BackgroundHealthcare ethics is neglected in clinical practice in LMICs such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal.MethodsThis was a cross sectional study conducted among resident doctors and ward nurses in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer’s V value was assessed to (...) ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05.ResultsOur study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath, Nuremberg code and Helsinki Declaration. A high percentage of respondents said that their major source of information on healthcare ethics were lectures, books, and journals. Attitude of doctors and nurses were significantly different in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula,paternalistic attitude of doctor was disagreed more by doctors. Notably, only few doctors stood in support of physician-assisted dying.ConclusionsSignificant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics. (shrink)
Introduction: Decisions to withdraw or withhold curative or life-sustaining treatment can have a huge impact on the symptoms which the palliative-care team has to control. Palliative-care patients and their relatives may also turn to palliative-care physicians and nurses for advice regarding these treatments. We wanted to assess Indian palliative-care nurses and physicians’ attitudes towards withholding and withdrawal of curative or life-sustaining treatment. Method: From May to September 2008, we interviewed 14 physicians and 13 nurses working in different palliative-care programmes in (...) New Delhi, using a semi-structured questionnaire. For the interviews and analysis of the data we followed Grounded-Theory methodology. Results: Withholding a curative or life-sustaining treatment which may prolong a terminal cancer patient’s life with a few weeks but also has severe side-effects was generally considered acceptable by the interviewees. The majority of the interviewees agreed that life-sustaining treatments can be withdrawn in a patient who is in an irreversible coma. The palliative-care physicians and nurses were of the opinion that a patient has the right to refuse life-saving curative treatment. While reflecting upon the ethical acceptability of withholding or withdrawal of curative or life-sustaining treatment, the physicians and nurses were concerned about the whole patient and other people who may be affected by the decision. They were convinced they can play an important advisory role in the decision-making process. Conclusion: While deciding about the ethical issues, the physicians and nurses do not restrict their considerations to the physical aspects of the disease, but also reflect upon the complex wider consequences of the treatment decisions. (shrink)
Section 1. Prologue -- section 2. The whole being -- section 3. Engaging with wholeness -- section 4. Wholeness in Kashmiri Shaivism -- section 5. The Buddhist perspective -- section 6. Wholeness in the modern world -- section 7. The workings of wholeness in our world -- section 8. Epilogue.
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.
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 comparison of corporate social performance with corporate financial performance has been a popular field of study over the past 25 years. The results, while broadly conclusive of a positive relationship, are not entirely consistent. In addition, most of the previous studies have concentrated on large-scale cross-industry studies and often with a single variable for corporate social performance, in order to produce statistically significant results. This weakens the richness of understanding that might be obtained from a single industry study with (...) multiple social variables, which would also allow investigation of inter-relationships between individual and sub-sets of social performance measures and between individual and sub-sets of social performance and financial performance measures. There have also been criticisms that the results lack a rigorous theoretical basis, and the paper demonstrates clearly how stakeholder theory must form the basis for this area of research. Following a review of the literature this paper presents the initial findings from a study of the U.K. Supermarket industry which suggest that contemporaneous social and financial performance are negatively related, while prior-period financial performance is positively related with subsequent social performance. Positive relationships between both age and size of the company with social performance are also found. (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)
K. Brad Wray’s new book is an excellent overview of the scientific realism debate, as well as a development of the state-of-the-art. Wray, whose views seem most strongly influenced by Bas van Fraassen and Thomas Kuhn, develops crucial aspects of the debate, such as the argument from underconsideration and the ability of anti-realism to explain the success of science. This book is clearly written, tightly argued, and well researched. I recommend it highly to all philosophers and students of philosophy interested (...) in scientific theory change or the scientific realism debate. (shrink)
Since the beginning of the 20th Century to the present day, it has rarely been doubted that whenever formal aesthetic methods meet their iconological counterparts, the two approaches appear to be mutually exclusive. In reality, though, an ahistorical concept is challenging a historical analysis of art. It is especially Susanne K. Langer´s long-overlooked system of analogies between perceptions of the world and of artistic creations that are dependent on feelings which today allows a rapprochement of these positions. Krois’s insistence on (...) a similar point supports this analysis. - I - Unbestritten bis heute gilt, formwissenschaftliche und ikonologische Methoden scheinen sich grundsätzlich auszuschließen, da die ersteren auf ahistorischen und die letzteren auf historischen Grundlagen aufbauen. Dem entgegen soll mit diesem Beitrag gezeigt werden, wie insbesondere die Forschungen Susanne K. Langers und ergänzend diejenigen von John M. Krois eine Annäherung beider Positionen ermöglichen. (shrink)
Whilst there is a growing volume of literature exploring the ethical implications of organisational change for HRM and the ethical aspects of certain HRM activities, there have been few published U.K. studies of how HR managers actually behave when faced with ethical dilemmas in their work. This paper seeks to enhance the foundations of such knowledge through an examination of the influence of organisational values on the ethical behaviour of Human Resource Managers within a sample of charities in the U.K. (...) and the Republic of Ireland. A qualitative research design is adopted utilising semi-structured interviews. Findings highlight ethical inconsistency in people management in the charity sector arising from the clear application of strong and explicit organisational values to external client groups but their limited influence on people management strategies and practices within the organisation. Many of the ethical issues faced by HRM professionals in both countries arise from this inconsistency. In their handling of ethical dilemmas, the HRM professionals exhibit a combination of a care ethic and a concern for justice but it is also clear that in situations of management intransigence, a desire to be conscience driven often gives way to a contingent approach. Whilst respondents considered it inappropriate for the HRM function to be the conscience of the organisation, it is seen to have a key role in providing management with advice on ethical action. However, the ability of HRM to influence ethical behaviour is highly dependent on the status of the function within the organisation. (shrink)
Attempts to extend the classical Hausdorff difference hierarchy to the case of partitions of a space to k > 2 subsets lead to non-equivalent notions. In a hope to identify the right extension we consider the extensions appeared in the literature so far: the limit-, level-, Boolean and Wadge hierarchies of k -partitions. The advantages and disadvantages of the four hierarchies are discussed. The main technical contribution of this paper is a complete characterization of the Wadge degrees of [ ¿ (...) ] º 2-measurable k -partitions of the Baire space. (shrink)
In this paper rejection systems for the “nonsense-logic” W and the k-valued implicational-negational sentential calculi of Sobociński are given. Considered systems consist of computable sets of rejected axioms and only one rejection rule: the rejection version of detachment rule.
The theoretical description of particle decay by a single particle theory requires the use of a probability density in time that is not present in conventional theories. The problem of single particle decay is consistently described here within the context of a single particle, relativistic dynamical theory. We derive experimentally testable differences between the standard model and Relativistic Dynamics for a two-state system: the neutral K-meson (K 0) system. We show that the estimate of mass difference between the two states (...) is theory dependent. (shrink)
We give two new characterizations of K-triviality. We show that if for all Y such that Ω is Y-random, Ω is -random, then A is K-trivial. The other direction was proved by Stephan and Yu, giving us the first titular characterization of K-triviality and answering a question of Yu. We also prove that if A is K-trivial, then for all Y such that Ω is Y-random, ≡LRY. This answers a question of Merkle and Yu. The other direction is immediate, so (...) we have the second characterization of K-triviality.The proof of the first characterization uses a new cupping result. We prove that if A≰LRB, then for every set X there is a B-random set Y such that X is computable from Y⊕A. (shrink)
Hiçbir bilim dalında, yazar, felsefe ve mantıkta yapabildiği kadarıyla, güvenilir araştırma sonuçlarını böylesine fütursuzca hiçe sayamaz. Bu durum için, Bay Coffey’in Mantık Bilimi gibi böyle bir kitabın yayınlanmasına borçluyuz: ve yalnızca, günümüzün pek çok mantıkçısının eserinin tipik bir örneği olarak, bu kitap saygıyı hak ediyor. Yazarın mantık anlayışı Skolastik filozoflarınki gibidir, ve onların bütün hatalarını yapıyor – elbette Aristoteles’e alışılageldik gönderilerle.. Yazar, modern matematiksel mantıkçıların büyük eserini hiç dikkate almamış – mantık konusunda bir ilerleme kaydeden eser, ancak astrolojisiz astronomi ve (...) simyasız kimya yapan bir şeyle karşılaştırılabilir. (shrink)
.........................Turkish ....................... Çalışmanın konusu dindarlık eğilimi ile meslekî tükenmişlik arasındaki ilişkidir. Dindarlık eğilimine göre meslekî tükenmişlik düzeyinde herhangi bir farklılık olup olmadığı ise çalışmanın temel problemini oluşturmuştur. Bu bağlamda meslekî tükenmişlik düzeyini ve dindarlık eğilimini belirlemek için kolayda örnekleme yöntemiyle Gümüşhane il merkezindeki ilkokul, ortaokul ve liselerde görev yapan farklı branşlardaki öğretmenlerden bir örneklem grubu oluşturulmuştur. Elde edilen meslekî tükenmişlik ve dindarlık eğilimi verilerinden yola çıkarak bu iki değişkenin ilişkisi araştırılmıştır. Çalışmada Frekans, Bağımsız t-Testi, Tek Yönlü Varyans AnaliziANOVA testleri kullanılmıştır. (...) Bunun yanında hesaplanan değerleri ve elde edilen verileri değerlendirmek için SPSS (16.0) istatistik paket programı kullanılmıştır. Araştırma iki bölümden oluşmuştur. İlk bölümde dindarlık eğilimi ile meslekî tükenmişlik ilişkisine teorik bir yaklaşım sunulmuştur; meslekî tükenmişlik ve dindarlık kavramı, meslekî tükenmişlikle ilgili yurt içinde ve yurt dışında yapılan araştırmalar ve son olarak da meslekî tükenmişlik ile dindarlık eğilimi arasındaki ilişkiden bahsedilmiştir. İkinci bölümde uygulama kısmı, çalışmanın problemi ve alt problemleri, hipotezler, evren ve örneklem, kullanılan ölçekle ilgili sınırlıklar, çalışma bulgularının analizi, bulguların tartışılması, sonuçlar ve çalışmanın önerileri sunulmuştur. Çalışmanın sonuçlarına göre meslekî tükenmişlik puanları cinsiyet değişkenine göre farklılaşmazken, sosyo-ekonomik durum değişkenine göre anlamlı farklılık göstermiştir. Bunun yanında dindarlık eğilimine yönelik anket maddeleri ile meslekî tükenmişlik puanları arasında anlamlı düzeyde farklılaşmalara ulaşılmıştır. Sonuç olarak dindarlık eğiliminin meslekî tükenmişliğe etki eden faktörlerden biri olduğu tespit edilmiştir. -/- ...................................English ...................... Subject of this study is correlation of occupational burnout with the tendency of religiosity. Our main problem consists of that whether to be any differences in occupational burnout level according to the tendency of religiosity. In this context, it has been propounded that the levels of occupational burnout and tendency of religiosity of a sample group which consists of teachers chosen convenience sampling method from primary schools, secondary schools and high schools in Gümüşhane province. Based on the resulting occupational burnout and tendency of religiosity, investigated the correlation between these two variables. In the study the Frequency, Independent t-Test and One Way Variance Analysis-ANOVA tests were used and the evaluation of data and finding calculated values, SPSS (16.0) statistics software package were used. According to the results of the survey, the occupational burnout scores a differentiation has not been shown according to gender when has been established a significant difference according to socioeconomic status variable as independent variables. Besides, have been established a significant difference between tendency of religiosity of items and occupational burnout scale scores. The study consists of two main parts. In the first part, to provide a theoretical approach to the relationship of occupational burnout and tendency of religiosity; the concept of occupational bornout, the studies made on occupational burnout in domestic and abroad, and finally the relation of occupational burnout and tendency of religiosity have been mentioned. In the second part, considered as part of practice, the problem of the study and sub problems, hypothesis, population and sample, limitations information about the scale used in the study, analyzing the findings of the study, discussing the findings and conclusions and recommendations of the study have been presented. (shrink)