This article reviews the incredible growth of electronic commerce (e-commerce) and presents ethical issues that have emerged. Security concerns, spamming, Web sites that do not carry an "advertising" label, cybersquatters, online marketing to children, conflicts of interest, manufacturers competing with intermediaries online, and "dinosaurs" are discussed. The power of the Internet to spotlight issues is noted as a significant force in providing a kind of self-regulation that supports an ethical e-commerce environment.

This article reviews the incredible growth of electronic commerce (e-commerce) and presents ethical issues that have emerged. Security concerns, spamming, Web sites that do not carry an "advertising" label, cybersquatters, online marketing to children, conflicts of interest, manufacturers competing with intermediaries online, and "dinosaurs" are discussed. The power of the Internet to spotlight issues is noted as a significant force in providing a kind of self-regulation that supports an ethical e-commerce environment.

Evolving practice requires peer review of clinical ethics (CE) consultation for quality assessment and improvement. Many institutions have identified the chart note as the basis for this process, but to our knowledge, electronic health record (EHR) systems are not necessarily designed to easily include CE consultation notes. This article provides a framework for the inclusion of CE consultation notes into the formal EHR, describing a developed system in the Epic EHR that allows for the elaborated electronic notation (...) of the CE chart note. The implementation of the “meaningful use” criteria for EHR, mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, requires that health professionals meet certain standards for quality, efficiency, and safety, all of which overlap with the goals of standardization, peer review, and quality improvement within CE consultation. (shrink)

Increasing numbers of health organisations are offering some or all of their patients access to the visit notes housed in their electronic health records. In some countries, including Sweden and the USA, this innovation is advanced with patients using online portals to access their clinical records including the visit summaries written by clinicians. In many countries, patients can legally request copies of their records; however, open notes are different because this innovation offers patients rapid, real-time access via electronic (...) devices. In this brief report, we explore what open notes might mean for placebo use in clinical care. Survey research into patient access to their clinical notes shows that increased transparency enhances patients’ understanding about their medications and augments engagement with their care. We reflect on the consequences of access for placebo prescribing, particularly for the common practice of deceptive placebo use, in which patients are not aware they are being offered a placebo. In addition, we explore how open notes might facilitate placebo and nocebo effects among patients. Bridging placebo studies with medical ethics, we identify a range of empirical research gaps that now warrant further study. (shrink)

While positive information in the context of clinical care can lead to placebo effects, negatively framed information can have negative or nocebo effects. Extant literature documents how doctor–patient encounters are fertile ground for suboptimal interactions leading to negative experiences for ethnoracial minority patients. In their _JME_ paper, Blease presents a critical perspective on the potential for patients’ access to their doctors’ clinical notes, ‘open notes’, to engender nocebo effects. 1 In this commentary, we affirm the central claim that nocebo effects (...) could emerge ‘via negative wording or framing of health information expressed by clinicians in documentation’. The advent of electronic health records (EHR) allowed patients the unprecedented opportunity to access personal clinical documentation, giving them a window into decision making around their health. This shift is undoubtedly complex, and thus warrants a more fulsome rendering of the unique challenges faced by ethnoracial minority patients. Herein, we highlight three... (shrink)

The article describes the difficult establishment of two of the eight series of the so-called Academy Edition of Leibniz’s Complete Writings and Letters. In 1976, Series VII, Mathematical writings, was realized by means of a collaboration between Knobloch in Berlin and Contro in Hannover. Juridical, staff, and technical problems had to be solved before the editorial work could begin. Series VIII, Scientific, Medical, and Technical writings, was realized in 2001, this time as an official project of the Berlin-Brandenburg Academy of (...) Sciences and Humanities. The international collaboration of co-workers from Berlin, Russia, and France was carried out through electronic means, especially through a digitalization of everything concerning the Leibnizian manuscripts. (shrink)

The following response by Hutto and Myin to Colombo’s original paper, “Explaining social norm compliance. A plea for neural representations,” contains some inaccurate quotations attributed to Colombo. These inaccuracies are not the fault of the authors, but are due to editorial mistakes and to problems involved in publishing electronic versions online first. Hutto and Myin worked from and were quoting from an earlier draft of Colombo’s paper (dated 2012), which is different from the revised version that was first published (...) online in January 2013. Because the inaccuracies were discovered only after Hutto and Myin’s response was published online, corrections were not possible. Also, the fact that page numbers are assigned only when hard copy publication occurs, and do not appear in the Online First publication made it impossible for Hutto and Myin, or for Colombo in his response, to provide pagination for quotations. The editors take responsibility and apologize to the authors for failin. (shrink)

In recognizing the wide range of sensuous perception and at the same time the originary capacity of aesthetic experience, Mikel Dufrenne has shown us the rich capabilities of phenomenology. It is in that spirit that this essay explores musical performance. Music is a multiple art. Its many traditions, forms, genres, and styles, its large variety of instruments and sounds, and its diverse uses and occasions make it difficult to speak of music as a single art form. There are, nonetheless, certain (...) common characteristics that all musics share in the ordering of successive sounds and silences in movement, pattern, and studied length. And, of course, these sounds and silences must be devised and generated, usually by a person but increasingly by other means, especially electronic. Finally, music has its contexts, the particular occasions when it is produced and heard. Perhaps there is indeed a generic musical art, a common ground where all these disparities come together. (shrink)

The magnetic dipole moment of the Kerr–Newman metric, defined by mass \, electrical charge \ and angular momentum \, is \, corresponding, for all values of \, to a gyromagnetic ratio \, which is also the value of the intrinsic gyromagnetic ratio of the electron, as first noted by Carter. Here, we argue that this result can be understood in terms of the particle-wave complementarity principle. For \ can only be defined at asymptotic spatial infinity, where the metric appears to (...) describe a spinning point particle, and therefore setting \, \, we necessarily have a model of the electron. From the Dirac equation we can construct a covariantly conserved four-current \ that is the source of the electromagnetic field generated by the charge \. The result \ then follows from the minimal gauge principle \ which is implicit in the formulation of the spinorial wave equation, and which can also be justified from the line action for a spin-1/2 point particle interacting with an external electromagnetic field, due to Berezin and Marinov. By contrast, analysis of the gyrogravito-magnetic effect, investigated classically by Wald and quantum mechanically by Adler et al., yields the result \ in all non-relativistic cases, which can be explained from the principle of equivalence. The results are in accord with the correspondence principle. (shrink)

This article describes a descriptive-qualitative method for analyzing and reviewing several textbooks for high school as samples commonly used by teachers and students in their teaching–learning to reveal possible misconceptions. This study focused on the subjects of quantum numbers and electronic configuration. From the advanced literature review to analyze the samples the occurrence of various misconceptions was noted. All textbooks described correctly the four symbols of quantum numbers, but none correlates correctly the magnetic-angular quantum number to the Cartesian labeled (...) orbitals. All textbooks consider mistakenly the meaning of aufbau as the building-up energy of orbitals by following (n + ℓ, n) rules on describing the electronic configuration for all atoms. Only one textbook states that the electronic configuration of transition metal atoms (3d series) can be described in the following order of shell (n), thus giving rise to two types of electronic configurations, [Ar] 3d 4s (Type I) beside [Ar] 4s 3d (Type II), leading further misconception. All textbooks described favorably an unpaired electron of ms = + ½ due to the specific agreement, which is a potential misconception in applying Hund’s rule. In drawing the diagram boxes of orbitals, they are arranged in increasing or decreasing the numeric mℓ, due to the specific agreement, and again leading to a potential misconception on describing the quantum number of electrons issued. Three textbooks introduced the terms of the last and the xth electron associated with the quantum numbers, leading to serious further misconceptions. No books stated that the ordering energy of the (n + ℓ, n) rule is true only for the first twenty atoms. (shrink)

BackgroundUse of routinely collected patient data for research and service planning is an explicit policy of the UK National Health Service and UK government. Much clinical information is recorded in free-text letters, reports and notes. These text data are generally lost to research, due to the increased privacy risk compared with structured data. We conducted a citizens’ jury which asked members of the public whether their medical free-text data should be shared for research for public benefit, to inform an ethical (...) policy.MethodsEighteen citizens took part over 3 days. Jurors heard a range of expert presentations as well as arguments for and against sharing free text, and then questioned presenters and deliberated together. They answered a questionnaire on whether and how free text should be shared for research, gave reasons for and against sharing and suggestions for alleviating their concerns.ResultsJurors were in favour of sharing medical data and agreed this would benefit health research, but were more cautious about sharing free-text than structured data. They preferred processing of free text where a computer extracted information at scale. Their concerns were lack of transparency in uses of data, and privacy risks. They suggested keeping patients informed about uses of their data, and giving clear pathways to opt out of data sharing.ConclusionsInformed citizens suggested a transparent culture of research for the public benefit, and continuous improvement of technology to protect patient privacy, to mitigate their concerns regarding privacy risks of using patient text data. (shrink)

Patient online record access (ORA) is spreading worldwide, and in some countries, including Sweden, and the USA, access is advanced with patients obtaining rapid access to their full records. In the UK context, from 31 October 2023 as part of the new NHS England general practitioner (GP) contract it will be mandatory for GPs to offer ORA to patients aged 16 and older. Patients report many benefits from reading their clinical records including feeling more empowered, better understanding and remembering their (...) treatment plan, and greater awareness about medications including possible adverse effects. However, a variety of indirect evidence suggests these benefits are unlikely to accrue without supplementation from internet-based resources. Using such routes to augment interpretation of the data and notes housed in electronic health records, however, comes with trade-offs in terms of exposing sensitive patient information to internet corporations. Furthermore, increased work burdens on clinicians, including the unique demands of ORA, combined with the easy availability and capability of a new generation of large language model (LLM)-powered chatbots, create a perfect collision course for exposing sensitive patient information to private tech companies. This paper surveys how ORA intersects with internet associated privacy risks and offers a variety of multilevel suggestions for how these risks might be better mitigated. (shrink)

In the context of office work, learning to handle an Enterprise Resource Planning system is important as implementation costs for such systems and associated expectations are high. However, these expectations are often not met because the users are not trained adequately. Electronic Performance Support Systems are designed to support employees’ ERP-related problem-solving and informal learning. EPSS are supposed to enhance employees’ performance and informal workplace learning through task-specific and granular help in task performance and problem-solving. However, there is little (...) empirical research on EPSS. Two survey studies addressed this research gap. In the first study, 301 people working in Human Resource -related positions and functions evaluated the learning potential of EPSS as well as potential advantages and obstacles concerning the implementation and use of EPSS. Though other measures are currently assessed as more important for learning, HR employees expect a strong increase in the significance of EPSS for employee learning. In the second study, 652 users of ERP software completed a questionnaire on characteristics of their daily work tasks, team characteristics, individual dispositions, their coping with ERP-related problems, and characteristics of EPSS. Findings indicate that the most frequently available and used approach when dealing with an ERP-related problem is consulting colleagues. Three EPSS types can be distinguished by their increasing integration into the user interface and their context-sensitivity. While external and extrinsic EPSS are available to many users, intrinsic EPSS are less common but are used intensively if available. EPSS availability is identified to be a strong positive predictor of frequency of EPSS use, while agreeableness as well as the task complexity and information-processing requirements show small negative effects. Moreover, more intensive ERP users use EPSS more frequently. In general, ERP users value, features such as context-sensitivity, an integration of the EPSS into the ERP system’s user interface, the option to save one’s own notes, and information displayed in an extra window. It is expected that EPSS will play an important role in workplace learning in the future, along with other measures. (shrink)

We note a range of interesting and challenging points which take forward the discourse around the ethics of sharing patient data. Of most note are criticisms of our jury recruitment and methods; questioning how we can engender trust and support from the wider, uninformed public when we only have the view of a small informed public; asking what work needs to be done to ethically transfer data from a clinical care setting to that of research; suggesting that dynamic (...) consent with opt-outs could be an avenue for allowing patients more control over the use of their medical data for research; and asking how we bridge from ‘is’ to ‘ought’. The first criticisms to be addressed focus on the recruitment and methods of our jury, raised by Carter.1 She suggests that the selection of participants, using a population distribution of responses to a data-sharing question, resulted in a jury too positively oriented to data sharing at the outset. Further, she suggests that we counted individual votes rather than allowing the jury to come to a collective position, that jurors were not asked to prioritise the common good, that we present a lack of data from the jury’s deliberations, and as a result, there is a difficulty with evaluating the reasoning and authenticity of deliberation. Regarding recruitment of our jury, our stated aim, which we acknowledge is not shared by all juries, was to achieve a sample which broadly matched what we would expect if …. (shrink)

The presence of stigmatizing language in the electronic health record (EHR) has been used to measure implicit biases that underlie health inequities. The purpose of this study was to identify the presence of stigmatizing language in the clinical notes of pregnant people during the birth admission. We conducted a qualitative analysis on N = 1117 birth admission EHR notes from two urban hospitals in 2017. We identified stigmatizing language categories, such as Disapproval (39.3%), Questioning patient credibility (37.7%), Difficult patient (...) (21.3%), Stereotyping (1.6%), and Unilateral decisions (1.6%) in 61 notes (5.4%). We also defined a new stigmatizing language category indicating Power/privilege. This was present in 37 notes (3.3%) and signaled approval of social status, upholding a hierarchy of bias. The stigmatizing language was most frequently identified in birth admission triage notes (16%) and least frequently in social work initial assessments (13.7%). We found that clinicians from various disciplines recorded stigmatizing language in the medical records of birthing people. This language was used to question birthing people's credibility and convey disapproval of decision‐making abilities for themselves or their newborns. We reported a Power/privilege language bias in the inconsistent documentation of traits considered favorable for patient outcomes (e.g., employment status). Future work on stigmatizing language may inform tailored interventions to improve perinatal outcomes for all birthing people and their families. (shrink)

RESUMEN El Servicio de Extensión Bibliotecaria es el medio adecuado que tiene la biblioteca para expandirse hacia la comunidad, de esa forma permite que aquellos usuarios que no la visitan hagan uso de sus servicios y documentos. Sin embargo, pocos conocen su historia y evolución a través del tiempo. Se muestra una revisión bibliográfica y el estado actual de este servicio. Los elementos incluidos en esta recolección abarcan publicaciones periódicas, sitios web, revistas electrónicas, publicados entre el siglo XVIII y el (...) presente. El documento pretende brindar una aproximación histórica al servicio de extensión bibliotecaria en las bibliotecas. ABSTRACT The Library Extension Service is the appropriate method a library has to expand into the community in a way that users who don’t visit it use its services and documents. However, just a few people know its history and development through time. A bibliographic review is shown along with the current state of this service. The elements included in it cover regular publications, web sites and electronic journals published from the XVIII century to the present time. The paper expects to provide a historical approach to the library extension service in libraries. (shrink)

This fully revised new edition re-establishes Paul Griffiths's survey as the definitive study of music since the Second World War. The disruptions of the war, and the struggles of the ensuing peace, were reflected in the music of the time: in Pierre Boulez's radical reforming of compositional technique and in John Cage's move into zen music, in Milton Babbitt's settling of the serial system and in Dmitry Shostakovich's unsettling symphonies, in Karlheinz Stockhausen's development of electronic music and in Luigi (...) Nono's pursuit of the universally human, in Iannis Xenakis's view of music as sounding mathematics and in Luciano Berio's consideration of it as language. The initiatives of these composers and their contemporaries opened prospects that have continued to unfold. This constant expansion of musical thinking since 1945 has left us with no single history of music. Paul Griffiths's study accordingly follows several different paths, showing how and why they converge and diverge. In addition to the composers mentioned above, others whose music is discussed include Steve Reich, Jean Barraque, Elliott Carter, Olivier Messiaen, Gyorgy Kurtag, Harrison Birtwistle, and Gyorgy Ligeti. Publication and recording details are given for the works of all these composers and many others. (shrink)

Per the OpenNotes directive of the 21st Century Cures Act implemented in 2021, patients and their legally recognized representatives must be able to access the electronic medical record in real time. This is an opportunity for clinical ethicists and other providers to reflect on their charting practices, particularly how and when they quote patients. Although using direct quotations is common because it seems to avoid misinterpretation, it may not always be appropriate. In this article, we discuss some of the (...) risks and benefits of quoting in the context of OpenNotes and provide suggestions for how clinical ethicists can leverage their unique position to help mitigate some of these risks and promote more reflective charting practices among the teams they work with. (shrink)

This paper draws on an in-depth phenomenological analysis of some interviews taken from volunteers, inviting them to reflect on their lived experiences of meaningfulness in the context of volunteering and citizenship. It is found that while some testimonies reinforce the standard conceptions of meaningfulness, other testimonies vary from it. The main challenge of this contribution consists in phenomenologically describing this alternative picture of meaningfulness, depicted as the event of witnessing. In a final part, the authors consider how volunteering is at (...) times especially prone to further experiences of witnessing. (shrink)

Our natural environment is in a lamentable state, notwithstanding today’s increasing ecological awareness. One cause frequently cited is our diminished perception of and relation to nature on ontological grounds. None of the alternative visions offered to date has been considered to really challenge the prevailing detached utilitarian and empirical framework. However, continued attempts on various levels are needed to rearticulate and reinvigorate the currently dormant and neglected plurality of approaches to nature. Although neither Heidegger nor Levinas was primarily concerned with (...) the relation of humans to nature, their works do seem to offer a voice to express our genuine way of being as a “Dasein in the world,” and the depth of its implications, as well as to reveal the “exteriority of nature.” A close examination of their views can show how they may contribute to a broadening of our perception, so that nature may appear to us not primarily as a commodity but foremost as an inspiring source of meaningfulness that at the same time appeals to our ethical ability. (shrink)