevention measures by inducing uncontrollable moral hazards. Third, it would expose the insurance companies to unbearable financial risks and cause substantial negative external impacts. The government should intervene in the private insurance market in preparation for future public health emergencies. (shrink)

The published version of this article one reference was originally given with an incorrect author name. This has now been corrected online.

Compared with data that is initially collected for research purposes, the mandatory authorization of a government database for secondary use deserves greater scrutiny because it consists of information that is collected initially for administrative purposes. Using the case of Taiwan’s National Health Insurance (NHI) Database as an example, this paper analyzes the ethical issues that emerge when the research participants are “participated” in studies without their consent, according to the current policy. The proponents of secondary use for research purposes maintain (...) that the authorized use of the NHI Database is necessary for public interests, while the opponents argue that the potential lack of democratic accountability and the infringement on people’s rights to privacy and information autonomy is unwarranted. Drawing on the solidarity‐based approach, this paper proposes a temporal solution as a possible reform direction for better ethical justification of the secondary use of the NHI Database. (shrink)

Through users’ cross-system comparative experience engaging with the health systems in Taiwan and other countries, this article probes into their understandings and value judgments and specifically their reasonings for the ‘solidarity with whom?’ question in the health sector solidarity. With the cross-system comparison approach, the study adopted semi-structured interviews with 30 Taiwanese participants who have studied, lived or worked abroad and engaged with the health system in Canada, the USA or the UK. This approach offers the opportunity for one to (...) evaluate the health system in the home country from a relative viewpoint from the host country. The participants suggested that the boundary of Taiwan’s National Health Insurance (NHI) should be as inclusive as possible, covering all legal residents in Taiwan regardless of their status, and that the citizens should share more financial responsibility. The ethical reasons for supporting the NHI include recognizing health sector solidarity among people, considering the coverage as a protection of the human right to health, humanitarian reasons and self-interest. Three archetypes of users emerged from the synthesis: Universalists, Rationalists and Republicans. The cross-system comparative experience makes the participants have more supportive attitudes toward the ideals of health sector solidarity. (shrink)

To understand the impact of social, financial, cultural capitals, negative culture, and socioeconomic status of families on educational aspiration in the senior high school student athletes, it will be beneficial to promote their career developments. The purpose of this study is to explore the influence of ethnicity, year of sport experience family income, the educational expectations of significant others, and the three aforementioned types of capital on educational aspiration among the senior high school student athletes. This study was conducted with (...) a sample of 262 U-18 male baseball student athletes. Of the participants, 20.20% had attained the qualifications to play on the national team. The results showed that monthly family income positively affected social capital and positively indirectly affected educational aspirations through social capital, whereas monthly family income negatively affected negative culture and positively affected educational aspirations through negative culture. Moreover, social capital positively affected educational aspirations compared with negative culture negatively affected educational aspirations. The results serve as a reference for the formulation of educational policy as it relates to student athletes. (shrink)

A two-part survey was conducted, where respondents reported ethically challenging incidents encountered in the previous two years and actions taken to address them. 132 certified counseling psychologists participated and reported 136 ethical dilemmas. The top categories of dilemmas pertained to breaking confidentiality between respondents and clients, including mandatory reporting, collaborating with education associates, and interjecting by the authority. 82% of the respondents took actions to address the dilemmas. These actions ranged from steering a middle course, upholding professional ethical standards, seeking (...) consultation to taking no actions. Potential environmental contributors to the dilemmas and actions taken to address them were explored. (shrink)

This study aims to investigate the moderating effect of the board chair's role on the relationship between board human capital and firm performance. Board human capital has been regarded as a valuable asset that enhances firm performance. Especially, the board chair plays a crucial role in developing this high-echelon human capital. This study utilises a set of longitudinal data to examine 275 firms in Taiwan. The result indicates that board human capital is positively related to firm performance, and the individual (...) human capital of the board chair represents a moderating effect on the relationship between board human capital and performance. (shrink)

With the increase in depth of coal mining, the hydrogeological complexity largely increases and water inrush accidents happen more frequently. For the safety of coal mining, horizontal directional drilling and grouting techniques have been implemented to detect and plug the fractures and conduits that deliver high-pressure groundwater to coal mine. Taking the grouting engineering performed at Xingdong coal mine at 980 m below sea level as an example, we collected the data of grouting quantity, the loss of drilling fluid, gamma (...) value, water temperature, average water absorption, distance between grouting loss points, water pressure on coal seam floor, and aquifuge thickness at 90 boreholes in the mine to conduct grey relational analysis, first. The analysis showed that the grouting quantity was highly correlated with all other factors. Subsequently, grey system evaluation was used to evaluate the risk of water inrush from the coal seam floor. The results of risk analysis illustrated that three water inrushes from Ordovician limestone occurred in mining face 2127, 2125, and 2222 in the study area were all located in the area with a risk score higher than 65. Through grouting, the identified cracks were effectively blocked and waterproof layers beneath the coal seam floors were constructed to reduce the threat of water inrush. By comparing the risk assessment results with three water inrush cases before grouting operation, we found that water inrush areas were consistent with the area of higher risk. (shrink)

I lay out the framework for my theory of sensory imagination in “Imagining as a guide to possibility.” Sensory imagining involves mental imagery , and crucially, in describing the content of imagining, I distinguish between qualitative content and assigned content. Qualitative content derives from the mental image itself; for visual imaginings, it is what is “pictured.” For example, visually imagine the Philadelphia Eagles defeating the Pittsburgh Steelers to win their first Super Bowl. You picture the greenness of the field and (...) the football’s brown oblong shape. Some of what you imagine isn’t explicitly pictured, however. That it is Sunday, that it is the Super Bowl: these facts are assigned. (shrink)