Objective Futile treatment, which by definition cannot benefit a patient, is undesirable. This research investigated why doctors believe that treatment that they consider to be futile is sometimes provided at the end of a patient9s life. Design Semistructured in-depth interviews. Setting Three large tertiary public hospitals in Brisbane, Australia. Participants 96 doctors from emergency, intensive care, palliative care, oncology, renal medicine, internal medicine, respiratory medicine, surgery, cardiology, geriatric medicine and medical administration departments. Participants were recruited using purposive maximum variation sampling. (...) Results Doctors attributed the provision of futile treatment to a wide range of inter-related factors. One was the characteristics of treating doctors, including their orientation towards curative treatment, discomfort or inexperience with death and dying, concerns about legal risk and poor communication skills. Second, the attributes of the patient and family, including their requests or demands for further treatment, prognostic uncertainty and lack of information about patient wishes. Third, there were hospital factors including a high degree of specialisation, the availability of routine tests and interventions, and organisational barriers to diverting a patient from a curative to a palliative pathway. Doctors nominated family or patient request and doctors being locked into a curative role as the _main_ reasons for futile care. Conclusions Doctors believe that a range of factors contribute to the provision of futile treatment. A combination of strategies is necessary to reduce futile treatment, including better training for doctors who treat patients at the end of life, educating the community about the limits of medicine and the need to plan for death and dying, and structural reform at the hospital level. (shrink)

Christian development agencies have been the primary vehicle of choice for holistic involvement and witness. This has played straight into an Enlightenment manner of thinking that compartmentalizes values, limiting the opportunities for explaining the theological and conceptual foundations for development practice and for public witness concerning religious faith. New institutional models appropriate to witness and holistic Christian service need to be considered. An `S4' type organization, explored in practice in Indonesia in an interfaith setting, allows for a more effective sharing (...) of the gospel and robust development work. (shrink)

Robert Putnam's work was a double-edged sword for social capital scholars. It brought unprecedented attention to the research agenda but also created conceptual confusion. Many scholars have tried to disentangle Coleman's concept of social capital from what some described as Putnam's “fuzzy psychological notion” of civic culture values. Despite the rigour of these efforts, Putnam's influence remains, because scholars and policy makers are drawn to the benefits his work promised. This article takes a different tack, and seeks to extricate Putnam's (...) early ideas from the social capital debates by offering an alternate theorization of his original findings. It returns to Making Democracy Work and argues that Putnam mis-stepped when he took the rational choice route and invoked Coleman's concept of social capital. It takes an ideational approach to explaining civic culture. The resulting “ideational social capital” suggests a different research agenda, which just might deliver on Putnam's early promise. (shrink)

This paper will first introduce the development of professional ethics of counseling and psychotherapy in mainland China. Ethical awareness is often limited due to variations in training experiences. Aligning with ethics codes can also bring challenges due to nuances within Chinese culture. Furthermore, the authors discuss the ethical challenges regarding the principles of multiple relationships, informed consent, and confidentiality in the context of Chinese culture. These ethical issues are often discussed within an individualistic cultural frame and presentation from a collectivist (...) culture offers a unique perspective in the ethics literature. (shrink)

The aim of this thematic literature review is to explore nurses' perceptions of ethical issues in the care of older people. Electronic databases were searched from September 1997 to September 2007 using specific key words with tight inclusion criteria, which revealed 17 primary research reports. The data analysis involved repeated reading of the findings and sorting of those findings into four themes. These themes are: sources of ethical issues for nurses; differences in perceptions between nurses and patients/relatives; nurses' personal responses (...) to ethical issues; and the patient—nurse relationship. The findings reveal that ageism is one of the major sources of the ethical issues that arise for nurses caring for older people. Education and organizational change can combat ageist attitudes. Wider training is required in the care of older people, workplace skills, palliative care and pain management for older people. The demands of a changing global demography will necessitate further research in this field. (shrink)

Since the mid-twentieth century, the ‘Scientific Revolution’ has arguably occupied centre stage in most Westerners’, and many non-Westerners’, conceptions of science history. Yet among history of science specialists that position has been profoundly contested. Most radically, historians Andrew Cunningham and Perry Williams in 1993 proposed to demolish the prevailing ‘big picture’ which posited that the Scientific Revolution marked the origin of modern science. They proposed a new big picture in which science is seen as a distinctly modern, western phenomenon rather (...) than a human universal, that it was invented in the Age of Revolutions 1760–1848, and that science be de-centred within the new big picture: treated as just one of many forms of human knowledge-seeking activity. Their paper is one of the most highly cited in the history of science field, and has the potential to transform the way that science educators, science communicators, science policy-makers and scientists view science. Yet the paper and historians’ scholarly response to it are not well-known outside the history discipline. Here I attempt to bridge that disciplinary gap with a review of scholarly papers published 1994–2014 that cited Cunningham and Williams or otherwise discussed the Scientific Revolution, to gauge the extent of support for the old and new big pictures. I find that the old big picture is disintegrating and lacks active defenders, while many scholars support aspects of the new big picture. I discuss the significance of this for scholars in ‘applied’ fields of science studies such as education, communication and policy. (shrink)

Spontaneous activity levels prior to stimulus presentation can determine how that stimulus will be perceived. It has also been proposed that such spontaneous activity, particularly in the default-mode network (DMN), is involved in self-related processing. We therefore hypothesised that pre-stimulus activity levels in the DMN predict whether a stimulus is judged as self-related or not. Method: Participants were presented in the MRI scanner with a white noise stimulus that they were instructed contained their name or another. They then had to (...) respond with which name they thought they heard. Regions where there was an activity level difference between self and other response trials two seconds prior to the stimulus being presented were identified. Results: Pre-stimulus activity levels were higher in the right temporoparietal junction (RTPJ), the right temporal pole (RTP), and the left superior temporal gyrus in trials where the participant responded that they heard their own name than trials where they responded that they heard another. Conclusion: Pre-stimulus spontaneous activity levels in particular brain regions, largely overlapping with the DMN, predict the subsequent judgement of stimuli as self-related. This extends our current knowledge of self-related processing and its apparent relationship with intrinsic brain activity in what can be termed a rest-self overlap. (shrink)

Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...) the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values. The model requires that ethics and law be taught across the medical education curriculum and integrated with the basic and clinical sciences and that they be perceived as an integral component of medical evidence and practice. Law, in particular, would rank as equal in normative authority to the relevant clinical scientific “facts” of the case, with graduating doctors having as strong a basic command of each category as the other. The normalization of legal knowledge as part of the clinician’s evidence base to be utilized in practice may provide adequate consolation for clinicians who may initially resent further perceived incursions on their traditional independence and discretion. (shrink)

Much of the commentary in the wake of the Charlie Gard litigation was aimed at apparent shortcomings of the law. These include concerns about the perceived inability of the law to consider resourcing issues, the vagueness of the best interests test and the delays and costs of having disputes about potentially life-sustaining medical treatment resolved by the courts. These concerns are perennial ones that arise in response to difficult cases. Despite their persistence, we argue that many of these criticisms are (...) unfounded. The first part of this paper sets out the basic legal framework that operates when parents seek potentially life-sustaining treatment that doctors believe is against a child’s best interests, and describes the criticisms of that framework. The second part of the paper suggests an alternative approach that would give decision-making power to parents, and remove doctors’ ability to unilaterally withhold or withdraw life-sustaining treatment that they regard is futile. This proposal is grounded in several values that we argue should guide these regulatory choices. We also contend that the best interests test is justifiable and since the courts show no sign of departing from it, the focus should be on how to better elucidate the underlying values driving decisions. We discuss the advantages of our proposed approach and how it would address some of the criticisms aimed at the law. Finally, we defend the current role that the judiciary plays, as an independent state-sanctioned process with a precedent-setting function. (shrink)

Engineering programs in the United States have been experimenting with diverse pedagogical approaches to educate future professional engineers. However, a crucial dimension of ethics education that focuses on the values, personal commitments, and meaning of engineers has been missing in many of these pedagogical approaches. We argue that a value-based approach to professional ethics education is critically needed in engineering education, because such an approach is indispensable for cultivating self-reflective and socially engaged engineers. This paper starts by briefly comparing two (...) prevalent approaches to ethics education in science and engineering: professional and philosophical. While we acknowledge that both approaches help meet certain ethics education objectives, we also argue that neither of these is sufficient to personally engage students in authentic moral learning. We make the case that it is important to connect ethics education to the heart, which is extensively driven by values, and present a value-based approach to professional ethics education. We provide some classroom practices that cultivate a safe, diverse, and engaging learning environment. Finally, we discuss the implications of a value-based approach to professional ethics education for curriculum design and pedagogical practice, including opportunities and challenges for engineering faculty eager to incorporate value-based inquiry into their classrooms. (shrink)

Background Victoria was the first Australian state to legalize voluntary assisted dying (elsewhere known as physician-assisted suicide and euthanasia). Some institutions indicated they would not participate in voluntary assisted dying. The Victorian government issued policy approaches for institutions to consider Objective To describe and analyse publicly available policy documents articulating an institutional objection to voluntary assisted dying in Victoria. Methods Policies were identified using a range of strategies, and those disclosing and discussing the nature of an institutional objection were thematically (...) analysed using the framework method. Results The study identified fifteen policies from nine policymakers and developed four themes: (1) extent of refusal to participate in VAD, (2) justification for refusal to provide VAD, (3) responding to requests for VAD, and (4) appeals to state-sanctioned regulatory mechanisms. While institutional objections were stated clearly, there was very little practical detail in most documents to enable patients to effectively navigate objections in practice. Conclusion This study demonstrates that despite having clear governance pathways developed by centralized bodies (namely, the Victorian government and Catholic Health Australia), many institutions’ public-facing policies do not reflect this guidance. Since VAD is contentious, laws governing institutional objection could provide greater clarity and regulatory force than policies alone to better balance the interests of patients and non-participating institutions. (shrink)

This study examines whether and how board gender diversity can affect corporate wage inequity by drawing on diversity theory and gender socialization and ethicality theories. Building on an exogenous relaxation of China’s one-child policy (OCP) in 2013, which led to a substantial decline in the female labor force participation rate. Our empirical analysis suggests that board gender diversity is negatively associated with corporate wage inequity. This result is robust to various endogeneity and sensitivity analyses. We find that the OCP relaxation (...) only increases average executive pay; it does not affect employee pay. One potential mechanism driving our results is that the decline in board gender diversity caused by the OCP relaxation reduces supervision, restriction, and fairness within the firm, which increases executives’ pursuit of personal interests and ultimately leads to the rise of wage inequity. Our findings are particularly significant for firms in capital-intensive industries, firms with a low level of employee bargaining power, and large firms. (shrink)

Fourteen subjects were tape‐recorded while they undertook to find a law to summarize numerical data they were given. The source of the data was not identified, nor were the variables labeled semantically. Unknown to the subjects, the data were measurements of the distances of the planets from the sun and the periods of their revolutions about it—equivalent to the data used by Johannes Kepler to discover his third law of planetary motion.Four of the 14 subjects discovered the same law as (...) Kepler did (the period varies as the 3/2 power of the distance), and a fifth came very close to the answer. The subiects' protocols provide a detailed picture of the problem‐solving searches they engaged in, which were mainly, but not exclusively, in the space of possible functions for fitting the data, and provide explanations as to why some succeeded and the others failed.The search heuristics used by the subjects are similar to those embodied in the BACON program, computer simulation of certain scientific discovery processes. The experiment demonstrates the feasibility of examining some of the processes of scientific discovery by recreating, in the laboratory, discovery situations of substantial historical relevance. It demonstrates also, that under conditions rather similar to those of the original discoverer, a law can be rediscovered by persons of ordinary intelligence (i.e., the intelligence needed for academic success in a good university). The data for the successful subjects reveal no “creative” processes in this kind of a discovery situation different from those that are regularly observed in all kinds of problem‐solving settings. (shrink)

This study explores the philosophical and religious dimensions of Lusheng musical instruments in the Qiandongnan Miao and Dong Autonomous Prefecture, Guizhou Province, China. The study's qualitative research method involved conducting interviews and observations, and the use of qualitative research design grounded in ethnomusicological theory and philosophical and religious frameworks. A purposive sampling technique was used to identify participants comprising musicians, community leaders, artisans, religious figures, and elders having extensive knowledge about Lusheng traditions. A thematic content analysis approach was used to (...) analyze the data collected. The results of the study reveals that the Miao and Dong communities deeply integrate one Lusheng instrument, a traditional reed-pipe, into their cultural, spiritual, and social fabric. The research highlights Lusheng’s significance in religious ceremonies such as funerals and the Drum Zang Festival, where it functions as a sacred medium, facilitating communication with ancestors and deities. Philosophically, Lusheng music embodies communal unity, continuity and the interconnectedness of life and death. Economically, Lusheng music supports local artisans and performers, contributing to the region’s economy through its production and performance during festivals and tourist attractions. Educationally, Lusheng music fosters cultural identity, religious understanding, and artistic expression, ensuring its transmission across generations. Through formal and informal educational programs, the Lusheng remains a vibrant part of community life, blending tradition with creative innovation. The study underscores the importance of preserving Lusheng as both a cultural and spiritual artifact, enriching the lives of the Miao and Dong people while maintaining its relevance in the modern world. (shrink)

Existing regulation of end-of-life care is flawed. Problems include poorly-designed laws, policies, ethical codes, training, and funding programs, which often are neither effective nor helpful in guiding decision-making. This leads to adverse outcomes for patients, families, health professionals, and the health system as a whole. A key factor contributing to the harms of current regulation is a siloed approach to regulating end-of-life care. Existing approaches to regulation, and research into how that regulation could be improved, have tended to focus on (...) a single regulatory instrument (e.g., just law or just ethical codes). As a result, there has been a failure to capture holistically the various forces that guide end-of-life care. This article proposes a response to address this, identifying “regulatory space” theory as a candidate to provide the much-needed holistic insight into improving regulation of end-of-life care. The article concludes with practical implications of this approach for regulators and researchers. (shrink)

Defining the purposes of engineering ethics education (EEE) is paramount for the engineering education community, and understanding the purposes of EEE can be a catalyst for actively involving students in the learning process. This chapter presents a conceptual framework for systematically describing and comparing various approaches to the purposes of EEE. Such a framework is inherently embedded with a tension between a normative approach and a pragmatic approach regarding the purposes of EEE. The normative approach focuses on what the purposes (...) of EEE should be, an ‘ideal world’ scenario, given the needs of the engineering profession and of society at large. Conversely, the pragmatic approach starts from the question ‘What can be achieved through educational practice?‘ and results from ‘actual world’ situated outcomes of stakeholder negotiations. The authors’ framework balances these. They – scholars from diverse cultural backgrounds – assert that the purposes of EEE are socially constructed and vary from country to country based on unique historical, political, and cultural contexts. Their framework embraces both the individualistic and holistic aspects of EEE, incorporating perspectives from both Western and non-Western traditions. It identifies six purposes of EEE (knowledge, actions, personal traits, relationships, etc.), aligning these with examples (e.g., moral knowledge, desirable actions, ethical skills or competencies, care ethics, etc.) and theoretical frameworks (moral epistemology, moral psychology, virtue ethics, objects or qualities of relations, etc.). It is problematic and potentially dangerous when engineering educators design ethics-learning activities without critically examining the purposes of these activities and assessing whether these purposes are justified for educating ethically and professionally competent engineers. This chapter provides tools to help avoid such pitfalls. (shrink)

TikTok has one of the most advanced algorithm systems and is the most addictive as compared to other social media platforms. While research on social media addiction is abundant, we know much less about how the TikTok information system environment affects users’ internal states of enjoyment, concentration, and time distortion, which in turn influences their addiction behavior. To fill this gap, this study collects responses from 659 adolescents in China aged between 10 and 19 years old, and the data is (...) then analyzed using Partial Least Square. We find that the system quality has a stronger influence than information quality in determining adolescents’ experience with TikTok and that the flow experience has significant direct and indirect effects on TikTok addiction behavior. Notably, this study finds that TikTok addiction is determined by users’ mental concentration on the medium and its content. Several theoretical insights from the stimulus–organism–response model and the flow theory are used to explain the findings. (shrink)

Many of the negative connotations of corporate social responsibility (CSR) are linked to its perceived role as a public relations exercise. Following on calls for more positive engagement by public relations professionals in organisational strategic planning and given the rapidly increasing interest in CSR as a business strategy, this article addresses the question of how the theory and practice of public relations can provide direction and support for CSR. To this end, this article explores leadership styles and motivations of a (...) sample of corporate leaden from prominent Australian-based corporations in relation to their chosen CSR activities to examine the current position of, and potential for, professional communicators' impact in shaping CSR-driven policies at a strategic level. We find that while public relations theory has evolved, many leaders still see public relations professionals only as a source of positive publicity. Our findings suggest that the model of distributive leadership has more relevance to an emerging idea of public relations involvement in CSR than more traditional understandings of leadership. We conclude that the public relations profession needs to develop a greater understanding of senior management approaches to the development and dissemination of CSR activities to support organisational leadership as it currently operates with respect to CSR. (shrink)

Statistics show, that even though an ethical respect for nature is both widely advocated by current mainstream environmental philosophy and is increasingly publicly accepted, this is not enough to ensure the needed practical actions to protect and preserve the natural world and its living beings. This reflects a disconnection between the related intellectual or theoretical appreciation of the integrity or value within the natural world and the sorts of practices needed to heal or to motivate the actions needed for ecological (...) integrity and sustainability. Awareness of this disunity or disconnection calls for a philosophical examination of this disconnection. This paper argues that the disunity between knowledge and practice reflects a “blind spot” in those sorts of mainstream environmental philosophy that attempt to establish a rational basis for an ethical respect for nature and humans’ ethical responsibility to the environment. This paper shall reveal that blind spot and its origin by examining and building on Ed Casey’s analysis and phenomenological description of an original and authentic directly lived ethical response to the environment that he calls the “first moment of ethical response.” Casey’s description of this “first moment of ethical response,” rooted in his phenomenological horizon, allows him to break away from the horizon of current mainstream environmental ethics and uncover a field of original and authentic ethical experience that opens an area of investigation closed to current environmental ethics. In this way Casey’s work can reveal the limitations of the scientific horizon of mainstream environmental ethics and has great value in the overcoming of the blind spot and its ill effect. (shrink)

Science and Society presents comments on some of the social and economic implications of the new biology. Here, Cao Tian‐qin presents a perspective from China on recent developments in biotechnology.

Interpenetration, a central idea in Huayan Buddhist metaphysics, is commonly understood as the mutual dependence of all things. However, in Religion and Nothingness, Keiji Nishitani proposes that while everything is interdependent, each entity is also absolutely independent. Furthermore, Nishitani attributes a "non-objective" mode of being to entities in interpenetration. These tensions between dependence and independence, and objecthood and non-objecthood, reveal the uniqueness of Nishitani’s view and the limitations in the traditional understanding of interpenetration. This paper explores these tensions within Nishitani, (...) contrasts Nishitani’s approach to interpenetration with both the common view and Fazang’s view, addresses Nishitani’s treatment of contradictory utterances, and reflects on the relation between metahpysics and ethics in Buddhist philosophy. (shrink)

Foresight of development of science and technology.

Developmental and neuroscience works have demonstrated that the moral judgment is influenced by theory of mind, which refers to the ability to represent the mental states of different agents. However, the neural and cognitive time course of interactions between moral judgment and ToM remains unclear. The present event-related potential study investigated the underlying neural substrate of the interaction between moral judgment and ToM by contrasting the ERPs elicited by moral judgments for self and for others in moral dilemmas. In classic (...) moral dilemmas, the agents must choose between the utilitarian choice and the non-utilitarian choice. The ERPs were recorded from participants who made moral judgments for self and for others when the agent made utilitarian or non-utilitarian choices during the dilemma. The results revealed that the moral judgment for others elicited a larger frontal late positive component than that for self when the agents made utilitarian choices, while no difference was observed on early components of N1, P2, and N2. Moreover, individual differences in mentalizing ability were negatively correlated with the LPC amplitudes. These findings suggested that ToM modulated the late controlled process but not the early automatic process during moral judgments. (shrink)

The author establishes an elementary system AS which contains functions +, ≐ and a constant 0 and then proves the semi-completeness and the decidability of AS, using the theory of systems of inequalities.

Objectives To determine the role played by law in medical specialists9 decision-making about withholding and withdrawing life-sustaining treatment from adults who lack capacity, and the extent to which legal knowledge affects whether law is followed. Design Cross-sectional postal survey of medical specialists. Setting The two largest Australian states by population. Participants 649 medical specialists from seven specialties most likely to be involved in end-of-life decision-making in the acute setting. Main outcome measures Compliance with law and the impact of legal knowledge (...) on compliance. Results 649 medical specialists (of 2104 potential participants) completed the survey (response rate 31%). Responses to a hypothetical scenario found a potential low rate of legal compliance, 32% (95% CI 28% to 36%). Knowledge of the law and legal compliance were associated: within compliers, 86% (95% CI 83% to 91%) had specific knowledge of the relevant aspect of the law, compared with 60% (95% CI 55% to 65%) within non-compliers. However, the reasons medical specialists gave for making decisions did not vary according to legal knowledge. Conclusions Medical specialists prioritise patient-related clinical factors over law when confronted with a scenario where legal compliance is inconsistent with what they believe is clinically indicated. Although legally knowledgeable specialists were more likely to comply with the law, compliance in the scenario was not motivated by an intention to follow law. Ethical considerations (which are different from, but often align with, law) are suggested as a more important influence in clinical decision-making. More education and training of doctors is needed to demonstrate the role, relevance and utility of law in end-of-life care. (shrink)

Because of difficulty processing the electronic medical record data of patients with cerebrovascular disease, there is little mature recognition technology capable of identifying the named entity of cerebrovascular disease. Excellent research results have been achieved in the field of named entity recognition, but there are several problems in the pre processing of Chinese named entities that have multiple meanings, of which neglecting the combination of contextual information is one. Therefore, to extract five categories of key entity information for diseases, symptoms, (...) body parts, medical examinations, and treatment in electronic medical records, this paper proposes the use of a BERT-BiGRU-CRF named entity recognition method, which is applied to the field of cerebrovascular diseases. The BERT layer first converts the electronic medical record text into a low-dimensional vector, then uses this vector as the input to the BiGRU layer to capture contextual features, and finally uses conditional random fields to capture the dependency between adjacent tags. The experimental results show that the F1 score of the model reaches 90.38%. (shrink)