There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

There is a claim that clinical ethics support services (CESS) improve healthcare quality within healthcare organisations. However, there is lack of strong evidence supporting this claim. Rather, the current focus is on the quality of CESS themselves or on individual learning outcomes. In response, this article proposes a theoretical framework leading to empirical hypotheses that describe the relationship between a specific type of CESS, moral case deliberation and the quality of care at the organisational level. We combine insights from the (...) literature on CESS, organisational learning and quality improvement and argue that moral case deliberation causes healthcare professionals to acquire practical wisdom. At the organisational level, where improving quality is a continuous and collective endeavour, this practical wisdom can be aggregated into morisprudence, which is an ongoing formulation of moral judgements across cases encountered within the organisation. Focusing on the development of morisprudence enables refined scrutinisation of CESS-related quality claims. (shrink)

How do work motivations and sector perceptions differ between graduate students at prestigious Business Schools and Public Policy in Asia? Where do Asia’s future business and government leaders want to work, and why? To answer these questions, we compare Asian Master of Business Administration students with Master of Public Policy and Master of Public Administration students from three leading Schools based in Singapore through a survey study and a series of seven focus groups. Our findings indicate that work motivations, sector (...) perceptions, and career preferences differ between both groups but slightly less so than between their Western counterparts. Moreover, future Asian leaders equally value being successful while many view government as bureaucratic and prone to cronyism regardless of degree program and employment preference. We discuss how our findings may advance a more robust management and leadership research agenda for Asia. (shrink)

This study reports on the hierarchy of organizational values in public and private sector organizations in Slovenia and the Netherlands. We surveyed 400 managers in Slovenia and 382 in the Netherlands using an identical questionnaire on the importance of a selection of values in everyday decision making. In Slovenia, impartiality, incorruptibility, and transparency were rated significantly higher in the public sector, while profitability, obedience, and reliability were rated more important in business organizations. In contrast, in the Netherlands, 11 values differed (...) significantly between the sectors. Thus, a greater value congruence exists between the sectors in Slovenia than in the Netherlands, with a larger “common core” of values in Slovenia (14) compared with the Netherlands (9), just as we hypothesized. Historical and cultural developments, such as the communist rule in Slovenia and the different influences of the Protestant work ethic in both countries, led to more similarities between business and government organizations in the “new” EU member state, Slovenia. (shrink)

We are grateful for the thoughtful replies to our article. 1 We are especially encouraged that all respondents agree that it is of value to develop a theoretical framework which helps to study how clinical ethics support services (CESS) induce individual and organisational learning. We have focused on the relations between moral case deliberation (MCD), organisational learning and quality improvement from a predominantly sociological perspective. The goal of our theoretical framework was to establish hypotheses which allow for empirical evaluation of (...) the relation between CESS and quality of care. Two major concerns seem to underly the commentaries: the framework (1) lacks a normative standard which allows for ethical justification of the outcome of repeated MCD, 2 and (2) the focus on morisprudence does not sufficiently emphasise the need for ‘structured, consistent, and facilitated processes for fair and robust moral case deliberation’. 3 In other words, it... (shrink)

Kolbe and de Melo-Martin (2023) provide a much needed reflection on the methods by which we measure moral distress. Their analysis, however, gives off the impression that the measures of moral dist...

PurposeAlthough an increasing body of literature suggests a relationship between brain irradiation and deterioration of neurocognitive function, it remains as the standard therapeutic and prophylactic modality in patients with brain tumors. This review was aimed to abstract and evaluate the prediction models for radiation-induced neurocognitive decline in patients with primary or secondary brain tumors.MethodsMEDLINE was searched on October 31, 2021 for publications containing relevant truncation and MeSH terms related to “radiotherapy,” “brain,” “prediction model,” and “neurocognitive impairments.” Risk of bias was (...) assessed using the Prediction model Risk Of Bias ASsessment Tool.ResultsOf 3,580 studies reviewed, 23 prediction models were identified. Age, tumor location, education level, baseline neurocognitive score, and radiation dose to the hippocampus were the most common predictors in the models. The Hopkins verbal learning and the trail making tests were the most frequent outcome assessment tools. All studies used regression as machine learning method. All models were judged to have a high risk of bias mainly due to issues in the analysis.ConclusionExisting models have limited quality and are at high risk of bias. Following recommendations are outlined in this review to improve future models: developing cognitive assessment instruments taking into account the peculiar traits of the different brain tumors and radiation modalities; adherence to model development and validation guidelines; careful choice of candidate predictors according to the literature and domain expert consensus; and considering radiation dose to brain substructures as they can provide important information on specific neurocognitive impairments. (shrink)

Throughout the career of the renowned sociologist Zygmunt Bauman, who passed away on January 9, 2017, a strand of the utopian impulse continued to manifest itself in his work. From his early socialist orientation to his later, more humanistic expressions and his analysis and critique of the liquid modern society, a development poignantly described by Michael Jacobsen in an article in this journal in 2004,1 Bauman's sociology was driven by seeking possibilities and alternatives to the society that he described and (...) explained, a quest for hope in the long term in a situation that justified pessimism in the short and middle term. His utopianism was not an attempt to sketch a blueprint of another society but an impulse... (shrink)

How do work motivations and sector perceptions differ between graduate students at prestigious Business Schools and Public Policy in Asia? Where do Asia’s future business and government leaders want to work, and why? To answer these questions, we compare Asian Master of Business Administration students with Master of Public Policy and Master of Public Administration students from three leading Schools based in Singapore through a survey study and a series of seven focus groups. Our findings indicate that work motivations, sector (...) perceptions, and career preferences differ between both groups but slightly less so than between their Western counterparts. Moreover, future Asian leaders equally value being successful while many view government as bureaucratic and prone to cronyism regardless of degree program and employment preference. We discuss how our findings may advance a more robust management and leadership research agenda for Asia. (shrink)

Abstract:Since Homeric times, psychotherapy has been an essential part of the medical act. Initially, the word of physicians had a magical character. Plato rationalizes this in many of his dialogues. In "Charmides," he dives deeper into this matter and proposes to apply it to every disease. Analysing this dialogue has fundamental consequences for psychotherapy: 1) Remedy and epodé (charm) must be applied in every doctor–patient relationship. 2) The body can only be healed if the soul is cured first by a (...) charm. Patients must "offer" their souls to the physician, which implies the need for confidence and the unavoidable asymmetry which characterize doctor–patient relationships. 3) The openness of the patient's soul to the physician and the physician's "beautiful speech" to the patient will enable the latter to reach the state of sophrosyne (temperance), the condition of the possibility of true health. In the discussion of the meaning of sophrosyne, Socrates questions every one of the disciples' propositions and concludes that the only thing one can be sure of is that sophrosyne is a way of searching for virtue (areté). Later, in Theaetetus, Plato adds another element: temperance is a homoiosis theó, that is, the assimilation of patient with God. With this, Plato seals the ethical character of psychotherapy forever. (shrink)

First, I would like to thank Dr. Phillips for his generous words about the potential interest of my work. He speaks about the fact that it is "insightful" and thought-provoking ("it offers us much to think about"). In his comment Dr. Phillips reviews the main moments of the evolution of treatment by words in the Greek world and he focuses on Plato's Dialogue Charmides, whose analysis is the center of my article. He even quotes some parts of the dialogue, which (...) I mention too, although in a different translation. He rightfully underlines the moment in which Socrates tells Charmides: "And the soul... my dear friend, is cured by means of certain charms, and these charms consist of beautiful words. It is a result of... Read More. (shrink)

Se plantea la pregunta de si efectivamente el delirio es idéntico a la irracionalidad,como se ha postulado desde la Ilustración. Se hace una breve síntesis de la forma como ha sido concebida la locura desde la Antigüedad Clásica hasta nuestros días. De esta revisión es importante destacar cómo el carácter absoluto del "ego cogito" de Descartes hace impensable la locura como posibilidad humana y abre el camino a su conceptualización como enemiga de la razón, vale decir, como irracionalidad. Como argumento (...) en favor a la tesis contraria al racionalismo, se menciona el sentido biográfico de la locura, ejemplificado en figuras literarias, como Edipo, Ofelia y Don Quijote. Lo común a todas estas vidas que terminan en la locura es un afán desmedido por permanecer en lo ilusorio, en el autoocultamiento, de tal modo que cuando una circunstancia los obliga a ver su propia verdad transforman "una realidad imposible en una posible irrealidad", vale decir, enloquecen. Ahora bien, tanto en las figuras literarias como en los esquizofrénicos de la práctica diaria, encontramos que el desborde se produce no hacia lo irracional y dionisíaco, sino exactamente en la dirección opuesta: hacia lo apolíneo y racional. La tesis de que en la base de la locura habría un exceso y no una falta de racionalidad, tratamos de demostrarla a través del análisis de dos casos paradigmáticos, en los que aparece tematizada la entrega al dominio absoluto de la razón como capacidad analítica y sintética y a la razón como luz que saca a los objetos cognoscibles desde las sombras. El delirio sería, entonces, el producto de un imperio sin contrapeso de la razón,entendida ésta ya sea como "ratio" o como "logos". (shrink)

Gödel once offered an argument for the general reflection principle in set theory that took the form of an analogy with Leibniz' Monadology. I discuss the mathematical and philosophical background to Gödel's argument, reconstruct the proposed analogy in detail, and argue that it has no justificatory force.

While 4E approaches to cognition are increasingly introduced in educational contexts, little has been said about how 4E commitments can inform pedagogy aimed at fostering ethical competencies. Here, we evaluate a 4E-inspired ethics exercise that we developed at a technical university to enliven the moral imagination of engineering students. Our students participated in an interactive tinkering workshop, during which they materially redesigned a healthcare artifact. The aim of the workshop was twofold. Firstly, we wanted students to experience how material choices (...) at the levels of design and functionality can enable morally significant reimaginings of the affordances commonly associated with existing artifacts. We term this type of reimagining world-directed moral imagination. Secondly, through the design process, we wanted students to robustly place themselves in the lived embodied perspectives of (potential) users of their selected artifacts. We term this person-directed moral imagination. While student testimonies about the exercise indicate that both their world-directed and person-directed moral imagination were enlivened, we note that the fostering of robust person-directed moral imagination proved challenging. Using 4E insights, we diagnose this challenge and ask how it might be overcome. To this end, we engage extensively with a recent 4E-informed critique of person-directed moral imagination, raised by Clavel Vázquez and Clavel-Vázquez (2023). They argue that person-directed moral imagination is profoundly limited, if not fundamentally misguided, particularly when exercised in contexts marked by emphatic embodied situated difference between the imaginer and the imagined. Building upon insights from both the 4E field and testimonies from critical disability studies, we argue that, while their critique is valuable, it ultimately goes too far. We conclude that a 4E approach can take on board recent 4E warnings regarding the limits of person-directed moral imagination while contributing positively to the development of moral imagination in engineering ethics education. (shrink)

"Ludvig Holberg was the foremost representative of the Danish-Norwegian Enlightenment and also a European figure of note. He was an Enlightenment thinker in the conventional sense, with significant works in natural law and history, but also a very important body of moral essays and epistles. He authored several engaging autobiographies and European travelogues; and - not least - a major utopian novel that was a European bestseller, a couple of interesting satires, and a large number of plays, mainly comedies. These (...) comedies have secured Holberg's status as the most significant playwright in Scandinavia before Ibsen and Strindberg; his plays remain hugely popular and have hardly been off the stage since he died. Through his extensive oeuvre, but especially through his plays, Holberg had a decisive influence on the formation of modern Danish as a literary language, something that was a self-conscious effort on the part of a man who saw himself as an educator of the public. Despite all these accomplishments Holberg is most often remembered outside of the Nordic countries for Edvard Grieg's Holberg Suite and in the title of one of the most prestigious prizes in the humanities. It is the aim of the contributors to this volume to revive Holberg as a very major figure from a very minor corner of the Enlightenment world, presenting the latest scholarship from Scandinavia on the main areas of Holberg's work with serious emphasis on the wider European Enlightenment context and perspectives. It will appeal to all those researching intellectual history, history of philosophy, literary history/studies, theatre studies, church historiography, Scandinavian studies and Enlightenment Europe."--. (shrink)

In this paper I address the current debate on ontic versus epistemic conceptualizations of mechanistic explanation in the mechanisms literature. Illari recently argued that good explanations are subject to both ontic and epistemic constraints: they must describe mechanisms in the world in such fashion that they provide understanding of their workings. Elaborating upon Illari’s ‘integration’ account, I argue that causal role function discovery of mechanisms and their components is an epistemic prerequisite for achieving these two aims. This analysis extends Illari’s (...) account in important ways, putting more pressure on ontic readings of mechanistic explanation and providing an answer to the question how ontic and epistemic constraints on mechanistic explanation are related. I argue these point in terms of cases on memory research drawn from neuroscience and research on extinct neurogenetic mechanisms from early nervous systems biology. (shrink)

This paper investigates conceptions of explanation, teleology, and analogy in the works of Immanuel Kant (1724-1804) and Georges Cuvier (1769-1832). Richards (2000, 2002) and Zammito (2006, 2012, 2018) have argued that Kant’s philosophy provided an obstacle for the project of establishing biology as a proper science around 1800. By contrast, Russell (1916), Outram (1986), and Huneman (2006, 2008) have argued, similar to suggestions from Lenoir (1989), that Kant’s philosophy influenced the influential naturalist Georges Cuvier. In this article, I wish to (...) expand on and further the work of Russell, Outram, and Huneman by adopting a novel perspective on Cuvier and considering (a) the similar conceptions of proper science and explanation of Kant and Cuvier, and (b) the similar conceptions of the role of teleology and analogy in the works of Kant and Cuvier. The similarities between Kant and Cuvier show, contrary to the interpretation of Richards and Zammito, that some of Kant’s philosophical ideas, whether they derived from him or not, were fruitfully applied by some life scientists who wished to transform life sciences into proper sciences around 1800. However, I also show that Cuvier, in contrast to Kant, had a workable strategy for transforming the life sciences into proper sciences, and that he departed from Kant’s philosophy of science in crucial respects. (shrink)

Bernard Williams argued that historical and philosophical inquiry were importantly linked in a number of ways. This introductory chapter distinguishes four different connections he identified between philosophy and history. (1) He believed that philosophy could not ignore its own history in the way that science can. (2) He thought that when engaging with philosophy’s history primarily to produce history, one still had to draw on philosophy. (3) Even doing history of philosophy philosophically, i.e. primarily to produce philosophy, required a keen (...) sense of how historically distant from us past philosophers were, on his view, because the point of reading them was to confront something different from the present. (4) He held that systematic philosophy itself needed to be done historically, engaging not necessarily with its own history, but with that of the concepts it sought to understand. The chapter closes with an overview of the volume’s structure and content. (shrink)

This review discusses Zygmunt Bauman’s Retrotopia, published shortly after the renowned sociologist’s death, in the light of his engagement with the thought of Pope Francis during the last years of his life. It traces some of the main themes of this engagement, and addresses its role and importance in the context of the book as well as in the aims of Bauman’s sociology as a whole. As the insecurities and anxieties of liquid modernity in our increasingly violent world lead many (...) to give up on the effort of building a better future and turn towards the ‘retrotopia’ of an ideal past, a crucial sign of hope is found in the words of Pope Francis. In his efforts as a sociologist, Zygmunt Bauman seeks to redirect our gaze to the future and to engage in dialogue, understood as the art of living together. (shrink)

The Russian invasion of Ukraine on February 24, 2022, has already caused large amounts of greenhouse gas (GHG) emissions and will continue to do so for manyyears after hostilities have ceased mainly because of the emissions linked to the rebuilding of destroyed or damaged housing, public buildings, infrastructure, factories, and the like. My aim in this paper is to discuss how in a time of climate emergency such emissions of war should impact the political morality of states initiating, continuing, and (...) ending war (through a just and enduring peace) as understood by just war theory (JWT). My point of departure is a study by Lennard de Klerk and six co-authors detailing the emissions of the first year of the Russo-Ukrainian war. (shrink)

Decentralized clinical trials (DCTs) have the potential to advance the conduct of clinical trials, but raise several ethical issues, including obtaining valid informed consent. The debate on the ethical issues resulting from digitalization is predominantly focused on direct risks relating to for example data protection, safety, and data quality. We submit however, that a broader view on ethical aspects of DCTs is needed to touch upon the new challenges that come with the DCT practice. Digitalization has impacts that go beyond (...) its direct purposes, by shaping behaviors, experiences, social relations, and values. We examine four elements of the informed consent procedure that are affected by DCTs, while taking these soft impacts of technologies into account: (i) informing participants and testing understanding, (ii) freedoms in relation to responsibilities and burdens, (iii) trust in participant-researcher relations, and (iv) impacts on the concept of privacy. Our analysis reveals that a broad view is key for optimal conduct of DCTs. In addition, it provides insight into the ethical impacts of DCTs on informed consent. Technologies such as DCTs potentially have profound impacts which are not immediately addressed by the existing regulatory frameworks, but nonetheless important to recognize. These findings can guide future practices of DCTs to foster the important values of clinical research in this novel approach for conducting clinical trials. (shrink)

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

What do players of videogames mean when they say they want to shoot zombies? Surely they know that the zombies are not real, and that they cannot really shoot them, but only control a fictional character who does so. Some philosophers of fiction argue that we need the concept of imaginative desires to explain situations in which people feel desires towards fictional characters or desires that motivate pretend actions. Others claim that we can explain these situations without complicating human psychology (...) with a novel mental state. Within their debates, however, these scholars exclusively focus on non-interactive fictions and children’s games of make-believe. In this paper, I argue that our experience of immersive, interactive fictions like videogames gives us cause to reappraise the concept of imaginative desires. Moreover, I describe how i-desires are a useful conceptual tool within videogame development and can shed new light on apparently immoral in-game actions. (shrink)

The method of positron emission tomography illustrates the circular logic popular in subtractive neuroimaging and linear reductive cognitive psychology. Both require that strictly feed-forward, modular, cognitive components exist, before the fact, to justify the inference of particular components from images after the fact. Also, both require a "true" componential theory of cognition and laboratory tasks, before the fact, to guarantee reliable choices for subtractive contrasts. None of these possibilities are likely. Consequently, linear reductive analysis has failed to yield general, reliable, (...) componential accounts. (shrink)

ROBERT A. COOKE, CPA, has owned or co-owned three successful small businesses and is the author of six books, including Doing Business Tax-Free and How to Start Your Own S Corporation, Second Edition, both from Wiley.

Dynamic Epistemic Logic This article tells the story of the rise of dynamic epistemic logic, which began with epistemic logic, the logic of knowledge, in the 1960s. Then, in the late 1980s, came dynamic epistemic logic, the logic of change of knowledge. Much of it was motivated by puzzles and paradoxes. The number … Continue reading Dynamic Epistemic Logic →.

The guiding premise of this chapter is that we, as teachers in higher education, must consider how the content and form of our teaching can foster inclusivity through a responsiveness to neurodiverse learning styles. A narrow pedagogical focus on lectures, textual engagement, and essay-writing threatens to exclude neurodivergent students whose ways of learning and making sense of the world may not be best supported through these traditional forms of pedagogy. As we discuss in this chapter, we, as engineering ethics educators, (...) designed and implemented a new engineering ethics exercise with which we aimed to promote inclusivity at the levels of form and content. At the content level, students were invited to critically engage with inclusivity-undermining ableist assumptions in technology development. This took shape, at the formal level, through a hands-on ‘material tinkering’ workshop in which students collaboratively and creatively altered (or ‘hacked’) artifacts used in contexts of disability and healthcare, so as to operationalize values of inclusivity and accessibility. Our hunch was that this hands-on tinkering workshop would simultaneously encourage a meaningful way of engagement with these ethical issues and values, while also enacting a more inclusive learning environment by enriching the range of pedagogical activities and learning formats available to our students. As we aim to show in this chapter, we believe this hunch largely panned out - though there are clear areas for future improvement pertaining to the pilot exercise itself and the research we conducted on the exercise. We begin by offering a description of our tinkering exercise. We discuss the exercise’s source of inspiration (2.1) and its implementation (2.2), which is visually captured via photographic documentation. We then discuss (3) how we utilized a triangulated research method to assess the pedagogical value of the exercise. After we discuss our findings, we conclude by identifying areas for future improvement (4). (shrink)

‘The God of peace’ in the New Testament. Why does the New Testament use the expression ‘the God of peace’ and what is the meaning of this phrase? In the Old Testament, the God of Israel is often connected with peace, but he is never called ‘the God of peace’. Not until the Hellenistic period is this expression sporadically found in Judaism (once in the Testaments of the Twelve Patriarchs and once in Philo). As for the biblical Umwelt, the gods (...) of the ancient Near East were not very peace-loving, and in the perception of Greco-Roman culture the god of war, Arès/Mars, as one of the twelve Olympians was much more prominent than Eirènè/Pax. However, the expression ‘the God of peace’ is found several times in the Corpus Paulinum and once in the letter to the Hebrews. This article investigates all New Testament texts that have this formula, suggesting that the apostle Paul could be responsible for the wording. In conclusion, Paul states that the God of Israel desires to establish a definitive peace in his creation through the crucifixion and resurrection of Jesus Christ and by finally defeating all powers of evil. This apostolic message further indicates that Christians are supposed to be bearers of peace, promoting a peaceful atmosphere in their environment and in the world. (shrink)