For medical interventions there is a gap between what clinical scientific research has established as likely to carry clinical benefit and what the National Institute for Clinical Excellence (NICE) has judged as cost-effective. This gap is the affordability gap. It is created by a value judgement made by NICE and affirmed by the Secretary of State for Health. This value judgement operates to affect other value judgements made in actual clinical situations where at least one choice of treatment falls into (...) the affordability gap. This paper considers how the creation of this affordability gap impacts upon actual clinical decisions. It explores these issues in the context of the choice between a drug-eluting stent and a bare metal stent for elective coronary angioplasty. It also argues that the option of an NHS procedure with a top-up fee to cover the cost of the affordability gap is a genuine one; that this option could improve clinical outcomes; that it is morally acceptable; and that the rules that prevent the utilization of this option should be relaxed. (shrink)

The problem of academic dishonesty in general and exam cheating in particular, has been ubiquitous in schools, colleges, and universities around the world. This paper reports on the findings from teachers’ and students’ experiences and perceptions of exam cheating at Nepali schools, colleges, and universities. In so doing, the paper highlights the challenges of maintaining academic integrity in Nepali education systems. Based on qualitative research design, the study data were collected by employing semi-structured interviews with the teachers and the students. (...) Findings from the study indicated that over-emphasized value given to marks/grades and the nature of exam questions among others were the predominant factors. Our findings contribute to the practical understanding that academic institutions in Nepal have largely failed to communicate the value of academic honesty and integrity to the students of all levels of education despite the increasing prevalence of exam cheating. Therefore, exam cheating requires urgent attention from academic institutions, educators, and education leaders to educate students about the long-term educational and social values of academic honesty and integrity. (shrink)

Public benefit corporations are National Health Service, that is, state, entities whose function to provide healthcare in discharge of public duties. If we regardvalue as the output of such organisations, it seems logical to connect the values of the organisation to thevalue produced by such organisations. But, on closer examination there are competing underlying logics in play: (1) those based on promoting organisational efficiency and efficacy; and (2) those based on the idea of building service provision around the clinician–patient relationship. (...) Underlying these logics are differing value sets. These clash. Because of the clashing of underlying moral frameworks the connection between values andvalue becomes hard, if not impossible. This paper argues that (1) the clash in these moral frameworks must be addressed by the organisation rather than between individuals or groups of individuals within the organisation; (2) alloying duties within hybrid professionals submerges but does not resolve these conflicts; (3) one approach could be to impose on the organisation itself an ethical imperative to promote, enhance and protect from deterioration the welfare of the patients; (4) a board ethics committee is a possible organisational structure that could transparently and fairly balance clashes within the competing moral frameworks in a way that could reconcile the competing logics and (5) if such conflicts can be better resolved at the organisational level what the organisation must do to achieve its objectives will become clearer because what needs to be valued would naturally emerge connecting values,value and what is valued. (shrink)

The aim of this report is to present an example of a multidisciplinary Indian-Swedish co-operation on ethics in health care. It is based on a conference held in Asia Plateau, Panchgani, Maharasthra, India in 1998. The emphasis is on ethical values that are important for consumers of health care and professionals, and also for different cultures in developed and developing countries. The importance of human dignity is stressed. Sixteen recommendations are given in an appendix.

This paper introduces the medical factual matrix as a new and potentially valuable tool in medical ethical analysis. Using this tool it demonstrates the idea that a defined medical intervention can only be meaningfully declared futile in relation to a defined goal of treatment. It argues that a declaration of futility made solely in relation to a defined medical intervention is inchoate. It recasts the definition of goal futility as an intervention that cannot alter the probability of the existence of (...) the important outcome states that might flow from a defined intervention. The idea of value futility and the extent of physician obligations in futile situations are also addressed. It also examines the source of substantive conflicts which commonly arise within the doctor-patient relationship and the ensuing power relations that operate between doctor and patient when questions of futility arise. (shrink)

Academic research studies examining the ethical attitudes and behaviors of salespeople have produced several frameworks that explore the ethical decision-making processes to which salespeople adhere when faced with ethical dilemmas. Past literature enriches our understanding; however, a critical review of the relevant literature suggests that an emotional route to salesperson ethical decision-making has yet to be explored. Given the fact that individuals’ emotional capacities play an important role in decision-making when faced with an ethical dilemma, there is a need for (...) empirical research in this area. We address this issue by outlining and testing an emotion-based model to study the ethical attitudes and behaviors of salespeople in a relational selling context. Building on the cognitive-affective model proposed by Gaudine and Thorne (J Bus Ethics 31:175–187, 2001 ), we outline a framework that incorporates higher order prosocial emotions: capacity for concern and capacity for guilt. We include salesperson’s role clarity within the organization as a moderator to examine person–situation interaction. (shrink)

Descartes is not well known for his contributions to ethics. Some have charged that it is a weakness of his philosophy that it focuses exclusively on metaphysics and epistemology to the exclusion of moral and political philosophy. Such criticisms rest on a misunderstanding of the broader framework of Descartes’ philosophy. Evidence of Descartes’ concern for the practical import of philosophy can be traced to his earliest writings. In agreement of wisdom that is sufficient for happiness. The Third part of his (...) Discourse on the Method presents what he calls a provisional morality, a morality to govern our behaviour while we are in the process of revising our beliefs and coming to certainty. In the tree of philosophy, in the Preface to the French translation of the Principles of Philosophy, morals are listed as one of the fruits of the tree, along with medicine and mechanics. It is also a theme in the letters he exchanged with the Princess Elisabeth of Bohemia in the mid-1640s, together with another concern the passions, what they are, and more importantly, how to control them. These themes are intertwined again in Descartes last major work, The Passions of the Soul (1649). Descartes did not write extensively on ethics, and this has led some to assume that the topic lacks a place within his philosophy. It is an attempt to outline Descartes’ ethical ideas mainly in Discourse on the Method. (shrink)

The difficulty in discovering a difference between killing and letting die has led many philosophers to deny the distinction. This paper seeks to develop an argument defending the distinction between killing and letting die. In relation to Rachels’ cases, the argument is that (a) even accepting that Smith and Jones may select equally heinous options from the choices they have available to them, (b) the fact that the choices available to them are different is morally relevant, and (c) this difference (...) in available choices can be used to distinguish between the agents in certain circumstances. It is the principle of justice, as espoused by Aristotle, which requires that equal things are treated equally and that unequal things are treated unequally that creates a presumption that Smith and Jones should be treated differently. The magnitude of this difference can be amplified by other premises, making the distinction morally relevant in practical reality. (shrink)

Relates To Important Mystical Concepts Contained In Guru Granth. Seeks To Revive The Original Spiritual Doctrines Of The Great Masters And Impact Contemporary Meaning Of Their. 13 Chapters-Bibliography, Index. Without Dustjacket.

This article maps the Manvantara section of the Mārkaṇḍeya Purāṇa to reveal a patronymic pattern at play which is key to understanding the interplay between the mythologies of Goddess and Sun found in the Mārkaṇḍeya. It explains why the Devī Māhātmya occurs, especially in the Manvantara, which has puzzled scholars since colonial times. The article argues that the compositional strategy was implemented to present the Goddess as an analog to Viṣṇu, Manu, Sun, and the Indian king, all paragons of preservation.

To note that the study of Sanskrit narrative literature, in particular the Epics and Purāṇas, has been plagued with the propensity towards diachronic dissection would be little more than a truism in most scholarly circles. Yet it is with this truism we are forced to begin as we strive to shed the old skin of colonial era receptions of these texts. While there have been notable efforts made to embrace Sanskrit narrative as synchronic wholes, there isn’t much in the way (...) of a systematic methodology for doing so. This paper, therefore, is aimed at charting a methodology for synchronic study of Sanskrit narrative literature, paying particular attention to narrative frames. It advances five avenues of thematic import based on the structure of Sanskrit narrative: inception import, association import, exposition import, framing import, and impetus import. Examples are primarily drawn primarily from the Mahābhārata and the Mārkaṇḍeya Purāṇa. Note that key terms arising from the discussion in this chapter are bolded throughout and appear in a “terminology guide” appended to the end of this study for the sake of reader reference. (shrink)

Race and ethnicity are closely related, contentious concepts that have been abused and misinterpreted through history, but have a vast potential for good, at least in the health sciences. This article is not intending to elaborate on the conceptual foundations of race and ethnicity; I have addressed that elsewhere and summarized my stance in the glossary reprinted below in the Appendix. The terminology used here follows the glossary. Assuming that the conceptual foundations of my stance are reasonable, the questions addressed (...) here focus on public health and its primary health science, epidemiology, in a European context. The questions are simple ones:1.In epidemiology and public health what are we trying to achieve when we use the concepts of race and ethnicity?2.What would we lose by rejecting these concepts?3.If we do not reject them, how do we put the concepts into operation to help achieve our goals?4.What practical actions can result from the application of these concepts in order to improve the health and well-being of populations? (shrink)

In recent months, pharmaceutical manufacturers have brought legal challenges to a provision of the 2022 Inflation Reduction Act (IRA) empowering the federal government to negotiate the prices Medicare pays for certain prescription medications. One key argument made in these filings is that price negotiation is a “taking” of property and violates the Takings Clause of the US Constitution. Through original case law and health policy analysis, we show that government price negotiation and even price regulation of goods and services, including (...) patented goods, are constitutional under the Takings Clause. Finding that the IRA violates the Takings Clause would radically upend settled constitutional law and jeopardize the US’s most important state and federal health care programs. (shrink)

Business leadership increasingly requires a master’s degree in business and graduate management admission test scores continue to be an important component of applications for admission to such programs. Given the ubiquitous use of GMAT scores as gatekeepers for business leadership, GMAT scores are likely to influence organizational ethical behavior through gender, cultural, and other biases in the GMAT. There is little prior literature in this area and we contribute by empirically documenting that GMAT scores are negatively related to the cultural (...) dimensions of masculinity and power distance and are positively related to math literacy, uncertainty avoidance, and individualism. We estimate that cultural factors may account for as much as an 80-point difference in cross-national mean GMAT scores which are also related negatively to local language literacy, national educational spending, wealth per capita, wealth inequality, and gender development. Most interestingly, we also find a significant negative association of GMAT scores with ethical orientation. These findings have important implications for business schools and corporate ethics and leadership. (shrink)

Senior service colleges provide professional education to prepare military and government civilians for public service at the senior levels of strategy and policy. Inclusive in the program of study...

This work underscores the true brilliance and timelessness of colonial metaphors of authorship that extend into the postmodern Age. The emphasis is upon both re-invention and comprehensive scholarship on music and film.

Integrates the seemingly diverse studies of Newtonian physics, quantum mechanics, astrophysics, and molecular biology to explain the timeless philosophies of the ages." Includes biographical profiles of several scientists or philosophers who contributed to human understanding of these realities.

In the 1958 lecture, “Hegel and the Greeks,” how does Heidegger intimate a complex sense of historical temporalization when he suggests that the ‘whole of philosophy in its history’ is contained in the title: “Hegel and the Greeks?” Our hypothesis may appear contrarian to contemporary assumptions: a complex notion of origin as paradoxically ‘futural’— particularly in its metaphysical breadth in say the Phenomenology of Spirit and the Science of Logic—is also at work in Heidegger’s thought. This is particularly acute when (...) Heidegger examines the origin of philosophy in ancient Greek thought as a space that opens a future horizon of Being to dawn—that is, some calling that comes from the unforeseeable future to transcend what Heidegger sees as the end, finality, and ‘collapse’ ofphilosophy after Hegel. (shrink)

This paper aims to understand the kind of activities that industrial actors develop in order to protect their enterprises during industrial crisis conditions. A series of political unrest, insurgency, economic turmoil, deadly earthquakes, and economic embargo at the Indo- Nepal boarder escalated the industrial crisis in Nepal. The quest for sustainability of enterprises during the enduring nature of the crisis stimulated for a more detail conversation and survey. A perceptual survey of industrial actors accompanying conversation therein indicates that trade union (...) and association leaders develop positive attitude and advance specific activities for protecting their enterprises during industrial crisis conditions. The study finds that an empathic nature helps to develop a positive attitude among the industrial actors, which seems contributory for enterprises to survive during crisis conditions. The actors tend to positively perceive significance of specific activities under the conditions of difficulties and hardships and enhance immunity to the industrial crisis. This paper argues that the empathic nature of the industrial actors becomes more effective to safeguard the pluralistic interests of the stakeholders of the enterprise than the self- centric nature of the actors. The actors are not only engaged in safeguarding their claims on the industry but are also contributing—beyond their routine work—positively to strengthen the enterprise immunity during difficulties. This paper concludes with an insight of shifting managerial attention from the generic concepts like cost minimisation and product differentiation to the concepts of regularity in supply of goods and services in the business network by expanding the scope of industrial relations vertically and horizontally. The empathic nature of industrial actors enhances the effectiveness of the general system theory and social network theory by developing understanding of the role of industrial actors’ relations in sustaining and operationalizing a business network under organizational crisis conditions. (shrink)

The European Legacy, Volume 17, Issue 3, Page 400-401, June 2012.

Used wisely the concepts of race and ethnicity in research have great potential, but used unwisely they can do immense damage. We need to consider the potential issues that might require a change of emphasis or application of ethics in a multi-ethnic society. Doing no harm is the most important ethical pillar in the ethnicity and health field. Ethnic differences can be used in damaging ways. Without the ethic of beneficence in place it is better not to draw attention to (...) ethnic differences. Respect is the pre-condition for autonomy. Autonomy of ethnic minority populations to live in their own traditional way is not easy to achieve in multi-ethnic societies. There are difficult issues in multi-ethnic societies that require great sensitivity to create a sense of fairness and justice. Justice is the core value that underpins equity. There is a deep paradox – to promote equality, we may need to treat people and groups unequally. Ethical codes need to be modified to emphasize the importance of including ethnic minority populations in research and not bypassing them, as has been happening. It is correct, for example, that potential research participants' personal details are guarded. If such a person, however, does not read it may be unethical to send written information about a project. It may be more ethical to tele phone or even call at the doorstep of such a person. The history of racism in research is worrying, not least the fear that it might return. We need a governing code of conduct. Ethical research can help ethnic minority groups to move from the shadows of society and participate in a vibrant, healthy, multi-ethnic society. (shrink)

The popularity of ‘food sovereignty’ to cover a range of positions, interventions, and struggles within the food system is testament, above all, to the term’s adaptability. Food sovereignty is centrally, though not exclusively, about groups of people making their own decisions about the food system—it is a way of talking about a theoretically-informed food systems practice. Since people are different, we should expect decisions about food sovereignty to be different in different contexts, albeit consonant with a core set of principles. (...) In this paper we look at the analytical points of friction in applying ideas of food sovereignty within the context of Indigenous struggles in North America. This, we argue, helps to clarify one of the central themes in food sovereignty: that it is a continuation of anti-colonial struggles, even in post-colonial contexts. Such an examination has dividends both for scholars of food sovereignty and for those of Indigenous politics: by helping to problematize notions of food sovereignty and postcoloniality, but also by posing pointed questions around gender for Indigenous struggles. (shrink)

Using a popular Sufi tale as a starting point, the author shows that in a postmodern age, wisdom can best be characterized as a willingness to see how parts and wholes relate to each other and how new meanings emerge from a dialogical interplay between the two. Wisdom can also be characterized by openness, by the ability to perceive connections among various viewpoints, and by a strong tolerance for ambiguity.

We revisit a typological puzzle due to Horn (Doctoral Dissertation, UCLA, 1972) regarding the lexicalization of logical operators: in instantiations of the traditional square of opposition across categories and languages, the O corner, corresponding to ‘nand’ (= not and), ‘nevery’ (= not every), etc., is never lexicalized. We discuss Horn’s proposal, which involves the interaction of two economy conditions, one that relies on scalar implicatures and one that relies on markedness. We observe that in order to express markedness and to (...) account for a bigger typological puzzle, namely the absence of lexicalizations of ‘XOR’ (= exclusive or), ‘all-or-none’, and many other imaginable logical operators, one must restrict the basic lexicalizable elements to a small set of primitives. We suggest that an ordering based perspective, following Keenan and Faltz (Boolean semantics for natural language, 1985), makes the stipulated primitives that we arrive at more natural. We also propose a modification to Horn’s proposal, based on recent work on implicatures, in which only the implicature condition is operative and in which markedness is part of the definition of the alternatives for scalar implicatures rather than an independent condition. (shrink)

Purpose The high rate of internet penetration has led to the proliferation of social media use, even at the workplace, including academia. This research attempts to develop a topology and thereby determine the dominant use motive for faculty’s use of SM. Design/methodology/approach In this two-part study, a two-stage research design has been adopted for topology development based on the application of Uses and Gratifications Theory. In the second part, the Technology Acceptance Model is applied to discern the dominant motive for (...) SM use in academia. Findings The work is able to develop a seven-item topology, conforming to the basic three use motives, namely, hedonic, utilitarian and social. The work shows faculty attach more value to the instrumental utility of SM, while the hedonic function is also significant. Practical implications Discerning dominant motive implies that SM use at the workplace should not be banned, rather effective regulated use will instil the faculty to enhance work outcomes. The conceptualisation of topology for SM use in academia at the workplace can aid in designing an effective organisation policy, and design of an internal SM platform. Originality/value The study is unique towards topology development for academic faculty and has many important implications for management and academia, especially towards policy design for SM use at the workplace. (shrink)

We present evidence that preschool children oftentimes understand disjunctive sentences as if they were conjunctive. The result holds for matrix disjunctions as well as disjunctions embedded under every. At the same time, there is evidence in the literature that children understand or as inclusive disjunction in downward-entailing contexts. We propose to explain this seemingly conflicting pattern of results by assuming that the child knows the inclusive disjunction semantics of or, and that the conjunctive inference is a scalar implicature. We make (...) two assumptions about implicature computation in the child: that children access only a proper subset of the adult alternatives, and that children possess the adult capacity to strengthen sentences with implicatures. As a consequence, children are expected to sometimes not compute any implicatures at all, but in other cases they are expected to compute an implicature that is different from the adult implicature. We argue that the child’s conjunctive strengthening of disjunctive sentences realizes the latter possibility: the adult infers that the conjunction is false but the child infers that the conjunction is true. This behaviour is predicted when our assumptions about child development are coupled with the assumption that a covert exhaustive operator is responsible for strengthening in both the child and the adult. Specifically, children’s conjunctive strengthening is predicted to follow from the same mechanism used by adults to compute conjunctive free choice implicatures in response to disjunctive permission sentences. We furthermore argue that this parallel between the child and the adult extends to disambiguation preferences. In particular, we present evidence that children prefer to strengthen disjunctions to conjunctions, in matrix and embedded positions ; this result mirrors previous findings that adults prefer to compute free choice, at the root and under every. We propose a disambiguation strategy that explains the preference for conjunctive strengthening – by both the child and the adult – even though there is no general preference for exhaustification. Specifically, we propose that the preference for a conjunctive strengthening follows from a pragmatic preference for a complete answer to the Question Under Discussion. (shrink)

While the concepts of race and ethnicity have been abused historically, they are potentially invaluable in epidemiology and public health. Epidemiology relies upon variables that help differentiate populations by health status, thereby refining public health and health care policy, and offering insights for medical science. Race and ethnicity are powerful tools for doing this. The prerequisite for their responsible use is a society committed to reducing inequalities and inequities in health status. When this condition is met, it is irresponsible not (...) to utilize these concepts. (shrink)

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)