Background: Most previous studies on moral distress focused on the factors that cause moral distress, paying inadequate attention to the moral conflict of nurses’ values, the physician–nurse power hierarchy, and the influence of the culture. Research objective: To analyze the main causes for moral distress with interpretive interactionism. Research design: A qualitative study was adopted. Participants: Through purposeful sampling, 32 nurses from 12 different departments were chosen as the samples. Ethical considerations: Approval from the Institutional Review Board of the Kaohsiung (...) Medical University Hospital. Findings: Moral distress is likely to occur in the following clinical situations: patients have no idea about their diseases; the medical decisions fail to meet the optimum benefit of patients; and patients with terminal cancers are not given a proper death. The reason why nurses become trapped in moral distress is that they fail to achieve moral goodness. Inadequate confidence, the physician–nurse power hierarchy, and the Oriental culture affect nurses’ goodness-based intention for patients, which deteriorates moral distress. Discussion: The main cause for moral distress is the moral goodness of nurses. If nurses’ goodness-based intention for patients is inconsistent with the moral objective of achieving optimum benefit for patients, it leads to moral distress. Culture is an essential background factor of care for patients. In the Oriental culture, family members influence patients’ right to know about their diseases, the choice of treatment, and patients’ autonomy of not receiving cardio-pulmonary resuscitation. This results in moral distress in medical care. Conclusion: The occurrence of moral distress demonstrates that nurses have moral characteristics such as goodness and caring. It is suggested that appropriate educational strategies can be adopted to weaken the power hierarchy between physicians and nurses and enhance nurses’ confidence and cultural sensitivity, so as to reduce the moral distress of nurses. (shrink)

Background: As moral action could help nurses reduce moral distress, it is necessary to carry out qualitative research to present the experiences in which nurses apply moral action. Aim: To describe and analyze the phronesis applied by nurses in the face of moral distress. Research design: The research participants were invited to participate in in-depth interviews. The research materials were based on the stories described by the research participants and recorded by means of first-person narrative. Narrative analysis was applied to (...) interpret the nurses’ phronesis. Participants: Twenty-seven nurses from Taiwan. Ethical considerations: The Institutional Review Board of the Kaohsiung Medical University Hospital in Taiwan confirmed that this study passed the research ethical review. Findings: According to the narrative analysis results, the phenomenon of moral distress contains difficulty, action, and idea transformation. The difficulty is the source of moral distress, action is the practice of moral courage, and idea transformation is the nurse’s emotional movement. Action and idea transformation are collectively called phronesis in this study. Discussion: Moral distress refers to a state of suffering caused by situations in which nurses cannot carry out their ethical intentions. Phronesis is the process through which nurses take actions and relocate the subjects and is an ethical way to find relief from moral distress. Starting with empathy and respectful attitudes arising from self-reflection, nurses may be helped to get relief from the suffering of moral distress. Conclusion: Phronesis can help nurses positively face the emotional strain of moral distress. This article puts forward a narrative method to complete the four steps of phronesis: write about the care experience, identify the difficulties in the stories, seek the possibility of action, and form a new care attitude, which could help nurses learn to reduce their moral distress. (shrink)

BackgroundThe therapeutic effect of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson's disease (PD) is related to the modulation of pathological neural activities, particularly the synchronization in the β band (13–35 Hz). However, whether the local β activity in the STN region can directly predict the stimulation outcome remains unclear.ObjectiveWe tested the hypothesis that low-β (13–20 Hz) and/or high-β (20–35 Hz) band activities recorded from the STN region can predict DBS efficacy.MethodsLocal field potentials (LFPs) were recorded in (...) 26 patients undergoing deep brain stimulation surgery in the subthalamic nucleus area. Recordings were made after the implantation of the DBS electrode prior to its connection to a stimulator. The maximum normalized powers in the theta (4–7 Hz), alpha (7–13 Hz), low-β (13–20 Hz), high-β (20–35 Hz), and low-γ (40–55 Hz) subbands in the postoperatively recorded LFP were correlated with the stimulation-induced improvement in contralateral tremor or bradykinesia–rigidity. The distance between the contact selected for stimulation and the contact with the maximum subband power was correlated with the stimulation efficacy. Following the identification of the potential predictors by the significant correlations, a multiple regression analysis was performed to evaluate their effect on the outcome.ResultsThe maximum high-β power was positively correlated with bradykinesia–rigidity improvement (rs = 0.549, p < 0.0001). The distance to the contact with maximum high-β power was negatively correlated with bradykinesia–rigidity improvement (rs = −0.452, p < 0.001). No significant correlation was observed with low-β power. The maximum high-β power and the distance to the contact with maximum high-β power were both significant predictors for bradykinesia–rigidity improvement in the multiple regression analysis, explaining 37.4% of the variance altogether. Tremor improvement was not significantly correlated with any frequency.ConclusionHigh-β oscillations, but not low-β oscillations, recorded from the STN region with the DBS lead can inform stimulation-induced improvement in contralateral bradykinesia–rigidity in patients with PD. High-β oscillations can help refine electrode targeting and inform contact selection for DBS therapy. (shrink)

This dissertation is a study in Peirce's early metaphysics embedded in his writings between 1859 and 1867, which have received scant attention. Its purpose is to unravel his concept of reality and some relevant epistemological notions. Peirce's early metaphysical speculations can be divided into two parts. One is a system which covers thought between 1859 and 1862. The other manifests in lectures and writings between 1863 and 1867. The present study, consisting of five chapters, includes both of them. ;Murray G. (...) Murphey is one of the very few scholars who have attempted to take Peirce's early theories of knowledge and reality seriously. Thus the first chapter delineates his general interpretation of Peirce's first system, as a base for further discussions in the next two chapters. The second chapter clarifies Peirce's notion of metaphysics and then criticizes Murphey's understanding of Peirce's view of metaphysics. Similarly, the task of the third chapter is twofold: on the one hand, focusing on the epistemological and metaphysical issues, it provides an exposition of Peirce's system in detail and shows that some of his philosophical doctrines can be traced back to that system; on the other hand, it critically examines Murphey's interpretations of Peirce's texts and demonstrates that they involve misunderstandings or are one-sided. The fourth chapter scrutinizes Peirce's early writings on logic, which is regarded as a branch of semiotic and the foundation of metaphysics. It first elucidates Peirce's unpsychological view of logic as well as his notion of symbol and then discloses his theory of individual and diachronic view of knowledge therein embedded. Furthermore, Peirce's thesis that the function of a proposition is to reduce the impression to unity is investigated. Finally, it sums up the epistemological and metaphysical significance of Peirce's logical theory above expounded and, especially, specifies the fundamental tenets of Peirce's concept of reality implicitly involved in his early semeiotical approach to logic. The last chapter is simply a brief conclusion, roughly adumbrating Peirce's later doctrine of reality and how, in many aspects, it is foreshadowed by his early thought. (shrink)

Entrepreneurial intention is an important condition for promoting substantive entrepreneurial behavior, which in turn alleviates employment pressure and promotes sustainable economic and social development. Based on national survey data of university students, descriptive statistical analysis of variables and binary logistic regression analysis were used to empirically analyze the factors influencing university students’ entrepreneurial intentions in five aspects, including innate endowment, acquired characteristics, entrepreneurship courses, and entrepreneurial practice, and social support. The regression results showed that both the factors of innate endowment (...) and acquired characteristics passed the significance test. The entrepreneurship course factor had a significant impact on entrepreneurial intention, with the mean value of the number of entrepreneurship courses hitting 1.80, which is much lower than the other subdivision factors, indicating that there is a greater demand for entrepreneurship courses offered by university students, while the actual situation is less than satisfactory. The entrepreneurial practice factor is also an important factor, with an overall mean of 3 or more, and has a significant impact on entrepreneurial intentions, but in comparison, the factor of having an off-campus practice base for entrepreneurial practice has the lowest mean score, which shows that there is some room for improvement in the construction of off-campus practice bases. The social support factor significantly influences the willingness to start a business, and the mean score for each factor is above the medium level. By understanding which students are more willing to start a business and which factors are more likely to influence their willingness to start a business, we can further consider what kind of entrepreneurial skills and entrepreneurship education can lead to high-quality entrepreneurship and employment. (shrink)

Entrepreneurial intention is an important condition for promoting substantive entrepreneurial behavior, which in turn alleviates employment pressure and promotes sustainable economic and social development. Based on national survey data of university students, descriptive statistical analysis of variables and binary logistic regression analysis were used to empirically analyze the factors influencing university students’ entrepreneurial intentions in five aspects, including innate endowment, acquired characteristics, entrepreneurship courses, and entrepreneurial practice, and social support. The regression results showed that both the factors of innate endowment (...) and acquired characteristics passed the significance test. The entrepreneurship course factor had a significant impact on entrepreneurial intention, with the mean value of the number of entrepreneurship courses hitting 1.80, which is much lower than the other subdivision factors, indicating that there is a greater demand for entrepreneurship courses offered by university students, while the actual situation is less than satisfactory. The entrepreneurial practice factor is also an important factor, with an overall mean of 3 or more, and has a significant impact on entrepreneurial intentions, but in comparison, the factor of having an off-campus practice base for entrepreneurial practice has the lowest mean score, which shows that there is some room for improvement in the construction of off-campus practice bases. The social support factor significantly influences the willingness to start a business, and the mean score for each factor is above the medium level. By understanding which students are more willing to start a business and which factors are more likely to influence their willingness to start a business, we can further consider what kind of entrepreneurial skills and entrepreneurship education can lead to high-quality entrepreneurship and employment. (shrink)

This study empirically examined the effects of ethical leadership and ethical climate on employee ethical behavior in the international port context using survey data collected from 128 respondents who worked in Taiwan International Ports Corporation in Taiwan. Research hypotheses were formulated from the previous literature and tested using structural equation modeling. Results indicated that ethical leadership had a significant impact on ethical climate and the ethical behavior of TIPC employees. Ethical climate was found to be positively associated with employee ethical (...) behavior. The theoretical and practical implications of the research findings are discussed. (shrink)

Career sustainability is a well-researched issue in academics and other sectors. Technology advancements and COVID-19 have jeopardized career sustainability. Numerous studies have explored the influence of individual characteristics on career sustainability, but few have focused on leadership. In addition, cultural factors must be considered because leadership is rooted in culture. In particular, inclusive leadership reflects traditional Chinese culture. Therefore, based on self-determination social exchange theories, we analyzed the effects of inclusive leadership on career sustainability as well as the roles of (...) thriving at work and supervisor developmental feedback in career sustainability. In total, 363 samples were collected from China. The results revealed that inclusive leadership improves career sustainability through SDF and thriving at work. Theoretically, our study fills the research gap and establishes a mechanism and theoretical framework for inclusive leadership and career sustainability. Practically, we offer guidance for enterprises to cultivate inclusive leadership and improve career sustainability. (shrink)

This paper reports on the long-term effectiveness of a non-formal co-curricular educational program based on a campus ecogarden at a Hong Kong university in developing pro-sustainability awareness, attitudes and behavior among undergraduate students. This service-based, nature-based experiential learning program, termed the Ecogarden Farmer and Biodiversity Surveyor, has been running at the university since 2015. The program is divided into two consecutive phases: a training phase comprising various learning activities and a successive internship phase consisting of the all-round practical tasks involved (...) in managing the garden. A retrospective evaluation of the program using phenomenographic approach and content analysis was adopted to reveal the diversity of students’ learning experience, as the indicators of the success of the program. Of 112 participants from 4 cohorts, 32 completed online questionnaires, and semi-structured interviews were successfully conducted with twelve participants, three from each of the four cohorts. The results indicated that the program’s outcomes could be categorized into five themes. Most outcomes fit into the theme ‘an increase in knowledge and skill level,’ followed by ‘rise in environmental awareness,’‘facilitation of personal growth,’ and ‘enhancement of career development.’ Many structural experiences revealed may suggest the success of the program. The longer the participants had participated in the program, the more in-depth and diversified reflection of the senior participants relating to personal development were mentioned. This study provides critical insights into the validity of retrospective program evaluation for assessing the long-term impact of EfS programs by introducing a cross-sectional study of different cohorts as a serial time-point sampling strategy. (shrink)

In this article, the researchers explore the following question. Can corporate social responsibility (CSR) and the corporate reputation of a firm lead to its brand equity in business-to-business (B2B) markets? This study discusses CSR from customers' viewpoints by taking the sample of industrial purchasers from Taiwan small-medium enterprises. The aims of this study are to investigate: first, the effects of CSR and corporate reputation on industrial brand equity; second, the effects of CSR, corporate reputation, and brand equity on brand performance; (...) and third, the mediating effects of corporate reputation and industrial brand equity on the relationship between CSR and brand performance. Empirical results support the study's hypotheses and indicate that CSR and corporate reputation have positive effects on industrial brand equity and brand performance. In addition, corporate reputation and industrial brand equity partially mediate the relationship between CSR and brand performance. (shrink)

This study aimed to discuss the relationships among the brand image of universities (external variables), university satisfaction (mediating variables) and customer lifetime value (internal variables). The findings can serve as a reference for higher educational institutions in strengthening their advantages and overcoming their shortcomings, as well as for administrative decision-making. A questionnaire survey was conducted on university students in Taiwan, and 470 valid samples were retrieved. The data were analysed with structural equation modelling and multi-group analysis. The results showed that (...) brand image influences customer satisfaction, which in turn affects customer lifetime value. Satisfaction is a partial mediating variable between brand image and customer lifetime value. Multi-group analysis found that gender has no interfering effect between brand image and satisfaction, nor does it between satisfaction and customer lifetime value or between brand image and customer lifetime value. (shrink)

This paper examines how industrial buyers’ attributions of their suppliers’ actions of corporate social responsibility are related to both the brand advocacy and brand equity. Using a sample of 173 questionnaires gathered in Taiwan, we find that CSR perceptions of industrial buyers are more strongly and positively related to brand advocacy and brand equity when industrial buyers interpret CSR activities of their suppliers as driven more by intrinsic motives and less by extrinsic motives. Furthermore, brand advocacy mediates the interactive effects (...) of CSR and CSR attribution on industrial brand equity. (shrink)

A large body of research links testosterone and cortisol to male-male competition. Yet, little work has explored acute steroid hormone responses to coalitional, physical competition during middle childhood. Here, we investigate testosterone, dehydroepiandrosterone, androstenedione, and cortisol release among ethnically Chinese boys in Hong Kong, aged 8–11 years, during a soccer match and an intrasquad soccer scrimmage, with 63 participants competing in both treatments. The soccer match and intrasquad soccer scrimmage represented out-group and in-group treatments, respectively. Results revealed that testosterone showed (...) no measurable change. DHEA increased during both treatments in the majority of participants and the degree of change had no relation to independent variables or covariate measures. Most boys experienced androstenedione increases during match play, but no significant differences during the intrasquad soccer scrimmage competitions. The magnitude of change differed significantly between treatments and was positively associated with age. These latter findings suggest boys’ androstenedione responses may be sensitive to competitor type. For most subjects, cortisol significantly increased during match play, decreased during the intrasquad soccer scrimmage, and differed significantly between treatments, suggesting each treatment promoted a different psychological state among competitors. Cortisol/DHEA molar ratio decreased during the intrasquad scrimmage, suggestive of a more relaxed mental state. These data shed new light on potential proximate mechanisms associated with coalitional competition among prepubescent boys, with relevance to adrenarche and life history theory. (shrink)

Drowsy driving is a major cause of automobile accidents. Previous studies used neuroimaging based approaches such as analysis of electroencephalogram (EEG) activities to understand the brain dynamics of different cortical regions during drowsy driving. However, the coupling between brain regions responding to this vigilance change is still unclear. To have a comprehensive understanding of neural mechanisms underlying drowsy driving, in this study we use transfer entropy, a model-free measure of effective connectivity based on information theory. We investigate the pattern of (...) information transfer between brain regions when the vigilance level, which is derived from the driving performance, changes from alertness to drowsiness. Results show that the couplings between pairs of frontal, central, and parietal areas increased at the intermediate level of vigilance, which suggests that an enhancement of the cortico-cortical interaction is necessary to maintain the task performance and prevent behavioral lapses. Additionally, the occipital-related connectivity magnitudes monotonically decreases as the vigilance level declines, which further supports the cortical gating of sensory stimuli during drowsiness. Neurophysiological evidence of mutual relationships between brain regions measured by Transfer entropy might elucidate the understanding of cortico-cortical communication during drowsy driving. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Relational autonomy is an alternative concept of autonomy in which an individual is recognized as embedded into society and influenced by relational factors. Social context, including social location, political structure, and social forces, significantly influence an agent to develop and exercise autonomy skills. The relational approach has been applied in clinical practice to identify relational factors impacting patient autonomy and decision-making, yet there is a knowledge gap in how these factors influence the demonstration of relational autonomy in the context (...) of medical decisions of adults. Objective The present study targeted the existing knowledge of what and how relational factors impact individuals making medical decisions using the theoretical framework of relational autonomy. Methods A meta-synthesis study was utilized. Four electronic databases, including Embase, OVID Medline, CINAHL, and PubMed, were searched, along with gray literature and reference lists, to identify relevant studies. Results 23 studies reporting 21 qualitative and two mixed-method studies were reviewed. Four themes emerged from the qualitative findings: (1) supportive relationships facilitate an individual’s relational autonomy; (2) obtaining comprehensive information from broader sources helps individuals exercise relational autonomy; (3) undue family pressure impedes the exercising of patient relational autonomy; and (4) healthcare providers’ dominant voice hampers the demonstration of relational autonomy. Conclusions Applying relational autonomy to assist adults in making well-considered decisions is essential. The meta-synthesis suggests establishing a supportive relationship between individuals, healthcare providers, and family. A supportive relationship will allow healthcare providers to make judgments in line with an individual’s values and wishes with the aim of promoting relational autonomy. Advance care planning was proposed as the effective solution to obtain a consensus between individuals and their families while respecting an individual’s values and preferences. Furthermore, it is considered crucial for healthcare providers to appreciate an individual's values and incorporate their preferences into recommendations. (shrink)

Discovering high-utility itemsets (HUIs) consists of finding sets of items that yield a high profit in customer transaction databases. An important limitation of traditional high-utility itemset mining (HUIM) is that only the utility measure is used for assessing the interestingness of patterns. This leads to finding several itemsets that have a high profit but contain items that are weakly correlated. To address this issue, this paper proposes to integrate the concept of correlation in HUIM to find profitable itemsets that are (...) highly correlated, using the all-confidence and bond measures. An efficient algorithm named FCHM (fast correlated high-utility itemset miner) is proposed to efficiently discover correlated high-utility itemsets (CHIs). Two versions of the algorithm are proposed: FCHM|$_{all\text{-}confidence}$| and FCHM|$_{bond}$|⁠, which are based on the all-confidence and bond measures, respectively. An experimental evaluation was done using four real-life benchmark datasets from the HUIM literature: mushroom, retail, kosarak and foodmart. Results show that FCHM is efficient and can prune a huge amount of weakly CHIs. (shrink)

Background: Burnout is a stress-induced syndrome considered to be closely related to work. Although social support could relief burnout syndrome, its effect on learning burnout in medical students remains unclear. The objectives of the study are to evaluate the association between learning burnout and social support in Chinese medical students.Methods: A cross-sectional online survey was distributed to students who participated in online learning in a medical college in Wuhan during the COVID-19 epidemic. We used the Lian version of the Maslach (...) Burnout Inventory to assess learning burnout and the Social Support Rating Scale to assess social support. Chi-square tests were used to analyze factors associated with burnout. Independent t-test and multiple logistic regression were explored to analyze the relationship between social support and burnout.Results: A total of 684 students have completed the survey, of which 315 met standard criteria for learning burnout. Multiple logistic regression analysis has revealed that seniors, low family income and low social support were significant predictors of learning burnout. After adjusting for the grade and family income, there was a significant and relevant association between social support and learning burnout.Conclusions: Learning burnout was highly prevalent in medical students at our college. Senior students and low family income might be risk factors for learning burnout. Social support, especially subjective support and utilization of support might play a protective role in reducing the risk of learning burnout. (shrink)

The high turnover of nurses has become a global problem. Several studies have proposed that nurses' perceptions of the ethical climate of their organization are related to higher job satisfaction and organizational commitment, and thus lead to lower turnover. However, there is limited empirical evidence supporting a relationship between different types of ethical climate within organizations and facets of job satisfaction. Furthermore, no published studies have investigated the impact of different types of ethical climate on the three components of organizational (...) commitment. This study attempts to explore the different types of ethical climate that exist in hospitals, and the degree of job satisfaction and organizational commitment of nurses in Taiwan. It uses path analysis to understand which types of ethical climate influence different facets of job satisfaction. The study also examines the impact of different types of ethical climate and facets of job satisfaction on the three components of organizational commitment. Questionnaires were distributed to 352 nurses. The relationships among variables were assessed by factor analysis, reliability, descriptive statistics, correlations, and regression. The important conclusion is that hospitals can increase job satisfaction and organizational commitment by influencing an organization's ethical climate. Hospital administrators can foster within organizations the climate types of caring, independent, and rules climate that increase satisfaction, while preventing organizations from developing the type of instrumental climate that decreases it. (shrink)

The Taizhou school of philosophy, followers of Wang Yangming, places significant emphasis on the body, which has led to theoretical challenges concerning the potential dissipation of natural desires. Critics contend that while Taizhou philosophy acknowledges the natural state of human existence, it fails to provide a satisfactory explanation for the existence of evil and tends to overlook the crucial role of deliberate moral practice by idealizing the natural as morally perfect. Drawing on insights from embodied cognition, this article aims to (...) shed light on the nuanced perspectives of Taizhou moral philosophy and address common criticisms regarding its approach to evil and moral practice. I will explore Taizhou’s holistic understanding, which integrates mind and body, self and others, offering fresh insights into the interplay between deliberation and spontaneity within moral practices. As a comparative and interdisciplinary endeavor, this work seeks to bridge the divide between Eastern and Western philosophical traditions and between moral philosophy and empirical science. This article not only aims to enhance our understanding of Taizhou philosophy but also strives to illuminate broader implications for ethical behavior and moral reasoning in a diverse, global context. (shrink)

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)

Background The Constitutional Court of South Korea declared that an abortion ban was unconstitutional on April 11, 2019. The National Health Care System will provide abortion care across the country as a formal medical service. Conscientious objection is an issue raised during the construction of legal reforms. Methods One hundred sixty-seven perioperative nurses responded to the survey questionnaire. Nurses’ perception about conscientious objection, support of legislation regarding conscientious objection, and intention to object were measured. Logistic regression was used to explore (...) the factors associated with support of the legislation and the intention to conscientiously object. Results Only 28.8% of the responding nurses were aware of health care professionals’ conscientious objection. The majority felt that patients’ rights should be prioritized over health care professionals’ conscientious objection. On the other hand, 45.8% supported the legislation on conscientious objection to abortion, and 42.5% indicated a willingness to refuse to participate in an abortion case if conscientious objection was permitted. Religion, awareness of conscientious objection, and prioritizing of nurses’ right to conscientious objection were significantly associated with supporting the legislation. Moreover, religion and prioritizing nurses' rights were significantly associated with the intention to conscientiously object. Conclusions This study provides information necessary for further discussion of nurses’ conscientious objection. Nursing leaders, researchers, and educators should appeal to nurses and involve them in making policies that balance a women's right to non-discrimination and to receiving appropriate care with nurses' rights to maintain their moral integrity without compromising their professional obligation. (shrink)

When people interact with social robots, they treat them as real social agents. How people depict robots is fun to consider, but when people are confronted with embodied entities that move and talk – whether humans or robots – they interact with them as authentic social agents with minds, and not as mere representations.

The present essay aims to throw light on the study of dialectical thinking from a cultural-historical perspective. Different forms of dialectic are articulated as ideal types, including the Greek dialectic, the Hegelian dialectic, the contemporary German negative dialectic, the Chinese dialectic, and the Indian negative dialectic. These influential cultural products in the history of the East and the West, articulated as ideal types, serve as constellations that could facilitate further empirical studies on dialectical thinking. An understanding of the complexity of (...) these constellations reveals the pitfalls of investigating dialectical thinking without an appropriate conceptualization of the research target. With the ideal types of dialectic as "figure," and Vygotsky's thesis of the cultural-historical origin of higher psychological processes as "ground," we explore possibilities for further lines of inquiry on dialectical thinking. Adhering to the Scribnerian multilevel scheme that reconstructs Vygotsky's thesis, and returning to the core ideas of Vygotsky himself, we discover new, meaningful questions about the study of dialectical thinking. In the research area of "culture and cognition," consideration of a cultural-historical perspective appears to be both necessary and promising. (shrink)