Purpose The debate about the end-of-life care decision is becoming a serious ethical and legal concern in the Far-Eastern countries of Korea, China and Japan. However, the issues regarding end-of-life care will reflect the cultural background, current medical practices and socioeconomic conditions of the countries, which are different from Western countries and between each other. Understanding the genuine thoughts of patients who are critically ill is the first step in confronting the issues, and a comparative descriptive study of these perspectives (...) was conducted by collaboration between researchers in all three countries. Methods Surveys using self-reporting paper questionnaire forms were conducted from December 2008 to April 2009 in Korea (six hospitals in two regions), China (five hospitals in four regions) and Japan (nine hospitals in one region). The subjects were patients who were critically ill who had been diagnosed as having cancer. A total of 235 participants (Korea, 91; China, 62; Japan, 52) were eventually recruited and statistically analysed. Results Most respondents had sometimes or often thought of their own death, mostly fear of ‘separation from loved ones’. They wanted to hear the news regarding their own condition directly and frankly from the physician. A quarter of them preferred making end-of-life care decisions by themselves, while many respondents favoured a ‘joint decision’ with their family members. The most favoured proxy decision maker was the spouse, followed by the children. Most admitted the necessity of ‘advance directives’ and agreed with artificial ventilation withdrawal in irreversible conditions. The most common reason was ‘artificial prolongation of life is unnecessary’. Most respondents agreed with the concept of active euthanasia; however, significant differences were sometimes observed in the responses according to variables such as patient's country of origin, age, gender and education level. Conclusion Patients in Far-Eastern countries gave various responses regarding end-of-life care decisions. Although familial input is still influential, most patients think of themselves as the major decision maker and accept the necessity of advance directives with Westernization of the society. Artificial ventilation withdrawal and even active euthanasia may be acceptable to them. (shrink)

Do liberals’ and conservatives’ brain processes differ in moral reasoning? This research explains these groups’ dissimilar moral stances when they face ethical transgressions in business. Research that explores the effects of ideological asymmetry on moral reasoning processes through moral foundations has been limited. We hypothesize two different moral reasoning processes and test them in the South Korean culture. Study 1 uses the neuroscientific method of event-related potentials to explore the dissociable neural mechanisms that underlie Korean liberals’ and conservatives’ moral reasoning (...) processes in business ethical transgressions. Liberals’ early frontal negative-going brain waves showed that they are quick to pass negative judgment by intuitively detecting violations of fairness, while conservatives’ temporoparietal positive-going brain waves showed that they have a higher motivation to respect authority. Both liberals’ and conservatives’ ERP components occur within the first second of the decision-making phase, suggesting the rapid and intuitive nature of moral reasoning processes. Study 2 tests a mediating process and confirms that Korean liberals exhibit the moral engagement strategy, through the fairness foundation. These findings from our interdisciplinary research deepen the knowledge of the complexity of human morality in business ethics research. (shrink)

BackgroundMotor imagery training has a similar effect to that of physical training on motor performance. The objective of this study was to investigate the short-term effectiveness of motor imagery training on response inhibition using the stop signal task.MethodsParticipants were divided into a physical training group, a motor imagery training group, and a motor imagery combined with physical training group. All participants performed 10 SST training sessions over 5 days. Both stop signal reaction time and non-signal reaction time were measured before (...) and after SST training.ResultsThere were significant interaction and time effects, although the group effect was not statistically significant. Bonferroni post hoc analysis showed that MIPT group revealed a significantly greater change in SSRT than PT and MIT groups, while there was no significant difference between PT and MIT groups. SSRT significantly decreased after training in all groups. In NSRT, there was a significant effect of time, but there was no significant interaction effect or group effect.ConclusionResponse inhibition could be enhanced via training, and it was most effective when motor imagery and physical training were combined. We demonstrate that motor imagery training significantly improves response inhibition and should be accompanied by physical training when performing SST. (shrink)

Customer injustice has received considerable attention in the field of organizational behavior because it generates a variety of negative outcomes. Among possible negative consequences, customer-directed sabotage is the most common reaction, which impacts individuals’ well-being and the prosperity of organizations. To minimize such negative consequences, researchers have sought to identify boundary conditions that could potentially attenuate the occurrence of customer-directed sabotage. In this study, we explore potential attenuation effects of emotional stability and attentiveness on the customer injustice–sabotage linkage. The results (...) showed emotional stability and attentiveness moderate the relationship between customer injustice and customer-directed sabotage. Specifically, the representatives with higher emotional stability or higher attentiveness are less likely to engage in customer-directed sabotage when they experience customer injustice. Moreover, there is a three-way interaction among daily customer injustice, emotional stability, and attentiveness that predicts daily customer-directed sabotage. Theoretical and practical contributions, limitations, and directions for future development are also discussed. (shrink)

Using data drawn from a racially/ethnically diverse sample of participants ( N = 1,489; 52% female; Mage_T1: 18.10; 34% Latino, 21% White, 20% Asian, 11% Black, 11% multiracial/multiethnic, and 3% other), we conducted a binary logistic regression to identify which factors during adolescence and early adulthood were associated with voting behavior in the 2020 presidential election. There were three main findings. First, young adults who had more cross-racial/ethnic friendships and those who participated in volunteer activities during their senior year (...) of high school were more likely to vote. Second, having cross-racial/ethnic friendships and endorsing self-transcendence values (benevolence, universalism) in early adulthood were positively associated with voting behavior, even when controlling for high school factors. Third, those who endorsed self-enhancement values were more likely to vote when they had more cross-racial/ethnic friendships during high school. Implications for voting patterns among young adults in future presidential elections are discussed. (shrink)

1. Yŏn'gyŏngjae Sŏng Hae-ŭng. "Yŏn'gyŏngjae chŏnjip", innŭn sasil ŭl kŭdaero kirok hada -- 2. P'ungsŏk Sŏ Yu-gu. "Imwŏn kyŏngjeji", hŭlkuk kwa chongittŏk in hangmun ŭn anŭrira -- 3. Oju Yi Kyu-gyŏng. "Ojuyŏn munjang chŏnsan'go", pakhak kwa kojŭnghak ŭro modŭn kŏt ŭl pyŏnjŭng hara -- 4. Tasan Chŏng Yag-yong. "Mongmin simsŏ", sidae rŭl ap'ahago paeksŏngdŭl ŭi pich'am han sam e punno haeya handa -- 5. Ch'ujae Cho Su-sam. "Ch'ujae chip", nara ka mangharyŏmyŏn pandŭsi yomul i naonda -- 6. Nakhasaeng Yi Hak-kyu. (...) "Yŏngnam akpu", mal hanŭn cha nŭn choe ka ŏpta -- 7. Kuhwajae Hong Sŏng-mo. "Tongguk sesigi", sot e kadŭkhan kuk ŭl han sutkal ro mat poda -- 8. Hosan Cho Hŭi-ryong. "Sŏgu mangnyŏllok", hanŭl arae kajang t'ongk'wae han il ida -- 9. Sŏp'a Yu Hŭi. "Munt'ong", ilsaeng ŭl nŭl sibi sok esŏ saranne -- 10. Hyegang Ch'oe Han-gi. "Kihak", taedong ilt'ong ŭi isang segye rŭl kuhyŏn hada -- 11. Kosanja Kim Chŏng-ho. "Taedong yŏjido", chido ro ch'ŏnha ŭi hyŏngse rŭl salp'il su itta -- 12. Paegun Sim Tae-yun. "Pongni chŏnsŏ", mani ilgŭlsurok pongni ka tŏuk manajinda -- 13. Suun Ch'oe Che-u. "Tonggyŏng taejŏn", hangmun ŭro marhajamyŏn 'tonghak' irago haeya handa -- 14. Tongmu Yi Che-ma. "Kyŏkch'igo", i ch'aek i ch'ŏllima ka toeji ank'ennŭn'ga? (shrink)

BackgroundDrawing from Erikson’s theory, Domino and Affonso constructed the Inventory of Psychosocial Balance, a scale with satisfactory reliability and validity. However, the lack of a credible Chinese version of the scale may hinder research on ego development in Taiwan. The aim of the present study was to construct a short form Chinese IPB. In addition, factor analysis was employed to shorten the original 120-item scale to make it suitable for application in the older adults in the future.MethodsThe study involved three (...) steps: The first step was to establish the 120-items of the Chinese Inventory of Psychosocial Balance, and we conducted translation, back-translation, expert validity, and reliability of pilot study for this step. Following the first step was to construct the short-form C-IPB in the second step, and the CIPB-SF was developed via item analysis and factor analysis. Finally, we assessed the reliability and validity of the CIPB-SF via structural equation model in the third step.ResultsThree hundred eight older adults without cognitive disorder completed the IPB. The 40-item CIPB-SF was completed through item analysis and factor analysis. The internal consistency test of CIPB-SF and the eight stages were good. The CIPB-SF had acceptable validity, except in the intimacy and identity stages, in which validity was only fair. Compared with the IPB, the CIPB-SF had good reliability and acceptable validity. However, because of its conciseness, the 40-item CIPB-SF was more suited for application among the Chinese elderly population because its application avoids physical overload.ConclusionThe CIPB-SF served as a concise scale for assessing ego development in our study. This scale can also serve as a useful tool for convenient screening in the future. (shrink)

Incentivising has shown to improve participation in clinical trials. However, ethical concerns suggest that incentives may be coercive, obscure trial risks and encourage individuals to enrol in cli...

BackgroundIn the 1970s, the Federal Trade Commission declared that allowing medical providers to advertise directly to consumers would be “providing the public with truthful information about the price, quality or other aspects of their service.” However, our understanding of the advertising content is highly limited.ObjectiveTo assess whether direct-to-consumer medical service advertisements provide relevant information on access, quality and cost of care, a content analysis was conducted.MethodTelevision and online advertisements for medical services directly targeting consumers were collected in two major urban (...) centres in Nevada, USA, identifying 313 television advertisements and 200 non-duplicate online advertisements.ResultsBoth television and online advertisements reliably conveyed information about the services provided and how to make an appointment. At the same time, less than half of the advertisements featured insurance information and hours of operation and less than a quarter of them contained information regarding the quality and price of care. The claims of quality were substantiated in even fewer advertisements. The scarcity of quality and cost information was more severe in television advertisements.ConclusionThere is little evidence that medical service advertising, in its current form, would contribute to lower prices or improved quality of care by providing valuable information to consumers. (shrink)

Background Supporting physicians in Intensive Care Units s as they face dying patients at unprecedented levels due to the COVID-19 pandemic is critical. Amidst a dearth of such data and guided by evidence that nurses in ICUs experience personal, professional and existential issues in similar conditions, a systematic scoping review is proposed to evaluate prevailing accounts of physicians facing dying patients in ICUs through the lens of Personhood. Such data would enhance understanding and guide the provision of better support for (...) ICU physicians. Methods An SSR adopts the Systematic Evidenced Based Approach to map prevailing accounts of caring for dying patients in ICUs. To enhance the transparency and reproducibility of this process, concurrent and independent use of tabulated summaries, thematic analysis and directed content analysis is adopted. Results Eight thousand three hundred fifty-eight abstracts were reviewed from four databases, 474 full-text articles were evaluated, 58 articles were included, and the Split Approach revealed six categories/themes centered around the Innate, Individual, Relational and Societal Rings of Personhood, conflicts in providing end of life care and coping mechanisms employed. Conclusion This SSR suggests that caring for dying patients in ICU impacts how physicians view their personhood. To resolve conflicts within individual concepts of personhood, physicians use prioritization, reframing and rely on accessible, personalized support from colleagues to steer coping strategies. An adapted form of the Ring Theory of Personhood is proposed to direct timely personalized, appropriate and holistic support. (shrink)

Background Conventional consent practices face ethical challenges in continuously evolving digital health environments due to their static, one-time nature. Dynamic consent offers a promising solution, providing adaptability and flexibility to address these ethical concerns. However, due to the immaturity of the concept and accompanying technology, dynamic consent has not yet been widely used in practice. This study aims to identify the facilitators of and barriers to adopting dynamic consent in real-world scenarios. Methods This scoping review, conducted in December 2022, adhered (...) to the PRISMA Extension for Scoping Reviews guidelines, focusing on dynamic consent within the health domain. A comprehensive search across Web of Science, PubMed, and Scopus yielded 22 selected articles based on predefined inclusion and exclusion criteria. Results The facilitators for the adoption of dynamic consent in digital health ecosystems were the provision of multiple consent modalities, personalized alternatives, continuous communication, and the dissemination of up-to-date information. Nevertheless, several barriers, such as consent fatigue, the digital divide, complexities in system implementation, and privacy and security concerns, needed to be addressed. This study also investigated current technological advancements and suggested considerations for further research aimed at resolving the remaining challenges surrounding dynamic consent. Conclusions Dynamic consent emerges as an ethically advantageous method for digital health ecosystems, driven by its adaptability and support for continuous, two-way communication between data subjects and consumers. Ethical implementation in real-world settings requires the development of a robust technical framework capable of accommodating the diverse needs of stakeholders, thereby ensuring ethical integrity and data privacy in the evolving digital health landscape. (shrink)

This study focuses on CEO hubris and its detrimental effect on corporate financial performance along with an examination of critical corporate governance contingencies that may moderate the negative effect. From 654 observations of 164 Korean firms over the years 2001–2008, we found that CEO power exacerbated the negative effect of CEO hubris on corporate financial performance, whereas board vigilance mitigated it. This study provides empirical evidence that entrenchment problems arising from CEO hubris would be exacerbated as CEOs become more powerful, (...) but weakened as board of directors become more vigilant. Theoretical contributions and practical implications will be discussed. (shrink)

BackgroundThe COVID-19 pandemic has changed the healthcare landscape drastically. Stricken by sharp surges in morbidity and mortality with resource and manpower shortages confounding their efforts, the medical community has witnessed high rates of burnout and post-traumatic stress amongst themselves. Whilst the prevailing literature has offered glimpses into their professional war, no review thus far has collated the deeply personal reflections of physicians and ascertained how their self-concept, self-esteem and perceived self-worth has altered during this crisis. Without adequate intervention, this may (...) have profound effects on their mental and physical health, personal relationships and professional efficacy.MethodsWith mentions of the coronavirus pervading social media by the millions, this paper set out to collate and thematically analyse social media posts containing first-person physician reflections on how COVID-19 affected their lives and their coping mechanisms. A consistent search strategy was employed and a PRISMA flowchart was used to map out the inclusion/exclusion criteria.ResultsA total of 590 social media posts were screened, 511 evaluated, and 108 included for analysis. Salient themes identified include Disruptions to Personal Psycho-Emotional State, Disruptions to Professional Care Delivery, Concern for Family, Response from Institution, Response from Society and Coping Mechanisms.ConclusionIt is evident that the distress experienced by physicians during this time has been manifold, multi-faceted and dominantly negative. Self-concepts were distorted with weakened self-esteem and perceived self-worth observed. The Ring Theory of Personhood (RToP) was adopted to explain COVID-19’s impact on physician personhood as it considers existential, individual, relational and social concepts of the self. These entwined self-concepts serve as ‘compensatory’ to one another, with coping mechanisms buffering and fortifying the physician’s overall personhood. With healthcare institutions playing a vital role in providing timely and targeted support, it was further proposed that a comprehensive assessment tool based on the RToP could be developed to detect at-risk physicians and evaluate the presence and effectiveness of established support structures. (shrink)

It is evident, in the face of the COVID-19 pandemic that has physicians confronting death and dying at unprecedented levels along with growing data suggesting that physicians who care for dying patients face complex emotional, psychological and behavioural effects, that there is a need for their better understanding and the implementation of supportive measures. Taking into account data positing that effects of caring for dying patients may impact a physician’s concept of personhood, or “what makes you, ‘you’”, we adopt Radha (...) Krishna’s Ring Theory of Personhood (RToP) to scrutinise the experiences of physicians working in intensive care units (ICU) using a fictional scenario that was inspired by real events. The impact of death and dying, its catalysts, internal constituents, external factors, dyssynchrony, and buffers, specific to ICU physicians, were identified and explored. Such a framework allows for ramifications to be considered holistically and facilitates the curation of strategies for conflict resolution. This evaluation of the RToP acknowledges the experience and wide-ranging effects it has on ICU physicians. As such, our findings provide insight into their specific needs and highlight the importance of support on a personal and organisational level. Although further research needs to be conducted, the RToP could serve as the basis for a longitudinal assessment tool supported by the use of portfolios or mentorship due to their provision of personalised, appropriate, specific, timely, accessible and long-term support. (shrink)

Background The principles of dynamic consent are based on the idea of safeguarding the autonomy of individuals by providing them with personalized options to choose from regarding the sharing and utilization of personal health data. To facilitate the widespread introduction of dynamic consent concepts in practice, individuals must perceive these procedures as useful and easy to use. This study examines the user experience of a dynamic consent-based application, in particular focusing on personalized options, and explores whether this approach may be (...) useful in terms of ensuring the autonomy of data subjects in personal health data usage. Methods This study investigated the user experience of MyHealthHub, a dynamic consent-based application, among adults aged 18 years or older living in South Korea. Eight tasks exploring the primary aspects of dynamic consent principles–including providing consent, monitoring consent history, and managing personalized options were provided to participants. Feedback on the experiences of testing MyHealthHub was gathered via multiple-choice and open-ended questionnaire items. Results A total of 30 participants provided dynamic consent through the MyHealthHub application. Most participants successfully completed all the provided tasks without assistance and regarded the personalized options favourably. Concerns about the security and reliability of the digital-based consent system were raised, in contrast to positive responses elicited in other aspects, such as perceived usefulness and ease of use. Conclusions Dynamic consent is an ethically advantageous approach for the sharing and utilization of personal health data. Personalized options have the potential to serve as pragmatic safeguards for the autonomy of individuals in the sharing and utilization of personal health data. Incorporating the principles of dynamic consent into real-world scenarios requires remaining issues, such as the need for powerful authentication mechanisms that bolster privacy and security, to be addressed. This would enhance the trustworthiness of dynamic consent-based applications while preserving their ethical advantages. (shrink)