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)

We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formalsanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formalsanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formalsanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

ABSTRACT:We combine prior research on ethical decision-making in organizations with a rational choice theory of corporate crime from criminology to develop a model of corporate offending that is tested with a sample of U.S. managers. Despite demands for increased sanctioning of corporate offenders, we find that the threat of legal action does not directly affect the likelihood of misconduct. Managers’ evaluations of the ethics of the act, measured using a multidimensional ethics scale, have a significant effect, as do outcome expectancies (...) that result from being associated with the misconduct but not facing formal sanctions. The threat of formal sanctions appears to operate indirectly, influencing ethical evaluations and outcome expectancies. Obedience to authority also affects illegal intentions, with managers reporting higher prospective offending when they are ordered to engage in misconduct by a supervisor. (shrink)

This article argues that current data for the safety and efficacy of fecal microbiota transplants as a treatment for any indication, including recurrent Clostridioides difficile infection, is low-quality. It develops a governance proposal that encourages production of high-quality evidence by incentivizing well-designed RCTs of stool and stoolderived microbial products. The proposal would require that FDA change its current enforcement approach, but it would not require any change in statutes or regulations.

Исследование посвящено философскому осознанию природы духовности человека. Автор рассматривает духовность внутреннего мира человека как единство высших чувств души и нравственного сознания. Для специалистов в области философии, методологии науки.

Diagnosis theory reasons about incomplete knowledge and only considers the past. It distinguishes between violations and non-violations. Qualitative decision theory reasons about decision variables and considers the future. It distinguishes between fulfilled goals and unfulfilled goals. In this paper we formalize normative diagnoses and decisions in the special purpose formalism DIO2 as well as in extensions of the preference-based deontic logic PDL. The DIagnostic and DEcision-theoretic framework for DEontic reasoning DIO2 formalizes reasoning about violations and fulfillments, and is used to (...) characterize the distinction between normative diagnosis theory and decision theory. The extension of the preference-based deontic logic PDL shows how normative diagnostic and decision-theoretic reasoning — i.e. reasoning about violations and fulfillments — can be formalized as an extension of deontic reasoning. (shrink)

This paper provides a philosophical critique of professional stereotypes in medicine. In the course of this critique, we also offer a detailed analysis of the concept of care in health care. The paper first considers possible explanations for the traditional stereotype that caring is a province of nurses and women, while curing is an arena suited for physicians and men. It then dispels this stereotype and fine tunes the concept of care. A distinction between ‘caring for’ and ‘caring about’ is (...) made, and concomitant notions of parentalism are elaborated. Finally, the paper illustrates, through the use of cases, diverse models of caring. Our discussion reveals the complexity of care and the alternative modes of caring in health care. (shrink)

Is there a rational and ethical basis for efforts to rescue individuals in dire straits? When does rescue have ethical support, and when does it reflect an irrational impulse? This paper defines a Rule of Rescue and shows its intuitive appeal. It then proceeds to argue that this rule lacks support from standard principles of justice and from ethical principles more broadly, and should be rejected in many situations. I distinguish between agent-relative and agent-neutral reasons, and argue that the Rule (...) of Rescue qualifies only in a narrow range of cases where agent-relative considerations apply. I conclude that it would be wise to set aside the Rule of Rescue in many cases, especially those involving public policies, where it has only weak normative justification. The broader implications of this analysis are noted. (shrink)

The aim of this study was to reflect on the origins and meanings of names describing investment practices that integrate a consideration of environmental, social and corporate governance issues in the academic literature. A review of 190 academic papers spanning the period from 1975 to mid-2009 was conducted. This exploratory study evaluated the associations and disassociations of the primary name assigned to this genre of investment with variables grouped into five domains, namely Primary Ethical Position, Investment Strategy, Publication Date, Regions (...) Covered and Periodical Type. The study indicated that papers coded as expressing a deontological ethical position were more frequently associated with the name Ethical Investment , whereas those with an ambiguous ethical position were less frequently associated with Ethical Investment . Three investment strategies (positive screening, best-in-class and cause-based investing) were unusually associated with the primary name Responsible Investment . A strong preference for the name Ethical Investment was noted in the United Kingdom, and contrasted starkly with an apparent aversion for this name in the United States. The name Ethical Investment is significantly more frequently used in journals dealing with ethics, business ethics and philosophy than in finance, economic and investment journals. Finally, the study yielded some weak hints that the name Responsible Investment might perhaps be linked to an egoist ethical position. On the basis of this, and because these have already been substantively linked through the Principles for Responsible Investment in the popular discourse, we follow the heuristic tradition set by Sparkes (Business Ethics Eur Rev 10:194–201, 2001 ), and propose that Responsible Investment be defined as ‘Investment practices that integrate a consideration of ESG issues with the primary purpose of delivering higher-risk-adjusted financial returns’. (shrink)

Analyses The Problems Of Understanding Exegesis And Translation. Scrutinises Peculiariaties Of Grammar, Syntax, Diction, Style And Metaphor In Various Languages And Their Forms-Prose, Poetry, Drama Etc In India And Western Tradition-In English, German, French, Greek, Sanskrit And Pali Texts. Emphazises The Importance Of Classical Languages In Which Religion And Philosophical Works Have Been Written.

A caregiver from the dominant U.S. culture and a patient from a very different culture can resolve cross‐cultural disputes about treatment, not by compromising important values, but by focusing on the patient's goals.

Objectives: Hospital ethics committees increasingly affect medical care worldwide, yet there has been little evaluation of these bodies. Israel has the distinction of having ethics committees legally required by a Patients' Rights Act. We studied the development of ethics committees in this legal environment.Design: Cross-sectional national survey of general hospitals to identify all ethics committees and interview of ethics committee chairpersons.Setting: Israel five years after the passage of the Patients' Rights Act.Main measurements: Patients' rights and informal ethics committee structure and (...) function.Results: One-third of general hospitals have an ethics committee, with committees concentrated in larger facilities. Hospitals without committees tended to lack any structure to handle ethics issues. Committees tend to be interdisciplinary and gender-mixed but ethnic mix was poor. Confidentiality is the rule, however, legal liability is a concern. One-third of patients' rights ethics committees never convened and most committees had considered fewer than ten consults. Access to the consultation process and the consultation process itself varied substantially across committees. Some patients' rights ethics committees attempted to solve cases, others only rendered decisions. Informal committees often refused to consider cases within Patients' Rights Act jurisdiction.Conclusions: Despite statutory requirement, many Israeli patients and clinicians do not have access to ethics committees. The scant volume of cases shows serious discrepancies between practice and Patients' Rights Act regulations, suggesting the need for education or revision of the law. Heterogeneity in committee function demonstrates need for substantial improvement. (shrink)

Diagnosis theory reasons about incomplete knowledge and only considers the past. It distinguishes between violations and non-violations. Qualitative decision theory reasons about decision variables and considers the future. It distinguishes between fulfilled goals and unfulfilled goals. In this paper we formalize normative diagnoses and decisions in the special purpose formalism DIO(DE)2 as well as in extensions of the preference-based deontic logic PDL. The DIagnostic and DEcision-theoretic framework for DEontic reasoning DIO(DE)2 formalizes reasoning about violations and fulfillments, and is used to (...) characterize the distinction between normative diagnosis theory and (qualitative) decision theory. The extension of the preference-based deontic logic PDL shows how normative diagnostic and decision-theoretic reasoning — i.e. reasoning about violations and fulfillments — can be formalized as an extension of deontic reasoning. (shrink)

This paper proposes an ethical framework for rationing publicly financed health care. We begin by classifying alternative rationing criteria according to their ethical basis. We then examine the ethical arguments for four rationing criteria. These alternatives include rationing high technology services, non-basic services, services to patients who receive the least medical benefit, and services that are not equally available to all. We submit that a just health care system will not limit basic health care to persons unable to pay for (...) it. Furthermore, justice in health care requires limiting publicly-financed non-basic health care, striving for equality in access to basic health care, and relying on medical benefit to ration non-basic health care. (shrink)

Although psychologists study both the objective (behavior) and the subjective (phenomenology) components of cognition, we argue that an overemphasis on the subjective drives a wedge between psychology and other closely related scientific disciplines, such as comparative studies of cognition and artificial intelligence. This wedge is particularly apparent in contemporary studies of episodic recollection and future planning, two related abilities that many have assumed to be unique to humans. We shall challenge this doctrine. To do so, we shall adopt an ethological (...) approach to comparative cognition and this necessitates two requirements. The first is that memory and planning need to be characterized in terms of objectively defined properties as opposed to purely phenomenological ones; the ability to remember what happened, where, and how long ago is a critical behavioral criterion for episodic memory. The second requirement is the identification of an ethological context in which these memories would confer a selective advantage. As a consequence, we turn this debate into an empirical evaluation in nonlinguistic animals and one embodied in synthetic creatures. Indeed, our behavioral conception of flexibly deployable information about “what, where, and when” has so far supported a comparative cognition in animals as diverse as corvids and primates. We argue that this approach may clarify and challenge ideas that have been based solely on research with human subjects, without the need to be constrained by phenomenological assumptions based on human‐centric ways of thinking. (shrink)

This article presents the results of an empirical study of the “sportification” of amateur-level competitive computer gaming. How do amateur players, who are unlikely to become professional esports players, turn what is considered to be enjoyable entertainment into a collective activity that demonstrates traits traditionally associated with professional sports, such as self-discipline, a focus on achieving results and overcoming personal limitations? Ethnographic research, consisting of in-depth interviews and participant observations, was conducted in the last quarter of 2019 based on a (...) series of tournaments (Rocket League, Counter-Strike: Global Offensive, League of Legends, and Rainbow Six Siege) managed by a student esports club of a Moscow-based university. Such clubs combine different levels of esports practice: players who consider themselves amateurs who attend tournaments “for fun”, players seeking professionalization and who have already received the first modest revenue from their activity, as well as players who achieved the status of a cyberathlete through membership in one of the university teams. Thus, student esports represents an ideal environment for exploring the dynamics of changes in the meanings that players put into their activity, as well as for finding elements holding to­gether what could be called “esports culture”. The analysis conducted in the present article is based not so much on the interpretations of the phe­nomenon of esports that exists in the field of game studies, as on two clas­sical sociological traditions: the writings of Erving Goffman and Howard Becker, on the one hand, and those of Max Weber and Norbert Elias on the other. As a result, the process of the “sportification” of the amateur practice of competitive computer games is presented in the article as a change in the actors’ level of reflexivity: towards the game, towards themselves during play, and towards the world around the game, occurring as they move through the stages of the “career of a competitive player”. ­. (shrink)

The paper explores the ethical and psychological issues that arise when family members request that “everything possible” be done for a particular patient. The paper first illustrates this phenomenon by reviewing the well known case of Helga Wanglie. We proceed to argue that in Wanglie and similar cases family members may request futile treatments as a means of conveying that (1) the loss of the patient is tantamount to losing a part of themselves; (2) the patient should not be abandoned (...) or disvalued in any way; or (3) the patient is owed special obligations by virtue of the special relationship in which the family and the patient stand. We maintain that families can best express these important messages by caring for patients, rather than by making requests for futile interventions. Likewise, when life-sustaining measures are futile, health providers can best fulfill their professional obligations by assuring patients' dignity and comfort, rather than by applying futile interventions. (shrink)

Jewish law has a history stretching from the early period to the modern State of Israel, encompassing the Talmud, Geonic and later codifications, the Spanish Golden Age, medieval and modern responsa, the Holocaust and modern reforms. Fifteen distinct periods are separately studied in this volume, each one by a leading specialist, and the emphasis throughout is on the development of the institutions and sources of the law.