BackgroundThe COVID-19 pandemic has created ethical challenges for intensive care unit (ICU) professionals, potentially causing moral distress. This study explored the levels and causes of moral distress and the ethical climate in Dutch ICUs during COVID-19.MethodsAn extended version of the Measurement of Moral Distress for Healthcare Professionals (MMD-HP) and Ethical Decision Making Climate Questionnaire (EDMCQ) were online distributed among all 84 ICUs. Moral distress scores in nurses and intensivists were compared with the historical control group one year before COVID-19. ResultsThree (...) hundred forty-five nurses (70.7%), 40 intensivists (8.2%), and 103 supporting staff (21.1%) completed the survey. Moral distress levels were higher for nurses than supporting staff. Moral distress levels in intensivists did not differ significantly from those of nurses and supporting staff. “Inadequate emotional support for patients and their families” was the highest-ranked cause of moral distress for all groups of professionals. Of all factors, all professions rated the ethical climate most positively regarding the culture of mutual respect, ethical awareness and support. “Culture of not avoiding end-of-life-decisions” and “Self-reflective and empowering leadership” received the lowest mean scores. Moral distress scores during COVID-19 were significantly lower for ICU nurses (p < 0.001) and intensivists (p < 0.05) compared to one year prior.ConclusionLevels and causes of moral distress vary between ICU professionals and differ from the historical control group. Targeted interventions that address moral distress during a crisis are desirable to improve the mental health and retention of ICU professionals and the quality of patient care. (shrink)

The founders of reformational philosophy, H. Dooyeweerd and D.H.Th. Vollenhoven, each published in short succession, viz. 1949 and 1950, a voluminous study in the history of philosophy. Whoever reads both works is struck by the remarkable differences in treatment. In this contribution these differences are analysed, but there is also indication of agreement. The article ends with a number of conclusions based on the analysis.

The article is devoted to almost unknown monastery of the Russian Orthodox Church, a Holy Trinity Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia that was one of the important pilgrimage places of the royal family in the 17th century. Despite the fact that the monastery was founded in the reign of Tsar Alexei Mikhailovich, it is an important link in the historical and cultural development of our Fatherland, primarily because the extant architectural monuments of outstanding artistic qualities. That is why the architectural ensemble (...) of the monastery occupies a prominent place in the history of Russian culture. In addition, Novo-Solovetskaya poustinia is an important historical object providing data on the development of Russian spiritual and artistic culture of the late seventeenth century. The question of cultural-historical and social roles that Orthodox monasteries played in the history of Russia is still not sufficiently studied is. The modern development of the Russian state cannot be complete without the restoration of the positive legacy that has been lost in our culture and morality. In this regard, the study of development and formation of the Orthodox monastic culture may fill this gap. Historical development of the Zosimo-Savvatievskaya Novo-Solovetskaya Krasnokholmskaya poustinia, its architecture can contribute to the restoration of our historical memory, which is an important factor in the revival of our national identity. The author of the article also tells about the history of monastery in tough years of godless power and about the people, who died for their faith and who are called now the new martyrs. (shrink)

Our fascination with artificial intelligence (AI), robots and sentient machines has a long history, and references to such humanoids are present even in ancient myths and folklore. The advancements in digital and computational technology have turned this fascination into apprehension, with the machines often being depicted as a binary to the human. However, the recent domains of academic enquiry such as transhumanism and posthumanism have produced many a literature in the genre of science fiction (SF) that endeavours to alter this (...) antagonistic notion of AI. In his novel Klara and the Sun, Kazuo Ishiguro explores this notion of AI as a caring machine capable of nursing an ailing young girl back to health. Through this portrayal of AI as a sentient being capable of empathy and cognition, Ishiguro is attempting to usher in a new perception of AI: a posthuman perception that challenges the conventional notions of AI as a machine devoid of emotions. The novel further expands on the idea of self, soul and human consciousness and ponders on the question, what makes humans human, and if it is possible to imbibe these qualities onto an AI. Owing to the novelty of this notion, an unexplored avenue that deserves further exploration, this paper examines the plausibility of this new notion of AI through a careful exegesis of the novel. The paper also attempts to chart the impact of SF in society and culture. The study reveals a positive shift in perception towards AI, and there seems to be much scope for interdisciplinary and transdisciplinary research. (shrink)

The paper focuses on Nāgārjuna, the founder of the middle way school of Mahāyāna Buddhism. It argues that while Nāgārjuna’s rejection of the notion of ontological independence is justified and corr...

This is a review of the biographic drama Love and Mercy. More than a story of the evolution of The Beach Boys, it is the story of the lead Beach Boy, Brian Wilson, and his struggle with substance abuse, mental illness, family stress, emerging love, and a controlling psychologist. Interwoven are many bioethics themes, including the doctor–patient relationship, conflict of interest, autonomy, and patient welfare. For those unaware of the sadness and torment running directly alongside the sunny, bubbly life of (...) The Beach Boys, this film is an eye-opener. It is also a great reminder of the importance of boundaries between clinicians and their patients. (shrink)

In 1918, Emmy Noether published a (now famous) theorem establishing a general connection between continuous 'global' symmetries and conserved quantities. In fact, Noether's paper contains two theorems, and the second of these deals with 'local' symmetries; prima facie, this second theorem has nothing to do with conserved quantities. In the same year, Hermann Weyl independently made the first attempt to derive conservation of electric charge from a postulated gauge symmetry. In the light of Noether's work, it is puzzling that Weyl's (...) argument uses local gauge symmetry. This paper explores the relationships between Weyl's work, Noether's two theorems, and the modern connection between gauge symmetry and conservation of electric charge. This includes showing that Weyl's connection is essentially an application of Noether's second theorem, with a novel twist. (shrink)

Earp, Lewis, and Hart make a comprehensive and compelling argument for ending the “war on drugs,” highlighting the importance of both ending the criminalization of people who use drugs, and...

В монографии представлены взгляды авторов на возникновение и развитие либеральной и консервативной идеологий в политической истории российского государства.

Commentary and supercommentary, with text, on Īśvarapratyabhijñā, classical verse work, expounding the Trika philosophy in Kashmir Sivaism, by Utpala, fl. 900-950.

Изложено понимание рассуждения как метода рационального познания, рассмотрены его разновидности: аргументативные, интерпретативные, прогностические, квалификационные и вычислительные. Для аспирантов и соискателей.

The United States recognized intellectual property rights from its earliest days and included, in its constitution, a clause which expresses this, "To promote the Progress of Science and useful Arts, by securing for limited Times to Authors and Inventors the exclusive Right to their respective Writings and Discoveries." These few words found in Article 1, Section 8, Clause 8 have grown into a massive body of laws that govern works that were unimaginable to Thomas Jefferson and his contemporaries. Our question (...) today is very simple: is the latest metamorphosis of copyright law, the Digital Millennial Copyright Act of 1998, prudent policy? Specifically, we are concerned with three issues which critics have raised regarding this act: chilling effects on fair use, suppression of innovation, and overreach. We will also touch on the criticism which stresses that the DMCA further expands a system which increasingly and unfairly favors the content industries. This will be limited to illustrating extant tensions between copyright owners and society and also the difficulties law faces in keeping pace with the current, rapid and overwhelming technological and cultural change. We rely primarily on leading cases to establish the impact on fair use and innovation or to demonstrate over reach. (shrink)