One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...) In this paper, we discuss the bioethicists’ response in relation to the state's possible role in clarifying the best interests standard. We identify and characterise two clarificatory strategies employed by bioethicists —elaborative and enumerative—and argue that the state should adopt the latter. Beyond the practical difficulties of the former strategy, a state adoption of it would inevitably be prejudicial in a pluralistic society. Given the gravity of best interests decisions, and the delicate task of respecting citizens with different understandings of best interests, only the enumerative strategy is viable. We argue that this does not commit the state to silence in providing guidance to and supporting healthcare providers, nor does it facilitate the abuse of the vulnerable. Finally, we address two methodological worries about adopting this approach at the state level. The adoption of the enumerative strategy is not defeatist in attitude, nor does it eventually collapse into (a form of) the elaborative strategy. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

Volume 46, Issue 6, November 2020, Page 658-675.

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

1. An Tŏng-mun ŭi hangmun chŏngsin kwa ch'ŏse pangsik -- 2. An Tŏng-mun ŭi Samsan Sŏwŏn wisang chŏngnip kwa kŭ ŭimi -- 3. Ha Ik-pŏm ŭi sam kwa munhak -- 4. Pak Ch'i-bok ŭi Nammyŏnghak kyesŭng yangsang -- 5. Kang Pyŏng-ju ŭi hangmun kwa munhak -- 6. Chŏng Chae-gyu ŭi hangmun chŏngsin kwa 'Taehak' haesŏk -- 7. Kim Chin-ho ŭi haksŏl e taehayŏ -- 8. Kwak Chong-sŏk ŭi Myŏngdŏksŏl nonjaeng -- 9. Kim Hwang ŭi Kyŏnghak Sipto e taehayŏ.

For more than two thousand years, Confucius has been an inseparable part of China's history. Yet despite this fame,Confucius the man has been elusive. Now, in The Authentic Confucius , Annping Chin has worked through the most reliable Chinese texts in her quest to sort out what is really known about Confucius from the reconstructions and the guesswork that muddled his memory. Chin skillfully illuminates the political and social climate in which Confucius lived. She explains how Confucius made (...) the transition from court advisor to wanderer, and how he reluctantly became a professional teacher as he refined his judgment of human character and composed his vision of a moral political order. The result is an absorbing and original book that shows how Confucius lived and thought: his habits and inclinations, his relation to the people of the time, his work as a teacher and as a counselor, his worries about the world and the generations to come. In this book, Chin brings the historical Confucius within our reach, so that he can lead us into his idea of the moral and to his teachings on family and politics, culture and learning. The Authentic Confucius is a masterful account of the life and intellectual development of a thinker whose presence remains a powerful force today. (shrink)

Commemorative artefacts purportedly speak – they communicate messages to their audience, even if no words are uttered. Sometimes, such artefacts purportedly communicate demeaning or pejorative messages about some members of society. The characteristics of such speech are, however, under-examined. I present an account of the paradigmatic characteristics of the speech of commemorative artefacts (or, “commemorative artefactual speech”), as a distinct form of political speech. According to my account, commemorative artefactual speech paradigmatically involves the use of an artefact by an authorised (...) member of a group to declare the importance of remembering a subject, in virtue of some feature of the subject. Then, I outline a variety of ways that commemorative artefactual speech can go awry. Such speech can be unauthorised, involve unfair exclusion or incorrect identification, be aesthetically inadequate, invoke clandestine explanations, and be directed at inappropriate subjects. I conclude with a discussion of the implications of my account for resisting problematic commemorative artefactual speech. (shrink)

Elective egg freezing for fertility preservation - commonly referred to as social egg freezing or non-medical egg freezing, will be permitted in Singapore from 2023. There...

Interpretations of ethical egoism as advocating the unconstrained harming of others, or as an absurd meta-ethical definition of morality, are unwarranted. The social definition of morality provided by, e.g., William Frankena, fails to rule out egoism. Instead, it forms the background against which egoism develops as a possible, normative position. Examples from "The Immoralist" and "Zorba the Greek" illustrate this possibility.

In lieu of an abstract, here is a brief excerpt of the content:Underplayed Ethics and the Dilemmas of Psychiatric CareChong Siow Ann and Tamra LysaghtThe practice of psychiatry is fraught with uncertainty. The exact causes and the biological substrates underlying mental disorders remain to be elucidated; even the diagnosis of these disorders is descriptive and not based on an etiological understanding and no biological diagnostic markers have been validated. The manifestation of almost all mental disorders results from a complex interaction (...) of biological and environmental factors which encompasses the patient’s unique life history, experiences and relationship with others and the community. In the face of such uncertainties — at times extending to the types of treatment (psychiatry is generally acknowledged not be an exact science) — it has been argued that adopting a pragmatic approach is necessary.1 Accordingly, this approach necessitates high ethical standards among mental health practitioners.Some mental illnesses are associated with varying degrees and types of cognitive impairments. Others have certain symptoms like auditory hallucinations and delusions that might severely compromise the patients’ autonomy, distort their sense of reality, increase the risk of harm to themselves or others and render them incapable of making informed decisions in their treatment and participation in research.Consequently, there are issues that are particular to the provision of mental healthcare. These include the need for enforced involuntary treatment with the corollary of depriving a patient of his personal liberty even [End Page 173] though it is often justified on the grounds that it is in the patient’s best interests. However, at times, it is the legal and societal obligation of mental health practitioners to protect those who might be harmed from the patient’s action that might seem to be more pressing. In this situation of double agency, lies the tension of providing confidential care for patients and acting as “an agent of the state” where that patient’s confidentiality might be breached and his liberty infringed upon. This situation is further aggravated by the stigma that clings ever so tenaciously to those who suffer from mental disorders and where it is the norm to stereotype them as dangerous and unpredictable.Consideration of a patient’s autonomy is also challenged by characteristics that are unique to the practice of psychiatry. The prescription of certain psychotropic medications can alter how people think and feel, while psychotherapy works towards changing the patient’s views and values. The philosopher, Jennifer Radden, describes this process as “re-forming the patient’s whole self or character … akin to the responsibilities of raising children”.2 The psychotherapeutic relationship is thus particularly personal and intimate because patients are asked to provide information that often reveals their innermost feelings, fears and fantasies. This information is provided on the basis of trust and assurance of confidentiality, and with expectation of being helped.Jeremy Holmes and Gwen Adshead have elaborated on the vulnerability of patients seeking psychotherapy: they might be particularly susceptible to exploitation because their past experiences of being exploited have led to their distress and help seeking — their dependency and the extreme privacy of the therapeutic relationship make any transgression difficult to be uncovered.3 There is a calamitous combination of the “unconscious wish in the patient to be used” with the complicity of an unethical therapist seeking to fulfil his own interests.4As in any other doctor-patient relationship, the relationship between the mental healthcare practitioner and the patient is one of unequal power where the former is ascendant. While that power should be exercised to heal and to relieve suffering, it also gives the practitioner tremendous power “to harm, reject, misunderstand, or exploit patients who struggle with the experience of mental illness, which itself may generate helplessness, despair, distress, and exceptional dependence on the clinician”.5 Given the potential of doing good and harm coupled with the likelihood of being so significant in the life of the patient,6 providing care for those with mental disorders and distress is necessarily ethically exacting — arguably more so than in other medical practice settings. [End Page 174]This precariousness has led to the suggestion that ethics in psychiatry should have a special status and that the more general principles of biomedical ethics are too limited in scope to... (shrink)

This paper attends to find out the relationship among religious belief, society and Song-Jiang Battle Array in southern Taiwan, by using the qualitative methods which include literature analyses and the fieldwork investigations. In the process of research, the origin and development of Song-Jiang Battle Array are emerging step by step, which demonstrates that development and evolvement of Song-Jiang Battle Array are most related to contemporaneous social formations. They influenced the relationship between government and people and also affected the relationship between (...) religious belief and Song-Jiang Battle Array. In the end, people’s devotions toward religion are the main force of uniting people in rural society of southern Taiwan and have played an essential role in helping maintain their heritage. All of that is not established in one night. It has been evolving for hundreds of years. Keywords: Song-Jiang Battle Array , S outhern Taiwan , R eligious belief , Government , F olk art array. (shrink)

本书是一本关于陈冲体验人生感悟人生的书法集子。内容包括:悟道篇;明理篇;做人篇;处世篇等。.

In lieu of an abstract, here is a brief excerpt of the content:Virtual GalleryPhotographs are by Christine Chin, a student in the MFA program in Photography at Purdue University. Click for larger view View full resolution Click for larger view View full resolution Click for larger view View full resolution Click for larger view View full resolution Click for larger view View full resolution Click for larger view View full resolution Click for larger view View full resolution Click for (...) larger view View full resolution Click for larger view View full resolution Click for larger view View full resolutionCopyright © 2001 The Johns Hopkins University Press... (shrink)

This book contains an introduction to symbolic logic and a thorough discussion of mechanical theorem proving and its applications. The book consists of three major parts. Chapters 2 and 3 constitute an introduction to symbolic logic. Chapters 4–9 introduce several techniques in mechanical theorem proving, and Chapters 10 an 11 show how theorem proving can be applied to various areas such as question answering, problem solving, program analysis, and program synthesis.

Cancer has garnered increasing interest among philosophers. This chapter focuses on cancer medicine and precision oncology, an influential approach to cancer which seeks to individualize treatment on the basis of genetic or molecular features of disease. It reviews a range of ontological, epistemic, and ethical questions raised by precision oncology, relating developments in cancer medicine to broader issues in the philosophy of science and medicine.

Li Zehou is known as the "intellectual leader of the Chinese Enlightenment" of the 1980s. His major quest has always been for a way to define the role of human agency versus determinism on the one hand, and voluntarism on the other. In the 1980s, Li came forward with a philosophical anthropology (his "theory of subjectivity" or "practice") that moves between two poles: On the one hand, mankind is different from the animals because of its capacity to mold its own (...) environment in a goal-directed way by means of "tools," which means that subjectivity is real if mankind can indeed to a great extent control its own destiny. On the other hand, human control over nature is subject to limitations that are largely determined by the level of technology and social organization in any given society at a certain time. Li attributes the widespread appeal of Maoist voluntarism in China to the persistence of the belief in the transformative power of the human will, unaided by science and technology. (shrink)

What should we do about “tainted” public commemorations? Recent events have highlighted the urgency of reaching a consensus on this question. However, existing discussions appear to be dominated by two naïve opposing views – to remove or preserve them. My aims in this essay are two-fold. First, I argue that the two views are not naïve, but undergirded by concerns with securing self-respect and with the character of our engagement with the past. Second, I offer a qualified defence of vandalising (...) tainted commemorations. The defence comprises two parts. I consider two prominent suggestions – to install counter-commemorations and to add contextualising plaques – and argue that they are typically beset with difficulties. I then argue that in some circumstances, constrained vandalism is a response to tainted commemorations which effectively adjudicates the demands of the two opposing views. (shrink)

This essay examines Zhuangzi's idea, in his dialogue with Hui Shi in the De Chong Fu, of being without human qing. This idea is situated within the contrast that Zhuangzi constantly makes between heaven and human beings. Some contexts for this contrast are described. The essay concludes that qing should be read as basically referring to “facts" in the Zhuangzi, including certain factual beliefs about (false or mistaken) emotions.

What is it for something to be a disability? Elizabeth Barnes, focusing on physical disabilities, argues that disability is a social category. It depends on the rules undergirding the judgements of the disability rights movement. Barnes’ account may strike many as implausible. I articulate the unease, in the form of three worries about Barnes’ account. It does not fully explain why the disability rights movement is constituted in such a way that it only picks out paradigmatic disability traits, nor why (...) only the traits identified by the movement as constituting experiences of social and political constraint count as disability. It also leaves out the contribution of people other than disability activists, to the definition of disability. I develop Barnes’ account. On my account, a person is disabled if she is in some state which is constitutive of some constraint on her legitimate interests. This state must be the subject of legitimate medical interest and be picked out by the disability rights movement as among the traits for which they are seeking to promote progress and change. My account addresses the worries about Barnes’ account. It is also able to include all disabilities, rather than only physical ones. (shrink)

We live in the Age of Big Data. In medicine, artificial intelligence and machine learning algorithms, fueled by big data, promise to change how physicians make diagnoses, determine prognoses, and develop new treatments. An exponential rise in articles on these topics is seen in the medical literature. Recent applications range from the use of deep learning neural networks to diagnose diabetic retinopathy and skin cancer from image databases, to the use of various machine learning algorithms for prognostication in cancer and (...) cardiovascular disease. Many factors are driving the adoption of AI in health care, from... (shrink)

I attempt to adjudicate the disagreement between those who seek to reconceptualize disability as mere difference and their opponents. I do so by reviewing a central conviction motivating the resistance, concerning the relationship between disability and well-being. I argue that the conviction depends on further considerations about the costs and extent of change involved in accommodating individuals with a particular disability trait. I conclude by considering three pay-offs of this clarification.

While interdisciplinary work on morality has largely been confined to a dialogue between psychologists and philosophers on the one hand, and economists and philosophers on the other, this volume brings together papers from a wider field ...