OBJECTIVES: To measure the preference regarding disclosure of a serious diagnosis, and its determinants, of the Lebanese public. DESIGN AND SETTING: Non-random sample survey of 400 persons interviewed in health care facilities in Beirut in 1995. RESULTS: Forty-two per cent of respondents generally preferred truth not to be disclosed directly to patients. Preference for disclosure was associated with younger age, better education and tendency to rapport-building with physicians. There were no meaningful associations between place of residence (urban/rural), level of religious (...) practice, or religious affiliation, and preference for disclosure. CONCLUSIONS: Under one plausible interpretation, this survey suggests that the expectation for concealment will decrease as the advantage of knowledge in better coping with disease is understood by an increasingly better educated public, and that the Lebanese public will increasingly come to expect direct and full disclosure of serious diagnoses. (shrink)

This book discusses how rational choice theory grew out of RAND's work for the US Air Force. It concentrates on the work of William J. Riker, Kenneth J. Arrow, James M. Buchanan, Russel Hardin, and John Rawls. It argues that within the context of the US Cold War with its intensive anti-communist and anti-collectivist sentiment, the foundations of capitalist democracy were grounded in the hyper individualist theory of non-cooperative games.

"Neuroscience and Philosophy" begins with an excerpt from "Philosophical Foundations of Neuroscience," in which Maxwell Bennett and Peter Hacker question the ...

One of the difficulties nurses experience in clinical practice in relation to ethical issues in connection with young oncology patients is moral distress. In this descriptive correlational study, the Moral Distress Scale-Paediatric Version (MDS-PV) was translated from the original language and tested on a conventional sample of nurses working in paediatric oncology and haematology wards, in six north paediatric hospitals of Italy. 13.7% of the total respondents claimed that they had changed unit or hospital due to moral distress. The items (...) with the highest mean intensity in the sample were almost all connected with medical and nursing competence and have considerably higher values than frequency. The instrument was found to be reliable. The results confirmed the validity of the MDS-PV (Cronbach’s alpha = 0.959). This study represents the first small-scale attempt to validate MDS-PV for use in paediatric oncology-ematology nurses in Italy. (shrink)

To commemorate 40 years since the founding of the Journal of Business Ethics, the editors in chief of the journal have invited the editors to provide commentaries on the future of business ethics. This essay comprises a selection of commentaries aimed at creating dialogue around the theme Business versus Ethics?. The authors of these commentaries seek to transcend the age-old separation fallacy :409–421, 1994) that juxtaposes business and ethics/society, posing a forced choice or trade off. Providing a contemporary take on (...) the classical question “if it’s legal is it ethical?”, David Hess explores the role of the law in promoting or hindering stakeholder-oriented purpose and governance structure. Jeffrey Harrison encourages scholars to move beyond the presupposition that businesses are either strategic or ethical and explore important questions at the intersection of strategy and ethics. The proposition that business models might be inherently ethical or inherently unethical in their design is developed by Sheila Killian, who examines business systems, their morality, and who they serve. However, the conundrum that entrepreneurs are either lauded for their self-belief and risk-taking, or loathed for their self-belief and risk-taking, is discussed by M. Tina Dacin and Julia Roloff using the metaphor of taboos and totems. These commentaries seek to explore positions that advocate multiplicity and tensions in which business ethics is not either/or but both. (shrink)

Genomic research results and incidental findings with health implications for a research participant are of potential interest not only to the participant, but also to the participant's family. Yet investigators lack guidance on return of results to relatives, including after the participant's death. In this paper, a national working group offers consensus analysis and recommendations, including an ethical framework to guide investigators in managing this challenging issue, before and after the participant's death.

Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases. Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s. Methods: This study analysed all cases of assisted suicide facilitated by Exit Deutsche Schweiz (E) and Dignitas (D) between 2001 and 2004 and (...) investigated by the University of Zurich’s Institute of Legal Medicine (E: n = 147; D: n = 274, total: 421). Furthermore, data from the Exit Deutsche Schweiz study which investigated all cases of assisted suicide during the period 1990–2000 (n = 149) were compared with the data of the present study. Results: More women than men were assisted in both organisations (D: 64%; E: 65%). Dignitas provided more assistance to non-residents (D: 91%; E: 3%; p = 0.000), younger persons (mean age in years (SD): D: 64.5 (14.1); E: 76.6 (13.3); p = 0.001), and people suffering from fatal diseases such as multiple sclerosis and amyotrophic lateral sclerosis (D: 79%; E: 67%; p = 0.013). Lethal medications were more often taken orally in cases assisted by Dignitas (D: 91%; E: 76%; p = 0.000). The number of women and the proportion of older people suffering from non-fatal diseases among suicides assisted by Exit Deutsche Schweiz has increased since the 1990s (women: 52% to 65%, p = 0.031; mean age in years (SD): 69.3 (17.0) to 76.9 (13.3), p = 0.000), non-fatal diseases: 22% to 34%, p = 0.026). Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study. (shrink)

Research on self-agency emphasizes the importance of a comparing mechanism, which scans for a match between anticipated and actual outcomes, in the subjective experience of doing.This study explored the “feeling of doing” in individuals with checking symptoms by examining the mechanism involved in the experienced agency for outcomes that matched expectations. This mechanism was explored using a task in which the subliminal priming of potential action-effects generally enhances people’s feeling of causing these effects when they occur, due to the unconscious (...) perception of a match between primed and observed outcomes. The main result revealed a negative relationship between checking and self-agency for observed outcomes that were primed prior to actions. This suggests that checking individuals fail to grasp the correspondence between actual outcomes of their actions and expected ones. We discuss the possible role of undermined self-agency in checking phenomena and its relationship with cognitive dysfunction. (shrink)

This paper analyses the National Populist Challenges to Europe’s Center Right. It assesses the cases of the UK, Germany and France. It poses three questions for Europe: How will political integration be achieved and maintained? What policies will foster economic inclusion in the Eurozone? And, third, what are the best means to achieve economic solvency and growth. The paper make a case that neoliberal economic policies over the past decades have undermined some nations' public sector and have also contributed to (...) tensions between the geographical east and west of Europe. (shrink)

Background: In Switzerland, non-medical right-to-die organisations such as Exit Deutsche Schweiz and Dignitas offer suicide assistance to members suffering from incurable diseases.Objectives: First, to determine whether differences exist between the members who received assistance in suicide from Exit Deutsche Schweiz and Dignitas. Second, to investigate whether the practices of Exit Deutsche Schweiz have changed since the 1990s.Methods: This study analysed all cases of assisted suicide facilitated by Exit Deutsche Schweiz and Dignitas between 2001 and 2004 and investigated by the University (...) of Zurich’s Institute of Legal Medicine. Furthermore, data from the Exit Deutsche Schweiz study which investigated all cases of assisted suicide during the period 1990–2000 were compared with the data of the present study.Results: More women than men were assisted in both organisations. Dignitas provided more assistance to non-residents, younger persons : D: 64.5 ; E: 76.6 ; p = 0.001), and people suffering from fatal diseases such as multiple sclerosis and amyotrophic lateral sclerosis. Lethal medications were more often taken orally in cases assisted by Dignitas. The number of women and the proportion of older people suffering from non-fatal diseases among suicides assisted by Exit Deutsche Schweiz has increased since the 1990s : 69.3 to 76.9, p = 0.000), non-fatal diseases: 22% to 34%, p = 0.026).Conclusions: Weariness of life rather than a fatal or hopeless medical condition may be a more common reason for older members of Exit Deutsche Schweiz to commit suicide. The strong over-representation of women in both Exit Deutsche Schweiz and Dignitas suicides is an important phenomenon so far largely overlooked and in need of further study. (shrink)

[full article, abstract in English; abstract in Lithuanian] Armstrong’s theory of laws and causation may be articulated as something like the following, which we may refer to as the received view: “Laws are intrinsic higher-order relations of ensuring between properties. The instantiation of laws is identical with singular causation. This identity is a posteriori.” Opponents and advocates of this view, believe that it may fairly and correctly be attributed to Armstrong. I do not deny it; instead I seek to reconsider (...) the received view, specifically by treating it as a part of Armstrong’s metaphysics. The main features that should concern us are truthmaker theory and the formal account of the constitutive parts of states of affairs. I also discuss Bird’s ultimate argument against Armstrong and show how its impact is weakened by this proper reading. (shrink)

During the past few years considerable debate has arisen within academic journals with respect to the use of smart drugs or cognitive enhancement pharmaceuticals. The following paper seeks to examine the foundations of this cognitive enhancement debate using the example of methylphenidate use among college students. The argument taken is that much of the enhancement debate rests upon inflated assumptions about the ability of such drugs to enhance and over-estimations of either the size of the current market for such drugs (...) or the rise in popularity as drugs for enhancing cognitive abilities. This article provides an overview of the empirical evidence that methylphenidate has the ability to significantly improve cognitive abilities in healthy individuals, and examines whether the presumed uptake of the drug is either as socially significant as implied or growing to the extent that it requires urgent regulatory attention. In addition, it reviews the evidence of side-effects for the use of methylphenidate which may be an influential factor in whether an individual decides to use such drugs. The primary conclusions are that neither drug efficacy, nor the benefit-to-risk balance, nor indicators of current or growing demand provide sufficient evidence that methylphenidate is a suitable example of a cognitive enhancer with mass appeal. In light of these empirically based conclusions, the article discusses why methylphenidate might have become seen as a smart drug or cognitive enhancer. (shrink)

This article compares James M. Buchanan's and John Rawls's theories of democratic governance. In particular it compares their positions on the characteristics of a legitimate social contract. Where Buchanan argues that additional police force can be used to quell political demonstrations, Rawls argues for a social contract that meets the difference principle.

This article assesses how autonomy and machine learning impact the existential risk of nuclear war. It situates the problem of cyber security, which proceeds by stealth, within the larger context of nuclear deterrence, which is effective when it functions with transparency and credibility. Cyber vulnerabilities poses new weaknesses to the strategic stability provided by nuclear deterrence. This article offers best practices for the use of computer and information technologies integrated into nuclear weapons systems. Focusing on nuclear command and control, avoiding (...) autonomy and machine learning is recommended as one means to reduce the existential risk of unintended nuclear conflict. (shrink)

This paper proposes a Cournot game organized by three competing firms adopting bounded rationality. According to the marginal profit in the past time step, each firm tries to update its production using local knowledge. In this game, a firm’s preference is represented by a utility function that is derived from a constant elasticity of substitution production function. The game is modeled by a 3-dimensional discrete dynamical system. The equilibria of the system are numerically studied to detect their complex characteristics due (...) to difficulty to get an explicit form for those equilibria. For the proposed utility function, some cases with different value parameters are considered. Numerical simulations are used to provide an experimental evidence for the complex behavior of the evolution of the system. The obtained results show that the system loses its stability due to different types of bifurcations. (shrink)

More than 40 primary studies, and three recent systematic reviews and meta-analyses, have shown a clear association between pharmaceutical industry funding of clinical trials and pro-industry results. Industry sponsorship biases published scientific research in favour of the sponsors, a result of the strong interest commercial sponsors have in obtaining favourable results.Three proposed remedies to this problem are widely agreed upon among those concerned with the level of sponsorship bias: financial disclosure, reporting standards and trial registries. This paper argues that all (...) of these remedies either fail to address the mechanisms by which pharmaceutical companies’ sponsorship leads to biased results—design bias, multiple trials with predictable outcomes, fraud, rhetorical effects and publication bias—or else only inadequately address those mechanisms. As a result, the policies normally proposed for dealing with sponsorship bias are unable to eliminate it. Only completely separating public clinical research from pharmaceutical industry funding can eliminate sponsorship bias. (shrink)

We show that it is consistent that the reaping number r is less than u , the size of the smallest base for an ultrafilter. To show that our forcing preserves certain ultrafilters, we prove a general partition theorem involving Ramsey ideals.

In this paper we continue an ongoing dialogue that has as its goal the critical appraisal of theoretical perspectives on culture and health, in an effort to move forward scholarship on culture and health. We draw upon a programme of scholarship to explicate theoretical tensions and challenges that are manifest in the discourses on culture and health and to explore the possibilities Bourdieu's theoretical perspective offers for reconciling them. That is, we hope to demonstrate the need to move beyond descriptions (...) ‘of’ culture to an understanding of cultures as dynamic, and to show ways cultural practices create contexts that have the potential to foster or impede health.In our early research, largely undertaken in Canada's multicultural context, we sought to make visible the ways in which culture shaped conceptions of health and influenced health practices of immigrant groups. In recent years this focus has expanded to include populations that reflect the cultural and social diversity of our region. From the outset we attempted to move towards a conception of culture as negotiated, unifying, transformative and dynamic. While this position continues to hold appeal we are continually reminded that, despite our leanings towards constructivism, there is salience to the notion of culture as having enduring elements. It is this tension between the view of culture as embodied and enduring and culture as constructed and dynamic that we seek to examine.We explore whether Bourdieu's theoretical perspective offers promise for reconciling these apparently competing views. Using exemplars from our research we share insights that Bourdieu's work has offered to our analyses, thereby enabling us to move towards a view of culture that holds in tension these apparently contradictory positions of culture as both essence (albeit unstable, negotiated) and constructed. (shrink)

In a representative vignette study in Germany with 1,653 respondents, we investigated laypeople’s attribution of moral responsibility in collaborative medical diagnosis. Specifically, we compare people’s judgments in a setting in which physicians are supported by an AI-based recommender system to a setting in which they are supported by a human colleague. It turns out that people tend to attribute moral responsibility to the artificial agent, although this is traditionally considered a category mistake in normative ethics. This tendency is stronger when (...) people believe that AI may become conscious at some point. In consequence, less responsibility is attributed to human agents in settings with hybrid diagnostic teams than in settings with human-only diagnostic teams. Our findings may have implications for behavior exhibited in contexts of collaborative medical decision making with AI-based as opposed to human recommenders because less responsibility is attributed to agents who have the mental capacity to care about outcomes. (shrink)

Is capitalism inherently predatory? Must there be winners and losers? Is public interest outdated and free-riding rational? Is consumer choice the same as self-determination? Must bargainers abandon the no-harm principle? Prisoners of Reason recalls that classical liberal capitalism exalted the no-harm principle. Although imperfect and exclusionary, modern liberalism recognized individual human dignity alongside individuals' responsibility to respect others. Neoliberalism, by contrast, views life as ceaseless struggle. Agents vie for scarce resources in antagonistic competition in which every individual seeks dominance. This (...) political theory is codified in non-cooperative game theory; the neoliberal citizen and consumer is the strategic rational actor. Rational choice justifies ends irrespective of means. Money becomes the medium of all value. Solidarity and good will are invalidated. Relationships are conducted on a quid pro quo basis. However, agents can freely opt out of this cynical race to the bottom by embracing a more expansive range of coherent action. (shrink)

The relevance of the study has two sides — individual and general. In its essential aspect, it is the development of achievements of predecessors by consistently taking into account the latest data on trends and changes in the interconnected spheres of education, economics and culture. In the individual aspect, it is about improving the professional means of improving the efficiency of teaching foreign languages in order to form students with a high level of linguistic-professional competence. Public relevance is the goal (...) of educating young people in a new patriotic direction, because today, due to various global influences, the classical principles of life in the agrarian system, created in recent centuries, or in the industrial society, are devalued due to various global influences. The purpose of the study in a broad sense was to highlight the causes and consequences of the European religious Reformation as the main factor in accelerating the movement of the whole of Western Europe to the position of the world leader that previously belonged to China. We see precis e tasks in the integrated analysis on the basis of the latest discoveries of many humanities and exact sciences in the educational, economic and cultural systems of Germany and other successful European states. On this basis, we hope to fulfill the public task which is to make significant proposals in the plans and practice of higher education reform in Ukraine. The methodology of the study relies on the best classical means, on the principle of historicism and the continuity of the connection between the material and the ideal, a modern multidisciplinary approach. For the highest effectiveness of the research, we will use the latest scientific data and recommendations of the innovators who collect and use these data. The results of the study mostly follow from the mentioned new discoveries. They testify that in ancientt history, in the role of locomotives of civilizational progress in the western part of Eurasia, direct descendants of the inventors of agriculture acted, among which the especially great contribution belongs to the ancestors of Ukrainians from the territories of Trypillya and the Great Trypillya. It is indicated that during the existence of the Great Trypillya, future German farmers acquainted themselves with the technologies of the Great Trypillya, so the German language, through borrowed words, became part of the Indo-European family. It is noted that after the collapse of the Great Trypillya, the Germans and Slavs became neighbors along the meridian Elbe. In the age of steppe invasions, future Ukrainians and Germanic tribes did not get in contact, and the influence of the Roman Empire was mostly experienced by western lands. Emphasis was placed on the evolution of ideological, religious and other paradigms in the territory of Germany after the collapse of the Holy Roman Empire, which determined the development of the nation for the next hundreds of years. The religious and philosophical paradigmatic origins of those unique features of culture and education that during the nineteenth century were emphasized. brought Germany to the position of the scientific and technological leader of the world. The high role of German neo-humanism and the Berlin Research University were noted. In the final section, special attention is paid to religious issues and to the destructive impact on social and other processes in the German immigration flows of Islamists. The conclusions focus on the competition of several important paradigms in the education of modern Germany and the proposals made to incorporate German experience in legislation and the use of the Bologna process. An important caution is made regarding the choice of Germany's strategy for the development of the scientific and educational complex 'within the framework of the Lisbon project. This country has become a world leader not only in alternative energy, but also in the implementation of the fourth industrial revolution. We consider an example of this leadership like the regular world conferences in Davos, which involve the majority of influential politicians and economists. (shrink)

While there are many points of opposition between the political philosophies of Marx and Kant, the two can greatly benefit from one another in various ways. Bringing the ideas of Marx and Kant together offers a promising way forward for each view. Most significantly, a powerful critique of capitalism can be developed from their combined thought: Kant’s political philosophy offers a robust idea of freedom to ground this critique, while Marx provides the nuanced understanding of social and political power structures (...) under capitalism that allows this idea of freedom to be properly applied. (shrink)

As these opening quotes acknowledge, the Prisoner’s Dilemma (PD) represents a core puzzle within the formal mathematics of game theory.3 Its rise in conspicuity is evident figure 2.1 above demonstrating a relatively steady rise in incidences of the phrase’s usage between 1960 to 1995, with a stable presence persisting into the twenty first century. This famous two-person “game,” with a stock narrative cast in terms of two prisoners who each independently must choose whether to remain silent or speak, each advancing (...) self-interest at the expense of the other and thereby achieving a mutually suboptimal outcome, mires any social interaction it is applied to into perplexity. The logic of this game proves the inverse of Adam Smith’s invisible hand: individuals acting on self interest will achieve a mutually suboptimal outcome. However, as this chapter illuminates, the assumptions underlying game theory drive this conclusion. (shrink)

This article challenges the view of disability presented by Harris in his article, “Is gene therapy a form of eugenics?”1 It is argued that his definition of disability rests on an individual model of disability, where disability is regarded as a product of biological determinism or “personal tragedy” in the individual. Within disability theory this view is often called “the medical model” and it has been criticised for not being able to deal with the term “disability”, but only with impairment. (...) The individual model of disability presupposes a necessary causal link between a certain condition in the individual and disablement. The shortcomings of such a view of disability are stated and it is argued that in order to have an adequate ethical discourse on gene therapy perspectives from disability research need to be taken into consideration. (shrink)

The article argues that Kant’s argument for ownership entails a standard of meaningful use by which property regimes can be evaluated: a regime must make it possible for usable objects to be meaningfully used. A particular form of fully communal ownership can satisfy this standard. Further, this form of communal ownership is compatible with Kantian freedom more broadly. I conclude that, if this is so, there is a great deal of space for further consideration of the rightfulness of diverse regimes (...) of ownership and exchange within a Kantian framework. (shrink)

This paper explores how the Leviathan that projects power through nuclear arms exercises a unique nuclearized sovereignty. In the case of nuclear superpowers, this sovereignty extends to wielding the power to destroy human civilization as we know it across the globe. Nuclearized sovereignty depends on a hybrid form of power encompassing human decision-makers in a hierarchical chain of command, and all of the technical and computerized functions necessary to maintain command and control at every moment of the sovereign's existence: this (...) sovereign power cannot sleep. This article analyzes how the form of rationality that informs this hybrid exercise of power historically developed to be computable. By definition, computable rationality must be able to function without any intelligible grasp of the context or the comprehensive significance of decision-making outcomes. Thus, maintaining nuclearized sovereignty necessarily must be able to execute momentous life and death decisions without the type of sentience we usually associate with ethical individual and collective decisions. (shrink)

The Greek original of Galen's is lost, nor has a copy of the complete translation into Arabic, made by Hunayn b. Ishāq in the first half of the ninth century, come down to us, though some passages of it are quoted by various Arab authors. A summary of the translation, however, was discovered by P. Kraus in a miscellaneous manuscript in Cairo and published by him in the Bulletin of the Faculty of Arts of the University of Egypt, vol. v/i.

This chapter uncovers the complex negotiations for authority in various representations about futures of life which have been advanced by different branches of the sciences, and have culminated in the emerging concept of life as algorithm. It charts the historical shifts in expertise and representations of life, from naturalists, to mathematical modellers, and specialists in computation, and argues that physicists, game theorists, and economists now take a leading role in explaining and projecting futures of life. The chapter identifies Richard Dawkins (...) and Max Tegmark at the forefront of the concept of life as algorithm: the first inspired by game theory as a means to study evolution; the second proposing that a materialist basis of life could place humans and artificial intelligence on an equal footing. Through close reading of their respective texts, the chapter demonstrates that both thinkers consider life as an algorithm programmed to achieve success in survival and reproduction. (shrink)

This article, reporting on selected data from a larger study, discusses some responses to end-of-life questions that elderly Japanese people who were living in small towns gave in a questionnaire survey. Japan is now the country with the largest number of elderly people in the world and confronts numerous social and economic questions concerning how best to cope with its older population. Although it is a highly urbanized society, Japan also has large semirural areas. The focus here is on the (...) questions in the survey that sought responses to ethical dimensions of end-of-life issues. The findings demonstrate the strength of traditional values that still exist throughout small towns in Japan. (shrink)

This paper reconsiders whether rational choice and game theory represent cases of economics imperialism. It follows the work of Uskali Maki who analyzes the significance and characteristics of disciplinary imperialism in natural science and social science. "Economics Imperialism" is a term often used to describe the increasing impact and reach of economics with respect to its encroachment on other disciplines including political science and psychology. Maki provides a framework for assessing whether the influence of one discipline on another could be (...) a case of "good imperialism" consistent with unification and greater explanatory power. The paper examines whether in the case of economics, "rational choice imperialism" is a better understanding of the question of contention. Rational choice has been used to model addiction, sex, marriage, sleep, and suicide. Applying tools offered by Maki, this paper argues that although the imperialism of rational choice over multiple disciplines provides a unified means of modeling human action, it does not demonstrably achieve deeper understanding of either individual or collective action. Furthermore, rational choice modeling may alter the human practices it analyzes if it is used in public policy. Thus although rational choice offers a means to check for deductive consistency within and among its models, it has elements suggestive of the "bad disciplinary imperialism" that Uskali provides a means to critique. (shrink)

The author congratulates Dr Brian Hurwitz, who recently reported the successful “intimidation” of an elderly competent widow into accepting badly needed therapy for a huge ulcerated carcinoma. He reports approvingly of the Israeli Patients' Rights Law, enacted in 1996, which demands detailed informed consent from competent patients before permitting treatment. But the law also provides an escape clause which permits coercing a competent patient into accepting life-saving therapy if an ethics committee feels that if treatment is imposed the patient will (...) give his/her consent retroactively. He suggests this approach as an appropriate middle road between overbearing paternalism and untrammelled autonomy. (shrink)

Originally used to decipher the 1950s nuclear stalemate, the “Prisoner’s Dilemma” might reveal how resources are unfairly distributed today.