Medical tourism is a practice, whereby individuals travel across national borders with the intention of receiving medical care. Medical tourists are motivated to travel abroad by a number of factors, including the affordability of care abroad, access to treatments not available at home, and wait times for care at home. In this article, we share the findings of interviews conducted with 32 Canadian medical tourists with the aim of developing a better understanding of medical tourism, the ethical issues it raises (...) for public health within Canada and other source countries for medical tourists, and to identify research gaps and policy responses to this practice. While patient and academic perspectives overlap in several regards, we suggest areas in which academic consideration of the ethical issues raised by medical tourism can be informed by patient perspectives. (shrink)
Background: Medical tourism involves patients travelling internationally to receive medical services. This practice raises a range of ethical issues, including potential harms to the patient's home and destination country and risks to the patient's own health. Medical tourists often engage the services of a facilitator who may book travel and accommodation and link the patient with a hospital abroad. Facilitators have the potential to exacerbate or mitigate the ethical concerns associated with medical tourism, but their roles are poorly understood. -/- (...) Methods: 12 facilitators were interviewed from 10 Canadian medical tourism companies. -/- Results: Three themes were identified: facilitators' roles towards the patient, health system and medical tourism industry. Facilitators' roles towards the patient were typically described in terms of advocacy and the provision of information, but limited by facilitators' legal liability. Facilitators felt they played a positive role in the lives of their patients and the Canadian health system and served as catalysts for reform, although they noted an adversarial relationship with some Canadian physicians. Many facilitators described personally visiting medical tourism sites and forming personal relationships with surgeons abroad, but noted the need for greater regulation of their industry. -/- Conclusion: Facilitators play a substantial and evolving role in the practice of medical tourism and may be entering a period of professionalisation. Because of the key role of facilitators in determining the effects of medical tourism on patients and public health, this paper recommends a planned conversation between medical tourism stakeholders to define and shape facilitators' roles. (shrink)
Following up on a 1989 paper on the subject, this essay revisits the question of ethical expertise in the court room. Informed by recent developments in the use of ethics experts, the authors argue 1) that the adversarial nature of court proceedings challenges the integrity of the ethicist's pedagogical role; 2) that the use of ethics experts as normative authorities remains dubious; 3) that clarification of the State's interest in “protecting the ethical integrity of the medical profession” is urgently required; (...) and 4) that the expertise of the ethicist may be more appropriately used in advising the legislature than in influencing the court. (shrink)
The Portraits of Care study used portraiture to investigate ideas about care and care giving at the intersection of art and medicine. The study employed mixed methods involving both qualitative and quantitative research techniques. All aspects of the study were approved by the Institutional Review Board. The study included 26 patient and 20 caregiver subjects. Patient subjects were drawn from across the lifespan and included healthy and ill patients. Caregiver subjects included professional and familial caregivers. All subjects gave their informed (...) consent for the study and the subsequent exhibition of artwork. The artist drew or painted 100 portraits during the 2-year study. A multi-disciplinary analysis team carried out the initial analysis of portraits and subject data. Findings from their qualitative analysis were used to develop a quantitative survey and qualitative journal tool that the public used to give feedback at the subsequent exhibition. Exhibition data confirmed the initial findings. Study results showed the introspection of subjects that revealed their sense of identity and psychological status. Patients appear as ‘whole people’, not fragmented by diagnosis. Caregivers' portraits reveal their commitment to care. There is also a sense of mutuality and fluidity in the background stories of subjects. Many patient subjects have been caregivers and, at times, caregivers are also patients. Public data emphasised the identity transformation of subjects, the centrality of the idea of mortality, the presence of hope despite adversity, and the importance of empathy and compassion in care. (shrink)
Purpose. The article is aimed to substantiate the view on the phenomenon of laughter as a subject of semiotic analysis, which leads to the following tasks: to reveal the possibilities of semiotics application in the study of laughter nature; to analyze the phenomenon of laughter as a cultural and natural phenomenon, as a sign and as an attribute; to consider the place of laughter in culture, which is understood as a sign system. Theoretical basis. The semiotic approach proceeds from the (...) fact that human lives in the world of signs, all the surrounding reality can be interpreted as a sign system. The basic concept of semiotics is the concept of a sign. The theoretical basis of the article is understanding the culture as a sign-symbolic system. Laughter is considered as a phenomenon ontologically rooted in human culture. At the same time, laughter is on the edge of culture. The research is based on the work of semiotic authors, cultural researchers, and the researchers of laughter. Originality. The originality lies in the application of the semiotic method to the research of laughter phenomenon, consideration of the dialectics of natural and cultural, signedness and non-signedness, manifested in the phenomenon of laughter. Conclusions. Laughter is considered as a psychophysiological phenomenon and as a cultural phenomenon. Laughter acts as an emotional manifestation, a physiological reaction, but socially and culturally mediated. In any case, laughter indicates an emotional or cognitive state of a human. Laughter acts as a process and result of the interpretation of a sign, a reaction to a sign. Laughter is a form and a means of communication. Being a natural phenomenon, in the process of social evolution, laughter acquires signedness, is integrated by culture as a sign system, and, at the same time, maintains a connection with nature. Thus, laughter occupies an ambivalent position between nature and culture. In the phenomenon of laughter, the dual state of human is revealed. In laughter, boundaries are blurred, the unity and opposition of natural and cultural, biological and social, soul and body, thought and feeling, sign and attribute are manifested. (shrink)
LetEO be the elementary ontology of Leniewski formalized as in Iwanu , and letLS be the monadic second-order calculus of predicates. In this paper we give an example of a recursive function , defined on the formulas of the language ofEO with values in the set of formulas of the language of LS, such that EO A iff LS (A) for each formulaA.
This article contains the proof of equivalence boolean algebra and syllogistics arc2. The system arc2 is obtained as a superstructure above the propositional calculus. Subjects and predicates of syllogistic functors a, E, J, O may be complex terms, Which are formed using operations of intersection, Union and complement. In contrast to negative sentences the interpretation of affirmative sentences suggests non-Empty terms. To prove the corresponding theorem we demonstrate that boolean algebra is included into syllogistics arc2 and vice versa.
In this paper I develop and defend a social conception of dignity. To that end, I look at what Holocaust survivors say about dignity since many have described their experiences in these terms. Unlike traditional conceptions, on my account dignity admits of degrees—one can have more or less dignity.
It is argued that anthropologists become moral relativists by mistake typically in two ways: (1) by confusing moral with factual discourse (dubbed the Normativist Fallacy) which derives in turn from a failure to distinguish adequately between direct and indirect discourse in the description of moral systems and preferences; or (2) by confusing definitive with hypothetical statements in descriptive ethics (the Definitivist Fallacy). Two representative arguments illustrating these errors are analyzed and some morals drawn from the results regarding the status of (...) relativist arguments in descriptive ethics and the prerogatives of applied anthropologists. (shrink)
The chief object of my paper is to clarify the notion of relativity to the means of observation as the basis for description of physical phenomena. This concept is so important that it deserves the name "the principle of relativity to the means of observation." This principle is particularly important to a correct understanding of quantum mechanics. The notion of relativity to the means of observation is, in a certain sense, a generalization of the notion of relativity to the system (...) of reckoning. The two notions play analogous roles in the corresponding theories. But while relativity theory, which rests upon the notion of relativity to the system of reckoning, takes into consideration only the motion of the means of observation as a whole, in quantum mechanics it is also necessary to take note of deeper properties of the means of observation. (shrink)
_ Source: _Volume 40, Issue 1, pp 104 - 115 It is intended in this study to present initial reliability and validity data for the Russian adaptation of the Multidimensional Inventory of Religious/Spiritual Well-being, as being related to personality factors and psychopathology. Therefore, the first version of the MI-RSWB-R was applied to a sample of 192 non-clinical subjects, together with the NEO Five Factor Inventory and the Symptom-Check-List. The original six-factor structure of the scale could be replicated for the MI-RSWB-R, (...) which also provides satisfying psychometric properties. In accordance with previous research the RSWB total score was linked to more favorable personality traits such as Extraversion, Openness to Experience, and Agreeableness, which was paralleled by substantial negative correlations with increased psychopathology. Our findings support the reliability and structural validity of the MI-RSWB-R as a standardized instrument for addressing the spiritual dimension in Russian populations. Further research in clinical surroundings is now recommended. (shrink)