Although the teaching of medical ethics and law in medical education is an old story that has been told many times in medical literature, recent studies show that medical students and physicians lack confidence when faced with ethical dilemmas and medico-legal issues. The adverse events rates and medical lawsuits are on the rise whereas many medical errors are mostly due to negligence or malpractices which are preventable. While it is true that many medical schools teach their students medical law and (...) ethics, there are wide variations in what is being taught because there is no universally agreed syllabus. Yet the knowledge of medical law and ethics is closely relevant to the medical profession and that failure in abiding the law may result in serious civil or even criminal consequences. While this paper does not propose to lay detailed analysis of the relevant areas of law or ethics, it proposes to cover some legal areas so as to highlight and bring to attention the need for a medical law and ethics course. This article also considers the problems faced and recommendation as to future directions to be taken with respect to teaching medical law and ethics. It concludes with a suggested course outline for the teaching of medical law and ethics. (shrink)

Background Rapid ethical access to personal health information to support research is extremely important during pandemics, yet little is known regarding patient preferences for consent during such crises. This follow-up study sought to ascertain whether there were differences in consent preferences between pre-pandemic times compared to during Wave 1 of the COVID-19 global pandemic, and to better understand the reasons behind these preferences. Methods A total of 183 patients in the pandemic cohort completed the survey via email, and responses were (...) compared to the distinct pre-pandemic cohort ; all were patients of a large Canadian cancer center. The survey covered broad versus study-specific consent; opt-in versus opt-out contact approach; levels of comfort sharing with different recipients; perceptions of commercialization; and options to track use of information and be notified of results. Four focus groups were subsequently conducted to elucidate reasons motivating dominant preferences. Results Patients in the pandemic cohort were significantly more comfortable with sharing all information and biological samples, sharing information with the health care institution, sharing information with researchers at other hospitals, sharing PHI provincially, nationally and internationally compared to the pre-pandemic cohort. Discomfort with sharing information with commercial companies remained unchanged between the two cohorts. Significantly more pandemic cohort patients expressed a wish to track use of PHI, and to be notified of results. Thematic analysis uncovered that transparency was strongly desired on outside PHI use, particularly when commercialization was involved. Conclusions In pandemic times, patients were more comfortable sharing information with all parties, except with commercial entities, where levels of discomfort remained unchanged. Focus groups identified that the ability to track and receive results of studies using one’s PHI is an important way to reduce discomfort and increase trust. These findings meaningfully inform wider discussions on the use of personal health information for research during global crises. (shrink)

Objectives: To study the attitudes of both medical and non-medical students towards the do-not-resuscitate decision in a university in Hong Kong, and the factors affecting their attitudes.Methods: A questionnaire-based survey conducted in the campus of a university in Hong Kong. Preferences and priorities of participants on cardiopulmonary resuscitation in various situations and case scenarios, experience of death and dying, prior knowledge of DNR and basic demographic data were evaluated.Results: A total of 766 students participated in the study. There were statistically (...) significant differences in their DNR decisions in various situations between medical and non-medical students, clinical and preclinical students, and between students who had previously experienced death and dying and those who had not. A prior knowledge of DNR significantly affected DNR decision, although 66.4% of non-medical students and 18.7% of medical students had never heard of DNR. 74% of participants from both medical and non-medical fields considered the patient’s own wish as the most important factor that the healthcare team should consider when making DNR decisions. Family wishes might not be decisive on the choice of DNR.Conclusions: Students in medical and non-medical fields held different views on DNR. A majority of participants considered the patient’s own wish as most important in DNR decisions. Family wishes were considered less important than the patient’s own wishes. (shrink)

Generation Y is a cohort of the population larger than the baby boom generation. Consisting of approximately 80 million people born between 1981 and 2000, Generation Y is the most recent cohort to enter the workforce. Workplaces are being redefined and organizations are being pressed to adapt as this new wave of workers is infused into business environments. One critical aspect of this phenomenon not receiving sufficient research attention is the impact of Gen Y ethical beliefs and ethical conduct in (...) workplace contexts. It is widely accepted that distinct generational experiences shape ethical ideologies and ethical ideologies in turn affect the way people function in the workplace. Thus, Gen Y’s unique cohort experiences are likely to shape their ethical ideologies and consequent workplace judgments and actions. In this article, we examine Gen Y’s ethical ideology and study its impact on workplace functioning regarding leadership style, teamwork, and judgments about ethical violations. Our analyses indicate that Gen Y’ers tend toward situationalism (high idealism and high relativism), and their socially connected orientation produces more lenient judgments of collaborative vs. unilateral ethical violations. However, Gen Y’ers do exhibit individual variation. Relativist Gen Y’ers are more tolerant of ethical violations, whereas, Gen Y Idealists are less tolerant of ethical violations. High Idealists also show stronger teamwork and leadership characteristics. In addition, Gen Y’ers possessing servant leader traits exhibit incrementally better teamwork, and greater perceived unacceptability of ethical violations. We conclude by discussing implications of these findings for managing ethical climates and conduct. (shrink)

Explaining how stereotypes and norms influence role-identities during reflected appraisal processes, we develop a theory about diverse groups of minority men—the “minority masculinity stress theory”—and apply it to Asian American men. We conceptually integrate hegemonic masculinity, stereotypes, and mental health to examine how Asian American men experience masculinity and how their experiences are uniquely stressful. We analyze elicited text from an open-ended questionnaire to explain two experiences of masculinity-related stress: trying to live up to the masculine ideal and enacting work-related (...) role-identities. Regarding the former, we discuss four illustrations—toughness, body image, restrictive emotionality, and heterosexuality—and two involving the latter—achiever and provider. We found that Asian American men receive stereotypical reflected appraisals that contradict potentially positive self-concepts and emphasize achievement beyond typical standards of hegemonic masculinity. Moreover, Asian American men’s role-identities contradict hegemonic masculinity, resulting in reflected appraisals that predispose them toward stress. (shrink)

Guanxi is perceived as a major determinant for successful business in China. This research paper investigates the importance of Guanxi from the Hong Kong Businessmen's viewpoint. It confirms previous findings in this area and adds on new dimensions. Therefore, practitioners and academics may further refine their knowledge in this subject.

Much philosophical progress has been made in elucidating the idea of evolutionary contingency in a recent re-burgeoning of the debate. However, additional progress has been impaired on three fronts. The first relates to its characterisation: the under-specification of various contingency claims has made it difficult to conceptually pinpoint the scope to which ‘contingency’ allegedly extends, as well as which biological forms are in contention. That is—there appears to be no systematic means with which to fully specify contingency claims which has (...) led to a tendency for authors to talk past each other. Secondly, on the matter of evidence, recent research has focused on the evidential import of convergent evolution which is taken to disconfirm the evolutionary contingency thesis. However, there has been a neglect of convergent evolution’s converse: ‘evolutionary idiosyncrasies’ or the singular evolution of certain forms, which I argue is evidentially supportive of evolutionary contingency. Thirdly, evolutionary contingency has often been claimed to vary in degrees and that the debate, itself, is a matter of ‘relative significance’. However, there has been no formal method of evaluating the strength of contingency and its relative significance in a particular domain. In this paper, I address all three issues by proposing a systematic means of fully specifying contingency theses with the concept of the modal range. Secondly, I propose an account of evolutionary idiosyncrasies, investigate the explanations for their occurrences, and, subsequently, spell out their significance with respect to the evolutionary contingency thesis. Finally, having been equipped with the evidential counterpart to convergent evolution, I shall sketch a likelihood framework for evaluating, precisely on the basis of a sequence of opposing data, the strength and relative significance of evolutionary contingency in a particular domain. With this in hand, the relative observations of idiosyncrasies and convergences can be informative of the strength and relative significance of contingency in any particular domain. (shrink)

Background Immense volumes of personal health information are required to realize the anticipated benefits of artificial intelligence in clinical medicine. To maintain public trust in medical research, consent policies must evolve to reflect contemporary patient preferences. Methods Patients were invited to complete a 27-item survey focusing on: broad versus specific consent; opt-in versus opt-out approaches; comfort level sharing with different recipients; attitudes towards commercialization; and options to track PHI use and study results. Results 222 participants were included in the analysis; (...) 83% were comfortable sharing PHI with researchers at their own hospital, although younger patients were more uncomfortable than older patients. While 56% of patients preferred broad consent, 38% preferred specific consent; 6% preferred not sharing at all. The majority of patients preferred to be asked for permission before entry into a contact pool. Again, this trend was more pronounced for younger patients. Approximately half of patients were uncomfortable sharing PHI with commercial enterprises. Most patients preferred to track PHI usage, with the highest proportion once again reported by the youngest patients. A majority of patients also wished to be notified regarding study results. Conclusions While most patients were willing to share their PHI with researchers within their own institution, many preferred a transparent and reciprocal consent process. These data also suggest a generational shift, wherein younger patients preferred more specific consent options. Modernizing consent policies to reflect increased autonomy is crucial in fostering sustained public engagement with medical research. (shrink)

The Gouldian argument for evolutionary contingency found in Wonderful Life can be dissected into three premises: palaeontological, macro-evolutionary, and developmental. Discussions of evolutionary contingency have revolved primarily around the developmental. However, a shift in methodological practice and new palaeontological evidence subsequent to the book’s publication appears to threaten the palaeontological premise that asserts high Cambrian disparity, or, roughly, that morphological differences between the Cambrian species were high. This presents a prima facie problem: Did the Cambrian consist of enough anatomical variety (...) to fuel a different outcome upon a replay of the tape of life? I investigate the role that disparity plays in the Gouldian argument for evolutionary contingency and conclude that the reduced disparity view does not undermine the argument, per se. As for the macro-evolutionary premise, Gould never offers any explicit justification for the idea that species sorting was indiscriminate or ‘lottery-like’ (though he certainly gestures at it). Putting aside the exegetical, I consider certain empirical avenues for underwriting the macro-evolutionary premise and argue that the most plausible route is to appeal to the special status of mass extinctions, a move that is not entirely unfamiliar to macro-evolutionists. That is, mass extinctions can be good sources of contingency due to their being ‘chancy’ in at least three respects. In sum, I update the palaeontological and macro-evolutionary premises as to reconstrue the Gouldian argument for evolutionary contingency in its strongest form. (shrink)

Background The use of lengthy, detailed, and complex informed consent forms is of paramount concern in biomedical research as it may not truly promote the rights and interests of research participants. The extent of information in ICFs has been the subject of debates for decades; however, no clear guidance is given. Thus, the objective of this study was to determine the perspectives of research participants about the type and extent of information they need when they are invited to participate in (...) biomedical research. Methods This multi-center, cross-sectional, descriptive survey was conducted at 54 study sites in seven Asia-Pacific countries. A modified Likert-scale questionnaire was used to determine the importance of each element in the ICF among research participants of a biomedical study, with an anchored rating scale from 1 to 5. Results Of the 2484 questionnaires distributed, 2113 were returned. The majority of respondents considered most elements required in the ICF to be ‘moderately important’ to ‘very important’ for their decision making. Major foreseeable risk, direct benefit, and common adverse effects of the intervention were considered to be of most concerned elements in the ICF. Conclusions Research participants would like to be informed of the ICF elements required by ethical guidelines and regulations; however, the importance of each element varied, e.g., risk and benefit associated with research participants were considered to be more important than the general nature or technical details of research. Using a participant-oriented approach by providing more details of the participant-interested elements while avoiding unnecessarily lengthy details of other less important elements would enhance the quality of the ICF. (shrink)

Authorising euthanasia and assisted suicide with advance euthanasia directives is permitted, yet debated, in the Netherlands. We focus on a recent controversial case in which a Dutch woman with Alzheimer’s disease was euthanised based on her AED. A Dutch euthanasia review committee found that the physician performing the euthanasia failed to follow due care requirements for euthanasia and assisted suicide. This case is notable because it is the first case to trigger a criminal investigation since the 2002 Dutch euthanasia law (...) was enacted. Thus far, only brief descriptions of the case have been reported in English language journals and media. We provide a detailed description of the case, review the main challenges of preparing and applying AEDs for persons with dementia and briefly assess the adequacy of the current oversight system governing AEDs. (shrink)

Elliott Sober can be understood as advancing two distinct arguments that similarly conclude that evolutionary theory does not say that Scriven’s infamous twins have the same fitness, despite the twins’ identical genotypes and phenotypes. The first argument relies on denying that evolutionary theory can say that the twins are in the same environment, and the second relies on asserting an epistemic access asymmetry between token fitness and trait fitness. Motivated by good reasons, I respond to both of these arguments by (...) showing that the theory of evolution by natural selection has adequate means for determining whether the twins are in the same environment via causal-probabilistic decomposition, and that equivalence in fitness can be asserted even from a partial theory of fitness, regardless of epistemology. Finally, I point out an absurd result regarding genetic drift as indiscriminate sampling that follows if Sober’s conclusion is true. (shrink)

This paper uses van Leeuwen’s Authority Legitimation framework to examine government posters published in the 1950s–1980s in Hong Kong, which serve as a means of shaping public opinion and legitimate social action. Martin and White’s Appraisal framework is also applied to provide the study with relevant analytical tools by which to construct evaluatively coherent authorial reading positions propagated by the government in the posters as well as aligning viewers with these desired positions. The government posters being studied are concerned with (...) various aspects of social practices in the domain of public health communication. This paper argues that the representations of these social practices are realized as texts – both visual and verbal – in the posters, as part of a broader recontextualization process where legitimate ways of doing things as stipulated in the government guidelines are recontextualized in these posters and conveyed to members of the public. The aim is two-fold: to provide a systematic analysis of how visual and verbal resources construe evaluation in the government posters and the consequent legitimation discourse as viewers are being persuaded to align with legitimate social practices; to highlight various forms of legitimation, namely, role model authority legitimation, impersonal authority legitimation, and conformity authority legitimation, that are realized in these posters through visual-verbal articulation. (shrink)

Within the philosophy of biology, Michael Scriven’s twins has become a well-known thought experiment, due to its being the impetus for various lines of discussion concerning the contentious definition of evolutionary fitness, the distinction between natural selection and genetic drift, and evolutionary environments. As one version of the story goes: two twins who, ex hypothesi, are genotypically and phenotypically the same are located side by side on a mountain. An unfortunate event ensues whereby a lightning strike kills one of the (...) twins, whilst the other twin survives. For added disparity, the surviving twin goes on to proliferate extensively by bearing a large number of offspring. Importantly, it is usually inferred, from the stipulations of the thought experiment, that the twins also have the same evolutionary fitness. The inference is important because the premise that the twins have the same fitness paves way for a number of influential views; most notably, it has led to the propensity interpretation of evolutionary fitness. (shrink)

In the rubber hand illusion one’s hand is hidden, and a fake hand is visible. We explored the situation in which visual information was available indirectly in a mirror. In the mirror condition, compared to the standard condition , we found no reduction of the RHI following synchronised stimulation, as measured by crossmanual pointing and by a questionnaire. We replicated the finding with a smaller mirror that prevented visibility of the face. The RHI was eliminated when a wooden block replaced (...) the fake hand, or when the hand belonged to another person or mannequin. We conclude that awareness of the reflection is the critical variable, despite the distant visual localisation of the hand in a mirror and the third-person perspective. Stimuli seen in a mirror activate the same response as stimuli seen in peripersonal space, through knowledge that they are near one’s body. (shrink)

We are grateful to Jongsma et al 1 for their interest in our article analysing the case of ‘Mrs A’, a Dutch woman with Alzheimer’s disease who received euthanasia based on her advance euthanasia directive.2 Their commentary criticises two elements of our analysis. First, the authors believe our reasons for doubting that Mrs A had the capacity to write and revise an AED rely on ‘partial’ empirical data and rest on normative errors. Second, they use two of our statements to (...) suggest we must endorse some implausible claims, for example, that ‘… in all situations and for all people, current well-being should always take precedence over all other values’. Jongsma et al assert: ‘Miller et al argue that people with dementia are impaired to make decisions.’ This casts our probabilistic claim about Mrs A’s capacity as an absolute claim about persons with dementia in general. It also implies we are using an outdated diagnosis-based view of capacity. The accusation then becomes explicit : > … several empirical studies have shown that patients with dementia are able to actively participate in qualitative studies and can respond to open questions in a meaningful way,[2-8] as well that they are able to complete an advance directive in the early phases of dementia.[9, 10] One can therefore not simply conclude on the basis of the diagnosis of dementia …. (shrink)

The counseling process involves attention, emotional perception, cognitive appraisal, and decision-making. This study aimed to investigate cognitive appraisal and the associated emotional processes when reading short therapists' statements of motivational interviewing. Thirty participants with work injuries were classified into the pre-contemplation or readiness stage of the change group. The participants viewed MI congruent, MI incongruent, or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the frontally oriented late positive complex. The P600/LPC's (...) amplitudes were more positive-going in the PC than in the RD group for the MI congruent statements. Within the PC group, the amplitudes of the N400 were significantly correlated with the participants' level of negative affect. Our findings suggest that the brief contents of MI statements alone can elicit late cognitive and emotional appraisal processes beyond semantic processing. (shrink)

Emergency online education has been adopted worldwide due to coronavirus disease 2019 pandemic. Prior research regarding online learning predominantly focused on the perception of parents, teachers, and students in tertiary education, while younger children’s perspectives have rarely been examined. This study investigated how family, school, and individual factors would be associated with primary school students’ satisfaction, perceived effectiveness, and preference in online learning during COVID-19. A convenient sample of 781 Hong Kong students completed an anonymous online survey from June to (...) October 2020. Logistic regression was conducted for 13 potential factors. Results indicated that only 57% of students were satisfied with their schools’ online learning arrangement and 49.6% regarded the online learning as an effective learning mode. Only 12.8% of students preferred online learning, while 67.2% of students preferred in-person schooling. Multiple analyses suggested that teacher–student interaction during online classes was positively associated with students’ satisfaction, perceived effectiveness, and preferences in online learning. Compared to grades 1–2 students, grades 3–6 students perceived more effectiveness and would prefer online learning. Happier schools were more likely to deliver satisfying and effective online education. Students who reported less happiness at school would prefer online learning, and students who reported less happiness at home would be less satisfied with online learning and reflected lower effectiveness. Teachers are encouraged to deliver more meaningful interactions to students and offer extra support to younger children during online classes. Primary schools and parents are encouraged to create a healthy and pleasant learning environment for children. The government may consider building up happy schools in the long run. The study findings are instrumental for policymakers, institutions, educators, and researchers in designing online education mechanisms. (shrink)

Resumen: ¿Puede el cine filosofar? ¿Puede la imagen en movimiento ser medio para que la filosofía opere en otra materia expresiva? Este artículo tiene como interés auscultar la capacidad de ciertos cines de hacer filosofía al interior de la gran pantalla. Por eso, se exponen las líneas teóricas que permiten la defensa de un cine filosófico capaz de ofrecer conceptos a través de la dimensión expresiva propia de las imágenes en movimiento. Dicho proceso tiene lugar al interior del trabajo poético (...) que el cine de autor ofrece y que, a razón de su distancia del tono general del cine clásico, supone una crítica a la metafísica en el territorio del séptimo arte. Se realiza el análisis de parte de la obra iniciática del director Wong Kar-Wai y su singular poética del des-encuentro. A razón de su trabajo al filo del cine moderno es posible evidenciar cómo el cine puede darnos qué pensar.: Is it possible for the cinema to philosophize? Can the moving image work as a means for philosophy to operate under a different expressive language? This article discusses the ability of certain cinemas to do philosophy on the big screen. It describes the theoretical approaches that argue for a philosophical cinema capable of offering concepts through the expressive dimension of moving images. This process takes place within the poetic work that an auteur’s cinema offers which, because of its distance from the general tone of classical cinema, implies a critique of metaphysics from within the territory of the seventh art. The article analyzes part of the early work of the director Wong Kar-Wai’s and his unique poetics of dis-encounter. Through his work on the margins of modern cinema, it is possible to show how the seventh art can offer us something to think about. (shrink)

Global engineering ethics is the engineering ethics’ response to globalization. It plays a major role in the received narrative about the need for a global engineering ethics, which is often illustrated by stories of some engineers A (of culture X) who interact with people or organizations of culture Y, and as a result encounter conflicts between their (i.e. culture X’s) ethical values and culture Y’s ethical values that generate ethical conundrums to the engineers. Global engineering ethics is thus needed to (...) help engineers to navigate through these ethical conundrums. However, the received narrative is insufficient in attending to the different nature and scope of ethical challenges for engineers and engineering practices in a globalized context, or so I shall argue. To understand these differences, I elaborate three basic presuppositions that create the need for global engineering ethics and explain their various interpretations. These presuppositions will then form the basis of my discussion of current approaches to global engineering ethics. I also argue that global engineering ethics is not merely reactive but also proactive, but the existing approaches have paid insufficient attention to the proactive dimension of global engineering ethics. So, I will end this chapter by arguing for the importance of the proactive dimension and exploring what it demands from engineers and engineering practices. (shrink)

RESUMENEl cine de Wong Kar-Wai es, principalmente, un cine sobre el tiempo. El director chino explora en sus películas la relación del sujeto con la temporalidad en la que se encuentra, mostrando el complejo entramado que une el pasado, el presente y el futuro en una tela que, al igual que la de Penélope, se teje tanto como se desteje. Quizá el mejor exponente de esta situación sea esa suerte de trilogía formada por Días salvajes, Deseando amar y 2046, (...) unida no por su argumento sino por la temática que abordan: el conflicto que viven unos personajes al encontrarse atrapados dentro de una temporalidad que sienten ajena o injusta.PALABRAS CLAVEWONG KAR-WAI, 2046, MEMORIA, IDENTIDADABSTRACTThe films by Wong Kar-Wai are primarily about time. This Chinese director explores in his films the subject’s relationship to the temporality in which he is, showing the complex network that links the past, the present and the future in a cloth which, like that of Penelope’s, is as much woven as unravelled. Perhaps the best example of this situation is that sort of trilogy formed by Days of Being Wild, In the Mood for Love and 2046, linked not by their argument but because they address the same issue: the conflict that the characters live since they are trapped within a temporality that they feel alien or unfair.KEYWORDSWONG KAR-WAI, 2046, MEMORY, IDENTITY. (shrink)

The Supreme Court has ruled in the case of Y that there is no requirement to seek the approval of the Court of Protection in decisions to withdraw clinically assisted nutrition and hydration from patients in a prolonged disorder of consciousness.1 Mr Y was 52-year-old man who suffered a cardiac arrest after a myocardial infarction as a result of coronary artery disease. It was not possible to resuscitate him for well over 10 min, resulting in severe cerebral hypoxia which caused (...) extensive brain damage. Mr Y’s family and the NHS Trust treating him agreed that Mr Y would not want to be kept alive through the provision of CANH given his poor prognosis. They sought a declaration that it was not mandatory for applications of withdrawal of CANH to come before the court, which was granted by Mrs Justice O’Farrell in the first instance.2 Permission was granted for the appeal to ‘leapfrog’ the Court of Appeal and to proceed to the Supreme Court for consideration. In the interim, Mr Y died after contracting acute respiratory sepsis, but the Supreme Court determined that the appeal should go ahead in light of the general importance of the issues raised. In delivering the opinion of the Supreme Court on 30 July 2018, Lady Justice Black rejected the historical distinction that had been drawn between patients in PDOC and non-PDOC patients, in a way that had justified judicial involvement for patients in PDOC but not for others.3 She was clear that the correct approach to all cases involving CANH was to make a decision based on what was in the best interests of the patient. She further outlined that: > The documentation supplied to us shows that the difficulty that there is in assessing the patient and in …. (shrink)

Although the same environmental regulations apply to all regions in China, legal enforcement can be different due to local economic development priorities. There is still a lack of knowledge about how regional disparities affect the operating performance results of the implementation of corporate environmental management practices, thus providing little information for foreign companies when they invest and develop their production base in China. To fill this research gap, this paper collects data from the Fortune 500 Chinese firms to investigate the (...) moderating role of regional disparities in affecting the performance results of corporate environmental management efforts based on the institutional theory. The disclosed corporate environmental responsibility practices serve as proxy to represent corporate environmental management practices. Content analysis approach was applied to collect and analyze CER practices published in the corporate reports of Chinese manufacturers. The results show that CER has a positive impact on operating income, while regional disparities influence the relationship between CER and corporate operating income. Specifically, CER and operating income are positively related in Eastern China; on the contrary, they are negatively related in Western China. This paper adds to the body of knowledge about environmental discrepancies in the same emerging economy, and provides insights for systematic consideration in terms of the issues of government environmental regulations and corporate environmental strategies. (shrink)

What accounts for the continued lack of clarity over the legal procedures for the patenting of DNA sequences? The patenting system was built for a "bricks-and-mortar" world rather than an information economy. The fact that genes are both material molecules and informational systems helps explain the difficulty that the patent system is going to continue to have.

BackgroundPast research shows that physicians experience high ill-being but also high well-being.ObjectiveTo shed light on how medical faculty’s experiences of their job demands and job resources might differentially affect their ill-being and their well-being with special attention to the role that the work-life interface plays in these processes.MethodsQualitative thematic analysis was used to analyze interviews from 30 medical faculty at a top research hospital in Canada.FindingsMedical faculty’s experiences of work-life conflict were severe. Faculty’s job demands had coalescing effects on their (...) stress, work-life conflict, and exhaustion. Although supportive job resources helped to mitigate the negative effects of job demands, stimulating job resources contributed to greater work-life conflict, stress, and exhaustion. Thus, for these medical faculty job resources play a dual-role for work-life conflict. Moreover, although faculty experienced high emotional exhaustion, they did not experience the other components of burnout. Some faculty engaged in cognitive reappraisal strategies to mitigate their experiences of work-life conflict and its harmful consequences.ConclusionThis study suggests that the precise nature and effects of job demands and job resources may be more complex than current research suggests. Hospital leadership should work to lessen unnecessary job demands, increase supportive job resources, recognize all aspects of job performance, and, given faculty’s high levels of work engagement, encourage a climate that fosters work-life balance. (shrink)

In his Meditations Descartes tells us that he initially thought error might be avoided if he withheld assent “no less carefully from what is not plainly certain and indubitable than from what is obviously false.” For example, he thinks it plainly certain and indubitable that he is “sitting by the fire, wearing a winter cloak, holding this paper in my hands, and so on.” And yet even what is “plainly certain and indubitable” can be doubted. “I will suppose, then, not (...) that there is a supremely good God, the source of truth; but that there is an evil spirit, who is supremely powerful and intelligent, and does his utmost to deceive me.” Such a deceiver can spin illusions that appear indubitably real and true—of hands, fire, cloak, paper—and not only when there are none present in any particular case but even where there are none at all in any case. “I will suppose that sky, air, earth, colors, shapes, sounds and all external objects are mere delusive dreams, by means of which he lays snares for my credulity.”2 The deceiver hypothesis is the most difficult skeptical doubt Descartes must surmount in the remaining Meditations. I say the deceiver hypothesis, and for Descartes the deceiver is a mere possibility, raised so as to motivate the reconstitution of knowledge that follows. That there might be a powerful deceiver is itself a threat to knowledge for Descartes. Indeed even the possibility of an evil deceiver is so powerful a threat that Descartes must do nothing less than prove God’s existence to reestablish certainty. It is only at the end of his Meditations that Descartes can say, as if looking back on a hysterical moment, that the evil deceiver idea was “exaggerated” and “ridiculous.”3.. (shrink)

The important roles of prediction and prior experience are well established in music research and fit well with Clark's concept of unified perception, cognition, and action arising from hierarchical, bidirectional predictive processing. However, in order to fully account for human musical intelligence, Clark needs to further consider the powerful and variable role of affect in relation to prediction error.