The medical profession has been surrounded from mixed feelings of admiration, mysticism, as well as of fear and refusal. Authors and enthusiastic directors have dedicated serials and movies to the physicians’ everyday work, in their ebbs and tides. Albanian cinema produced a score of titles dedicated to the medical profession, with some movies focusing on the physician as the principal role, and some others more peripherally. -/- The physician as a movie character underwent serious changes in the way (...) the directors and scripts defined it, and maybe even in the way the general audience perceived the same. Changes in this modeling of physician’s character were part of the maturation process of the Albanian cinematography that has otherwise been strongly politicized from scholars; this trend could as well, or mainly, be related to the intrinsic alterations of the Albanian society from the immediate post WWII, until the fall of the totalitarian regime. (shrink)

On the 17th of May 2020, the Albanian National Theatre in Tirana was demolished overnight, in the days of the first major lockdown due to the COVID-19 pandemic. The theatre was built in 1939, when the Italian military occupation of the Albanian territory was officially established, after decades of increasing influence on the local economy by the fascist regime. That day was the climax of a two-year-long protest against its demolition by local associations, and international organisations. This event demonstrates the (...) importance of debating on the contested material and immaterial traces that the Italian presence in Albania left behind, culminating with a military occupation during WWII. This text surveys the exhibitions, curated or organised by Italian institutions, with the aim of tracing the evolution of the colonial narrative from fascist propaganda to contemporary initiatives. Starting in the 1920s, the Italian Ministero delle Colonie opened trade exhibitions, ethnographic displays, political and recreational events. During the occupation, Albania was featured in the Mostra Triennale delle Terre Italiane d'Oltremare (1940) and many other venues up to recent shows in Tirana. The first exhibitions were essential devices to support Italian territorial claims, built on the argument of an alleged Mediterranean tradition of the area, reunited once again under the “Roman” identity flag. The political-ideological nature of the artistic productions, the biased historical discourses around the myth of Roman origins, and the aesthetics employed in such events formed a strong narration that lasted much longer than the military presence on the territory. Taking this case as an example, we will see how exhibitions were instrumental to the authoritarian regime in the identity-building process; how contested narratives can be twisted in the contemporary political debate; and to what degree this heritage can be considered a shared legacy by both parties, the coloniser and the colonised. (shrink)

Artistic work during communist regime in Albania has been a strictly controlled area, due to censorship and ideological limitations. However, the creative genius of some individuals was able to transmit religious images in a disguised form, particularly when themes were permissive to ambiguous messages. Depicting child abuse was a taboo for the everyday life, but not when focusing on certain historical periods that were purposefully stigmatized from the state propaganda. Some snapshots and images from the movie ‘Red poppies on the (...) wall’, shot in 1976, will reveal how the director and the working team operated on Christian symbols to showcase their working philosophy. Thus, sketching the abusive environment of an orphanage within the frames of a remote Roman punishment model, did nothing more, rather than confirmed the main concern that was tormenting authors while trying to delimit the events in time. The abused child is a reality beyond time, ideology and religion, and as such artworks dealing with it have their deserved professional space. (shrink)

There are numerous ways in which “the particular”—particular individuals, particular ideologies, values, beliefs, and perspectives—are sometimes overlooked, ignored, or even driven out of the healthcare profession. In many such cases, this is bad for patients, practitioners, and the profession. Hence, we should seek to find a place for the particular in health care. Specific topics that I examine in this essay include distribution of health care based on the particular needs of patients, the importance of protecting physicians’ right to conscientious (...) objection, the value in tolerating a plurality of moral and medical perspectives within the field, and more. Ultimately, as the imagery in the essay’s title suggests, I argue that if one cares about the “well-being” of the medical profession, then one should seek to avoid destroying the many diverse and particular entities that constitute it. (shrink)

Review of British Medical Association handbook on human rights and doctors.

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel (...) reluctant to the end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust. (shrink)

In the second half of the last century, Albanian society adopted a totalitarian way of communist thinking, that could not have spared medical disciplines. Psychiatry was and probably remains a stigmatized field, whose problems almost never were discussed openly. Specialized writings on psychiatry were available and could shed light on the themes and questions of concern. A periodical journal entitled Psychoneurological Works circulated in its print edition, with its first issue of 1959, its tenth issue of 1984 till it (...) ceased publishing some years later. The journal was a mixture of neurological and psychiatric contributions, with the latter reflecting consistent time-related shifts in thematic, terminology, and data exposure. The panegyric and enthusiastic statements served as a good disguise for the immense ailing of patients and the ethical challenges that psychiatrists were facing, while exerting their profession in the time of severe dictatorship, when the disrespect of human being reached its apogee. (shrink)

The communal characteristic of African Societies has frequently been juxtaposed with the individualistic tenets of Western polities. However, the evolution of African societies into liberal democracies with the obligation to promote and protect constitutionalism and individual liberties calls for a philosophical niche to bridge between communality and individuality. This paper argues that Africa’s moral and political philosophy is in an urgent need of a Kantian Copernican revolution to ameliorate the conflictual interface between sociality and individualism. The paper opines that the (...) revolution will help to harmonize the dilemmatic relationship between communitarianism and individual rights. The paper also contends that the Kantian categorical imperatives are necessary in eliminating the unclear deontological/teleological situatedness of African ideological philosophies. (shrink)

Lately, more and more authors have asserted their belief that one of the criteria which, together with the medical ones, can and should be applied in the policy of selecting and/or prioritizing the patients in need for the allocation of medical resources with limited availability, is the principle of individual responsibility for illness. My intention in this study is to highlight some very serious obstacles looming against the attempt to apply this principle in the distribution of the (...) class='Hi'>medical services with limited availability. Although there are numerous such obstacles, I shall only discuss five of them (the most important, in my opinion). These are: 1) the impossibility to establish with certainty whether a patient got ill due to his lifestyle; 2) the lack of a feasible and reliable method of establishing an individual’s responsibility for his lifestyle; 3) a patient’s right to privacy; 4) some moral requirements and principles and, last but not least, 5) the ethics of the medical profession. (shrink)

The article is devoted to the study of ideological and philosophical components correlation in the worldview formation. According to the author, it is fundamentally important to take for understanding Russian history and culture not speculative, but ideological coordinates as the basis. Ideology as a professed philosophy is incomparably higher than any palliative abstraction. It is necessary not to lower culture to the level of the masses, but to elevate a person to the level of culture, impossible without a cult.

In this essay, I use four war movies to explore conflicts of loyalty and how they are resolved, all to illustrate W.D. Ross’ multiple rule deontologism. The films are all fine WWII movies: The Enemy Below; Decision Before Dawn; John Rabe; and The Bridge on the River Kwai. In my analysis of each, I show how the protagonists face conflicts of their loyalty to themselves, their countrymen, their friends, and humanity in general, and resolve them in the face of (...) changing factual backgrounds. (shrink)

This article focuses on the religious information inside Ghanaian and Nigerian video movies regarding Akan and Yoruba women. More specifically, it focuses on the indigenous religious, Christian, and Islamic messages inside these movies in relation to women. The article demonstrates that Akan and Yoruba filmmakers, who dominate the Ghanaian and Nigerian video movie industries, are part of networks of religious institutions, predominantly Pentecostal-Charismatic Christian and modest Islamic ones. These organizations sponsor filmmakers to spread religious messages that promote hierarchical gender relations (...) and the suppression of equal rights for women, e.g., economic independence. By providing an overview of Akan and Yoruba belief systems, in respect of indigenous, Christian, and Islamic gender-related positional concepts and ideological communication on what is appropriate behavior for women, the author will show and support the hypothesis that these movies contribute to women’s demonization and (economic) discrimination. (shrink)

Background Professional communities such as the medical community are acutely concerned with negligence: the category of misconduct where a professional does not live up to the standards expected of a professional of similar qualifications. Since science is currently strengthening its structures of self-regulation in parallel to the professions, this raises the question to what extent the scientific community is concerned with negligence, and if not, whether it should be. By means of comparative analysis of medical and scientific codes (...) of conduct, we aim to highlight the role of negligence provisions in codes of conduct for scientists, and to discuss the normative consequences for future codes of conduct. -/- Methods We collected scientific and medical codes of conduct in a selection of OECD countries, and submitted each code of conduct to comparative textual analysis. -/- Results Negligence is invariably listed as an infraction of the norms of integrity in medical codes of conduct, but only rarely so in the scientific codes. When the latter list negligence, they typically do not provide any detail on the meaning of ‘negligence’. -/- Discussion Unlike codes of conduct for professionals, current codes of conduct for scientists are largely silent on the issue of negligence, or explicitly exclude negligence as a type of misconduct. In the few cases where negligence is stipulated to constitute misconduct, no responsibilities are identified that would help prevent negligence. While we caution against unreasonable negligence provisions as well as disproportionate sanctioning systems, we do argue that negligence provisions are crucial for justified trust in the scientific community, and hence that there is a very strong rationale for including negligence provisions in codes of conduct. (shrink)

Hospitals must have adequate lighting so that medical personnel can do their duties and attend to the requirements of patients and visitors. A comfortable recuperation environment may be created with the aid of good lighting. The relationship between daylighting and artificial lighting and their role in the design process will be mentioned. Specific areas of the hospital will be under adequate lighting analysis. The areas taken into consideration are entrance and waiting areas, circulation areas, operating theatres and clean rooms, (...) wards and bedrooms, ancillary areas, restaurant and kitchen, and exterior lighting. Some of these areas are also analyzed regarding the case study of the Military Hospital (University Trauma Hospital) of Tirana Albania. The purpose of this paper is to compare different lighting standards, the EU standards, and the Albanian ones. Solutions can be provided for lighting systems, starting from luminaries and lamps, to lighting controls and lighting management systems, from the early stage of design. The architect is the enabling partner to develop meaningful lighting solutions for all areas of healthcare facilities. (shrink)

Modern health care relies extensively on the use of technologies for assessing and treating patients, so it is important to be certain that health care technologies perform their professed functions in an effective and safe manner. Philosophers of technology have developed methods to assign and evaluate the functions of technological products, the major elements of which are described in the ICE theory. This paper questions whether the standard of evidence advocated by the ICE theory is adequate for ascribing and assessing (...) technologies employed in health care. The paper proposes that the general problem with the standard of evidence embodied in the ICE theory is too permissive for assessing medical technologies, in that it does not take into account the relative benefit and harm of medical technologies in ensuring safe functional performance in patients. The paper illustrates how evidence-based medicine has demonstrated the value of clinical research methods, including observational studies, randomized and non-randomized clinical trials, and formal techniques, such as meta-analysis, to measure therapeutic effectiveness. I argue, therefore, that evidence from clinical research studies should take precedence over the testimonial evidence and other types of non-clinical evidence, in providing justification for health technologies. (shrink)

This article is in a larger textbook of articles on Medical Ethics. It identifies a number of values that underlie professional commitments to confidentiality that are involved in protecting or promoting the client's (1) privacy, (2)social status, (3) economic advantages, (4) openness of communications, (5) seeking professional help, (6) trust in professionals, (7) autonomous control over personal information. The problem of making exceptions to confidentiality commitments is also examined.

This paper presents information about the moisture content and temperature level of brick walls in Tirana, Albania. The buildings whose walls have been studied were built in two different eras, throughout the twentieth century, and in more recent times. Given that during the second half of the twentieth century, Albania has been isolated from most of Europe and the West, and consequently the new architectural ideologies of the time, have not had the proper implementation there, the paper focuses on the (...) characteristic types of bricks used in Albania, the functions for which they are used, and their effectiveness in achieving comfort (thermal, moisture content control) during the two time periods mentioned above. Depending on the functions bricks perform in the walls studied in this paper, the walls are separated into two main groups: Walls in which bricks have structural role (red silicate brick walls, white silicate brick walls) and walls in which bricks do not have structural role (concrete block walls, holed brick walls). For all the types of bricks mentioned above, indoor moisture content and temperature measurements have been performed in all four cardinal directions. For the walls in which the bricks have a structural function, moisture measurements have been performed in all the facades of the buildings, because moisture in the bricks of these types of buildings, being a very important factor, directly affects the structural performance of the elements. The aim of the paper is to show the differences in moisture and temperature levels of the walls of these buildings, depending on the engineering and architectural techniques used during the building process, the use of insulation, and the masonry composition. (shrink)

Depuis 2020, le monde a connu une situation sanitaire exceptionnelle à la suite de la pandémie de Covid-19, faisant face à une incertitude dans le monde médical clinique, de la recherche et dans l’ensemble des domaines connexes en santé publique. Le caractère imprévisible et l’absence de données fiables en lien avec ce virus ont fait émerger une quantité d’enjeux éthiques concrets, cela a donc révélé un domaine particulier, la bioéthique, et plus particulièrement une profession, les bioéthiciens. Les « bioéthiciens » (...) se sont fait connaître du grand public en se dressant parfois comme des garde-fous contre des dérives sanitaires, à d’autres moments comme des lanceurs d’alertes face à des injustices naissantes, ou comme critiques, polémistes et parfois même militants dans les médias ou en tant qu’acteurs de première ligne dans les systèmes politico-sanitaires. Ces divers rôles et pratiques illustrent bien la diversité et l’hétérogénéité du domaine de la bioéthique. Toutefois, l’absence de professionnalisation traditionnelle et formelle de la bioéthique complexifie la compréhension de ce champ disciplinaire. Même en Amérique du Nord, où la pratique de la bioéthique est professionnalisée, il ne s’agit toujours pas d’une profession officiellement reconnue et le terme « bioéthicien » lui-même peut être controversé. La forte présence de cette profession durant la pandémie de Covid-19 a révélé l’importance de décrire ce qu’est un bioéthicien, les fonctions qu’il occupe et en quoi consistent ses interventions. Nous apportons cette clarification nécessaire en expliquant la nature de la bioéthique contemporaine dans toute sa diversité. Comme nous l’a démontré la pandémie de Covid-19, les bioéthiciens représentant un soutien et un guide indispensable de nos jours menés par leur esprit critique et leur réflexivité permanente. (shrink)

The history, critique and philosophy of the medical profession. What is real?

Nowadays, healthcare and medical education is qualified by test scores and competitiveness. This article considers its quality in terms of improving the moral competence of future healthcare providers. Objectives. Examining the relevance of moral competence in medico-clinical decision-making despite the paradigm shift and discussing the up-to-date findings on healthcare students. Design and method. N=115 participants were surveyed with a standard Moral Competence Test to examine how their moral competence development was affected by the learning environment and further important factors. (...) Results. The sample allowed the identification of a regress in moral competence during students’ pre-clinical curriculum, and progress during their clinical curriculum. A gender-related bias, a segmentation effect, and a pronunciation effect were noticed. Explanations. Scholarly literature usually reports a linear decrease of medical students’ C-scores resulting from, e.g., competitive trends in education. We identified such trends in terms of gender-specific competitive tactics. Religious and ethical affiliations were discussed to explain the unexpected gender bias and the related segmentation and pronunciation effects. The findings can be regarded as predictive for similar developments in educational institutions regardless of cultural contexts as the sample examined in this article represents medical education in a country facing a transition from a non-competitive to competitive tertiary education model, and between presecular and monocultural to secular and pluralist social ethics. (shrink)

Following the Introduction, the second section of this essay lays out Tom Cavanaugh’s helpful and convincing account of the enduring significance of the Hippocratic Oath in terms of how it responds to the problem of iatrogenic harm. The third section discusses something underemphasized in Cavanaugh’s account, namely, the key role of the virtue of piety within the Oath and the profession it establishes, and argues that this virtue should be regarded as integral to an authentic Hippocratic ethic. The fourth and (...) final section briefly examines the connection between medicine and philosophy, focusing on how both should be seen as wisdom-seeking ways of life, and shows the relevance of this for regarding the virtue of piety as the key virtue of medical practice. (shrink)

Modern bioethics is clearly dominated by deontologists who believe that we have some way of identifying morally correct and incorrect acts or rules besides taking account of their consequences. Robert M. Veatch is one of the most outspoken of those numerous modern medical ethicists who agree in rejecting all forms of teleological, utilitarian, or consequentialist ethical theories. This paper examines his critique of utilitarianism and shows that the utilitarianism of John Stuart Mill is either not touched at all by (...) his critique or can be defended against it. This article argues that the dominant deontological majority is mistaken and that a utilitarian theory of moral action very much like Mill’s is precisely what is needed by modern medical ethics and by those medical practitioners who are resolved to practice medicine in a reasonable and morally acceptable manner. (shrink)

This paper examines the question whether physicians are obligated by their professional ethos to defend a pacifist position. The question is a more concrete and applied formulation of the general thesis that there are what I will call “pacifist professions”: professions whose ethos requires their members to act in a pacifist way. Since the present paper is rather one in applied philosophy than a theoretical one about the foundation of pacifism, it will concentrate on the practical issue of whether and (...) how physicians can execute their profession in or during war. Theoretical questions on the nature and extent of pacifism will be considered only to the extent necessary to treat the main issue. The introductory section will give a short overview of some histori- cal aspects of physicians’ participation in war and show the relevance of the issue with recent examples. The remainder of this section will thus serve to set the stage and to outline the connections between the medical profession and questions of war and peace. The paper will then be divided into three other main parts: the first part will be devoted to defining in a general manner so-called “professional pacifism”. The second part will investigate whether and to what extent the medical profession can be classified as a pacifist profession, and the third part will look at the consequences of such a classification. (shrink)

There has been a significant increase in the use of radiological services in the past 30 years. There are many reasons for this, but one has received little attention: the increased role of patient autonomy in healthcare. Patients demand x rays, CT scans, MRI, and positron emission tomography scans. The key question in this article is how a moral principle, such as respect for patient autonomy, can influence the extension of radiological services. A literature review reveals how patient autonomy is (...) acknowledged in radiology, and how it is used both to explain and to justify the increase in radiological examinations. Furthermore, it also shows how the premises favouring patients’ exercise of their autonomy are not always present, which makes patient autonomy subject to adverse side effects and even abuse. Patient autonomy can be used to reduce the professionals’ responsibility for radiological examinations , to increase the popularity of the profession , to increase the income of the professionals or their institutions, and to promote professional activity. Patient autonomy intended to reduce paternalism, to legitimise otherwise morally unjustifiable actions , and to protect patients, can easily be used as a moral means for opposite ends. These adverse effects are not peculiar to radiology. However, they emerge particularly clearly in explanations and justifications of the substantial increase in radiological services, as well as in debates on overuse of radiological services. (shrink)

After an intensive 4-year process, the World Medical Association (WMA) has revised its International Code of Medical Ethics (ICoME). In their report outlining this process, Parsa-Parsi et al not only describe how the WMA sought to ‘cultivat[e] international agreement’ on a ‘global medical ethos’, but also outline the philosophical framework of the ICoME: how the WMA, as the ‘global representation of the medical profession’, created and revised the ICoME through the process of international professional self-regulation.1 However, (...) there is a significant tension to be found in this framework—one which contrasts the international scope of the ICoME with the supposed source of its legitimacy. Here, we seek to characterise this tension and the doubt which it casts on the legitimacy of the ICoME. (shrink)

While the consequences of mathematically-based software, algorithms and strategies have become ever wider and better appreciated, ethical reflection on mathematics has remained primitive. We review the somewhat disconnected suggestions of commentators in recent decades with a view to piecing together a coherent approach to ethics in mathematics. Calls for a Hippocratic Oath for mathematicians are examined and it is concluded that while lessons can be learned from the medical profession, the relation of mathematicians to those affected by their work (...) is significantly different. There is something to be learned also from the codes of conduct of cognate but professionalised quantitative disciplines such as engineering and accountancy, as well as from legal principles bearing on professional work. We conclude with recommendations that professional societies in mathematics should sponsor an (international) code of ethics, institutional mission statements for mathematicians and syllabuses of ethics courses for incorporation into mathematics degrees. (shrink)

Oppressive ideology regularly misrepresents features of structural injustice as normal or appropriate. Resisting such injustice therefore requires critical examination of the evaluative judgments encoded in shared concepts. In this paper, I diagnose a mechanism of ideological misevaluation, which I call "hermeneutical misfit." Hermeneutical misfit occurs when thick concepts, or concepts which both describe and evaluate, mobilize ideologically warped evaluative judgments which do not fit the facts (e.g. "slutty"). These ill-fitted thick concepts in turn are regularly deployed as if they merely (...) describe--a phenomenon I call "descriptive masquerade." I argue that, via descriptive masquerade, ill-fitted thick concepts smuggle in warped evaluative judgments alongside apparently value-neutral ‘mere facts’, a process which both reinforces those judgments and increases the difficulty of critique. I investigate the concept "obesity" as an example: scientists and medical practitioners will deploy this concept as if it "merely" describes, enabling the smuggling of a host of warped evaluative judgments. I suggest that, to resist this process, we should develop collective consciousness and articulate "meta-hermeneutical resources," or thick concepts which encode critique of other, ill-fitted concepts (e.g. "slut-shaming" or "fat-shaming"). (shrink)

If each of the subtypes of autism is defined simply as constituted by a set of symptoms, then the criteria for its observation are straightforward, although, of course, some of those symptoms themselves might be hard to observe definitively. Compare with telling whether or not someone is bleeding: while it might be hard to tell if someone is bleeding internally, we know what it takes to find out, and when we have the right access and instruments we can settle the (...) issue. But matters are not so simple for the autism subtypes. For one thing, how do we settle which symptoms to group together under one heading? One key difference between “autism disorder” and “Asperger’s disorder” is that the former exhibit language delays (sometimes extreme), whereas the latter do not. But is that a sign of genuinely distinct conditions or is that an artifact of the distinct groups of subjects that Leo Kanner and Hans Asperger worked with? And in general, although there are certainly types of behavior that are taken to be indicative of autism, none by itself is taken by diagnosticians to be either necessary or sufficient for a definitive diagnosis for any of the autism subtypes. What is the diagnostician to do? This is not merely an academic issue, as many parents can attest. Are we in a situation, then, that each practitioner has his or her own “pet” signs that are the “real keys” to the diagnosis? That would suggest that the term “autistic” might meet the fate of the outdated term “neurotic,” which turned out to be a pseudo-scientific term for an inexact clumping together of unrelated phenomena. The assumption amongst specialists seems to be that we will reach the point with "autism" that we have with "water": there will be a root essence to autism whose presence or absence settles a diagnosis. If that is to be the case, however, we have to settle the level of application of the concept. Does the term apply to people who exhibit particular behaviors? Or is it possible to exhibit “autistic” behaviors without actually being autistic, because autism is instead a particular feature of the mind (as, for example, in Baron-Cohen’s “impaired theory of mind module” theory, discussed below) which usually but not necessarily has behavioral effects? Or is autism located instead in the brain, perhaps in damage to key areas, which in turn would typically have an effect on modules of the mind? Or perhaps autism is located in genetics or biology, so that some people with damage to the brain caused by accidents so that they exhibit autistic symptoms would not actually be autistic. Conversely, supposing one had an “autistic brain” but showed none of (or not a sufficient number of) the symptoms, would one not be autistic? The assumption is that the genotypes and phenotypes will line up neatly, but if they do not, what happens to the concept “autistic?” (There is an analogy in the philosophy of sex and gender: androgen insensitive individuals tend to self-identify as female and have outward female traits, but have XY chromosomes—should we go with chromosomes or self-identity in assigning sex category?) Finally, the implications for these complications for diagnosis and categorization, with the attendant social and medical implications is discussed. The typical assumption of the medical profession is that autism cannot be “cured.” That assumes that autism is not simply the symptoms. However, at the same time, the tests used to diagnose ASDs work simply from the symptoms (for example, Baron-Cohen’s Sally/Anne test, which ASD children of a certain age almost all fail, but which practically no ASD adult fails). This implies an inherent confusion over the status of the concept. I conclude that attempts to make sense of some true or accurate summary of what it is to be autistic (such as one would find in the DSM) are almost certainly misguided and will vanish into history along with “neurotic.” But as with racial terms, which are similarly shifting and perverse, the term has already passed into the public sphere and will have a lasting and dangerous influence beyond its short scientific shelf-life. (shrink)

Legal theorists have characterized physical evidence of brain dysfunction as a double-edged sword, wherein the very quality that reduces the defendant’s responsibility for his transgression could simultaneously increase motivations to punish him by virtue of his apparently increased dangerousness. However, empirical evidence of this pattern has been elusive, perhaps owing to a heavy reliance on singular measures that fail to distinguish between plural, often competing internal motivations for punishment. The present study employed a test of the theorized double-edge pattern using (...) a novel approach designed to separate such motivations. We asked a large sample of participants (N = 330) to render criminal sentencing judgments under varying conditions of the defendant’s mental health status (Healthy, Neurobiological Disorder, Psychological Disorder) and the disorder’s treatability (Treatable, Untreatable). As predicted, neurobiological evidence simultaneously elicited shorter prison sentences (i.e., mitigating) and longer terms of involuntary hospitalization (i.e., aggravating) than equivalent psychological evidence. However, these effects were not well explained by motivations to restore treatable defendants to health or to protect society from dangerous persons but instead by deontological motivations pertaining to the defendant’s level of deservingness and possible obligation to provide medical care. This is the first study of its kind to quantitatively demonstrate the paradoxical effect of neuroscientific trial evidence and raises implications for how such evidence is presented and evaluated. (shrink)

The Consequentialist Scale (Robinson, 2012) [89] assesses the endorsement of consequentialist and deontological moral beliefs. This study empirically investigated the application of the Greek translation of the Consequentialist Scale in a sample of native Greek speakers. Specifically, 415 native Greek speakers completed the questionnaire. To uncover the underlying structure of the 10 items in the Consequentialist Scale, an Exploratory Factor Analysis (EFA) was conducted. The results revealed a three-factor solution, where the deontology factor exhibited the same structure as the original (...) work by Robinson (2012) [89], while the original consequentialism factor split into two separate factors. Significant Pearson's r correlations were observed between age and responses to the Consequentialist Scale. Separate EFAs were conducted for two age groups based on a medial split: younger (36 years old or less) and older (more than 36 years old). Interestingly, the younger group exhibited a two-factor solution with the same structure as the original work, while the older group showed a three-factor solution. A hierarchical k-means cluster analysis revealed that the cluster of participants who scored higher in deontology compared to consequentialism primarily consisted of older participants, whereas the two other clusters comprised of younger participants exhibited the reverse pattern. Neither gender nor previous experience with philosophy significantly affected scores on the Consequentialist Scale. Overall, our study provides evidence that the Consequentialist Scale is suitable for use in the Greek population. (shrink)

Human rights may feel self-apparent to us, but less than 80 years ago, one of the most advanced countries at the time acted based on an utterly contrary ideology. The view of social Darwinism that abandoned the idea of the intrinsic value of human lives instead argued that oppression of the inferior is not only inevitable but desirable. One of the many catastrophic outcomes is the medical data obtained from inhuman experiments at concentration camps. Ethical uncertainty over whether the (...) resulting insights should be a part of the medical literature provides a chance to consider the seemingly irreplaceable social construct of human dignity. Would any medical benefit justify the utilization of this illicit data? Would utilization even qualify as an insult to the dignity of the exploited subjects, or is this a question about intersubjective meaning? This work discusses the wisdom in blind adherence to human dignity, the possibility of retrospective insults, moral complicity, contrary viewpoints, and possible resolutions. (shrink)

This study is an attempt to analyze the factors that have contributed towards the success of the Democratic Party of Albania. It seeks to introduce new dimensions in measuring the success of a political party. The study rejects the elements of ‘office-holding’ and ‘policy – or performance-based’ measures of success, because they are determined by a complex array of economic, political, social and institutional factors. The concept of “party success” is defined in terms of: ‘breadth’ and ‘durability’. At the same (...) time the study aims at ‘emancipating’ the political parties from the past and macro-institutional factors, to which very often are ascribed the reasons for the perceived failure of politics in Albania. The approach used in this study has regarded the political parties as the real political actors that as such should assume the responsibility for the perceived failures. Neither the lack of political culture, nor the communist system, are the main factors to shape the activity and development of political parties in Albania. Both macro-institutional and historical structural approach has limited explanatory power for the success of the Democratic Party. Its success is a direct consequence of the decisions that the political parties themselves, including Democratic Party as one of the key actors, have taken. The research showed that the Democratic Party of Albania has been successful because and when its elite have been able to craft inclusive ideological programs and because of its extensive penetration in the country, which it owes to its structure as a mass party. The party has established patronage linkages with its sympathizers, the rank and file and militants and consequently has ensured their loyalty and maintained an extensive electoral penetration in country. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist (...) view that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

Our present day knowledge in the area of medicine in Ancient Egypt has been severally sourced from medical papyri several of which have been deduced and analyzed by different scholars. For educational purposes it is always imperative to consult different literature or sources in the teaching of ancient Egypt and medicine in particular. To avoid subjectivity the author has found the need to re-engage the efforts made by several scholars in adducing evidences from medical papyri. In the quest (...) to re-engage the efforts of earlier writers and commentaries on the medical papyri, we are afforded the opportunity to be informed about the need to ask further questions to enable us to construct or reconstruct both past and modern views on ancient Egyptian medical knowledge. It is this vocation the author sought to pursue in the interim, through a preliminary review, to highlight, comment and reinvigorate in the reader or researcher the need for a continuous engagement of some pertinent documentary sources on Ancient Egyptian medical knowledge for educational and research purposes. The study is based on qualitative review of published literature. The selection of those articles as sources was based on the focus of the review, in order to purposively select and comment on articles that were published based either on information from a medical papyrus or focused on medical specialization among the ancient Egyptians as well as ancient Egyptian knowledge on diseases and medicine. It was found that the Egyptians developed relatively sophisticated medical practices covering significant medical fields such as herbal medicine, gynecology and obstetrics, anatomy and physiology, mummification and even the preliminary form of surgery. These practices, perhaps, were developed as remedies for the prevailing diseases and the accidents that might have occurred during the construction of their giant pyramids. It must be stated that they were not without flaws. Also, the key issues raised from these literatures are but a few among the Egyptian medical corpus across the academic and publishing world. It should therefore afford researchers, students and readers the opportunity to continue the educational dialogue on the medical practices of the Ancient Egyptians. (shrink)

In this paper I describe a novel application of contemplative techniques to software engineering with the goal of augmenting the intellectual capabilities of knowledge workers within the field in four areas: flexibility, attention, creativity, and trust. The augmentation of software engineers’ intellectual capabilities is proposed as a third complement to the traditional focus of methodologies on the process and environmental factors of the software development endeavor. I argue that these capabilities have been shown to be open to improvement through the (...) practices traditionally used in spiritual traditions, but now used increasingly in other fields of knowledge work, such as in the medical profession and the education field. Historically, the intellectual capabilities of software engineers have been treated as a given within any particular software development effort. This is argued to be an aspect ripe for inclusion within software development methodologies. (shrink)

Euthanasia and the duty to die have both been thoroughly discussed in the field of bioethics as morally justifiable practices within medical healthcare contexts. The existence of a narrow connection between both could also be established, for people having a duty to die should be allowed to actively hasten their death by the active means offered by euthanasia. Choosing the right time to end one’s own life is a decisive factor to retain autonomy at the end of our lives. (...) However, there is no definitive consensus on why physicians should be the ones performing the medical procedure to end a person’s life. The moral problems arising from such assertion are not to be taken lightly, for medical tradition has long regarded the duty not to kill, not to actively end a patient’s life, as the core moral obligation that gives meaning to the medical profession. Our concern is to question the moral justifiability of the arguments offered by physicians not to actively help patients die. (shrink)

The Hippocratic Oath is a code of ethics defining correct behaviour by physicians they are required to commit themselves to before being accepted into the profession. It was the first code of ethics for any profession. While originating in Ancient Greece, it subsequently evolved, but the current code still embodies many of the core injunctions of the original code. The most widely accepted current form is the 2006 The Declaration of Geneva by the World Medical Association to be taken (...) before being admitted as a member of the medical profession. The most important of its injunctions are: ‘The health of my patient will be my first consideration’ and ‘I will maintain the utmost respect for human life’. The first is a rewording of the injunction from Epidemics, Book I, of the Hippocratic school: ‘Practice two things in your dealings with disease: either help or do not harm the patient.’ This was later simplified to the most basic precept of the Hippocratic Oath: ‘First, do no harm.’ It is one of the principal precepts of bioethics that all students in healthcare that, given an existing problem, it may be better not to do something, or even to do nothing, than to risk causing more harm than good. The development of neurotechnology could be subsumed with little modification under the Geneva formulation of the Hippocratic Oath, extending this precept to a commitment not to damage people’s psychological health. (shrink)

Ideological diversity has been on the research agenda in the social sciences for a couple of years. Yet in philosophy, the topic has not attracted much interest. This article tries to start filling this gap. We discuss a number of possible causes for the underrepresentation of right-wing and conservative philosophers in the academic profession. We also argue why this should be an important concern, not only morally, but also and primarily epistemically. Lastly, we explore whether the situation in philosophy is (...) more problematic than the situation in other fields, and what kind of ideological diversity would be desirable for academic philosophy. (shrink)

Browne 1 (this issue ) argues that what may appear to be a benevolent practice-disclosing the sex of a fetus to expecting parents who wish to know-is in fact an epistemically problematic and, as a result, ethically questionable medical practice. Browne worries that not only will the disclosure of fetal sex encourage sex-selective abortions (an issue we will not take up here), but also that it will convey a misleading and pernicious message about the relationship between sex and gender. (...) More specifically, she contends that the practice of disclosure is problematic because (1) it purports to establish the gender of the developing baby based on information about the baby's sex, whereas this is not a warranted inference because while sex is determined by biological factors, gender is determined by social factors and (2) it conflates (biological) sex with (social) gender or encourages such conflation or reduction and thereby promotes 'essentialistic' thinking about gender that is closely linked to sexism and social injustice. If (1) is true, then disclosing fetal sex amounts to misinforming or misleading prospective parents-and since misinforming patients is wrong, the act of disclosing is also wrong. However, beyond the wrongs of misinforming patients, the practice also perpetuates the harms associated with a rigidly gendered society through endorsing the message in (2), thus lending the authority of the medical profession to the gender-essentialist ideas that have underpinned, and continue to drive, sexism and social injustice. This analysis leads Browne to recommend that clinicians be prohibited from informing parents about the sex of their developing fetus. -/- We agree with Browne that gender essentialism-the notion that 'femaleness' and 'maleness' carve out distinct natural classes with innate, immutable properties-is not only a false metaphysical thesis, but also a pernicious idea insofar as the sexist attitudes it fosters motivate policies that systematically violate the human rights of women, as well as those of the LGBTQ community. However, we do not think that the disclosure of fetal sex misinforms prospective parents about the gender of their baby, nor do we believe that such disclosure presupposes or promotes gender essentialism properly understood. (shrink)

This paper critically engages Philip Mirowki's essay, "The scientific dimensions of social knowledge and their distant echoes in 20th-century American philosophy of science." It argues that although the cold war context of anti-democratic elitism best suited for making decisions about engaging in nuclear war may seem to be politically and ideologically motivated, in fact we need to carefully consider the arguments underlying the new rational choice based political philosophies of the post-WWII era typified by Arrow's impossibility theorem. A distrust (...) of democratic decision-making principles may be developed by social scientists whose leanings may be toward the left or right side of the spectrum of political practices. (shrink)

Is the history of philosophy primarily a contribution to PHILOSOPHY or primarily a contribution to HISTORY? This paper is primarily contribution to history (specifically the history of New Zealand) but although the history of philosophy has been big in New Zealand, most NZ philosophers with a historical bent are primarily interested in the history of philosophy as a contribution to philosophy. My essay focuses on two questions: 1) How did New Zealand philosophy get to be so good? And why, given (...) that is so good (a point I am at pains to establish), has it apparently had so slight a cultural impact within New Zealand itself? Did we get the wrong Anderson – the uninspiring William, who was Professor at Auckland, rather than his talented younger brother John, who had such a huge cultural influence as Professor of Philosophy at Sydney? Perhaps but that can only be part of the story since we managed to attract even bigger stars, (notably Karl Popper) as well as breeding bigger talents of our own (Prior, Baier, Bennett, Mulgan, Hursthouse, Waldron and many more). Do we export our best talent? Sometimes – but the stars that stay and the stars who arrive don’t seem to have much impact in New Zealand itself however brightly they shine in the international philosophical firmament. Is it too esoteric? Perhaps, but esoteric philosophy can still have a cultural impact, witness, Moore, Popper and the younger Anderson. Is it, like many of New Zealand’s cultural products (from romance novels to movies), primarily intended for an international audience? That’s a large part of the answer but only a part. Another part of the answer is that philosophy HAS had a cultural impact but that impact is not readily apparent. For NZ philosophers have been less keen to push their ideological barrows and more keen to produce critical thinkers, and critical thinkers don’t all think alike. The logician George Hughes was apparently a life-changing teacher not because he had a nostrum but because he taught people to think. As one of his students said ‘the only ism you believe in is the syllogism’. On the whole the history of New Zealand Philosphy is a ‘From Log Cabin to White House’ tale, ‘From colonial obscurity through struggle and adversity to philosophical excellence’. But there are shadows in the picture. Some departments have nearly come to grief through bureaucratic and political misadventures, and it is hard to resist the suspicion that there is often an element of hostility to philosophers on the part of both university bureaucrats and fellow-academics. I speculate as to why this is the case (we are too argumentative and don’t confine our argumentative tendencies to the cloister) but conclude with some upbeat reflections. on the future of New Zealand Philosophy. (shrink)

The practice of screening potential users of reproductive services is of profound social and political significance. Access screening is inconsistent with the principles of equality and self-determination, and violates individual and group human rights. Communities that strive to function in accord with those principles should not permit access screening, even screening that purports to be a benign exercise of professional discretion. Because reproductive choice is controversial, regulation by law may be required in most jurisdictions to provide effective protection for reproductive (...) rights. In Canada, for example, equal access can, and should be, guaranteed by federal regulations imposing strict conditions on the licences of fertility clinics. (shrink)

—This paper sets out to re-examine the impact of global television on the behavior of youths in Nigeria. The paper identifies cultural imperialism as the most significant impact of global television achieved through programs like sports, drama, musicals, and violent movies transmitted to Nigeria and other third world nations. These programs are transmitted under the guise of informative, educational and entertainment programs while the Nigerian youths are the most affected victims. Through careful analysis of previous researches and literatures, this paper (...) posits that Nigerian youths are caught between the dilemma of the foreign cultures and their indigenous cultures in terms of dress codes, speech, dance and the general ideologies. This paper concludes that aggressive cultural communication and government’s programs targeted at youths at all levels are one of the suggestions that can help tame the cultural dilemma among the youth. (shrink)

James Rachels’s distinction between killing and letting die maintains that there is morally no difference between killing a terminally ill patient and letting him/her die. Therefore, active and passive euthanasia dichotomy is a distinction without a difference. Hence, if passive euthanasia is allowed, active euthanasia should be permitted too. The paper demonstrated that the distinction between killing and letting die is: (1) irrelevant to euthanasia(2) extraneous to the medical profession, and (3) methodologically degressive. Furthermore, the paper demonstrated invalidity of (...) the bare difference argument of Rachels based on the distinction because of four reasons: (1) irrelevance to American Medical Association’s statement; (2) differences between the cases such as intentionality, causality, and agency; (3) straw man fallacy, (4) and weak analogy. Therefore, the paper concluded that relating the distinction between killings and letting die to bioethics and euthanasia is unjustifiable. (shrink)

The observation that a crisis of confidence regarding Psychiatry exists is a notion shared even among psychiatrists themselves. Psychiatry has a checkered history and its alliance with the pharmaceutical industry, aka Big-Pharma, continues to reinforce a need for healthy skepticism. Why? Mainly, an over-reliance on the questionable expertise and authority afforded psychiatry as the specialists of mental health. I contend that the authority of psychiatry is misplaced and too often harmful. Since the criteria required to justify and satisfy psychiatric expertise (...) is not fully established as can be substantiated by compelling reasons to rethink its authority as a reliable profession in its current form. Psychiatric expertise is not particularly scientific and this is especially dangerous in a sector that prescribes mind-altering drugs. There are a number of identified criteria that would otherwise substantiate psychiatric expertise and whilst partially existent, are nonetheless deficient. These major yet deficient aspects of psychiatric practice concern diagnostic problems – reliability and verification of diagnoses and accurate testable validity of diagnoses - mainly due to an absence of identifiable underlying biomarkers ordinarily related to disease or biological conditions. Psychiatrists often fail to distinguish between reactive-depression (reaction to external event or circumstance) and endogenous-depression (biological) resulting, in part, from incorrectly distinguishing between conditions constitutive of ‘trait’ (endogenous) and of those of ‘state’ (e.g. reactive depression; adverse effects from medication, etc.). (shrink)

A new world has probably emerged through the progression of technology which has led to significant debates on social, cultural, legal, and ethical issues, especially in the biomedical field in this century. Application of physician-patient relationship, principles of pluralism, autonomy, democracy, human dignity, and human rights is being challenged within the medicine and health-care system of today. Development of technology-based remedies has fostered greater degrees of medicalization. Hence, the automatic application of such technologies risks distorting the nature of medicine. To (...) be sure, there is a cultural shift that is affecting the society that is increasingly unable to adapt to traditional legal systems. This cultural shift, perhaps, demands new ethics. This entry aims to evaluate the gap between traditional deontological nature of medicine and the emerging new ethics and assess why bioethical reflection is needed. (shrink)

Background Bronchial asthma is one of the most common chronic conditions among children. Despite the improvement in asthma treatment regimens, its prevalence and related morbidity are increasing, especially among underserved, minority children. There are barriers in the management of asthma, which may impact the quality of outcomes. The goal of this study is to explore these barriers. Methods A cross-sectional study was conducted on interview data collected through 2019 from mothers of children (aged 6 - 12 years) with asthma visiting, (...) for convenience, a public shopping mall. The interviewees were randomly selected, because they met the inclusion criteria. Participants were considered if the mother answered “yes” to the following questions: Has your child had physician-diagnosed asthma? Is your child currently taking asthma medications of asthma? Two community nurses conducted the interviews. Data was obtained using administrative questionnaires. Data were analyzed using SPSS version 21.0 (IBM Inc., Chicago, IL, USA). Descriptive statistics of percentage, mean, frequency and standard deviation were applied for categorical and continuous variables. Results Three hundred mothers participated in this study. Their average age was 36.8 years, 55% were housekeepers by profession, and 34% had obtained less than high school education. The majority of children (61%) were males, 45% had moderate asthma, and 42% had mild asthma. The most frequent types of barriers identified by parents were environmental factors (67.7%), followed by health care providers (63%), the health care system (48%), and patient or family characteristics (43%). Mothers were specifically concerned about the use, safety, and long-term complications of medications, the impact of exercise limitation on their child’s quality of life, and their own quality of life. Conclusion This study showed several barriers against asthma care in Saudi Arabia, which mainly related to environmental or personal characteristics. This highlights the need to enhance current policies within the health care system in Saudi Arabia to overcome these barriers. (shrink)

It is easier to talk frankly to a person whom one trusts. It is also easier to agree with a scientist whom one trusts. Even though in both cases the psychological state that underlies the behavior is called ‘trust’, it is controversial whether it is a token of the same psychological type. Trust can serve an affective, epistemic, or other social function, and comes to interact with other psychological states in a variety of ways. The way that the functional role (...) of trust changes across contexts and objects is further complicated when communities and individuals mediate it through technologies, and even more so when that mediation involves artificial intelligence (AI) and machine learning (ML). In this chapter I look at the ways in which trust in institutions, and specifically the medical profession, is affected by the use of AI and ML. There are two key elements of this analysis. The first is a disanalogy between institutional trust in medicine and institutional trust in science (Irzik and Kurtulmus 2021, 2019; Kitcher 2001). I note that as AI and ML become a more prominent part of medicine, trust in a medical institution becomes more like trust in a scientific institution. This is problematic for institutional trust in medicine and the practice of medicine, since institutional trust in science has been undermined by, among other things, the spread of misinformation online and the replication crisis (Romero 2019). There is also a strong analogy between the psychological state of the person who trusts a scientific report or testimony and the psychological state of a patient who trusts individual recommendations made by a medical professional in a clinical setting. In both cases, institutional trust makes it less likely that a mistake or malfeasance will result in reactive attitudes, such as blame or anger, directed at other individual members of that institution. However, it also renders people vulnerable enough to blame the institution itself. This, with time, can erode trust in the institution and naturally leads to policy recommendations that aim to preserve institutional trust. I survey two ways in which that can be done with institutional trust in medicine in the age of AI and ML. (shrink)

This study investigates the nature of academic work in contemporary academia, which is set in an under-researched context, Vietnam. The research context is unique in its blending between long and rich cultural values and Western ideologies in management. The study examines how Vietnamese academics practice their academic roles in response to the interactions of those two domains. -/- Avoiding the approach of seeking for evidence of negative impacts of managerial controls on aspects of academic life as commonly used in the (...) existing literature, this study focuses on analysing the complexities in relationships of individual academics with management and other actors including managers, colleagues, students and scholar community. This approach is advanced in understanding both social and individual meanings in academic work as well as the social and cultural values which shape their perception of academic roles. -/- The research enquiry of producing an insight into academics’ work life and experience in contemporary academia informs a qualitative and interpretive research. The findings suggest that the application of managerial controls is less challenged whilst highly accepted in Vietnamese higher education as a context under the influence of Confucianism. The evidence of academics’ compliance and collective actions underpinned by Vietnamese cultural values in this study offers to reconsider the discrepancy of the nature of these phenomena in the belief of the West and the East. The study’s exploration of being an academic as multi-layered meanings expanding from within and outside of university roles proposes academics’ potential strengths in coping with insecurity and ambiguity at work. It then sharpens the suggestion that contemporary management in higher education needs to be mindful of the emotional-related and meaningful nature of academic profession for the best outcomes of both individual work and organisational aims rather than relying on either soft or hard controls. (shrink)