Patients and family members (N = 671) were surveyed in five Mid-Atlantic U.S. hospitals to ascertain the number and kinds of ethical concerns they are presently experiencing or have previously experienced while being sick or receiving medical care. Seventy percent of participants had at least one (range 0–14) type of ethical concern or question. The most commonly experienced concerns pertained to being unsure how to plan ahead or complete an advance directive (29.4%), being unsure whether someone in the family was (...) able to make their own decisions (29.2%), deciding about limiting life-sustaining treatments (28.6%), wondering about disclosing personal medical information to others in the family (26.4%) and not being sure whether to undergo treatment because of cost (26.2%). Most were interested to some degree in getting help from ethics consultants in the future (76.6%). Given this prevalence, common concerns might usefully be addressed systematically, rather than exclusively on a case-by-case basis. (shrink)

These are carefully placed in the context of Chinese society, demonstrating how Confucius responded to the conflicts and pressures of his time and offered ...

"In an era of economic devastation, ongoing legacies of colonization and imperialism, climate change and habitat loss, there is a call for a new understanding of the meaning and relevance of ethics. These essays on otherness, responsibility, and hospitality raise urgent questions about the state of ethics in tumultuous times. Contributors range from prominent theorists-including Levinas, Michel Foucault, Jacques Derrida, and Giorgio Agamben-to more recent theorists including Judith Butler, Enrique Dussell, and Rosi Braidotti. Perhaps most crucially, this reader emphasizes the (...) always vulnerable status of a radically different Other, even as it questions what responsibility to that Other might mean."-Provided by publisher. (shrink)

In this paper I will discuss three areas in which advances in human reproductive technology could occur, their uses and abuses, and their effects on society. First is the potential to drastically increase the success rate and availability of in vitro fertilization and embryo freezing. Second is the ability to perform biopsies on embryos prior to the onset of pregnancy. Finally, I will consider the adding or altering of genes in embryos, commonly referred to as genetic engineering.As new reproductive technologies (...) pass from experimental models into the potential for medical utilization, I believe that it will be important for lawmakers everywhere to avoid the impulse to outlaw procedures that a society believes to be unnatural at a first glance. Rather, I would hope that they can respond thoughtfully with legislation that serves two purposes — to protect the rights of couples to overcome infertility or to reduce the risk of genetic disease in their children-to-be, and more importantly, to protect children-to-be from the abuses that could result from some of the practices that I will discuss. (shrink)

Mental toughness (MT) is a key psychological variable related to achievement in performance domains and perseverance in challenging circumstances. We sought to understand the lived experiences of mentally tough high-altitude mountaineers, focusing primarily upon decisions to persevere or abort summit attempts. Phenomenological interviews were conducted with 14 mountaineers including guides, expedition leaders, and doctors (Mage = 44 years). A content analysis was employed to identify key themes in the data. Participants emphasized the importance of MT in extreme environments and described (...) rational, flexible, and vigilant decision-making. Turning around without summiting was the toughest decision reported, with recognition of the thin line between persevering and overstretching. In contrast to much MT literature, mountaineers accepted limits, demonstrated restraint, and sacrificed personal goals to aid others. Costly perseverance was also reported with some mountaineers described as “too tough”: overcompetitive, goal-obsessed, and biased decision-makers. These findings revealed both benefits and dangers of MT in mountaineering. (shrink)

Zhi 李贄, also named ( hao 號) Zhuowu 卓吾 (1527–1602), and argues that he articulates a coherent and compelling vision of a good life focused on the expression of genuine feelings distinctive to each individual. Through a study of literary texts and terms of art he refers to in his critical essay “On the Child-like Heart-mind” ( Tongxin Shuo 童心說), as well as the metaphors and images he fleshes out throughout his writings, I characterize Li’s ethical vision and show that (...) it is rooted in a particular loose and accommodating conception of human nature and centered on the simple and intuitive act of daily maintaining the birthright of our “child-like heart-mind.”. (shrink)

The effect of uniform lighting on face identity processing is little understood, despite its potential influence on our ability to recognize faces. Here, we investigated how changes in uniform lighting level affected face identification performance during face memory tests. Observers were tasked with learning a series of faces, followed by a memory test where observers judged whether the faces presented were studied before or novel. Face stimuli were presented under uniform bright or dim illuminations, and lighting across the face learning (...) and the memory test sessions could be the same or different. This led to four experimental conditions: Bright/Dim ; Bright/Bright; Dim/Bright; and Dim/Dim. Our results revealed that incongruent lighting levels across sessions significantly reduced sensitivity to faces and introduced conservative biases compared to congruent lighting levels. No significant differences in performance were detected between the congruent lighting conditions and between the incongruent lighting conditions. Thus, incongruent lighting deteriorated performance in face identification. These findings implied that the level of uniform lighting should be considered in an illumination-specific face representation and potential applications such as eyewitness testimony. (shrink)

Aggleton & Brown rightly point out the shortcomings of the medial temporal lobe hypothesis as an approach to anterograde amnesia. Their broader perspective is a necessary corrective, and one hopes it will be taken very seriously. Although they correctly note the dangers of conflating recognition and recall, they themselves make a similar mistake in discussing familiarity; we suggest an alternative approach. We also discuss implications of their view for an analysis of retrograde amnesia. The notion that there are two routes (...) by which the hippocampus can reactivate neuronal ensembles in the neocortex could help us understand some currently puzzling facts about the dynamics of memory consolidation. (shrink)

BackgroundThe Life Extension Medical Decision law enacted on February 4, 2018 in South Korea was the first to consider the suspension of futile life-sustaining treatment, and its enactment caused a big controversy in Korean society. However, no study has evaluated whether the actual implementation of life-sustaining treatment has decreased after the enforcement of this law. This study aimed to compare the provision of patient consent before and after the enforcement of this law among cancer patients who visited a tertiary university (...) hospital's emergency room to understand the effects of this law on the clinical care of cancer patients.MethodsThis retrospective single cohort study included advanced cancer patients aged over 19 years who visited the emergency room of a tertiary university hospital. The two study periods were as follows: from February 2017 to January 2018 (before) and from May 2018 to April 2019 (after). The primary outcome was the length of hospital stay. The consent rates to perform cardiopulmonary resuscitation (CPR), intubation, continuous renal replacement therapy (CRRT), and intensive care unit (ICU) admission were the secondary outcomes.ResultsThe length of hospital stay decreased after the law was enforced from 4 to 2 days (p = 0.001). The rates of direct transfers to secondary hospitals and nursing hospitals increased from 8.2 to 21.2% (p = 0.001) and from 1.0 to 9.7%, respectively (p < 0.001). The consent rate for admission to the ICU decreased from 6.7 to 2.3% (p = 0.032). For CPR and CRRT, the consent rates decreased from 1.0 to 0.0% and from 13.9 to 8.8%, respectively, but the differences were not significant (p = 0.226 and p = 0.109, respectively).ConclusionAfter the enforcement of the Life Extension Medical Decision law, the length of stay in the tertiary university hospital decreased in patients who established their life-sustaining treatment plans in the emergency room. Moreover, the rate of consent for ICU admission decreased. (shrink)

This paper aims to establish the meaning of Dharma as the principle of self-denial and emptiness. Dharma, a key concept in the religious thought of India, has the literal meaning of "supporter.” Something that supports something else does not exist for itself. Just as the truth supporting the universe is Dharma, so the four pillars supporting the roof of the house to prevent it from collapsing are also Dharma. The four pillars supporting the house do not exist for themselves, but (...) create an empty space in the house. In this respect, the essence of Dharma is self-denial, self-sacrifice. The traditional ascetic practices and religions in India is referred to as sanatana dharma, and the core is the complete extinction of I-ness. When individual consciousness is completely lost, mokṣa is achieved. The moment the eternal truth is achieved, the individual consciousness becomes zero, and this position can be likened to the center where the x- and y-axes meet in the coordinates of mathematics. Just as the center in the coordinates of mathematics is a place where the value of the x-axis is zero and the value of the y-axis is zero, the center of the universe, that is, nirvāṇa is achieved when individual consciousness is completely lost. Dharma is the path of becoming nothing to reach the zero point, and the process of self-denial is bound to entail pain. The pain involving voluntary self-denial can be rather a positive nourishment for the realization of Dharma. In fact, we can say that the core of the Hindu ethics of Aśrama-dharma and Varṇa-dharma is voluntary renunciation for the complete extinction of individual consciousness and renunciation concerning that which is possible. (shrink)

This paper primarily argues that Epidemiology is Ecosystem Science. It will not only explore this notion in detail but will also relate it to the argument that Classical Chinese Medicine was/is Ecosystem Science. Ecosystem Science and Ecosystem Science share these characteristics: they do not subscribe to the monogenic conception of disease; they involve multi variables; the model of causality presupposed is multi-factorial as well as non-linear.

Der Konfuzianismus ist auch im Westen keine unbekannte Lehre mehr. Zugleich trifft man ihr gegenüber auf erhebliche Vorurteile. Insbesondere im Zusammenhang mit der Debatte um den Kommunitarismus wird der Konfuzianismus häufig als kulturelle Grundlage autoritärer politischer Herrschaft hingestellt. Das ist nicht vollkommen falsch, beruht aber auf einer einseitigen Wahrnehmung des Konfuzianismus. Tatsächlich blickt dieser auf eine lange Geschichte politischer Instrumentalisierungen zurück. Gleichwohl enthält diese Lehre Konzepte, die dem gemeinschaftlichen Zusammenleben förderlich sein können.