Volume 25, Issue 2, February 2025, Page 36-38.

As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS (...) and responsive neurostimulation (RNS). Open-ended questions elicited motivations for joining the trial, understanding of study procedures at the time of initial informed consent, the process of exiting from research, and decisions about device removal or post-trial device use. Thematic analysis identified categories related to: limited preparedness for the end of research participation, straightforwardness of decisions to explant or keep the device, reconciling with the end of research participation, reconciling post-trial expectations, and achieving a sense of closure after exit from research. A preliminary theoretical model describes contextual factors influencing the process and experience of exit from research. Experiences of clinical trial participants should guide research practices to enhance the ethical design and conduct of clinical trials in DBS and other brain devices. (shrink)

The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview. A subset of participants who completed the survey were selected using a stratified (...) purposeful sampling strategy and invited to participate in an in-depth qualitative interview by phone or video conference. Data were analyzed using a mixed methods approach, including content analysis of survey responses and thematic analysis of interview responses. Over 1 year, 113 survey responses were received from US research personnel directly involved in obtaining informed consent from participants in neurological research. Frequently identified barriers to informed consent included: cognitive and communication impairments (e.g. aphasia), unrealistic expectations of research participants, mistrust of medical research, time constraints, literacy barriers, lack of available social support, and practical or resource-related constraints. Strategies to enhance informed consent included: involving close others to support participant understanding of study-related information, collaborating with more experienced research personnel to facilitate training in obtaining informed consent, encouraging participants to review consent forms in advance of consent discussions, and using printed materials and visual references. Beyond conveying study-related information, researchers included in this study endorsed ethical responsibilities to support deliberation necessary to informed consent in the context of misconceptions about research, unrealistic expectations, limited understanding, mistrust, and/or pressure from close others. Findings highlight the importance of training researchers involved in obtaining informed consent in neurological research to address disease-specific challenges and to support the decision-making processes of potential research participants and their close others. (shrink)

On Advaita philosophy; Sanskrit text with commentary and translation.

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

While Jameton’s (1984) definition of moral distress has been embraced by researchers and scholars for recognizing the many constraints that nurses experience on their moral agency, it has also been...

Herrera-Ferrá et al.’s (2023) attention to the cultural context of the neurorights movement contributes to the growing conversation on establishing neurorights in response to advancements in neuros...

Enck and Condley (2025) put forward a robust and plausible account of agent-regret. The authors argue that agent-regret, originating from the work of Bernard Williams, highlights two problems with...

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

Moral distress is a pervasive phenomenon in healthcare for which there is no straightforward “solution.” Rhetoric surrounding moral distress has shifted over time, with some scholars arguing that moral distress needs to be remedied, resolved, and eradicated, while others recognize that moral distress can have some positive value. The authors of this paper recognize that moral distress has value in its function as a warning sign, signaling the presence of an ethical issue related to patient care that requires deeper exploration, (...) rather than evidencing identification of the “right” course of action. Once the experience of moral distress is identified, steps ought to be taken to clarify the moral issue, and, if possible and reasonable, the patient’s values ought to be prioritized. This paper offers concrete actions steps, drawn from theory, which can be used in clinical practice to provide peer support or to facilitate self-reflection for morally distressed individuals. This approach empowers morally distressed individuals to explore ethical issues, identify concrete steps that can be taken, and mitigate feelings of powerlessness that are often associated with moral-constraint distress. The questions guide individuals and peers to reflect first on the micro-space and then more broadly on the institutional culture, facilitating meso- and macro-reflection and action. (shrink)

Supported decision making, as outlined by Peterson et al. highlights real-world challenges in the messy context of clinical care. We agree with Peterson et al. that patients...

Russell articulates compelling reasons that bioethicists and health care professionals should take individual responsibility for deconstructing structural injustices in healthcare through in...

A proposed state administrative rule would have required medical ethicists to approve certain aspects of gender-affirming care. The authors argue the proposed rule lacked appropriate justification compared to other instances of state-mandated ethics oversight and would undermine trust, raise practical challenges, and send harmful messages to society, patients, and providers.

Layers of complexity arise when a person arrives in an Intensive Care Unit (ICU) due to self-harm intended to end their life and when there is known past personal trauma. We highlight three importa...

Complex clinical ethics cases require a blend of compassion, sensitivity, and tenacity in order to navigate the hard work required of stakeholders. Each person comes to the table with rich historie...

In their article, Sankary et al. (2022) provided important preliminary findings on how research participants exiting from clinical trials engage in decisions related to the removal or post-trial us...

Sankary et al. (2022) report the results of an empirical study on research participant experiences of exiting research at the end of clinical trials of deep-brain-stimulation (DBS) and responsive n...

Bu araştırma Hz. Peygamber’e izafe edilen “Dünya müminin zindanı, kâfirin cennetidir” rivayetini konu edinmektedir. Zikri geçen hadisle ilgili literatür taraması yapıldığında müstakil bir araştırmaya rastlanmamaktadır. Esasında ilim geleneğimizde tek bir hadisi bütün yönleriyle inceleyen pek çok araştırma vardır. Ancak söz konusu haberin müsellem ve mesajı açık kabul edilmesi hem Arap hem de Batı araştırmalarına konu edilmemesinin gerekçesi olabilir. İlgili rivayetin temel hadis kaynaklarında muhtelif metinlerle, beş ayrı sahâbîden aktarıldığı tespit edilmiştir. Araştırmamızda sözü edilen metin ve senedler ayrı ayrı incelenerek rivayetin (...) hadis ilmi açısından değeri tartışılmıştır. Rivayetin pek çok tariki olduğu için araştırma merfu‘ haberlerle sınırlandırılmıştır. Sözü edilen rivayete temel hadis metinlerinde hangi bâb başlığı altında yer verildiği ve klasik hadis şerhlerinde metne nasıl yaklaşıldığı tetkik edilmiştir. Rivayetin “zühd” konusunun ayrılmaz bir parçası haline geldiği ve buna bağlı olarak vaaz ve irşad literatüründe önemli bir yer tuttuğu tespit edilmiştir. Hadiste müminin dünya hayatıyla ilişkisine dair serdedilen ifadeler, kabaca “fâni olan her şeye yüz çevirmek” şeklinde tanımlayabileceğimiz zühdle ilişkilendirilmesine yol açmıştır. Hadis şârihleri ise mezkûr haberi dünya arzularının cezb ediciliğiyle, süreklilik arz eden meşakkatli ibadetlerle mükellef olmanın verdiği zorlukla ve dünyada bireylerin başına gelen musibetlere karşı sabretmesi gerektiğiyle ilişkilendirmişlerdir. Bu bakımdan musannifler ile şârihlerin hadisi benzer perspektifle değerlendirdikleri görülmüştür. Çalışmamızda, Kur’an ve hadis metinlerinde yer alan metaforik anlatı biçimi göz önünde tutulduğunda hadisi farklı bir bakış açısıyla değerlendirmenin mümkün olup olmadığı tespit edilmiştir. Zira metafor, retorik sanatların önemli bir unsuru olup, benzetme edatlarını kullanmadan farklı konular arasında anlam bağlantısı kurma sanatıdır. İstiare, teşbih, alegori ve kinaye gibi türlerle benzerlikler taşısa da anlatılan konudan ziyade anlatım tarzını vurgulayarak sözleri güçlendirmesiyle diğerlerinden ayrılmaktadır. Metaforlar düşünce dünyasına derinlik katmakla kalmaz, aynı zamanda karmaşık veya soyut kavramların daha anlaşılır ifade edilmesine imkân tanır. Dilin gücünü ortaya çıkarırken, yaratıcı düşünce ve duygusal bağlantılar kurma becerisini pekiştirerek anlatının içerdiği mesajın vurgusunu artırır ve muhatapta daha derin etki bırakmayı sağlar. Tüm bunlardan hareketle ilgili metinde yer alan “zindan” kavramının metaforik bir anlam içerdiği kabul edildiğinde yeni bir yorum denemesine açık olduğu söylenebilir. Özellikle modern dönemde belirgin, açık ve fark edilir düzeyde ortaya çıkan düşünce ve ahlak krizine karşı bir anlamlandırma yolu seçerek ilgili rivayeti “medeniyet ve sünnet” ilişkisini göz önünde tutarak metaforik bir yorum denemesiyle ele aldık. Zira bu sözleriyle Resûl-i Ekrem’in çökmüş ve çürümekte olan medeniyetlerin haksızlık ve sefaletin kaynağı haline getirdiği tek dünyacı anlayışı reddettiği, nimetlere ve mahrumiyetlere karşı gereğinden fazla ya da az değer atfetmeyi kabul etmediği ve ölümle her şeyini kaybedeceğini düşünenlere karşı bilinç uyandırmaya çalıştığı iddia edilmektedir. Bunun yanında modern insanın İslâm medeniyetini yeniden canlandırabilmesini engelleyen bir dizi kriz vardır. Bunlar ruhsal, bireysel, düşünsel, metafizik ve toplumsal krizlerdir. İnsan, ruhsal krizi manevi ilerleme ve aydınlanmayla; bireysel krizi değerleri arzulara bırakmamakla; düşünsel krizi farklı düşüncelere açık bir şekilde eleştirel düşünceyi geliştirmekle; metafizik krizi dünyevi cazibelerden arınarak varoluşsal kısıtlamalara sırt çevirip bilgi ve anlam arayışına yönelmekle; toplumsal krizi toplumdaki değişimlere katkıda bulunarak insan hakları mücadelesi vermekle alt edebilir. Araştırmamızda insanın bu krizlerle başa çıkıp zindandan kurtularak özgürlüğe kavuşacağı ve kendi medeniyetini kurabileceği fikri metaforik bir yorum denemesiyle ileri sürülmüştür. Modern dönemde karşımıza çıkan sorunların tespitinin ve bu sorunlara dair çözüm önerilerinin rivayet kültüründen beslenmek suretiyle yapılmasının mümkün olup olmadığı da bu sayede tetkik edilmiştir. Bu kapsamda “Dünya müminin zindanı, kâfirin cennetidir” rivayetinin ne şekilde anlaşıldığı veya anlaşılması gerektiği etrafındaki tartışmalara temas edilerek yeni bir yorum arayışına gidilmiştir. Söz konusu arayış “deneme” olarak isimlendirilmiş ve sonraki araştırmacıların çok daha kapsamlı denemelerde bulunması hedeflenmiştir. (shrink)

R T Allen; Idealism, Theism and Education: some footnotes to Gordon & White, Journal of Philosophy of Education, Volume 21, Issue 2, 30 May 2006, Pages 283–.

Despite their status as high-income food producing nations, children and their caregivers, both in the United States (U.S.) and Australia can experience food insecurity. Nutrition researchers formed a joint U.S.-Australia collaboration to help advance food security for households with young children aged 0–5 years. This study investigated food insecurity from the perspective of caregivers, especially their perceptions of the impact of food insecurity on their own childhood, their current life, and for the children in their care. Semi-structured interviews were conducted (...) from July to September 2020 during the COVID-19 pandemic. Participants were recruited in Omaha, Nebraska, U.S. (_n_ = 19) and Melbourne, Victoria, Australia (_n_ = 22), during periods of stay-at-home public health orders. These two case study sites enabled an exploration of some universal, and some context-specific, social, economic, and health conditions that buffer, or exacerbate, food insecurity for families in these neo-liberal political settings. An inductive thematic analysis was conducted and established six themes:_growing up poor_, _lessons learned_,_ feeding a family amidst a pandemic_,_ caregiver coping strategies_, _food security in the early years_ and _protecting (young) children_. Perspectives on local anti-hunger strategies were organized to outline participant’s preferred solutions. Household food insecurity is conceptualized in public policy in the U.S. and Australia as a short-term crisis for people, justifying austere, time-limited and patchwork solutions. A narrative of caregivers’ lived experience of food insecurity suggests that it is inter-generational, and exacerbated by a food system shock (i.e., COVID-19). These findings from two varying cities and nations offer a different conceptualization of the timespan and nature of the phenomenon of food insecurity, challenging a dominant policy narrative and highlighting the inadequacy of current so-called solutions. (shrink)

1. Tasan ŭi kyŏnghak kwa yŏkhak -- 2. Tasanhak chʻongnon -- 3. Tasanhak kwa mongmin simsŏ -- 4. Sirhak sasang kwa Han sasang -- 5.Kaesin yuhak ŭro pon Hanʼguk chʻŏrhaksa -- 6. Kugyŏk Tasan sasŏ -- 7. Sasang uĭhak kwa saengmyŏng ŭihangnon -- 8. Hanʼguk munhwa ŭi insik, kugyŏkkanyangnok -- 9. Chamnok, susangnok, purok.

Background Developing a framework that illustrates causal relationships and an in-depth comprehension of contextual elements is essential for steering the development of ethical interventions to enhance nurses’ ethical decision-making. Research aim To examine the relationship between cultural competence, professional nursing values, and moral sensitivities of surgical nurses with a mediation analysis and structural equation model. Research design This study is descriptive and correlational. Participants and research context: This study was conducted with a total of 201 surgical nurses from two university (...) hospitals in Konya, Türkiye. Data were gathered face-to-face between June and October 2023 with the Moral Sensitivity Questionnaire (MSQ), Nurses Professional Values Scale-Revised (NPVS-R), and Nurse Cultural Competence Scale (NCCS). Ethical considerations Ethical approval from Necmettin Erbakan University Ethics Committee was obtained (Number: 2023/419). Results In this study, the mean scores for the surgical nurses were as follows: 89.3 ± 19.33 on the MSQ, 113.1 ± 20.74 on the NPVS-R, and 72.06 ± 18.61 on the NCCS. Nurses’ cultural competence level significantly affected their professional nursing values (β = 0.192; p =.007; R2 = 0.04), and their professional nursing values, in turn, had a significant effect on their moral sensitivities (β = −0.363; p <.001; R2 = 0.16). However, it was determined that the direct effect of nurses’ cultural competence level on their moral sensitivity was not statistically significant. In contrast, the indirect effect of nurses’ cultural competence level on their moral sensitivity, mediated by their professional nursing values was seen to be statistically significant (B = −0.070; p =.008). Conclusions This study showed that there is a significant positive relationship between the professional nursing values and cultural competence levels of surgical nurses and that as professional nursing values increase, their moral sensitivity also rises. Sensitivity with higher professional nursing values. Additionally, it was found that nurses’ professional values served as a mediating factor between their levels of cultural competence and moral sensitivity. Therefore, it is crucial to enhance the cultural competence, professional nursing values, and moral sensitivity of nursing students and registered surgical nurses and to improve their reasoning and decision-making skills in ethical dilemmas. (shrink)

Bu yazıda, Ürdün/Yermük Üniversitesi Fizik Bölümü öğretim üyesi Prof. Dr. M. Bâsil et-Tâî 'nin " God, Nature and the Cause: Essays in Islam and Science" isimli eseri tanıtılmıştır. Eser, Kalam Research&Media tarafından 2016 yılında ABD'de yayınlanmış olup, 224 sayfadır.

Gender discrimination and sexual harassment of female police officers by their male counterparts remain areas of liability where police departments appeared to have failed to effectively confront the nagging issues. However, the appreciable level of research conducted on these issues in the global North has not been matched by the South, where issues bordering on sexual violence have cultural underpinnings. Drawing from the case of the Nigeria Police Force, feminist analysis was used to explore the lived reality of 43 female (...) officers in a qualitative study. Participants expressed distress in abiding by structural discriminatory regulations against female officers which include non-admittance of married women into the force, forbidding unmarried officers from getting pregnant, and a stipulated minimum of three-year work period before a female officer can marry. Findings also indicated that participants suffer a variety of sexual harassment, intimidation, and, violence from their male colleagues, while they feel constrained in reporting their victimization. Important policy and practical implications requiring the Nigerian police to address hegemonic masculinity and promote gender equality were provided. (shrink)

This study explores Jihadist Salafism within Salafist Islam, characterized by its adherence to early Islamic practices and interpretations, advocating extreme and often violent approaches, including armed struggle, to achieve ideological objectives, deviating from mainstream Salafist principles. Despite considerable research on Salafism, understanding within the Turkish context remains limited. Salafist ideology in Turkey emerged in the 1980s, gaining momentum post-9/11 and peaking during the Syrian civil war. Focusing on Halis Bayancuk (Abu Hanzala), a prominent figure in Turkish politics and founder of (...) the Tawhid and Sunnah Community, known for his strict adherence to Salafist principles, this study meticulously analyzes his ideology, intertwined with a deep exploration of jihad principles. Using Quintan Wiktorowicz’s framework, Salafists are categorized into purists, politicos, and jihadists. The research aims to uncover nuances and insights about Salafist ideology in Turkey by employing document analysis. It uses discourse analysis to study Abu Hanzala’s religious and political views, aiming to provide a detailed understanding of Salafism’s complex structure in Turkey and its manifestation in the socio-political landscape. (shrink)

This article aims to improve the understanding of corporate governance and environmental reporting literature by analyzing the impact of board gender diversity (BGD) on environmental performance, environmental disclosure, and greenwashing behavior. The panel regression estimation technique with fixed effects was applied to Chinese firm data. As a result, it was found that more women who served on corporate boards enhanced the company's environmental performance and disclosures while limiting greenwashing behavior. The result indicated that women in top management play a constructive (...) role in establishing firms' active environmental initiatives. Furthermore, this relationship was nonlinear and exponentially increased when women's representation reached the threshold of 33.5% representation on board or higher. Based on the findings, no internal bias was found even after other governance and firm-level control factors and probable endogenies were considered and variable biases were omitted. Notably, the results present important implications for regulators and policymakers by highlighting the influential role of BGD in promoting environmentally responsible practices and reducing greenwashing. (shrink)

This article challenges the claim that Friedrich Nietzsche is a good reader of the French moralist, Chamfort, when it comes to Chamfort's politics. Chamfort is a meritocrat rather than the bitter egalitarian Nietzsche protrays him to be. Moreover, the moralist's meritocratic beliefs, his hopes for a new social order and the emergence of a new aristocracy resemble many of Nietzsche's own values. Had Nietzsche read Chamfort as a meritocrat, he could have found much to stimulate and clarify his own thoughts (...) about the aristocracy of the future. (shrink)

I and Thou sets out a dichotomy of human interactions between the merely objective I-It and the intense intersubjective relationship of the I-Thou, creating a problem of how one is to differentiate the I-It relations that are healthy and natural, and those that are limiting and detrimental. As a corrective to this ambiguity, I posit the principle of solidarity as a relation which retains the personhood of the Other yet still confines it to what Buber calls the I-It “relation”. To (...) do this I will discuss similar attitudes such as sympathy and camaraderie using them to draw out the meaning of solidarity in contradistinction to them, and show how solidarity functions as Gramsci’s Objectivity. (shrink)

This research aims to reveal the architectural and structural system features by examining the structure of traditional Kahramanmaraş houses and the effect of climate. Within the scope of the research, registered cultural assets in the old neighborhoods of Onikişubat district, which is located in the center of Kahramanmaraş city, will be examined. The research materials constitute old photographs of the city, engravings, and information about the buildings obtained from KUDEB and Kahramanmaraş Metropolitan Municipality units. In light of the information obtained (...) from the materials, visual studies of the buildings were prepared, and the traditional building character of the region was defined. As a result of the findings, it was revealed that the regional climate caused different architectural formations in Kahramanmaraş Traditional Turkish houses and the differences in structural system details. (shrink)