Malaysia had its first four patients with COVID-19 on 25 January 2020. In the same week, the World Health Organization declared it as a public health emergency of international concern. The pandemic has since challenged the ethics and practice of medicine. There is palpable tension from the conflict of interest between public health initiatives and individual’s rights. Ensuring equitable care and distribution of health resources for patients with and without COVID-19 is a recurring ethical challenge for clinicians. Palliative care aims (...) to mitigate suffering caused by a life-limiting illness, and this crisis has led to the awareness and urgency to ensure it reaches all who needs it. We share here the palliative care perspectives and ethical challenges during the COVID-19 pandemic in Malaysia. (shrink)

This paper examines to what extent Davidsonian truth-theoretic semantics can give an adequate account for empty names in natural languages. It argues that the prospect is dim because of a tension between metaphysical austerity, non-vacuousness of theorems and empirical adequacy. Sainsbury (2005) proposed a Davidsonian account of empty names called ‘Reference Without Referents’ (RWR), which explicates reference in terms of reference-condition rather than referent, thus avoiding the issue of existence. This is an inspiring account. However, it meets several difficulties. First, (...) there is no non-vacuous, interpretive truth-condition available for any T-sentence containing an empty name, because by stipulation there is no way to compose a true atomic sentence using an empty name in RWR. The absence of an interpretive truth-condition implies the absence of an interpretive reference-condition. It also entails empirical inadequacy to support an interpretation because the related propositional attitude can never be truly satisfied. These considerations cast doubt on whether truth is the proper vehicle to articulate meaning. This paper suggests that we can alleviating the problem by employing truth-conditions varying across contexts of utterance, rather than just contexts of evaluation. The result is a two-dimensional model-theoretic approach to empty names. It involves a new function coined counterfactual reference and the account is compatible with both descriptivism and Millianism. (shrink)

Understand Logic is a comprehensive introduction to this fascinating though sometimes challenging subject. As well as looking at logic in theoretical terms the book considers its everyday uses and demonstrates how it has genuine practical applications. It will take you step by step through the most difficult concepts and is packed with exercises to help you consolidate your learning at every stage. Covering everything from syllogistic logic to logical paradoxes and even looking at logic in Alice in Wonderland, this is (...) the only guide you will ever need. (shrink)

Russell had two theories of names and one theory of description. Logically proper names are Millian names, which have only denotation but no connotation. Ordinary names are not genuine names but disguised definite descriptions subject to quantificational analyses. Only by asserting that ordinary names are definite descriptions could Russell motivate his theory of description to solve three problems for Millian names, namely, Frege’s puzzle, empty reference and negative existentials. Critics usually discuss Russell’s theories of names and his theory of description (...) separately. This paper takes a new perspective and presents a dilemma for the overall project, arguing that it is hard to be a Russellian about names coherently. The central issue is whether contextualisation is semantic or pragmatic in nature, an issue very much alive in contemporary debates. This paper traces Russell’s ambiguity on this matter back to his conception of the roles of knowledge by acquaintance and knowledge by description in naming. (shrink)

This paper asks which free logic a Fregean should adopt. It examines options within the tradition including Carnap’s (1956) chosen object theory, Lehmann’s (1994, 2002) strict Fregean free logic, Woodruff’s (1970) strong table about Boolean operators and Bencivenga’s (1986, 1991) supervaluational semantics. It argues for a neutral free logic in view of its proximity towards explaining natural languages. However, disagreeing with Lehmann, it claims a Fregean should adopt the strong table based on Frege’s discussion on generality. Supervaluation uses strong table (...) and aims to give it a semantic justification. However, supervaluation is in turn justified by convention or mental experiments, which Lehmann argues as inadequate. The paper proposes a new justification of supervaluation based on sense and two-dimensional semantics. The resulting model, coined Supervaluational Neutral Free Logic (SNFL), resolves many conflicts between Lehmann and Bencivenga while staying close with Frege’s discussions about non-denotation. It also provides new insights into the relations among truth, logical truth, and supervaluated truth (or supertruth, for short). (shrink)

Background: Frailty is a natural consequence of the aging process. With the increasing aging population in Mainland China, the quality of life and end-of-life care for frail older people need to be taken into consideration. Advance Care Planning has also been used worldwide in long-term facilities, hospitals and communities to improve the quality of end-of-life care, increase patient and family satisfaction, and reduce healthcare costs and hospital admissions in Western countries. However, it has not been practiced in China. Research objective: (...) This study aimed to evaluate the effectiveness of a modified Advance Care Planning intervention in certainty of end-of-life care, preferences for end-of-life care, quality of life concerns, and healthcare utilization among frail older people. Research design: This study used a quasi-experimental design, with a single-blind, control group, pretest and repeated posttest approach. Participants and research context: A convenience sample of 74 participates met the eligibility criteria in each nursing home. A total of 148 frail older people were recruited in two nursing homes in Zhejiang Province, China. Ethical considerations: The study received ethical approval from the Clinical Research Ethics Committee, the Faculty of Medicine, and The Chinese University of Hong Kong, CREC Ref. No: 2016.059. Findings: The results indicated the Advance Care Planning programme was effective at increasing autonomy in decision making on end-of-life care issues, decreasing decision-making conflicts over end-of-life care issues, and increasing their expression about end-of-life care. Discussion: This study promoted the participants’ autonomy and broke through the inherent custom of avoiding talking about death in China. Conclusion: The modified Advance Care Planning intervention is effective and recommended to support the frail older people in their end-of-life care decision in Chinese society. (shrink)

BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

User intent classification is a vital component of a question-answering system or a task-based dialogue system. In order to understand the goals of users’ questions or discourses, the system categorizes user text into a set of pre-defined user intent categories. User questions or discourses are usually short in length and lack sufficient context; thus, it is difficult to extract deep semantic information from these types of text and the accuracy of user intent classification may be affected. To better identify user (...) intents, this paper proposes a BERT-Cap hybrid neural network model with focal loss for user intent classification to capture user intents in dialogue. The model uses multiple transformer encoder blocks to encode user utterances and initializes encoder parameters with a pre-trained BERT. Then, it extracts essential features using a capsule network with dynamic routing after utterances encoding. Experiment results on four publicly available datasets show that our model BERT-Cap achieves a F1 score of 0.967 and an accuracy of 0.967, outperforming a number of baseline methods, indicating its effectiveness in user intent classification. (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 (MI). Thirty participants with work injuries were classified into the pre-contemplation (PC,n= 15) or readiness stage of the change group (RD,n= 15). The participants viewed MI congruent (MI-C), MI incongruent (MI-INC), or control phrases during which their electroencephalograms were captured. The results indicated significant Group × Condition effects in the (...) frontally oriented late positive complex (P600/LPC). 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 (r= 0.607–0.649) 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)

A review of Meaghan Morris, Siu Leung and Stephen Chan Ching-kiu,_ Hong Kong Connections: Transnational Imagination in Action Cinema _.

This essay explores the theological and anthropological significance of birth, in order to discern what might be lost with the adoption of complete ectogestation (“artificial wombs”). Specifically, it considers both Saint Augustine and Karl Barth’s respective accounts of humanity’s whence—that is, their theological answer to the question of the nature and significance of our origins as individuals. I suggest that Augustine’s account of his origins emphasizes both his epistemic and biological dependency on his mother and nurses, while Barth’s stresses the (...) individual’s immediate derivation from God. Those disparate answers affect how they construe the relationships of parents and children and work themselves throughout their theological visions and imaginations. I conclude that careful consideration of humanity’s whence cannot answer whether we ought to pursue ectogestation; but it does help us account for how our understanding of God and ourselves might be altered if we gestate human life outside the womb. (shrink)

A thought-provoking comparative take on two seminal thinkers in Christian history In this book -- the first volume in the Kierkegaard as a Christian Thinker series -- Lee Barrett offers a novel comparative interpretation of early church father Augustine and nineteenth-century philosopher-theologian Soren Kierkegaard. Though these two intellectual giants have been paired by historians of Western culture, the exact nature of their similarities and differences has never before been probed in detail. Barrett demonstrates that on many essential theological levels Augustine (...) and Kierkegaard were more convergent than divergent. Most significantly, their parallels point to a distinctive understanding of the Christian life as a passion for self-giving love. Approaching Kierkegaard through the lens of Augustine, Barrett argues, enables the theme of desire for fulfillment in God to be seen as much more central to Kierkegaard's thought than previously imagined. (shrink)

In How to Talk to a Science Denier, Lee McIntyre tells the story of his own adventures in talking face to face with science deniers and their victims-including a Flat Earth convention in Denver, coal miners in rural Pennsylvania, and fishermen in the Maldives-and what he learned from the experience.

This essay defends the asymmetry between the badness of spontaneous and induced abortions in order to explain why anti-abortionists prioritize stopping induced abortions over preventing spontaneous abortions. Specifically, it argues (1) the distinction between killing and letting-die is of more limited use in explaining the asymmetry than has sometimes been presumed, and (2) that accounting for intentions in moral agency does not render performances morally inert. Instead, anti-abortionists adopt a pluralist, nonreductive account of moral analysis which is situated against a (...) backdrop that sees the limits of our ability to control the process of fertility as themselves valuable. Although this view is complex, the paper concludes by arguing that it has the advantage of explaining features of the anti-abortion outlook that have sometimes been overlooked. First, it accounts for why the pre-Roe regime of abortion restrictions primarily imposed penalties on doctors who induced abortions rather than the women who seek them. Second, it explains why the advent of ectogestation will not prompt anti-abortionists to compromise on ‘disconnect abortions,’ which putatively let the embryo die by extracting it from the mother’s womb. (shrink)

This paper explores the sense in which rational requirements govern our attitudes like belief and intention. I argue that there is a tension between the idea that rational requirements govern attitudes understood as standing states and the attractive idea that we can directly satisfy the requirements by performing reasoning. I identify the tension by (a) illustrating how a dispositional conception of belief can cause trouble for the idea that we can directly revise our attitudes through reasoning by considering John Broome's (...) view, and (b) advancing a general argument that a standing state cannot be directly affected by reasoning. I then propose a solution: by recognizing the proper targets of rational requirements as occurrent, rather than dispositional attitudes, we can preserve the idea that we can directly satisfy rational requirements through reasoning. (shrink)

Background Residual dried blood spots (rDBS) from newborn screening programmes represent a valuable resource for medical research, from basic sciences, through clinical to public health. In Hong Kong, there is no legislation for biobanking. Parents’ view on the retention and use of residual newborn blood samples could be cultural-specific and is important to consider for biobanking of rDBS. Objective To study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese (...) parents. Methods A mixed-method approach was used to study the views and concerns on long-term storage and secondary use of rDBS from newborn screening programmes among Hong Kong Chinese parents of children 0–3 years or expecting parents through focus groups (8 groups; 33 participants) and a survey (n = 1012, 85% mothers) designed with insights obtained from the focus groups. We used framework analysis to summarise the themes as supportive factors, concerns and critical arguments for retention and secondary use of rDBS from focus group discussion. We used multiple logistic regression to assess factors associated with support for retention and secondary use of rDBS in the survey. Results Both in focus groups and survey, majority of parents were not aware of the potential secondary use of rDBS. Overall secondary use of rDBS in medical research was well accepted by a large proportion of Hong Kong parents, even if all potential future research could not be specified in a broad consent. However parents were concerned about potential risks of biobanking rDBS including leaking of data and mis-use of genetic information. Parents wanted to be asked for permission before rDBS are stored and mainly did not accept an “opt-out” approach. The survey showed that parents born in mainland China, compared to Hong Kong born parents, had lower awareness of newborn screening but higher support in biobanking rDBS. Higher education was associated with support in rDBS biobanking only among fathers. Conclusion Long-term storage and secondary use of rDBS from newborn screening for biomedical research and a broad consent for biobanking of rDBS are generally acceptable to Hong Kong parents given their autonomy is respected and their privacy is protected, highlighting the importance of an accountable governance and a transparent access policy for rDBS biobanks. (shrink)

As scientific and engineering efforts become increasingly global in nature, the need to understand differences in perceptions of research ethics issues across countries and cultures is imperative. However, investigations into the connection between nationality and ethical decision-making in the sciences have largely generated mixed results. In Study 1 of this paper, a measure of biases and compensatory strategies that could influence ethical decisions was administered. Results from this study indicated that graduate students from the United States and international graduate students (...) studying in the US are prone to different biases. Based on these findings, recommendations are made for developing ethics education interventions to target these decision-making biases. In Study 2, we employed an ethics training intervention based on ethical sensemaking and used a well-established measure of ethical decision-making that more fully captures the content of ethical judgment. Similar to Study 1, the results obtained in this study suggest differences do exist between graduate students from the US and international graduate students in ethical decision-making prior to taking the research ethics training. However, similar effects were observed for both groups following the completion of the ethics training intervention. (shrink)

Several attempts have recently been made to explain moral systems and moral sentiments in light of evolutionary biological theory. It may be helpful to modify and extend this project with the help of a theory of communication developed by ethologists. The core of this approach is the idea that signals are best seen as attempts to manipulate others rather than as attempts to inform them. This addition helps to clarify some problematic areas in the evolutionary study of morals, and it (...) generates new, testable predictions about moral statements. (shrink)

Independent philosopher Lee (recently of the U. of Manchester) attends to the deeper implications of ecologically insensitive technology beyond its polluting effects. Contrasting modern with premodern worldviews provides the context for exploring how new sciences like biotechnology require an expanded environmental ethos encompassing both the biotic and the abiotic. The author considers misconceived the notions of nature as either a work of art or a mere social construct per some postmodern thinking. Annotation copyrighted by Book News, Inc., Portland, OR.

On one hand, Chinese consumers are well known for conspicuous consumption and the adoption of luxury products and named brands. On the other hand, they also have a bad reputation for buying counterfeit products. Their simultaneous preferences for two contrasting types of product present a paradox that has not been addressed in the literature. This study attempts to present an explanation of this paradox by examining the effects of traditional Chinese cultural values and consumer values on consumers’ deontological judgment of (...) pirated CDs and the amount of social benefits they perceive they gain from them. We interviewed 300 Hong Kong Chinese consumers, and found that face consciousness increased materialism and risk aversion, thereby producing a favorable deontological judgment of pirated CDs. Face consciousness also has a direct effect on the amount of social benefits perceived in pirated CDs. Both favorable deontological judgment and perceived social benefits contributed to a strong intention to buy pirated CDs. The results are discussed in a cultural perspective. (shrink)

This study gathered preliminary baseline data on the moral development of journalists using the Defining Issues Test, an instrument based on Kohlberg's 6 stages. Results show that a sample of journalists scored 4th highest among professionals tested using the DIT. The journalists ranked behind seminarians/philosophers, medical students, and physicians but above dental students, nurses, graduate students, undergraduate college students, veterinary students, and adults in general. No significant differences were found between various groups of journalists, including men and women, and broadcast (...) and print journalists. The journalists in the study scored significantly higher on the 3 journalism-specific dilemmas than on 3 nonjournalism dilemmas. (shrink)

There are few scientists of the twentieth century whose life's work has created more excitement and controversy than that of physicist David Bohm . For the first time in a single volume, The Essential David Bohm offers a comprehensive overview of Bohm's original works from a non-technical perspective. Including three chapters of previously unpublished material, and a forward by the Dalai Lama, each reading has been selected to highlight some aspect of the implicate order process, and to provide an introduction (...) to one of the most provocative thinkers of our time. (shrink)

Religion inspires honesty. The love of money incites dishonesty. Religious and monetary values apply to all religions. We develop a formative theoretical model of monetary wisdom, treat religiosity (God) and the love of money (mammon), as two yoked antecedents—competing moral issues (Time 1), and frame the latent construct in good barrels (performance or humane contexts, Time 2), which leads to (dis)honesty (Time 3). We explore the direct and indirect paths and the model across genders. Our three-wave panel data (411 participants) (...) show that religious and monetary values are negatively correlated. Directly, religiosity consistently curbs dishonesty; surprisingly, the love of money has no impact on dishonesty. In the performance context, the two mediation effects reduce dishonesty. Across genders, this mediation effect is nonsignificant for males but significantly excites females' honesty. In the humane context, the two mediation effects are nonsignificant. Across genders, for the love of money, males passively curb dishonesty by omission, and females actively engage in honesty by commission. Decision-makers must challenge people's moral issues, frame them in good barrels, and help people become good apples, choice architects, and moral and ethical decision-makers, promoting the Matthew effect in religion. We offer practical implications to individuals and organizations. (shrink)

What assumptions are built into the claim that experience has “phenomenal properties,” and could these assumptions turn out to be false? I consider the issue specifically for the similarity relations between experiences: for example, experiences of different shades of red are more similar to each other than an experience of red and an experience of green. It is commonly thought that we have a special kind of epistemic access to experience that is more secure than our access to the external (...) environment. In the first part of the paper, I argue than one way of elucidating this claim is especially plausible—that systematic error, of the kind subjects make about the external environment in traditional “skeptical” scenarios, is not conceivable for introspection of experience, including for our knowledge of similarity relations. I argue that focusing on similarity relations gives us a more interesting version of the argument than for other forms of experiential introspection. Then in the second part of the paper I describe an example, inspired by a similar case due to Sydney Shoemaker, in which a subject, despite being fully rational and attentive, apparently is systematically mistaken about the character of their experience in a surprising way. I argue that the example calls into question whether there are properties of experience satisfying the epistemic access constraint, and therefore whether experience has “phenomenal properties” in the intuitive sense. (shrink)

The Internet appears to offer psychologists doing research unrestricted access to infinite amounts and types of data. However, the ethical issues surrounding the use of data and data collection methods are challenging research review boards at many institutions. This article illuminates some of the obstacles facing researchers who wish to take advantage of the Internet's flexibility. The applications of the APA ethical codes for conducting research on human participants on the Internet are reviewed. The principle of beneficence, as well as (...) privacy and confidentiality, informed consent, deception, and avoiding harm are all illustrated through the use of a hypothetical online study. (shrink)

For the first time, the revised Common Rule specifies that public health surveillance activities are not research. This article reviews the historical development of the public health surveillance exclusion and implications for other foundational public health practices.

Some cases show that counterfactual conditionals (‘counterfactuals’ for short) are inherently ambiguous, equivocating between forward-tracking and backtracking counterfactu- als. Elsewhere, I have proposed a causal modeling semantics, which takes this phenomenon to be generated by two kinds of causal manipulations. (Lee 2015; Lee 2016) In an important paper (Hiddleston 2005), Eric Hiddleston offers a different causal modeling semantics, which he claims to be able to explain away the inherent ambiguity of counterfactuals. In this paper, I discuss these two semantic treatments (...) and argue that my (bifurcated) semantics is theoretically more promising than Hiddleston’s (unified) semantics. (shrink)

Minkoff et al.’s contention that Dobbs threatens pregnant women’s right to refuse medical treatments that would risk the embryo’s life offers a bracing set of challenges to ethicists who affirm the...

This essay argues that gratitude for one's own life is an intelligible attitude to have. It does so by arguing that reducing pro-attitudes in response to unintentional benefits to “appreciation” is too broad. Instead, such “appreciation” can be understood as gratitude if such benefits satisfy a number of conditions that track or are analogous to why we care about interpersonally bestowed benefits. One's own life satisfies those four conditions, which can make gratitude for it intelligible—when it is perceived as a (...) benefit. (shrink)

'A wonderfully assured and utterly riveting biography that captures not only the much-maligned Machiavelli, but also the spirit of his time and place. A monumental achievement.' - Jessie Childs, author of God's Traitors. 'A notorious fiend', 'generally odious', 'he seems hideous, and so he is.' Thanks to the invidious reputation of his most famous work, The Prince, Niccolò Machiavelli exerts a unique hold over the popular imagination. But was Machiavelli as sinister as he is often thought to be? Might he (...) not have been an infinitely more sympathetic figure, prone to political missteps, professional failures and personal dramas? Alexander Lee reveals the man behind the myth, following him from cradle to grave, from his father's penury and the abuse he suffered at a teacher's hands, to his marriage and his many affairs (with both men and women), to his political triumphs and, ultimately, his fall from grace and exile. In doing so, Lee uncovers hitherto unobserved connections between Machiavelli's life and thought. He also reveals the world through which Machiavelli moved: from the great halls of Renaissance Florence to the court of the Borgia pope, Alexander VI, from the dungeons of the Stinche prison to the Rucellai gardens, where he would begin work on some of his last great works. As much a portrait of an age as of a uniquely engaging man, Lee's gripping and definitive biography takes the reader into Machiavelli's world - and his work - more completely than ever before. (shrink)

Female-biased parental investment is unusual but not unknown in human societies. Relevant explanatory models include Fisher’s principle, the Trivers-Willard model, local mate and resource competition and enhancement, and economic rational actor models. Possible evidence of female-biased parental investment includes sex ratios, mortality rates, parents’ stated preferences for offspring of one sex, and direct and indirect measurements of actual parental behavior. Possible examples of female-biased parental investment include the Mukogodo of Kenya, the Ifalukese of Micronesia, the Cheyenne of North America, the (...) Herero of southern Africa, the Kanjar of south Asia, the Mundugumor of New Guinea, contemporary North America, and historical Germany, Portugal, and the United States. (shrink)