Patients in Quebec can legally obtain medical assistance in dying (MAID) if they are able to give informed consent, have a serious and incurable illness, are at the end of their lives and are in a situation of unbearable suffering. Since the Supreme Court of Canada’s 2015 Carter decision, access to MAID, under certain conditions, has become a constitutional right. Quebec physicians are now likely to receive requests for MAID from their patients. The Quebec and Canadian laws recognize a physician’s (...) right to conscientious objection, but this right is contested both in the medical ethics literature and in the public sphere. This paper presents the results of a qualitative study conducted with twenty Quebec physicians who did not integrate MAID into their medical practice, either because they were opposed to or deeply ambivalent about MAID. The interviews aimed to explore the reasons – religious and secular – for opposition to or ambivalence towards MAID. The secular reasons given by participants were grouped into four main categories: 1) the ends of medicine and professional identity, 2) the philosophy of palliative medicine and resource allocation in palliative care, 3) benevolent paternalism, the “good death”, and the interests of future selves, 4) the risk of a slippery slope and the protection of vulnerable people. (shrink)

Morality meters are a commonly used mechanic in many ethically notable video games. However, there have been several theoretical critiques of such meters, including that people can find them alienating, they can instrumentalise morality, and they reduce morality to a binary of good and evil with no room for complexity. While there has been much theoretical discussion of these issues, there has been far less empirical investigation. We address this gap through a qualitative study that involved participants playing (...) a custom-built visual novel game (The Great Fire) with different intuitive and counter-intuitive morality meter settings. Overall, we found that players’ attitudes towards the morality meter in this game was complex, context sensitive and variable throughout gameplay and that the intuitiveness of the meter encouraged participants to treat the meter more ‘as a moral guide’ that prompts reflection and less ‘as a score’ to be engaged with reactively. (shrink)

Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and (...) human rights. Methods This study used qualitative data from an internet-based survey distributed to the mailing list of the UK charity Bipolar UK, which contained multiple closed and open questions on advance decision-making in bipolar disorder. Quantitative analysis of a closed question about self-binding directives had already demonstrated endorsement amongst a very high proportion of participants with bipolar disorder who completed the survey. We conducted thematic analysis of responses from those participants who answered a subsequent open question about reasons for their view. Research was co-produced within a multi-disciplinary team, with clinical, legal, and ethical expertise, and lived experience of bipolar disorder. Ideas and methodologies associated with all these areas of expertise were used in the analysis of these reasons and to gain insight into the thoughts of individuals with bipolar disorder about self-binding directives and associated issues. Findings Between Oct 23 and Dec 5, 2017, 932 individuals with a self-reported clinical diagnosis of bipolar disorder completed the internet survey, with 565 (154 men; 400 women; 11 transgender or other) providing free text answers to the open question. A large majority of respondents endorsed self-binding directives, nearly all describing a determinate shift to types of distorted thinking and decision-making when unwell as their key justification. Responses indicating ambivalence were dominated by logistical concerns about the drafting and implementation of self-binding directives, while those who rejected self-binding directives also cited logistical concerns, validity of their thinking when unwell, and potential contravention of human rights. Interpretation This study is, to our knowledge, the first large study of reasons why mental health service users might endorse or reject the use of self-binding directives. The findings provide empirical support for introducing self-binding directives into mental health advance decision-making practice and policy and may help to address enduring ethical concerns surrounding possible implementation of the directive while a person retains decision-making capacity. The opinions expressed here in responses given by multiple service users with bipolar disorder challenge a prominent view within international disability rights debates that involuntary treatment and recognition of impaired mental capacity constitute inherent human rights violations. Funding The Wellcome Trust . (shrink)

Social Science relies heavily on the use of ethnography and other forms of qualitative study, research that may place the researcher as well as their subjects at significant ethical risk. In Canada, Research Ethics Boards are responsible for protecting research participants during these studies. But how much ethical oversight ought the Research Ethics Boards be entitled to? Are they repressing valuable qualitative studies or are the Social Science simply rebelling against new but appropriate control mechanisms (...) not formerly applied to them? This paper evaluates how well the changes made in the TCPS 2 respond to the concerns of Social Scientists as presented in the literature. (shrink)

A study was conducted on ethical leadership in institutions of higher education. Objectives of the study were: (i). Illustrate theories of ethical leadership in higher education institutions; (ii) Determine importance of ethical leadership in higher education institutions; and (iii) Determine challenges facing ethical leadership in institutions of higher learning. The total number of written texts sampled was 32. The researcher employed non-probability sampling. The type employed was online convenience sampling using web scraping. The interpretivism philosophical assumption led this (...) investigation, and the qualitative approach was used. Case study was employed as a design and content analysis as a data analysis tool. The study found out that ethical leadership is essential in higher education institutions because it establishes a solid ethical foundation, fosters an environment of integrity, and contributes to the institutions' long-term success and viability. It acts as a model for all stakeholders, motivating them to follow ethical concepts and values in their academic pursuits and institutional responsibilities. The challenges of ethical leadership in higher education institutions range from fiscal limits to issues about diversity, governance, and technology. It is vital for higher education institutions to address these concerns in order to maintain their integrity and efficiency. Recommendations included but were not limited to the following: (i)Ethical leaders should model the behaviour they expect from their staff and students. Show integrity, honesty, and justice in your acts and decisions; (ii) Establish Clear Ethical Standards: Develop an ethical code or set of fundamental ideas for your educational community. Ensure that these expectations are communicated to all stakeholders, including staff, students, parents, and the general public;(iii). Encourage Open Communication: Create an environment in which faculty and students can express concerns and report unethical behaviour. Encourage transparency and active listening while responding to remarks; and (iv). Ethical Decision-Making Training: Provide leaders and personnel with ethical decision-making training and professional development opportunities. Use case studies and real-life occurrences to help in discussions about ethical quandaries. (shrink)

This paper is concerned with two concepts of qualitativeness that apply to intensional entities. I propose an account of pure qualitativeness that largely follows the traditional understanding established by Carnap, and try to shed light on its ontological presuppositions. On this account, an intensional entity is purely qualitative iff it does not ‘involve’ any particular. An alternative notion of qualitativeness—which I propose to refer to as a concept of strict qualitativeness—has recently been introduced by Chad Carmichael. However, Carmichael’s definition (...) presupposes a highly fine-grained conception of properties and relations. To eliminate this presupposition, I tentatively suggest a different definition that rests on a concept of perspicuous denotation. In the penultimate section, both concepts of qualitativeness are put to work in distinguishing between different ‘grades’ of qualitative discriminability. (shrink)

Abstract Aim: The COVID-19 infection is transmitted either by human-to-human contact, social-physical contact, and respiratory droplets or by touching items touched by the infected. This has triggered some conflicted behaviors such as stigma, violence, and opposite behavior applause. The aim of this study is to explore several newspaper articles about stigma, violence, or insensitive behavior against healthcare professionals and to analyze the reason for these behaviors during these COVID-19 pandemics. Method: The website of the Turkish Medical Association "Press Releases (...) News" and online newspaper articles have been scanned using keywords and have been classified and analyzed according to the content of articles between the periods of March 11 to April 28, 2020. This is a qualitative study with content analysis. No official ethical permission was obtained as the study was conducted through open access internet news sites. Result: 16 reports were selected from online reports that matched the keywords of the study. 13 of these reports included desensitization, violence, lack of precaution, stigmatization, and applause, and 3 reports included doctors’ statements. After being categorized, content analyses were conducted. Conclusion: This study revealed the necessity of a multi-faceted evaluation of the problems faced by healthcare professionals who are at the forefront of the COVID-19 outbreak. This study has a primary role in the detection, diagnosis, and treatment of the pandemic and reveals that doctors are trying to fulfill their duties in an ethical framework despite stigmatized behavior. Authorities should provide various supports to protect healthcare professionals before, during, and after the epidemic for the success of the COVID-19 outbreak struggle. (shrink)

Aims and Objectives The purpose of this paper was to clarify the concept of ethical conflict in nursing and highlight the importance of tackling this issue. -/- Background Ethical conflict is on the rise in the nursing context. It is associated with the compromise of nurses' well-being and patient care. However, there is no thorough conceptual understanding of this concept. -/- Design Concept analysis. -/- Methods Databases (PubMed, PsycINFO, CINAHL, Scopus, Embase, Web of Science and SocINDEX) were searched for studies (...) between 1984 and 2021. Both quantitative and qualitative studies related to ethical conflict in nursing were included. Walker and Avant's method of concept analysis was used to identify the defining attributes, antecedents and consequences of the concept of ethical conflict in nursing. We followed the PRISMA-ScR checklist to report the study. -/- Results Thirty studies were included for conceptualization. Defining attributes were divided into four categories: (1) emotional responses, (2) incompatible values, (3) competing interests and (4) ambiguous obligations. The antecedents were (1) ethical sensitivity, (2) negative ethical climate, (3) insufficient authority, (4) unrealistic expectations, (5) poor collaboration and (6) inadequate resources. The consequences were identified as (1) moral residue, (2) loss of identity, (3) professional burnout and (4) poor patient care. -/- Conclusions A unified conceptual model of ethical conflict in nursing shed light on the ethical issues nurses might come across in practice. Despite the fact that ethical conflict is inherently negative, we conceptualised this concept as a neutral fact and an opportunity for nursing action. The construct identification provides basis for both the development of practice and the development of staff support and education. (shrink)

A study was conducted regarding ways in which higher education institutions can improve ethics. Theoretical frameworks used included: Virtue ethics, deontological and environmental ethics theories. The total sampled written texts were 94. Non-probability sampling was used. The type that was used was online convenience sampling through web scraping. Philosophical assumption that guided this study was interpretivism and the approach was Qualitative. Case study was used as a design and content analysis as a method (...) of data analysis. Some of the findings of the study included but were not limited to the following: Higher education's ethical and professional standards are critical for retaining the trust of students, staff, and the larger society. Institutions that prioritise ethics and standards will be better positioned to carry out their goal and positively impact society. The study recommended the following to Higher education stakeholders: Create faculty-led ethics committees to evaluate and advise on ethical issues such as teaching, research, and academic freedom. Make certain that these committees are composed of a diverse spectrum of faculty members with ethics expertise; Create explicit rules and protocols for using AI, machine learning, and big data ethically in academic research and administrative processes. Address the issues of discrimination, privacy, and accountability in AI applications; and Involve alumni in ethics programs and projects to encourage them to support and contribute to ethical education and research. Create opportunities for alumni to advise students on how to develop ethical professions. (shrink)

BACKGROUND Patients with chronic pain face significant barriers in finding clinicians to manage long-term opioid therapy (LTOT). For patients on LTOT, it is increasingly common to have them sign opioid treatment agreements (OTAs). OTAs enumerate the risks of opioids, as informed consent documents would, but also the requirements that patients must meet to receive LTOT. While there has been an ongoing scholarly discussion about the practical and ethical implications of OTA use in the abstract, little is known about how clinicians (...) use them and if OTAs themselves modify clinician prescribing practices. OBJECTIVE To determine how clinicians use OTAs and the potential impacts of OTAs on opioid prescribing. DESIGN We conducted qualitative analysis of four focus groups of clinicians from a large Midwestern academic medical center. Groups were organized according to self-identified prescribing patterns: two groups for clinicians who identified as prescribers of LTOT, and two who did not. PARTICIPANTS 17 clinicians from General Internal Medicine, Family Medicine, and Palliative Care were recruited using purposive, convenience sampling. APPROACH Discussions were recorded, transcribed, and analyzed for themes using reflexive thematic analysis by a multidisciplinary team. KEY RESULTS Our analysis identified three main themes: (1) OTAs did not influence clinicians’ decisions whether to use LTOT generally but did shape clinical decision-making for individual patients; (2) clinicians feel OTAs intensify the power they have over patients, though this was not uniformly judged as harmful; (3) there is a potential misalignment between the intended purposes of OTAs and their implementation. CONCLUSION This study reveals a complicated relationship between OTAs and access to pain management. While OTAs seem not to impact the clinicians’ decisions about whether to use LTOT generally, they do sometimes influence prescribing decisions for individual patients. Clinicians shared complex views about OTAs’ purposes, which shows the need for more clarity about how OTAs could be used to promote shared decision-making, joint accountability, informed consent, and patient education. (shrink)

Objective: This main aim of the study is to explore COVID-19 pandemic problems from the perspective of public health-clinical care ethics through online mediareports in Turkey. Method: This research was designed as a descriptive and qualitative study that assesses COVID-19 through online media reports on critics between the periods of March 11, 2020 and April 2 2020 as a quantitative as number of reports and qualitative study, across Turkey. Reports were from Turkish Medical Association (...) websites which included newspaper reports. Study data were presented as statistically and qualitative data case and headlines. No ethical or ofTicial permission was sought as the study was conducted through open access internet news sites. Results: This online reports analysis retrieved about 6723 articles about the COVID-19. According to study data, information about COVID-19 were themed as follows: general deTiciencies in taking action and isolation, lack of isolation, passengers and transport vehicles not quarantined ; insufTicient diagnostic tests, decision to test after healthcare professionals become infected, lack of equipment, lack of evaluation outbreak countries [Table 2]. Conclusion and Suggestions: COVID-19 is a pandemic and is a global public health problem that concerns every individual and needs to be handled carefully. This requires a multi-faceted preparation and education. In this context, healthcare professionals should be well trained in this aspect and have all the necessary equipment throughout the process. Additionally, it should work systematically with the cooperation of all health organizations, the Ministry of Health, local governments and of course the media, in order to inform society, fairly distribute the resources and to implement the safety measures effectively. BrieTly, lack of transparency, insufTicient information, limited resources, lack of public health protection measures such as partial quarantine decision, partial implementation of the scientiTic board's re c ommenda ti on s fo r e c on omi c rea s on s, and contradiction of the explanations are revealed as serious ethical problems. (shrink)

This study develops a Science–Technology–Society (STS)-based science ethics education program for high school students majoring in or planning to major in science and engineering. Our education program includes the fields of philosophy, history, sociology and ethics of science and technology, and other STS-related theories. We expected our STS-based science ethics education program to promote students’ epistemological beliefs and moral judgment development. These psychological constructs are needed to properly solve complicated moral and social dilemmas in the fields (...) of science and engineering. We applied this program to a group of Korean high school science students gifted in science and engineering. To measure the effects of this program, we used an essay-based qualitative measurement. The results indicate that there was significant development in both epistemological beliefs and moral judgment. In closing, we briefly discuss the need to develop epistemological beliefs and moral judgment using an STS-based science ethics education program. (shrink)

Background Genomic research on neurodevelopmental disorders (NDDs), particularly involving minors, combines and amplifies existing research ethics issues for biomedical research. We performed a review of the literature on the ethical issues associated with genomic research involving children affected by NDDs as an aid to researchers to better anticipate and address ethical concerns. Results Qualitative thematic analysis of the included articles revealed themes in three main areas: research design and ethics review, inclusion of research participants, and communication of (...) research results. Ethical issues known to be associated with genomic research in general, such as privacy risks and informed consent/assent, seem especially pressing for NDD participants because of their potentially decreased cognitive abilities, increased vulnerability, and stigma associated with mental health problems. Additionally, there are informational risks: learning genetic information about NDD may have psychological and social impact, not only for the research participant but also for family members. However, there are potential benefits associated with research participation, too: by enrolling in research, the participants may access genetic testing and thus increase their chances of receiving a (genetic) diagnosis for their neurodevelopmental symptoms, prognostic or predictive information about disease progression or the risk of concurrent future disorders. Based on the results of our review, we developed an ethics checklist for genomic research involving children affected by NDDs. Conclusions In setting up and designing genomic research efforts in NDD, researchers should partner with communities of persons with NDDs. Particular attention should be paid to preventing disproportional burdens of research participation of children with NDDs and their siblings, parents and other family members. Researchers should carefully tailor the information and informed consent procedures to avoid therapeutic and diagnostic misconception in NDD research. To better anticipate and address ethical issues in specific NDD studies, we suggest researchers to use the ethics checklist for genomic research involving children affected by NDDs presented in this paper. (shrink)

The current study presents the professional experiences of senior teacher educators (‘Associate Professors’), with an emphasis placed on ethical dilemmas they face during their administrative work. The main purpose is to characterize the critical incidents underlying these dilemmas, their interpretation, and the ways of balancing the different considerations in their resolution. A qualitative analysis of twelve narrative interviews pointed to four core values which underpinned the approaches taken by teacher educators in their handling of critical situations: perception of (...) integrity, empathy and care, commitment to the institution, and the need to promote initiatives. Findings indicate that the concept of integrity is central to the decision making processes, but that this concept is interpreted differently according to the personality characteristics, experience, and educational vision of the interviewees. It is proposed to conduct further studies that examine the interpretation of ‘integrity’ as a concept among senior teacher educators. (shrink)

Technology has already been part of our way of life. It is being used in the social world for social innovation and communication. It has become significant in human world for creation, but has also become an instrument for destruction. It challenges human reason for it becomes the reason itself. Such human reason is the essence of humanity, hence, humanism is equated to human reason. Likewise, it claims the ending of humanism for it enters in the discourse of posthumanism in (...) the technological realm. In this case, there is a need to clarify the idea of posthumanism that at same time uphold and will robust the sense of humanity. The study aims to articulate ethical concepts based on the idea of posthumanism as the study argues posthumanism as the synthesis of man and technology relation. The research design is qualitative in nature specifically a philosophical research employing two levels of analysis; synthesis and constructivism. The former is used to explicate and consolidate ideas on posthumanism and the latter is used to form concepts and principles on the ethical valuations. The study then presented threefold principles based on the ethical valuations on posthumanism vested in neutral position. (shrink)

This dissertation explores the influence of time constraints on different research practices. The first two parts present case studies, which serve as a basis for discussing the epistemological and ethical implications of temporal limitations in scientific research. Part I is a case study on gravitational wave research, conducted by the LIGO Scientific Collaboration. This exemplifies fundamental research – without immediate societal applications, open-ended in terms of timeline and in terms of research goals. It is based, in part, on (...) class='Hi'>qualitative interviews conducted with gravitational wave physicists. I show that considerations about time and speed play a role in every stage of research: goal setting, method design, and the evaluation and communication of results. Part II provides a case study on translational medicine, an approach explicitly dedicated to accelerating research in order to develop and implement new therapies. This epitomizes applied research with high social stakes, motivated by non-epistemic goals. Here, epistemic trade-offs between speed and reliability intersect with ethical trade-offs between different types of harms. In Part III, the insights from both of these case studies are used as the basis for a more general discussion concerning the pragmatic aspects of epistemic practices, especially in relation to current debates centered on the role of values in science. A particular focus is on the value of speed and the ability to generate reliable results, either via choice of methods, or via decisions about which goals to set, as well as decisions about when to stop further testing. The primary thesis of the dissertation is that pragmatic considerations stemming from limitations of resources are a necessary feature of the pursuit of epistemic aims, and that the epistemic is thus inherently pragmatic. (shrink)

Does DBS change a patient’s personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson’s disease and Primary Dystonia and some case reports, but there has been no qualitative (...) class='Hi'>study yet with patients suffering from psychiatric disorders. In this paper, we present the experiences of 18 patients with Obsessive-Compulsive Disorder (OCD) who are undergoing treatment with DBS. We will also discuss the inherent difficulties of how to define and assess changes in personality, in particular for patients with psychiatric disorders. We end with a discussion of the data and how these shed new light on the conceptual debate about how to define personality. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of a systematic (...) literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

Aim: The aim of this study is to reveal the convergence of public health ethics, institutional, collective, and individual ethics obligation during the COVID-19 pandemic and give some explanations with online media reports. Method: The study method is qualitative content analysis; this method was chosen as it would suit best the purpose of the study. The Turkish Medical Association, Turkish Public Health Association, and online newspaper articles and videos have been scanned using keywords. After (...) that, related online reports and interviews have been classified and analyzed according to the context in between May 22, 2020 and November 16, 2020. No official ethical permission was obtained as the study was conducted through open access internet news sites. Results: The COVID-19 scientific committee and the Ministry of Health has suggested a new way of normal life called controlled social life for all places in Turkey. In the frame of these recommendations, with the Google research engine, many articles of online media including some announcements of medical and legal associations, interviews, and calls made by the authorities were selected and analyzed. These articles and interviews containing each problem and pieces of information provided for the common understandings of the society were selected and evaluated at three topics individual, collective and state and institutional responsibility and obligations. Conclusion: Although the warnings of associations, health authorities, and scientists are mostly about personal-civil responsibility, some occurring practices have caused violations. In addition, the level of education, perception capacity, and habits that include existing social-cultural and religious rituals have prevented people from adapting to this new style of life, in other words, controlled social life. Therefore, besides the original national culture and customs, universal ethical responsibilities and obligations should teach starting from primary school and should consist of whole life understanding as a higher perspective. (shrink)

Family members can provide crucial support to individuals participating in clinical trials. In research on the “newest frontier” of Deep Brain Stimulation (DBS)—the use of DBS for psychiatric conditions—family member support is frequently listed as a criterion for trial enrollment. Despite the significance of family members, qualitative ethics research on DBS for psychiatric conditions has focused almost exclusively on the perspectives and experiences of DBS recipients. This qualitative study is one of the first to include both (...) DBS recipients and their family members as interview participants. Using dyadic thematic analysis—an approach that takes both the individuals and the relationship as units of analyses—this study analyzes the complex ways in which family relationships can affect DBS trial participation, and how DBS trial participation in turn influences family relationships. Based on these findings, we propose ways to improve study designs to better take family relationships into account, and better support family members in taking on the complex, essential roles that they play in DBS trials for psychiatric conditions. (shrink)

Religion and culture are interwoven and this can be seen among the Oron people in their use of the shrine as a socio-cultural and ethical institution. The shrine is an embodiment and the symbol of the very traditional religion of the people. As such, the shrine serves as a medium through which the norms, values, ethics, taboos, and morals are taught and enforced. There is also a great relationship between religion and justice as the shrine (Afi/Obio) as an ethical (...) institution serves as a tribunal of justice by the deities, divinities, and ancestors under the guidance and administration of the priest in tackling and resolving criminal activities, disputes as well as restoring social order and justice in Oron traditional society. The Oron Afi/Obio (Shrine) method of administering justice is beyond the Empirical application of the modern judiciary system that relies on physical facts and shreds of evidence, while the shrine, also, uses spiritual methods that involve Oath taking, incantation and necromancy. Globalization rather than modifying the lapses and loopholes of this system in the parlance of morality, ethics, and health has led to its abolition and break down. This work adopts the qualitative method. This work as primary research uses the conflict theory, phenomenological and Historical method. It identifies globalization as a threat to the traditional justice system and recommends that the shrine is a multi-faceted institution whose function can be adopted and applied to the Nigerian legal system where there is no or little evidence and oath swearing for politicians in our contemporary society. (shrink)

Once I had explored the research issue of North and South unification with a focus on the legal integration for uniform constitution and various statutes. It pushed me to deal with a big question, and looked like a semi-textbook with an inchoate idea and baby theory upon the completion of research project. The literature review thankfully had allowed the space of creativity and originality of my work product, and can also be a typical way of foreign graduate legal researchers in (...) the process of his dissertation work. They would be beneficial with new statutes and codes, for example, from the Korean Congress, that are enacted recently, which would be their research topic certainly original and contributive. This could be viewed as one of qualitative enclaves enmeshed into a larger scope of qualitative inquiry. This interplay is fairly consequential in excavating a new knowledge and research findings. It could be aboriginal -- one trait word to characterize the qualitative studies-- from the viewpoint of host country, but became original as a crop to expand the horizon of new knowledge. I have once argued that the quantitative studies are on generality of subjects and commonness for involved strands. This profile would vary that the qualitative studies tend to be strong with the story and enclaves. The e-age and rapid compression of space with the development of telecommunication technology also factor to change a paradigm of knowledge and research activities. At least, the contemporary society certainly would be more specific as if we can trace a person with the satellite spotting and the electronic identifier on the leg of sex criminals in Korea guarantees to be safeguarded from his potential danger. That may be favorable concerning the elements and environments of qualitative studies. For example, we may follow up by comparing the research work of Korean statute with the e-government of Korea displaying the statute. We can entertain many on-line sources of information and stories with the dissertations of aboriginal culture. With my time on the qualitative studies, I came across the nocebo effect illustrated with the fear of MERs-CoV in Korea. The effect looks into the negative dimension of human mind and his personality, which could aggravate the current challenge of national crisis, June, 2015. Paradoxically, the nocebo effect can be said to characterize the qualitative context of inquiry. As Freud suggested, the vast of human element is of unexplainable dimension that is less easily quantifiable or generizable over the population (Broome, 2010). This does not say that the continental researchers had been affected with a late nationalization or late development of region leaving them to search for an ego. This is to say that the qualitative studies could explain the part of truths for the universe and human. The researchers interested in deep knowledge could employ their method, but in ethics, who would not vulture the objects of his theme and conduct on due scientific ground. (shrink)

Imagination is necessary for scientific practice, yet there are no in vivo sociological studies on the ways that imagination is taught, thought of, or evaluated by scientists. This article begins to remedy this by presenting the results of a qualitative study performed on two systems biology laboratories. I found that the more advanced a participant was in their scientific career, the more they valued imagination. Further, positive attitudes toward imagination were primarily due to the perceived role of imagination (...) in problem-solving. But not all problem-solving episodes involved clear appeals to imagination, only maximally specific problems did. This pattern is explained by the presence of an implicit norm governing imagination use in the two labs: only use imagination on maximally specific problems, and only when all other available methods have failed. This norm was confirmed by the participants, and I argue that it has epistemological reasons in its favour. I also found that its strength varies inversely with career stage, such that more advanced scientists do (and should) occasionally bring their imaginations to bear on more general problems. A story about scientific pedagogy explains the trend away from (and back to) imagination over the course of a scientific career. Finally, some positive recommendations are given for a more imagination-friendly scientific pedagogy. (shrink)

Background: Current practice frequently fails to provide care consistent with the preferences of decisionally-incapacitated patients. It also imposes significant emotional burden on their surrogates. Algorithmic-based patient preference predictors (PPPs) have been proposed as a possible way to address these two concerns. While previous research found that patients strongly support the use of PPPs, the views of surrogates are unknown. The present study thus assessed the views of experienced surrogates regarding the possible use of PPPs as a means to help (...) make treatment decisions for decisionally-incapacitated patients. -/- Methods: This qualitative study used semi-structured interviews to determine the views of experienced surrogates [n=26] who were identified from two academic medical centers and two community hospitals. The primary outcomes were respondents’ overall level of support for the idea of using PPPs and the themes related to their views on how a PPP should be used, if at all, in practice. -/- Results: Overall, 21 participants supported the idea of using PPPs. The remaining five indicated that they would not use a PPP because they made decisions based on the patient’s best interests, not based on substituted judgment. Major themes which emerged were that surrogates, not the patient’s preferences, should determine how treatment decisions are made, and concern that PPPs might be used to deny expensive care or be biased against minority groups. -/- Conclusions: Surrogates, like patients, strongly support the idea of using PPPs to help make treatment decisions for decisionally-incapacitated patients. These findings provide support for developing a PPP and assessing it in practice. At the same time, patients and surrogates disagree over whose preferences should determine how treatment decisions are made, including whether to use a PPP. These findings reveal a fundamental disagreement regarding the guiding principles for surrogate decision-making. Future research is needed to assess this disagreement and consider ways to address it. (shrink)

The phenomenon of sexbots has lately been receiving increasing academic attention. The forms and uses of this humanoid sexual technology with AI have been analyzed and discussed by philosophers, sexologists, ethicists, and legal experts. Ethical debates about possible designs and uses receive the most attention in academic discussions. Quantitative and qualitative studies on how people outside this context look at and think about sexbots are scarce. Especially research with the online context as a research site seems to be missing. (...) However, This research site can be fruitful to explore people's (moral) attitudes, arguments, and intuitions. An inductive thematic analysis of online discussions about sexbots was carried out on three different subreddits on Reddit. Three themes were constructed. Themes include the assumed role of sexbots as seen from incel ideology, reasonings on hypothetical experiences of using a sexbot, and the use and meaning of sexbots in a context of political and sexual identity. The language in the discussions indicated a dominant male heteronormative perspective. Although similar elements to the scholarly debate like the use of sexbots to channel sexual misconduct or making analogies between the believed effects of the use of sexbots and pornography occurred, differences to the debate occurred in the themes of the hypothetical tendency to use a sexbot, and the indications on how it could change our definitions of ‘having sex’. These elements point toward a research gap in the academic discourse. Finally, the themes were aligned with the feminist discussion on sexbots. Richardon’s call for a ban and Kubes’ queer reading of sexbots were linked to our analysis. Further research could include exploring multiple online research sites to complement or contrast the indicated male heteronormative perspective with other perspectives ( LGBTQAI+,...) on the phenomenon of sexbots. (shrink)

There are two fundamental models to understanding the phenomenon of natural life. One is thecomputational model, which is based on the symbolic thinking paradigm. The other is the biologicalorganism model. The common difficulty attributed to these paradigms is that their reductive tools allowthe phenomenological aspects of experience to remain hidden behind yes/no responses (behavioraltests), or brain ‘pictures’ (neuroimaging). Hence, one of the problems regards how to overcome meth-odological difficulties towards a non-reductive investigation of conscious experience. It is our aim in (...) thispaper to show how cooperation between Eastern and Western traditions may shed light for a non-reductive study of mind and life. This study focuses on the first-person experience associated withcognitive and mental events. We studied phenomenal data as a crucial fact for the domain of livingbeings, which, we expect, can provide the ground for a subsequent third-person study. The interventionwith Jhana meditation, and its qualitative assessment, provided us with experiential profiles based uponsubjects' evaluations of their own conscious experiences. The overall results should move towards anintegrated or global perspective on mind where neither experience nor external mechanisms have thefinal word. (shrink)

The article aims to investigate and analyze the social impact of industrialization on Badli. Badli is one of the largest industrial zones in Delhi which also bears large slums neighboring to the industries. The literature available on the area is also limited to news articles and government reports, thus further research on Badli is required. The social implications were examined through naturalistic observational research and unstructured interviews of 10 individuals from Badli. Using thematic analysis and secondary data analysis the data (...) was interpreted into common themes and key ideas. The analysis showed most Industries in Badli are unauthorized and have issues such as unemployment, child labor, hazardous working conditions, nominal wages, producing illegal substances and lack of healthcare management. People living in the neighboring slum areas suffer from issues such as poor health care facilities, below par educational infrastructure, high crime rates, harmful drainage and ventilation services, congested housing structures, economic disparity, and toxic family environment. Thus Industrialization has deeper implications on the society of Badli which can be attributed to the influx of migrants, industries and poor governance by the administrative authorities to control and manage the industrial process in Badli. It can be concluded that there is a huge correlation between social change and industrialization. Further studies are required to create socio-economic policies catering to the situation in Badli for a long-lasting sustainable effect on the area. (shrink)

This study sets out to examine the ways Nigerian cyber-fraudsters (Yahoo-Boys) are represented in hip-hop music. The empirical basis of this article is lyrics from 18 hip-hop artists, which were subjected to a directed approach to qualitative content analysis and coded based on the moral disengagement mechanisms proposed by Bandura (1999). While results revealed that the ethics of Yahoo-Boys, as expressed by musicians, embody a range of moral disengagement mechanisms, they also shed light on the motives for (...) the Nigerian cybercriminals' actions. Further analysis revealed additional findings: “glamorization/de-glamorization of cyber-fraud” and “sex-roles-and-cultures”. Having operated within the constraint of what is currently available (a small sample size), this article has drawn attention to the notion that Yahoo-Boys and some musicians may be “birds of a feather.” Secondly, it has exposed a “hunter-and-antelope-relationship” between Yahoo-Boys and their victims. Thirdly, it has also highlighted that some ethos of law-abiding citizens is central to Yahoo-Boys’ moral enterprise. Yahoo-Boys, therefore, represent reflections of society. Arguably, given that Yahoo-Boys and singers are connected, and the oratory messages of singers may attract more followers than questioners, this study illuminates the cultural dimensions of cyber-fraud that emanate from Nigeria. In particular, insights from this study suggest that cyber-fraud researchers might look beyond traditional data sources (e.g., cyber-fraud statistics) for the empirical traces of “culture in action” that render fraudulently practices acceptable career paths for some Nigerian youths. (shrink)

The aim of this study was to explore the existence of moral distress among nurses in Lilongwe District of Malawi. Qualitative research was conducted in selected health institutions of Lilongwe District in Malawi to assess knowledge and causes of moral distress among nurses and coping mechanisms and sources of support that are used by morally distressed nurses. Data were collected from a purposive sample of 20 nurses through in-depth interviews using a semi-structured interview guide. Thematic analysis of (...) class='Hi'>qualitative data was used. The results show that nurses, irrespective of age, work experience and tribe, experienced moral distress related to patient/nursing care. The major distressing factors were inadequate resources and lack of respect from patients, guardians, peers and bosses. Nurses desire teamwork and ethics committees in their health institutions as a means of controlling and preventing moral distress. There is a need for creation of awareness for nurses to recognize and manage moral distress, thus optimizing their ability to provide quality and uncompromised nursing care. (shrink)

The gendered occupational role can have an impact on both employees and organizations they work for. This study aims to explore different sides and factors that are related to experience, challenges, and coping mechanisms of male dry cleaners amidst gendered occupational roles. The methodology used were: Heideggeran Phenomenology, Semi- structured Interview Guide, Interpretative Phenomenological Analysis (IPA) by van Kaam and modified by Moustakas. This st udy had 15 participants. Based on the data collected, the following themes were identified in (...) this study; namely, (1) The Steadf ast, (2) and The Challenged. Likewise, the following sub themes were identified from the data- gathering and are based on their perspectives. Masculinity of a male laundry employee can really affect the perspective of an in dividual, the more the male look masculine the more that the people can easily conclude that his physique is not suitable on the jobs like laundry, because people always expect that men should work on a heavy work like truck, construction sites, etc. (shrink)

Objectives: This study aimed to fill the gap between Vietnamese diabetic patients' needs and care through a qualitative study asking about their experiences with diabetes and quality of care. -/- Methods: Interviews with five diabetic patients were conducted at a tertiary general hospital located in southern Vietnam. The transcribed data were first subjected to quantitative text analysis using KH Coder to identify major categories of frequently used words, followed by a qualitative analysis of selected cases using (...) the Steps for Coding and Theorization (SCAT) method. -/- Results: The major categories of frequently used words were chronic health conditions, services, facilities, insurance, patient-doctor communication, and medication. SCAT analysis of three selected cases identified six themes: “Disregarding the disease at the early stage,” “Fear of complications,” “Satisfaction with hospital services and medical staff,” “Insurance-related problems,” “Long waiting times,” and “Communication barriers between patients and doctors.” Patients were satisfied with improved hospital facilities and services; however, the overloading of one hospital led to long waiting times and communication difficulties with doctors. Difficulties with health insurance were also observed, and patients were rather passive in disease management and needed to be empowered through improved communication with doctors and other care providers. -/- Conclusion: These findings from our trial of introducing a qualitative study into service evaluation suggest that listening to patients can help health providers learn their perspectives and be more responsive to their needs. (shrink)

This study aimed to enhance the mastery level of the campus journalists of Cuyo Central School, Division of Palawan in basic news writing through (CEB) Contextualized Error – Based Worktext. It used mixed methods, the quantitative approach was utilized to know the common errors committed by the participants of the study in writing news articles, their level of achievement and the testing of significant difference of their scores in pre-test and post – test. The challenges they met in (...) utilizing the intervention material was also presented through quantitative method. The qualitative method was utilized in presenting the changes to be done to further enhance the material based from the challenges met by the participants of the study. Interview method and Focus Group Discussion were used as instruments. The common errors committed by the pupil-journalists in content is Following the correct news writing format or style that gained a score of 31.7, in technical Showing the news writers ability with a mean of 27.4, while in ethics most news writers did not cited sources properly and observed copyright laws with a mean of 7.6. There is a significant difference between the scores of pre-tests and post-test as revealed by paired-t test, a p-value of almost 0.00 at 0.05 and 0.01 level of significance moved the researcher to reject the null hypothesis. The great challenges that the respondents posted is No sufficient and concrete examples to create meaningful learning with a frequency score of 10 or 100%. The challenges they met were the bases of the enhanced intervention material. It can be concluded that CEB Worktext is effective as intervention material and the enhanced worktext as output of this study will be more appropriate as review material for campus journalists. (shrink)

The study dealt with the present socio-economic status, perceptions and opportunities of maximizing the benefits of ecotourism to the local community. Responses from the local community, officials of the local government unit, and visitors using quantitative and qualitative method, particularly the inductive approach through survey, observation and interview was used. Local community involvement in tourism activity is limited to tour guiding, particularly the children, while the rest of the population are into farming, fishing and harvesting forest products. The (...) park was categorized as “Protected Landscape” under Republic Act 7586, now gaining its popularity and one of the fastest growing ecotourism sites in the Philippines is under the supervision of a private company. Visitor satisfaction and potential risk on environmental degradation were observed due to lack of regulation on the observance of carrying capacity. Tourism Action Plan for the destination was prepared but allocation for project for the local community that would contribute to their present socio-economic status was not evident. The geographical unit of the destination, its breath-taking view, the presence of various distinct flora and fauna made it to be labelled as the “Hidden Paradise and Mystical Eco-tourism in Nueva Ecija”. Sustainability in ecotourism, involves the participation of the communities that protect and manage the natural resources, cultural and indigenous knowledge and practices, environmental education and ethics. Community involvement equipped with proper education and conservation awareness, training, and employment opportunities may sustain the destination and enhance visitor satisfaction. (shrink)

Philosophy of religion is often regarded as a philosophical discipline in which irrelevant influences, such as upbringing and education, play a pernicious role. This paper presents results of a qualitative survey among academic philosophers of religion to examine the role of such factors in their work. In light of these findings, I address two questions: an empirical one (whether philosophers of religion are influenced by irrelevant factors in forming their philosophical attitudes) and an epistemological one (whether the influence of (...) irrelevant factors on our philosophical views should worry us). My answer to the first question is a definite yes, my answer to the second, a tentative yes. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

This study was designed to explore career-related strategies for strengthening poverty reduction programmes in Nigerian communities. Using a phenomenological framework and interpretive paradigm, the study used a qualitative research design. The participants of this study consisted of five key officers working in the Federal Ministry of Humanitarian Affairs and Poverty Alleviation (FMHAPA) in Nigeria and five counsellors working in Nigerian secondary schools. The participants were selected through a purposeful sampling process. Data collection measures include interviews, focus (...) group discussion, and document analysis. All participants were interviewed to collect data, which was analyzed using thematic analysis. To identify themes and patterns in the responses provided by the participants, the interviews were recorded and transcribed. In accordance with the findings of this study, career-related strategies for strengthening poverty reduction programmes in Nigerian communities include employability skills development, access to quality education, job creation and entrepreneurship, supportive networks, social justice and corporate responsibilities, and appropriate work policy. A major contribution of this study is the identification of career-related strategies to help strengthen poverty reduction programmes in Nigerian communities. Another contribution is the implications that can be drawn for career counselling. (shrink)

Many readers of Kant’s ethical writings take him to be primarily concerned with offering guidelines for action. At the least, they write about Kant as if this were the purpose of his ethical writings. For example, Christine Korsgaard, in her influential article Kant’s Analysis of Obligation: The Argument of Groundwork I, writes that, ‘‘the argument of Groundwork I is an attempt to give what I call a ‘motivational analysis’ of the concept of a right action, in order to discover what (...) that concept applies to, that is, which actions are right.’’ Similar comments are not hard to find in the secondary literature. This, however, is a fundamentally misguided way of reading Kant, since he repeatedly asserts that we do not need to do moral philosophy in order to discover which actions are right. We already know how to behave morally and do not need philosophers to tell us this. ‘‘Common human reason,’’ Kant argues, ‘‘knows very well how to distinguish in every case that comes up what is good and what is evil, what is in conformity to duty or contrary to duty.’’ Because people with pre-philosophical understanding know how to act morally, the purpose of moral philosophy cannot be to provide us with a set of rules for correct behavior. If we take Kant’s claims about common human reason seriously, then his aim in the Groundwork of the Metaphysics of Morals cannot be to discover which actions are right. (shrink)

ABSTRACT Objectives There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD. Design The study used a (...) qualitative approach to examine and analyse the perception and anticipated concerns of PHCPs regarding challenges of providing assisted dying in Queensland. Fourteen PHCPs were recruited using a purposive sampling strategy to obtain a broad representation of perspectives including work roles, geographical locations and workplace characteristics. Data were collected via one in-depth interview per participant. The transcripts were coded for patterns and themes using an inductive analysis approach following the tradition of Grounded Theory. Setting The study was conducted in hospital, hospice, community and residential aged care settings in Queensland, Australia. These included public and private facilities, secular and faith-based facilities, and regional/rural and urban facilities. Participants Interviews were conducted with fourteen PHCPs: 10 nurses and 4 physicians; 11 female and 3 male. The median number of years of palliative care practice was 17, ranging from 2 to 36 years. For inclusion, participants had to be practising palliative and hospice care providers. Results PHCPs are divided on whether VAD should be considered part of palliative care. Expectations of moral distress and uncertainty about practising VAD were identified in five areas: handling requests, assessing patient capacity, arranging patient transfers and logistical issues, managing unsuccessful attempts, and dealing with team conflicts and stigma. Conclusions The possibility of having to practise VAD causes moral distress and uncertainty for some PHCPs. Procedural clarity can address some uncertainties; moral and psychological distress, however, remains a source of tension that needs support to ensure ongoing care of both patients and PHCPs. The introduction of VAD post-legalisation may present an occasion for further moral education and development of PHCPs. (shrink)

The illness immersion condition prevents patients from enjoying everything worth living life for. In any case, according to Frank, this condition could represent one of the most insightful experiences towards understanding the meaning of life. Using the metaphor of phoenix taken from May, Frank identified four kinds of embodiments through which the phoenix can reveal itself in a patient after an illness immersion experience: the phoenix that could ever be and the phoenix that might have been; the recurrent and cumulative (...) phoenix and the reluctant phoenix. Based on these considerations, a qualitative study was conducted in order to give voice to the different phoenix embodiments focusing on several autobiographies of patients afflicted with severe or terminal illness. The analysis highlights several similarities that the different phoenixes shared ; however, a deep difference emerged in their worldview which proves able to lead them towards different epiphanies. These evidences reveal that every sick person should be understood, stimulated and accompanied throughout his lived experience of illness by an expressly designed and dedicated care. (shrink)

Introduction The major burden of the COVID-19 pandemic has been mainly on healthcare workers (HCWs) and as a result many of them have been afflicted with the disease thus far. -/- Purpose The present study was an effort to investigate Tehran University of Medical Sciences HCWs' experiences of COVID-19 during the pandemic in Tehran, Iran. -/- Methods This study is essentially a conventional qualitative content analysis. Twenty-six HCWs (including 7 physicians, 16 nurses, and 3 physiotherapists) were purposefully (...) selected to participate in the study. The data were collected from April 2020 to January 2021 through semi-structured face-to-face interviews. The interviews were transcribed and then analyzed based on the Graneheim and Lundman method using MAXQDA 12. -/- Results Based on the qualitative content analysis which resulted in 364 initial codes, three themes and eight subthemes were extracted. The extracted themes were “support,” “control,” and “improvement.” -/- Conclusions HCWs are in close contact with COVID-19 patients as part of their professional careers and the provision of quality patient care in times of crises is unattainable unless HCWs enjoy support and their own health is maintained. Making institutional, national, and international preparations for their protection is an obligation. (shrink)

Filipino's love for the elderly is undeniable. However, despite the respect they have for the elderly, an increasing amount of elderly abandonment is rising in the Philippines. The drastic increase in statistics of abandonment will still grow over the years because aging is inevitable. The primary goal of this study is to dig deeper into the experiences, challenges, and coping mechanisms of abandoned senior citizens inside of a home for the aged to spread awareness about this certain topic. By (...) the use of Interpretative Phenomenological Analysis, the study come up with the following findings: (1) The abandoned senior citizens chose to be inside the facility because they don't want to be a burden in their original homes. (2) Faith and religious works affect their psychological well-being. (3) Physical appearance does not affect their self-esteem. (4) Social support boosts their psychological well-being as well. (5) One of the biggest reasons why abandoned senior citizens left their homes is being neglected to cause them to leave and stay in home for the aged (6) Lastly, people inside the facilities accepted the fact that death is drawing closer to them but they don't want to die yet. (shrink)

BACKGROUND: Little is known about how hospitalized patients share decisions with physicians. METHODS: We conducted an observational study of patient-doctor communication on an inpatient medicine service among 18 hospitalized patients and 9 physicians. A research assistant (RA) approached newly hospitalized patients and their physicians before morning rounds and obtained consent. The RA audio recorded morning rounds, and then separately interviewed both patient and physician. Coding was done using integrated analysis. RESULTS: Most patients were white (61%) and half were female. (...) Most physicians were male (66%) and of Southeast Asian descent (66%). All physicians explained the plan of care to the patients; most believed that their patient understood. However, many patients did not. Physicians rarely asked the patient for their opinion. In all those cases, the decision had been made previously by the doctors. No decisions were made with the patient. Patients sometimes disagreed. CONCLUSIONS: Shared decision-making may not be the norm in hospital care. Although physicians do explain treatment plans, many hospitalized patients do not understand enough to share in decisions. When patients do assert their opinion, it can result in conflict. PRACTICE IMPLICATIONS: Some hospitalized patients are interested in discussing treatment. Improving hospital communication can foster patient autonomy. (shrink)

This qualitative research aims to explore and unravel the theory of natural law within its Greek context and its influence on political thought, particularly addressing the need to counteract the damages of tyranny and the cyclical succession of regimes, as articulated by Plato. This study reveals that the concept of natural law predates Stoics and it is rooted within the pre-Socratic natural philosophy. The study exposes that Aristotelian ethics and politics are rooted in the concept of (...) natural law, ultimately giving rise to the Aristotelian "mixed form of government" and laying the groundwork for republicanism. In extending this inquiry, I attempt to identify a parallel argument in ancient Iran, investigating the presence of natural law and its impact on the political landscape. The concept of natural law, emphasizing the alignment of social and political affairs with nature's rules, played a significant role in shaping the Indo-Iranian communities. The Sanskrit term rta and its Avestan equivalent, Aša, denote this foundational concept. However, the ascendancy of Zoroastrianism and its new theology led to the consolidation of all Indo-Iranian gods into the singular omnipotent deity, Ahura Mazdā. Ahura Mazdā, along with its prophet Zaraθuštra, possessed the authority to govern both earthly life and the afterlife. The exclusive attributes of Ahu and Ratu empowered God and its messenger to formulate and enact laws ensuring a place in heaven. Consequently, Divine Law and positive law became intricately intertwined within a unified legal framework. This divine law, sanctioned by God and enforced by the King, diverges from the Greek perspective, particularly that of Aristotle, where tyranny is seen as a deviation from the ideal political order. In the Iranian context, tyranny is synonymous with God's representation, sharing the holiness and regal attributes of a King, who, in the Iranian and Avestan sense, enjoys God's blessing as Xvarənah or Faer-e Izadi. The intertwining of law and authority of the King precludes the possibility of an independent legal sovereignty apart from the King’s authority. The monotheistic tenets of Zaraθuštra’s religion, officially established in the 4th century AD as the Religion of the State, solidify this integrated system. Consequently, the coexistence of republicanism or any mixed form of government within Iran becomes unattainable under the influence of this monotheistic doctrine. (shrink)

How children seek knowledge and evaluate claims may depend on their understanding of the source of knowledge. What shifts in their understandings about why scientists might disagree and how claims about the state of the world are justified? Until about the age of 41/2, knowledge is seen as self-evident. Children believe that knowledge of reality comes directly through our senses and what others tell us. They appeal to these external sources in order to know. The attainment of Theory of Mind (...) (ToM) at this age is commonly seen as the significant shift in development in understanding disagreements in knowledge claims. Children attaining ToM understand that someone exposed to incorrect or incomplete information might have false beliefs. Disagreement, then, is still attributed to objective sources of knowledge. The current study examines the later developing Interpretive Theory of Mind (iToM) as the basis for children’s understanding of how people with access to the same information might disagree and what this means for how to provide justification for a knowledge claim. Fourteen 2nd graders with the most iToM responses to four tasks and 14 with the fewest iToM responses were selected from a larger sample of 91. In analyses of interviews about a story in which two experts make different claims about a scientific phenomenon, those in the high iToM group noted subjective perspective and processes as the source of disagreement and suggested the need for investigation as the means to knowing. In contrast, those in the low iToM group mostly could not explain the source of disagreement and held that knowledge is acquired from external sources. A comparison of the interviews regarding the science story 2 years later allows for a qualitative description of the development. Those in the low iToM group showed more general recognition of subjective and constructive processes in knowing whereas those in the high iToM group identified interpretive processes and the relativity of perspectives with implications for how observations were conducted and interpreted. Only those in the high iToM group referred to the importance of evidence as a basis for knowledge claims at either point in the study. (shrink)

With the surge of the COVID-19 pandemic, online sellers faced challenges in managing their online business daily. Aside from it, their work-life balance has been negatively affected as well, considering that they work from home and are responsible for household responsibilities. Thus, this study is conducted during the pandemic and gathered data using a semi-structured interview through Messenger call. It is conducted to explore the lived experiences of online sellers and how they managed their online business and personal life. (...) It also determines the specific challenges they’ve encountered and how they coped with them. Lastly, this study aims to map out how these experiences will benefit online sellers and consumers and explain that online selling can be both sustainable and convenient in terms of earning a good living and meeting their daily needs. Moreover, three major conclusions emerged from this study’s findings: (1) online sellers faced psychological and physical difficulties in managing their online business during the pandemic, (2) online sellers discovered ways on how to cope with the struggles they are facing, and (3) online sellers reflected on their experience to be more effective in the online selling industry. (shrink)

Corporate activities conducted under the banner of creating shared value (CSV) have gained popularity over the last decade, and some MNCs have espoused that CSV has entered the heart of their practices. There has, however, been criticism about the lack of a standard definition of CSV. The purpose of the current study was to develop a working definition of CSV by identifying distinctions between CSV and various conceptions of corporate social responsibility (CSR). We conducted 26 semi-structured interviews with managers (...) and stakeholder representatives of five multinational corporations (MNCs) and three small and medium enterprises (SMEs), all headquartered or rooted in Asia. These firms had received public recognition for their CSV engagement. We compared and contrasted interviewees’ conceptions and descriptions of CSV and traditional CSR (philanthropy) and mapped these against Carroll’s four-layer model of responsible corporate management. Interviewees tended to frame CSV as a sustainable business model that generates social and economic value simultaneously. Traditional CSR was characterized as “giving back” some of the surplus from economic returns. In addition, interviewees described examples of strategic CSR, which involved pump-priming interventions for empowering and enabling stakeholders of the CSV practices of the focal firm to participate in the associated wealth and well-being co-creation. Keywords: Corporate social responsibility, creating shared value, qualitative, Asia. (shrink)

Chronic fatigue syndrome or myalgic encephalomyelitis remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker’s concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of treatments. (...) Against this background, robust qualitative and quantitative research from a range of countries has found that many doctors display uncertainty about whether CFS/ME is real, which may result in delays in diagnosis and treatment for patients. Strikingly, qualitative research evinces that patients with CFS/ME often experience suspicion by health professionals, and many patients vocally oppose the effectiveness, and the conceptualization, of their illness as psychologically treatable. We address the intersection of these issues and healthcare ethics, and claim that this state of affairs can be explained as a case of epistemic injustice. We find evidence that healthcare consultations are fora where patients with CFS/ME may be particularly vulnerable to epistemic injustice. We argue that the marginalization of many patients is a professional failure that may lead to further ethical and practical consequences both for progressive research into CFS/ME, and for ethical care and delivery of current treatments among individuals suffering from this debilitating illness. (shrink)

Introduction: The Kenyan government has put a spirited reform to ensure all Kenyans get universal healthcare. This has led to restructuring of several entities among them the health insurance industry. This is geared at alleviating the burden of catastrophic expenditure on health from the poor Kenyans. However, insurance uptake remains at less than a quarter of the population with many Kenyans still paying for healthcare out-of-pocket. These out-of-pocket payers often don’t afford the ever-increasing cost of healthcare in Kenya. This (...) class='Hi'>study looked at how doctors deal with patients given their modality of payment. Methodology: This was an online based survey that was distributed to Kenyan doctors via email by Kenya Medical Association. The survey sought information from the respondents on how they dealt with patients given their modality of payment. In addition, respondents were asked to provide an example of a case they had dealt with that touched on each payment modality. Results: Respondents gave their experiences where insurance had influenced their clinical decisions. Codes developed from the prose were; “inability to pay”, “harmful to the patient”, “changed the prescription” among others Health insurance played a crucial role whenever respondents made decisions. Top on the list of things that the majority indicated would be considered is insurance status and/or their ability of patients to pay for the services. Conclusion: Respondents are stuck in a limbo; striving to give the best care to patients but limited by the patients’ inability to pay. In explaining their experiences, respondents explain a situation where they intend to offer the best, but patients cannot afford. This especially so for those without health insurance who end up either not getting services or at the very best, get inferior services. (shrink)

Abstract -/- “The Obvious Invisibility of the Relationship Between Technology and Social Values” -/- We all too often assume that technology is the product of objective scientific research. And, we assume that technology’s moral value lies in only the moral character of its user. Yet, in order to objectify technology in a manner that removes it from a moral realm, we rely on the assumption that technology is value neutral, i.e., it is independent of all contexts other than the context (...) in which it is used morally or immorally by someone. However, there is a power to technology. At the very least, technology should be seen as reflecting the values that it rises from: a developmental context. Consequently, we can make the invisible moral realm visible as we investigate the relationship between culture and technology. Pragmatically, we can trace how cultural values inform what counts as a scientific question. When we look at the 1980s epidemiological model for AIDS we see how the presuppositions within a culture frame the type of question asked, i.e. What population do we see AIDS occurring in? This question initially leads scientific research away from actual individual behaviors until a different question is asked that leads the question towards behavioral epidemiological models rather than population models. Secondly, we can make visible the circumstance that depicts that what constitutes a scientific problem has a direct relationship to the types of technologies that are developed. We can more clearly see this circular relationship between culture and technology by looking at clinical research and practice regarding heart disease. Men who were dying of diagnosed heart disease were showing symptoms of problems in large arteries of the heart. Women were also dying of heart disease, but since their large arteries were not overwhelmingly compromised they were not being properly diagnosed until recently. Different technologies and protocol were needed to “see” different symptoms in the smaller vessels of women. Thirdly, I show how the types of technology developed, in turn, can create new values or enhance preexisting values within a culture. DNA research can be used to investigate long, unanswered questions about qualitative dimensions of life in quantitative manners. Yet, long held unanswered questions about a biological basis of race or intelligence are themselves rarely challenged as uninteresting or misguided even when they are tied to prejudicial qualitative assumptions if the chance of a “scientific” answer is possible. When existing technologies or modifications of existing technologies can be used they seem to direct human reactions and behaviors in predictable ways. The technologies themselves may be said to direct culture in ethically valenced manners. (shrink)