Background: Although ethics consultation has been introduced to clinical practice for many years, the results of empirical studies to evaluate the effectiveness of ethics consultation are still controversial. The design of randomised controlled trials is considered the best research design to evaluate the effect of a clinical practice on the outcomes of interests. In order to understand the effects of ethics consultation, we conducted this search for studies with the design of randomised controlled trials to evaluate ethics consultation.Objective: To provide (...) an integrated review of studies with the design of randomised controlled trials to evaluate the effectiveness of ethics consultation.Methods: PubMed was used to search for studies using the randomised controlled trial design to evaluate the effectiveness of ethics consultation. The search term used was “ethics consultation”. The selection criterion was limited to “randomised controlled trial”.Results: Four articles that met both search criteria were retrieved. One of these articles reported a study that did not actually use the design of a randomised controlled trial and is excluded from the following discussion.Conclusions: To apply randomised controlled trials to evaluate the effectiveness of ethics consultation is extremely difficult as long as two issues are not resolved: the standardisation of ethics consultation and a placebo for ethics consultation to eliminate the placebo effect. Thus, the results generated by the design of randomised controlled trials are always problematic. Furthermore, as long as the two issues exist, the results generated by the design of quantitative research methods always pose problems. (shrink)

[1] Sefer Orḥot Ḥayim leha-Rosh ʻim beʼur "ha-Shem orḥotenu" ... 2. Ḳunṭres Be-Shaʻar ha-melekh ʻal haḳdamat ha-Rambam, kolel tsiyunim u-meḳorim u-veʼurim be-divre ha-Rambam ṿeha-Raʼabad ... 3. Ḳunṭres Tashlum yefeh ʻenayim ʻal Seder Zeraʻim u-Ṭehorot, ʻeduyot, Tamid, Midot, Ḳenim ṿe-ʻod ṿe-hu tsiyunim ʻal mas. elu mi-Yerushalmi u-midrashim ... 4. Ḳunṭres Marʼot maḳom, ṿe-hu tsiyunim ʻal ha-meḳomot she-Rashi ṿe-Tos. meviʼim mirdrash o Yerushalmi ṿe-Tosefta ṿe-khu. ṿe-lo tsuyan meḳoro ... 5. Ḳunṭres Ṭeʻama de-ḳara, ṿe-hu ḳetsat ḥidushim ʻal ha-Torah ṿe-ʻal Neviʼim u-Khetuvim -- ḥeleḳ (...) 3. Heʻarot ʻal seder ha-Shas (ṿe-kholel gam ezeh ḳunṭresim). (shrink)

We develop and apply a multi-dimensional conception of explanatory depth towards a comparative analysis of inflationary and bouncing paradigms in primordial cosmology. Our analysis builds on earlier work due to Azhar and Loeb (2021) that establishes initial condition fine-tuning as a dimension of explanatory depth relevant to debates in contemporary cosmology. We propose dynamical fine-tuning and autonomy as two further dimensions of depth in the context of problems with instability and trans-Planckian modes that afflict bouncing and inflationary approaches respectively. In (...) the context of the latter issue, we argue that the recently formulated trans-Planckian censorship conjecture leads to a trade-off for inflationary models between dynamical fine-tuning and autonomy. We conclude with the suggestion that explanatory preference with regard to the different dimensions of depth is best understood in terms of differing attitudes towards heuristics for future model building. (shrink)

Background: With the coming of the Industrial Revolution, the levels of pollution grow significantly. This Technological development contributed to the worsening of shortness breath problems in great shape. especially in infants and children. There are many shortness breath diseases that infants and children face in their lives. Shortness of breath is one of a very serious symptom in children and infants and should never be ignored. Objectives: Along these lines, the main goal of this expert system is to help physician (...) in diagnosing and describe some common causes of shortness of breath in infants and children by diagnosing their cases through our expert system. Moreover, this system which we are presenting will give patient the appropriate diagnosis of disease and the treatment required. Methods: In this paper the strategy of the expert system for diagnosing a number of the existed shortness of breath in infants and children diseases such as (Asthma , Bronchiolitis, Viral Pneumonia, cough, Shortness of breath' dyspnea ', Epiglottitis, Croup, ABSCESS in the tonsil 'peritonsillar abscess', Bronchitis, Viral Bronchitis, Wheezing, sudden infant death syndrome 'SIDS' ) is introduced, an overview about the shortness of breath in children and infants diseases are delineated, the cause of diseases are sketched and the treatment of disease whenever conceivable is given . SL5 Object Expert System language was utilized for designing and implementing the proposed expert system. Results: The proposed shortness of breath in children and infants diseases diagnosis expert system was estimated by Medical students and they were satisfied with its result. Conclusions: The Proposed expert system is very useful for Respiratory physician, pediatrician, recently graduated physician, and for children's parents with shortness of breath problem. (shrink)

‘Substance’ (substantia, zelfstandigheid) is a key term of Spinoza’s philosophy. Like almost all of Spinoza’s philosophical vocabulary, Spinoza did not invent this term, which has a long history that can be traced back at least to Aristotle. Yet, Spinoza radicalized the traditional notion of substance and made a very powerful use of it by demonstrating – or at least attempting to demonstrate -- that there is only one, unique substance -- God (or Nature) -- and that all other things are (...) merely modes or states of God. Some of Spinoza’s readers understood these claims as committing him to the view that only God truly exists, and while this interpretation is not groundless, we will later see that this enticing and bold reading of Spinoza as an ‘acosmist’ comes at the expense of another audacious claim Spinoza advances, i.e., that God/Nature is absolutely and actually infinite. But before we reach this last conclusion, we have a long way to go. So, let me first provide an overview of our plan. In the first section of this paper we will examine Spinoza’s definitions of ‘substance’ and ‘God’ at the opening of his magnum opus, the Ethics. Following a preliminary clarification of these two terms and their relations to the other key terms defined at the beginning of the Ethics, we will briefly address the Aristotelian and Cartesian background of Spinoza’s discussion of substance. In the second section, we will study the properties of the fundamental binary relations pertaining to Spinoza’s substance: inherence, conception, and causation. The third section will be dedicated to a clarification of Spinoza’s claim that God, the unique substance, is absolutely infinite. This essential feature of Spinoza’s substance has been largely neglected in recent Anglo-American scholarship, a neglect which has brought about an unfortunate tendency to domesticate Spinoza’s metaphysics to more contemporary views. The fourth section will study the nature of Spinoza’s monism. It will discuss and criticize the interesting yet controversial views of the eminent Spinoza scholar, Martial Gueroult, about the plurality of substances in the beginning of the Ethics; address Spinoza’s claim in Letter 50 that, strictly speaking, it is improper to describe God as “one”; and, finally, evaluate Spinoza’s kind of monism against the distinction between existence and priority monism recently introduced into the contemporary philosophical literature. The fifth and final section will explain the nature, reality, and manner of existence of modes. We therefore have an ambitious plan; let’s get down to business. (shrink)

Public policies are designed to have an impact on particular societies, yet policy-oriented computer models and simulations often focus more on articulating the policies to be applied than on realistically rendering the cultural dynamics of the target society. This approach can lead to policy assessments that ignore crucial social contextual factors. For example, by leaving out distinctive moral and normative dimensions of cultural contexts in artificial societies, estimations of downstream policy effectiveness fail to account for dynamics that are fundamental in (...) human life and central to many public policy challenges. In this paper, we supply evidence that incorporating morally salient dimensions of a culture is critically important for producing relevant and accurate evaluations of social policy when using multi-agent artificial intelligence models and simulations. (shrink)

The question of whether knowledge is definable in terms of belief, which has played an important role in epistemology for the last 50 years, is studied here in the framework of epistemic and doxastic logics. Three notions of definability are considered: explicit definability, implicit definability, and reducibility, where explicit definability is equivalent to the combination of implicit definability and reducibility. It is shown that if knowledge satisfies any set of axioms contained in S5, then it cannot be explicitly defined in (...) terms of belief. S5 knowledge can be implicitly defined by belief, but not reduced to it. On the other hand, S4.4 knowledge and weaker notions of knowledge cannot be implicitly defined by belief, but can be reduced to it by defining knowledge as true belief. It is also shown that S5 knowledge cannot be reduced to belief and justification, provided that there are no axioms that involve both belief and justification. (shrink)

Theories of the liberal tradition have relied on independence as a norm of personhood. Feminist theorists such as Eva Kittay in Love's Labor have been instrumental in critiquing normative independence. I explore the role of corporeal vulnerability in Kittay's account of personhood, developing a comparison to the role it plays in Thomas Hobbes's Leviathan. Kittay's crucial contribution in Love's Labor is that once we acknowledge the facts of corporeal vulnerability, we must not only acknowledge but also affirm dependency in a (...) genuinely inclusive affirmation of personhood. While endorsing Kittay's “dependency critique,” I discover difficulties that beleaguer Kittay's development of new norms of personhood. I trace these to a dependency of Kittay's account on a crucial premise of the liberal model it resists. I argue that in order to affirm dependency in a manner that departs more thoroughly from the criticized aspects of liberal personhood, we must cease to position it in a dichotomy of power and vulnerability. I suggest that attending to the corporeality of vulnerability can aid us in developing the terms of a discourse affirming relational personhood while undermining that dichotomy. (shrink)

This article isolates ten prepositions, which constitute the undercurrent paradigm of contemporary discourse of health disease and medicine. Discussion of the interrelationship between those prepositions leads to a systematic refutation of this paradigm. An alternative set is being forwarded. The key notions of the existing paradigm are that health is the natural condition of humankind and that disease is a deviance from that nature. Natural things are harmonious and healthy while human made artifacts are coercive interference with natural balance. It (...) is suggested that the current paradigm is influenced by the world of finances and by instrumental reason. The alternative model suggests that human nature cannot be delineated. Humans fashion their own selves and nature by artificial means, medicine among them. The article discusses the implications of the paradigm adapted in various scholarly and popular debates such as the use of sex hormones for contraception, the care of the elderly, holistic medicine and distributive justice in health care. Medicine is not an isolated or a privileged realm. There is no unique entitlement to health care. It is always part of a broader agenda of social values and institutions. A open view of human societies, values and practices as they are situated within concrete material conditions is the platform required for an integrative and creative discourse of health care. (shrink)

Adaptation to climate change impacts is a key research topic in business ethics that poses substantial implications on the good lives of human beings. The commercial port sector is a highly relevant study focus with its pivotal roles in supply chains and international trade. Hence, it is important to investigate whether the port planning system and practice is appropriate in tackling climate change impacts. But beforehand, we must thoroughly understand the attitude and behaviors of port planners and operators on ports’ (...) climate adaptation planning. Through a survey towards 21 ports in Canada, the paper investigates the attitude and behaviors of port planners and operators on ports’ climate adaptation planning. Towards the end, we propose a new approach so as to enable port stakeholders to carry out climate adaptation planning effectively. The paper offers important insight to researchers to investigate the ways in developing effective climate adaptation plans and practice for ports and other business sectors. (shrink)

Background Whistleblowing is an action that particularly requires moral courage. Understanding the relationship between nurses’ levels of moral courage and their whistleblowing approaches is important for reducing adverse situations in healthcare services. Objectives This study aims to understand and analyze the relationship between nurses’ levels of moral courage and their whistleblowing approaches. Research design This is a descriptive and correlational study. Methods The study sample consists of 582 nurses actively working in a province in northwest Türkiye. Research data were collected (...) using an Information Form, the Nurses’ Moral Courage Scale, and the Whistleblowing Scale. Ethical considerations Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Findings Nurses were found to perceive their moral courage as high, and their whistleblowing levels were at a moderate level. There was a significant and moderate relationship between participants’ levels of moral courage and whistleblowing levels ( p <.05). Conclusions The findings emphasize the importance of promoting moral courage and creating an appropriate environment for exposing ethical violations. This study can contribute to the development of strategies to enhance nurses’ moral courage and foster a more ethical working environment in healthcare services. (shrink)

In many Western European countries, gender equality and sexual tolerance have increasingly become markers of national cultures and European values that face an insistent threat from Muslims. Gender equality and sexual tolerance are increasingly framed in cultural terms and they play an important role in the construction of a social imaginary based on a cultural antagonism between ‘us’ and ‘them’. This article argues that a new ‘culturalized’ social imaginary has been established by turning ‘immigrant workers’ into ‘Muslim immigrants’ over the (...) last three decades. The unending moral panics around Muslim immigrants’ cultural practices such as honor killings, forced marriages, headscarves, female circumcision and homophobia create a sense of imminent threat and force progressive movements to forge unlikely alliances with right-wing groups against the insidious threat. These alliances are not, however, ephemeral mobilizations in defense of ‘common achievements’; the notion of common achievements creates a sense of cultural sameness vis-a-vis Muslims. Thus, what we see is the displacement of the internal frontiers and the creation of a new ‘hegemonic bloc’ around ‘common cultural values’. And this hegemonic displacement creates unresolvable tensions within feminist and queer movements. (shrink)

Venneman and colleagues argue that “do not resuscitate” (DNR) is problematic and should be replaced by “allow natural death” (AND). Their argument is flawed. First, while end-of-life discussions should be as positive as possible, they cannot and should not sidestep painful but necessary confrontations with morality. Second, while DNR can indeed be nonspecific and confusing, AND merely replaces one problematic term with another. Finally, the study’s results are not generalisable to the populations of physicians and working nurses and certainly do (...) not support the authors’ claim that there is a movement to replace DNR with AND. (shrink)

Straipsnyje atskleidžiu tam tikrą pragmatizmo ir egzistencializmo suderinamumą tiesos sampratos aspektu. Siekdamas pagrįsti šį suartėjimą, tyrinėju Jameso pragmatinį metodą ir Nietzschės kritinį požiūrį į „valią tiesai“. Abu mąstytojai stoja prieš absoliučios, fiksuotos ir praktinių individo poreikių nepaisančios tiesos idėją. Atitinkamai, abu jie teigia, kad tiesa, suprantama ikiteoriškai, yra procesas, imanentiškas konkrečiai subjektų gyvenimo patirčiai. Pasitelkdamas pragmatinius ir egzistencialistinius svarstymus, aš kritiškai tyrinėju, kaip šie filosofai kvestionavo tiesą individo kaip veikėjo egzistencijos kontekste.

ABSTRACT The Daodejing (DDJ) is an ancient Chinese text traditionally taken as a representative Daoist classic expressing a distinctive philosophy from the Warring States Period (403–221 BCE). This essay explicates the ethical dimensions of the DDJ paying attention to issues related to war and peace. The discussion consists of four parts: (1) “naturalness” as an onto‐cosmological argument for a philosophy of harmony, balance, and peace; (2) war as a sign of the disruption of the natural pattern of things initiated by (...) the proliferation of desire; (3) defensive war and appropriate war conduct required when one has to be involved in warfare; and (4) the natural and spontaneous way of living that would prevent war from happening in the first place. This essay attempts to show that what makes the DDJ different from other military texts, or what is called the “art of war corpus” in China is that the discourse of war and warfare in the DDJ is presented via its unique understanding of peace at the personal and social levels. The DDJ is meant to be an inquiry into an effective method to prevent war from happening amid a world full of selfish interests and excessive desires. It proposes that peace is not only a condition in which there is freedom from war and overt violence, but a state of harmony that marks human life and its betterment. (shrink)

We develop a dimension theory for D-semianalytic sets over an arbitrary non-Archimedean complete field. Our main results are the equivalence of several notions of dimension and a theorem on additivity of dimensions of projections and fibers in characteristic 0. We also prove a parameterized version of normalization for D-semianalytic sets.

In this article I argue that textual evidence from David Hume's A Treatise of Human Nature does not support J. Baird Callicott's professedly Humean yet holistic environmental ethic, which understands the community (e.g., the biotic community) as a ‘metaorganismic’ entity ‘over and above’ its individual members. Based on Hume's reductionist account of the mind and his assimilation of the metaphysical nature of the mind to that of the community, I also argue that a Humean account of the community should be (...) likewise reductionist. My conclusion is that Callicott's anti-reductionist holism is at least foreign to, and at worst incompatible with, Hume's philosophy. (shrink)

This paper presents and discusses a recent Israeli proposal to legislate on the rights of the dying patient. A gap exists between elitist biases of the committee proposing the law, and popular values and sentiments. The proposed law divides the dying patients into two groups: “those who wish to go on living” and “those who wish to die”. The former will have a right to life prolonging extraordinary care. It is not clear who would foot the bill for this care. (...) Also it is hard to see how this munificence could fail to discriminate against all other patients. Both the secular ethicists and the rabbis involved in drawing up the proposal accepted the assumption that it is good for some terminal patients to die. The rabbis objected, however, to direct and active interventions that shorten life. The solution arrived at was to install timers in the ventilators so as to allow them to expire automatically unless the patient wishes for their resetting. (shrink)