The growing prevalence of health care ethics consultation (HCEC) services in the U.S. has been accompanied by an increase in calls for accountability and quality assurance, and for the debates surrounding why and how HCEC is evaluated. The objective of this study was to evaluate the effectiveness of HCEC as indicated by several novel outcome measurements in East Asian medical encounters.
This study investigates the complexities in the relationship between perceptions of organizational politics and performance ratings by examining the moderating effect of impression management on that relationship. Expectancy theory was employed to better understand the moderating effect. We proposed that two kinds of impression management tactics occurred: supervisor-focused and job-focused, respectively. It was hypothesized that increased exercise of impression management would mitigate the negative effects of perceptions of organizational politics and performance ratings. Data were collected from 290 full-time employees of (...) ten state-owned enterprises in Taiwan. Hierarchical moderated regression analysis of data revealed that the job-focused tactics exerted a significant moderating effect on the relationship between perceptions of organizational politics and performance ratings. When perceptions of organizational politics are low, employees who engage in high levels of job-focused impression management tactics are more likely to gain better ratings than those who employ low-level tactics. (shrink)
Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan.
Individual physicians and physician-associated factors may influence patients’/surrogates’ autonomous decision-making, thus influencing the practice of do-not-resuscitate orders. The objective of this study was to examine the influence of individual attending physicians on signing a DNR order. This study was conducted in closed model, surgical intensive care units in a university-affiliated teaching hospital located in Northern Taiwan. The medical records of patients, admitted to the surgical intensive care units for the first time between June 1, 2011 and December 31, 2013 were (...) reviewed and data collected. We used Kaplan–Meier survival curves with log-rank test and multivariate Cox proportional hazards models to compare the time from surgical intensive care unit admission to do-not-resuscitate orders written for patients for each individual physician. The outcome variable was the time from surgical ICU admission to signing a DNR order. We found that each individual attending physician’s likelihood of signing do-not-resuscitate orders for their patients was significantly different from each other. Some attending physicians were more likely to write do-not-resuscitate orders for their patients, and other attending physicians were less likely to do so. Our study reported that individual attending physicians had influence on patients’/surrogates’ do-not-resuscitate decision-making. Future studies may be focused on examining the reasons associated with the difference of each individual physician in the likelihood of signing a do-not-resuscitate order. (shrink)
This paper explores the issue of personal factors that impinge upon education. More specifically, it addresses professional jealousy among teachers and how it affects the moral practice of teaching. Our focus is teachers? emotions in general and teachers? jealousies in particular, in the context of the ideal of the moral teacher. We identify and criticise three common dichotomies that tend to mar explorations of teachers? emotions. We illustrate issues of professional jealousy as revealed in an interview with a headteacher in (...) Taiwan, explaining the societal context and eliciting the emotional issues. We argue that too little attention is given to the moral practice of teaching qua emotional labour: labour that places moral burdens on teachers as individual human beings. We maintain that teacher training must focus more on the moral and emotional self-education of teacher trainees and professional teachers, helping them to lead well-rounded lives as integrated personal and professional beings. (shrink)
Extra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the (...) survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014. (shrink)
A hybrid preference framework is proposed for strategic conflict analysis to integrate preference strength and preference uncertainty into the paradigm of the graph model for conflict resolution (GMCR) under multiple decision makers. This structure offers decision makers a more flexible mechanism for preference expression, which can include strong or mild preference of one state or scenario over another, as well as equal preference. In addition, preference between two states can be uncertain. The result is a preference framework that is more (...) general than existing models which consider preference strength and preference uncertainty separately. Within the hybrid preference structure, four kinds of stability are defined as solution concepts and a post-stability analysis, called status quo analysis, which can be used to track the evolution of a given conflict. Algorithms are provided for implementing the key inputs of stability analysis and status quo analysis within the extended preference structure. The new stability concepts under the hybrid preference structure can be used to model complex strategic conflicts arising in practical applications, and can provide new insights for the conflicts. The method is illustrated using the conflict over proposed bulk water exports from Lake Gisborne in Newfoundland, Canada. (shrink)
Judging similarities among objects, events, and experiences is one of the most basic cognitive abilities, allowing us to make predictions and generalizations. The main assumption in similarity judgment is that people selectively attend to salient features of stimuli and judge their similarities on the basis of the common and distinct features of the stimuli. However, it is unclear how people select features from stimuli and how they weigh features. Here, we present a computational method that helps address these questions. Our (...) procedure combines image-processing techniques with a machine-learning algorithm and assesses feature weights that can account for both similarity and categorization judgment data. Our analysis suggests that a small number of local features are particularly important to explain our behavioral data. (shrink)
The relationships between age and the life-supporting treatments use, and between gender and the life-supporting treatments use are still controversial. Using extracorporeal membrane oxygenation as an example of life-supporting treatments, the objectives of this study were: to examine the relationship between age and the extracorporeal membrane oxygenation use; to examine the relationship between age and the extracorporeal membrane oxygenation use; and to deliberate the ethical and societal implications of age and gender disparities in the initiation of extracorporeal membrane oxygenation. This (...) is a population-based, retrospective cohort study. Taiwan’s extracorporeal membrane oxygenation cases from 2000 to 2010 were collected. The annual incidence rate of extracorporeal membrane oxygenation use adjusting for both age and gender distribution for each year from 2000 to 2010 was derived using the population of 2000 as the reference population. The trend of extracorporeal membrane oxygenation use was examined using time-series linear regression analysis. We conducted joinpoint regression for estimating the trend change of extracorporeal membrane oxygenation use. The trends of extracorporeal membrane oxygenation use both for different gender groups, and for different age groups have been significantly increasing over time. Men were more likely to be supported by extracorporeal membrane oxygenation than women. Women’s perspectives toward life and death, and women’s perception of well-being may be associated with the phenomenon. In addition, the patients at the age of 65 or older were more likely to be supported by extracorporeal membrane oxygenation than those younger than 65. Family autonomy/family-determination, and the Confucian tradition of filial piety and respecting elders may account for this phenomenon. This study showed gender and age disparities in the initiation of extracorporeal membrane oxygenation use in Taiwan, which may be accounted for by the cultural and societal values in Taiwan. For a healthcare professional who deals with patients’/family members’ medical decision-making to initiate life-supporting treatments, he/she should be sensitive not only to the legality, but also the societal and ethical issues involved. (shrink)
The hukou system is a mandatory household registration system in China that assigns an individual either an urban/non-agricultural hukou or a rural/agricultural hukou based on one’s birthplace. This system favors urban residents and discriminates against rural residents in accessing state-owned resources such as employment, education, health care, and housing. To better understand how this institutionally imposed hukou identity impacts an individual’s sense of fairness in the ultimatum game, we conducted a field experiment in China using 9–12-year-old children and collected 672 (...) observations. Subjects played a one-shot ultimatum game to allocate 20 yuan in groups of two. We employed a 2 ×\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\times $$\end{document} 2 ×\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\times $$\end{document} 2 experiment design and used the strategic method ultimatum game. We primed our subjects with their hukou identity before they made their decisions in the experiment. Results of this study show that hukou salience mainly affects rural hukou subjects, who belong to the perceived less-favored social group. On one hand, when the hukou identity is made salient, rural hukou proposers decrease their amount offered regardless of their responder’s hukou type. On the other hand, rural hukou responders expect higher offers from their urban hukou proposers when the hukou identity is revealed. We interpret these results as that rural hukou subjects tend to seek compensations for their perceived hukou inferiority to achieve fair distributions. (shrink)
