As Medicine shifts from a paternalistic practice to a patient-centered approach, the concept of medical informed consent (IC) has evolved to safeguard patient autonomy. However, its current implementation still presents many challenges in clinical practice. We assessed the knowledge and attitudes of the general Lebanese population regarding the IC process as well as their sociodemographic and medical correlates. An anonymous online survey was distributed to the Lebanese population using social media channels. A sample of 500 adults with an average age (...) of 36.2 ± 13.5 years, including 319 females and 181 males, was recruited. Most of the respondents had a university degree (85.8%), reported previous hospital admissions (75.9%) and had signed an IC for surgical procedures (40.7%). Few participants were knowledgeable about IC Lebanese law. Variability in knowledge level was significantly related to gender and a previous hospitalization history. Positive attitudes toward patient autonomy (53.1%) and shared decision-making (57.5%) correlated with older age, female gender, graduate education, and a previous history of signing an IC document. Males were more likely to believe that IC has positive effects on health than females. This is the first study that provides novel findings regarding Lebanese peoples’ awareness of the ethico-legal components of medical IC. (shrink)

Keď sa ľudia nachádzajú medzi inými, správajú sa viac prosociálne, morálne a štedro. Čo však môže ovplyvniť ich správanie v momente, keď sú sami? Aby sa správali ako medzi inými? Jedna z možností môže byť vyvolať pocit, že sa niekto pozerá. Tento účel môže splniť aj obyčajné zrkadlo. Naše výskumy podporujú vplyv zrkadla na dodržiavanie pravidla na súboroch dospelých a detí. V obidvoch experimentoch prítomnosť zrkadla zvyšovala šancu na dodržiavanie stanoveného pravidla. Ako však niečo tak jednoduché ako zrkadlo môže ovplyvniť (...) správanie? Jeden z prístupov tvrdí, že vizuálny stimul spustí automatickú percepciu „niekto sa pozerá“, aj napriek tomu, že je to iba odraz v zrkadle. Ďalší možný prístup vychádza z predpokladu, že na seba upriamená pozornosť vyvoláva sebauvedomovanie, pričom sa zviditeľňuje prípadný rozpor medzi konaním a štandardom. Porušenie pravidla v takom momente by mohlo ohroziť sebaúctu. V treťom prístupe autori vychádzajú z princípu negatívnej spätnej väzby. Nakoniec by sme radi spomenuli naše experimenty a navrhli ďalšie možnosti skúmania v tejto oblasti. (shrink)

The study aimed to identify the reality of decision-making in the local NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. A Census Method of the possible study community (...) was adopted, and the use of the Statistical Package for Social Sciences (SPSS) was mainly based on the analysis and analysis of the data obtained through the survey tool. The study reached a set of results, the most important of which are: NGOs follow a decision-making mechanism. NGOs examine the problems and causes of the organization. Organizations are less concerned with stakeholder participation. Make decision. The main recommendations of the study are: To promote systematic methods of decision-making in NGOs in Gaza Strip: Local NGOs in Gaza Strip should continue to develop their competencies in order to make sound and correct decisions and encourage them to follow the scientific methodologies in the mechanism of taking Decisions. (shrink)

The study aimed to identify Design Thinking and its use in NGOs in Gaza Strip. In order to achieve the objectives of the study and to test its hypotheses, the analytical descriptive method was used, relying on the questionnaire as a main tool for data collection. The study society was one of the decision makers in the local NGOs in the Gaza Strip. The study population reached 78 local NGOs in Gaza Strip. The overall inventory of the possible study community (...) was based mainly on the use of the SPSS in processing and analyzing the data obtained through the survey tool. Smart-PLS was also used to construct the structural equation model (SEM) Analyzing the relationship between study variables. The study found that Design Thinking mediates the relationship between the management of process design and decision making with a holistic effect. The study showed the interest of local NGOs in creating a good mental image in the local community. And the ownership of local NGOs to the expertise and technical skills required to implement the projects, and showed the adoption of local NGOs in their activities to meet the needs of the beneficiaries and their wishes, and local NGOs analyze the problem, and causes, through data relevant to the decision, based on reference data for decision-making. The main recommendations of the study are: The need for senior management in the local NGOs in Gaza Strip to adopt the methodology of design thinking because of its impact on the sustainability of the projects, design the technical feasibility study and meet the wishes of the beneficiaries. (shrink)

End-of-life organ donation is controversial in Islam. The controversy stems from: scientifically flawed medical criteria of death determination; invasive perimortem procedures for preserving transplantable organs; and incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: reinterpreting religious scriptures, reeducating faith leaders, and utilizing media (...) campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life. (shrink)

Parochial altruism is manifested in the most violent of conflicts. Although it makes evolutionary sense for kin, many non-kin groups also behave parochially altruistically in response to threat from out-groups. It is possible that such non-kin groups share a sense of “fictive” kinship which encourages them to behave parochially altruistically for each other’s benefit. Our findings show that individuals not directly involved in a conflict approved of parochial altruism enacted by an in-group against an out-group more when the out-group posed (...) a threat to the in-group; however, this effect wasgreaterwhen the in-group members expressed fictive kinship by addressing each other using kinship metaphors such as “brothers.” Furthermore, although males approved of parochial altruism more than females, as the male warrior hypothesis would suggest, the effects of threat and kinship metaphor on approval of parochial altruism applied to both genders. These findings were replicated in an honour and non-honour culture. (shrink)

This essay explores seventeenth- and early eighteenth-century programs of natural inquiry where conjecture—an uncertain category of knowledge—played a vital role in the advancement of the sciences. It shows how early modern investigators used conjectures as a bridge between knowledge and ignorance and the process of conjecturing as a way to expand the mental state of inquiry. In publishing their conjectures, they were heeding Francis Bacon’s call to inspire hope and urge fellow experimenters to continue researching complex natural phenomena. Fellow investigators (...) could help to test, verify, revise, invalidate, or propose new inferences in a dialectical, collaborative process. The author argues that, by the eighteenth century, public conjecturing marked a particular kind of broad-minded experimental philosopher. This essay situates conjectures within agnotology—the study of culturally produced ignorance—and Baconian communication of knowledge and ignorance. It explores the philosophical and moral tensions investigators navigated when specifying nature’s unknowns. (shrink)

[1] Hagadah shel Pesaḥ -- [2] Pirḳe Avot -- [3] Mishle -- [4] Shir ha-shirim -- [5] Megilat Ḳohelet -- 6. Megilat Ekhah -- [7] Megilat Rut -- [8] Sefer Tehilim.

Ces deux ouvrages qui font la matière de ce volume se complètent parfaitement, c'est pourquoi ils paraissent sous le même titre. L'auteur analyse dans Esquisse d'une esthétique l'activité gratuite de l'artiste. Le procès de la conscience dénonce d'un côté la conscience de l'autre, reconnaît que les religions et les philosophies ne sont que des issues qui permettent de combler le vide d'être que la conscience a creusé en nous.

Nietzsche : by way of an introduction -- Winnicott : the psychoanalytic family -- Anti-Oedipus : reading, listening, analysing -- Process notes : productions and syntheses -- Sophocles : under the sign of nemesis -- Cixous : the unseen seen -- Dôsirand : the transitional subject.

L’ascension et la chute récentes de la loi islamiste en Égypte appellent une réflexion, non seulement sur le rôle social des idées féministes islamiques, mais aussi sur les raisons des changements politiques, ainsi que sur les questions d’opposition éthique et de principe. Mon approche de ce sujet ne reprend pas l’opposition habituelle entre laïc et islamique, ni la critique du libéralisme laïc, mais propose une critique de tout mouvement féministe, qu’il soit laïc ou islamique, qui s’autorise de lui-même à coopérer (...) ou à être réduit au silence par des régimes politiques corrompus. La première partie de l’article traite de la question des relations fragiles entre les féministes et l’État plus particulièrement dans le contexte égyptien contemporain. La deuxième partie examine les ambiguïtés morales des positions du féminisme islamique. (shrink)

Težnja suvremene zdravstvene skrbi podrazumijeva holistički pristup i osobi usmjerenu skrb. Ističu se pojedini primjeri u kojima takav vid doživljaja čovjeka dolazi do izražaja ne samo poštivanjem autonomije pacijenta već i postupanjima koja nadilaze određene standardizirane postupke. To je viša razina shvaćanja čovjeka od dominantnog biomedicinskog modela. U ovome radu prikazat će se iskustva triju medicinskih sestara iz Republike Hrvatske koje su tijekom redovnog pružanja zdravstvene njege sudjelovale u podjeli sakramenata. Riječ je o podjeli sakramenta krštenja kod novorođenčeta s predviđenim (...) smrtnim ishodom i nemogućnošću dolaska svećenika, te sakramenta svete pričesti kod bolesnika kojemu svećenik nije mogao fizički pristupiti. Prikazani su preliminarni rezultati uz pregled literature, a s ciljem pripreme sveobuhvatnijeg istraživanja uz veći obuhvat ispitanika. Prvi rezultati pokazuju da u zdravstvenom sustavu Republike Hrvatske postoje medicinske sestre koje sudjeluju u podjeli sakramenata, ali da pri tome iskazuju kako nemaju dostatna znanja o istima. Tijekom redovnog obrazovanja medicinskih sestara ne postoje sadržaji koji bi obuhvatili opisane fenomene iako se naglašava nužnost zadovoljavanja duhovnih potreba pacijenata. (shrink)

Machine generated contents note: 1. Introduction; 2. International law and postcolonial Africa; 3. Violence and conflicts in Africa; 4. Institutional responses to conflicts; 5. Genesis of the African Union; 6. Structures and philosophy of the African Union; 7. The African Union's peacebuilding travails in Burundi; 8. The African Union and peace initiatives in post-state Somalia; 9. Towards an African Union philosophy on peacebuilding?.

Les Enjeux du discours philosophique pour l'Afrique est consacré non pas à l'ethnophilosophie, mais à l'orientation africaine en philosophie ou de la philosophie qui se déploie sous des talents et plumes aussi riches que contradictoires : Placide Tempels, John Mbiti et Alexis Kagame, Nkrumah, Paulin Hountondji, Eboussi Boulaga, Marcien Towa, Niamkey Koffi, Abdou Touré, Yacouba Konaté, Jean-Godefroy Bidima, Augustin Dibi, etc. Ce n'est pas un ouvrage de "philosophie africaine", si l'adjonction de l'épithète africaine devrait trahir la philosophie qui, depuis Platon, (...) est universelle et ses "vérités" indépendantes des limitations géographiques, raciales et nationales. L'Afrique a, certes, ses limites dans tous les sens du substantif, mais la vocation trans-territoriale du discours philosophique demeure. Elle s'incarne dans le pari que prend Les enjeux du discours philosophique pour l'Afrique de redire, dans les termes de la théorie critique, de l'espace africain ce qu'il garderait sous un double voile d'ignorance et d'opulence. Il s'agit des défis rapportés aux langues, aux savoirs et aux orphelins du savoir, aux pouvoirs et aux orphelins du pouvoir, aux sous-développements et aux démocraties du même ordre, aux idéologies, etc. (shrink)

Salem, Sara. “Feminismo islámico, interseccionalidad y decolonialidad.” Tábula Rasa 21 (2014): 111-122.

This paper proposes a conceptual framework for understanding the implementation process of a complex intervention concerned with professional role change. The proposed framework holds that the intervention must address three interacting systems (socio-cultural, educational and disciplinary) through which a health professional role is evolved. Each system is operationalized by four dimensions (values, methods, actors and targets). As for the implementation, the framework posits that it can be analyzed, by depicting the barriers and facilitators located within the dimensions of the three (...) interacting systems and within the intervention involved in the process through using the “menu of constructs” approach suggested by the Consolidated Framework for Implementation Research (CFIR). The implications of this framework, on theoretical research and practical levels, are reviewed. (shrink)

Islam - Early works to 20th century ; Islamic ethics - Early works to 20th century.

Islam and End-of-Life Practices in Organ Donation for Transplantation: New Questions and Serious Sociocultural Consequences Content Type Journal Article Pages 175-205 DOI 10.1007/s10730-009-9095-8 Authors Mohamed Y. Rady, Mayo Clinic Hospital in Phoenix 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Joseph L. Verheijde, Mayo Clinic College of Medicine 5777 East Mayo Boulevard Phoenix Arizona USA 85054 Muna S. Ali, Arizona State University Phoenix Arizona USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume (...) 21, Number 2. (shrink)

Background: Healthcare organizations are now challenged to retain nurses’ generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses’ dedication, commitment, satisfaction, and loyalty to their organization. Purpose: This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses’ organizational commitment, job (...) satisfaction, and turnover intention. Methods: A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection. Findings: The result revealed positive significant correlations between nurses’ perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses’ turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention. Recommendation: Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses’ commitment and satisfaction and decreasing their turnover intention. (shrink)

The aim of this article is (1) to investigate the ‘neurosciences’ as an object of study for historical and genealogical approaches and (2) to characterize what we identify as a particular ‘style of thought’ that consolidated with the birth of this new thought community and that we term the ‘neuromolecular gaze’. This article argues that while there is a long history of research on the brain, the neurosciences formed in the 1960s, in a socio-historical context characterized by political change, faith (...) in scientific and technological progress, and the rise of a molecular gaze in the life sciences. They flourished in part because these epistemological and technological developments were accompanied by multiple projects of institution-building. An array of stakeholders was mobilized around the belief that breakthroughs in understanding the brain were not only crucial, they were possible by means of collaborative efforts, cross-disciplinary approaches and the use of a predominantly reductionist neuromolecular method. The first part of the article considers some of the different approaches that have been adopted to writing the history of the brain sciences. After a brief outline of our own approach, the second part of the article uses this in a preliminary exploration of the birth of the neurosciences in three contexts. We conclude by arguing that the 1960s constitute an important ‘break’ in the long path of the history of the brain sciences that needs further analysis. We believe this epistemological shift we term the ‘neuromolecular gaze’ will shape the future intellectual development and social role of the neurosciences. (shrink)

Organ donation after cardiac or circulatory death (DCD) has been introduced to increase the supply of transplantable organs. In this paper, we argue that the recovery of viable organs useful for transplantation in DCD is not compatible with the dead donor rule and we explain the consequential ethical and legal ramifications. We also outline serious deficiencies in the current consent process for DCD with respect to disclosure of necessary elements for voluntary informed decision making and respect for the donor's autonomy. (...) We compare two alternative proposals for increasing organ donation consent in society: presumed consent and mandated choice. We conclude that proceeding with the recovery of transplantable organs from decedents requires a paradigm change in the ethics of organ donation. The paradigm change to ensure the legitimacy of DCD practice must include: (1) societal agreement on abandonment of the dead donor rule, (2) legislative revisions reflecting abandonment of the dead donor rule, and (3) requirement of mandated choice to facilitate individual participation in organ donation and to ensure that decisions to participate are made in compliance with the societal values of respect for autonomy and self-determination. (shrink)

Objective To determine the attitudes of Egyptian patients regarding their participation in research and with the collection, storage and future use of blood samples for research purposes. Design Cross-sectional survey. Study population Adult Egyptian patients (n=600) at rural and urban hospitals and clinics. Results Less than half of the study population (44.3%) felt that informed consent forms should provide research participants the option to have their blood samples stored for future research. Of these participants, 39.9% thought that consent forms should (...) include the option that future research be restricted to the illness being studied. A slight majority (66.2%) would donate their samples for future genetic research. Respondents were more favourable towards having their blood samples exported to other Arab countries (62.0%) compared with countries in Europe (41.8%, p<0.001) and to the USA (37.2%, p<0.001). Conclusions This study shows that many individuals do not favour the donation of a blood sample for future research. Of those who do approve of such future research, many favour a consent model that includes an option restricting the future research to the illness being studied. Also, many Egyptians were hesitant to have their blood samples donated for genetic research or exported out of the Arab region to the USA and European countries. Further qualitative research should be performed to determine the underlying reasons for many of our results. (shrink)

In 1968, the Harvard criteria equated irreversible coma and apnea with human death and later, the Uniform Determination of Death Act was enacted permitting organ procurement from heart-beating donors. Since then, clinical studies have defined a spectrum of states of impaired consciousness in human beings: coma, akinetic mutism, minimally conscious state, vegetative state and brain death. In this article, we argue against the validity of the Harvard criteria for equating brain death with human death. Brain death does not disrupt somatic (...) integrative unity and coordinated biological functioning of a living organism. Neurological criteria of human death fail to determine the precise moment of an organism’s death when death is established by circulatory criterion in other states of impaired consciousness for organ procurement with non-heart-beating donation protocols. The criterion of circulatory arrest 75 s to 5 min is too short for irreversible cessation of whole brain functions and respiration controlled by the brain stem. Brain -based criteria for determining death with a beating heart exclude relevant anthropologic, psychosocial, cultural, and religious aspects of death and dying in society. Clinical guidelines for determining brain death are not consistently validated by the presence of irreversible brain stem ischemic injury or necrosis on autopsy; therefore, they do not completely exclude reversible loss of integrated neurological functions in donors. The questionable reliability and varying compliance with these guidelines among institutions amplify the risk of determining reversible states of impaired consciousness as irreversible brain death. The scientific uncertainty of defining and determining states of impaired consciousness including brain death have been neither disclosed to the general public nor broadly debated by the medical community or by legal and religious scholars. Heart-beating or non-heart-beating organ procurement from patients with impaired consciousness is de facto a concealed practice of physician-assisted death, and therefore, violates both criminal law and the central tenet of medicine not to do harm to patients. Society must decide if physician-assisted death is permissible and desirable to resolve the conflict about procuring organs from patients with impaired consciousness within the context of the perceived need to enhance the supply of transplantable organs. (shrink)

The study aimed at identifying the personal variables and their effect in promoting job creation in Gaza Strip through business incubators. The researchers used the descriptive analytical approach to achieve the study objectives. The study population consisted of 92 of the pilot projects benefiting from the three business incubators in Gaza Strip (Palestinian Information Technology Incubator, UCAS Technology Incubator and Business and Technology Incubator). The study reached a number of results, the most important of which are the existence of statistically (...) significant differences on entrepreneurship attributed to each age as most of them are between the ages of 22-30, Gender for males, business incubator, scientific qualification for the specialties of information technology and engineering, and years of experience. Based on the findings, the researchers recommend focusing on university students in guiding them towards entrepreneurship and helping new graduates to start entrepreneurship. And to guide students to scientific disciplines that help them in entrepreneurship after graduation, whether starting a small business or self-employment, support females to entrepreneurship as most of the entrepreneurs are male, in addition to stimulating males as well. (shrink)

Background: Ascertaining the relationship between ethical ideology, moral judgment, and ethical decision among academic nurse educators at work appears to be a challenge particularly in situations when they are faced with a need to solve an ethical problem and make a moral decision. Purpose: This study aims to investigate the relationship between ethical ideology, moral judgment, and ethical decision as perceived by academic nurse educators. Methods: A descriptive correlational research design was conducted at Faculty of Nursing, Alexandria University. All academic (...) nurse educators were included in the study (N = 220). Ethical Position Questionnaire and Questionnaire of Moral Judgment and Ethical Decisions were proved reliable to measure study variables. Ethical considerations: Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent. Findings: This study reveals a significant positive moderate correlation between idealism construct of ethical ideology and moral judgment in terms of recognition of the behavior as an ethical issue and the magnitude of emotional consequences of the ethical situation (p < 0.001; p = 0.031) respectively. Also, there is a positive significant moderate correlation between relativism construct of ethical ideology and overall moral judgment (p = 0.010). Approximately 3.5% of the explained variance of overall moral judgment is predicted by idealism together with relativism. Discussion: The findings suggest that variations in ethical position and ideology are associated with moral judgment and ethical decision. Conclusion: Organizations of academic nursing education should provide a supportive work environment to help their academic staff to develop their self-awareness and knowledge of their ethical position and promoting their ethical ideologies and, in turn, enhance their moral judgment as well as develop ethical reasoning and decision-making capability of nursing students. More emphasis in nursing curricula is needed on ethical concepts for developing nursing competencies. (shrink)

Volume 20, Issue 6, June 2020, Page 22-24.

Background Nurses are challenged with many situations that require them to solve ethical dilemmas and make moral decisions based on professional values and a sense of accountability and responsibility. To support their decisions, it is important to know how they perceive and relate their ethical ideology, professional values, and clinical accountability in their workplace. Purpose The study’s aim was twofold: to investigate the ethical ideology and perceived importance of professional values and accountability among nurses. Further, explore the relationship between each (...) of ethical ideology and professional values with nurses’ work accountability. Methods A correlational study was conducted in an Egyptian hospital. All nurses were invited to participate = 192, and 150 nurses (78.3%) completed the study questionnaires. The Ethical Position Questionnaire, the Professional Values Scale, and the Clinical Vignettes Assessment for Clinical Accountability were proven to be reliable study measures. Ethical considerations Ethics Committee approval, written informed consent, data privacy and confidentiality, and participants’ right to voluntary participation and withdrawal were maintained. Results Nurses showed good ethical ideology (75 ± 6.2) and are more idealistic while maintaining professional values (108 ± 10.8). Most nurses believed they were accountable for documenting errors, completing incident reports, and calling physicians to discuss or manage the situations. Ethical ideology and the idealism subscale were positively correlated with overall nurses’ professional values (r = 0.321, p < 0.004, r =0.464, p 0.000), respectively. On the other hand, work accountability showed a partial correlation in some areas with ethical ideology and professional values. Discussion Professional values and nurses' accountability appear to be influenced by ethical positions and ideology. Conclusion Healthcare organizations should provide a supportive work environment to help nurses develop self-awareness, and knowledge of their ethical ideologies, which improve professional values and clinical accountability in their practice. Ethical ideology and professional values should be emphasized more in nursing curricula. (shrink)

The world’s first COVID-19 human challenge trial using the D614G strain of SARS-CoV-2 is underway in the United Kingdom. The Wellcome Trust is funding challenge stock preparation of the Beta variant (B.1.351) for a follow-up human challenge trial, and researchers at Imperial College London are considering conducting that trial. However, little has been written thus far about the ethical justifiability of human challenge trials with SARS-CoV-2 variants of concern. While vaccine resistance as such does not increase risks for volunteers in (...) COVID-19 challenge trials, we explore two specific characteristics of some variants that may initially be thought to make such trials unethical and conclude that SARS-CoV-2 variant challenge trials can remain ethical. (shrink)

In addition to opening a fertile field for inquiry in analytical social epistemology, Miranda Fricker’s work has provided powerful conceptual tools that merge descriptive capacity and political potency. For this reason, over the last fifteen years, the conceptual repertoire introduced by the author has been well received in both academic and political arenas. At times, the concepts of both testimonial and hermeneutical injustice acquire excessive dimensions in the literature, and this undermines, on the one hand, their analytical precision and, on (...) the other, their usefulness. In this paper I argue against Fricker’s structural parallelism thesis and defend an independent treatment of each of these concepts. On this basis, to counteract the hyperinflation of the concept of hermeneutic injustice, I proceed with an exercise of conceptual precision. To this end, I identify the conditions that make hermeneutic injustice both unjust and hermeneutic. Finally, I present theoretical and practical reasons to encourage the rigorous use of these concepts. (shrink)

Background: Today, healthcare organizations are challenged to retain nurses’ generation and to maintain justice that is a predictor of nurses’ behaviors in their work environment. Acquiring knowledge about the level of organizational justice and workplace deviance could help in identifying factors amenable for change that can make a difference in enhancing nurses’ dedication and loyalty to their organizations. Aim: The aim of this study was to investigate nurses’ perception of organisational justice and workplace deviance in their hospital, and to determine (...) the relationship between perceived organisational justice and workplace deviance. Methods: A cross-sectional design was used with a convenient sample of all nurses (N = 400) who were working in inpatient care units at two Egyptian hospitals affiliated to the university and private health sectors in Alexandria governorate, Egypt. Organisational justice and workplace deviance questionnaires proved valid and reliable to measure studied variables. Descriptive analysis, Student’s t-test, Pearson correlation (r), and regression analysis (R2) were used for statistical analysis. Ethical considerations: This study was approved by the Ethics Committee at the Faculty of Nursing, Alexandria University. Informed consent, information confidentiality, and voluntary participation were guaranteed. Results: This study showed that overall nurses’ perceptions of organisational justice and workplace deviance are lower than the average. Organisational justice significantly related negatively to workplace deviance (r = −0.152, p = 0.002) and organisational justice as an independent variable contributed a significant predictive power of workplace deviance (R2 = 0.023). Conclusions: This study highlighted important implications for hospital and nurse managers to create and maintain a healthy and supportive work environment that promotes organisational justice and decreases workplace deviance. To achieve this, a culture of respectful communication, justice in policies, and a proper procedure for allocating resources, workload, and rewards systems is a must. Educational interventions to increase nurses’ awareness of workplace deviance and its potential consequences and coping strategies are imperative for the health of the nursing profession. (shrink)

The Royal College of Physicians of London published the 2013 national clinical guidelines on prolonged disorders of consciousness in vegetative and minimally conscious states. The guidelines acknowledge the rapidly advancing neuroscientific research and evolving therapeutic modalities in PDOC. However, the guidelines state that end-of-life decisions should be made for patients who do not improve with neurorehabilitation within a finite period, and they recommend withdrawal of clinically assisted nutrition and hydration . This withdrawal is deemed necessary because patients in PDOC can (...) survive for years with continuation of CANH, even when a ceiling on medical care has been imposed, i.e., withholding new treatment such as cardiopulmonary resuscitation for acute life-threatening illness. The end-of-life care pathway is centered on a staged escalation of medications, including sedatives, opioids, barbiturates, and general anesthesia, concurrent with withdrawal of CANH. Agitation and distress may last from several days to weeks because of the slow dying process from starvation and dehydration. The potential problems of this end-of-life care pathway are similar to those of the Liverpool Care Pathway. After an independent review in 2013, the Department of Health discontinued the Liverpool Care pathway in England. The guidelines assert that clinicians, supported by court decisions, have become the final authority in nonconsensual withdrawal of CANH on the basis of “best interests” rationale. We posit that these guidelines lack high-quality evidence supporting: 1) treatment futility of CANH, 2) reliability of distress assessment from starvation and dehydration, 3) efficacy of pharmacologic control of this distress, and 4) proximate causation of death. Finally, we express concerns about the utilitarian-based assessment of what constitutes a person’s best interests. We are disturbed by the level and the role of medical authoritarianism institutionalized by these national guidelines when deciding on the worthiness of life in PDOC. We conclude that these guidelines are not only harmful to patients and families, but they represent the means of nonconsensual euthanasia. The latter would constitute a gross violation of the public’s trust in the integrity of the medical profession. (shrink)