Respect for patient autonomy is paramount in resolving ethical tensions in end-of-life care. The concept of relational autonomy has contributed to this debate; however, scholars often use this concept in a fragmented manner. This leads to partial answers on ascertaining patients’ true wishes, meaningfully engaging patients’ significant others, balancing interests among patients and significant others, and determining clinicians’ obligations to change patients’ unconventional convictions to enhance patient autonomy. A satisfactory solution based on relational autonomy must incorporate patients’ competence (apart from (...) decisional capacity), authenticity (their true desires or beliefs) and the involvement level of their significant others. To that end, we argue that John Christman’s procedural approach to relational autonomy provides critical insights, such as the diachronic or socio-historical personhood, sustained critical reflection and his recent explication of the nature of asymmetrical relationships and helpful interlocutors. This study reviews Christman’s account, proposes minor modifications and advocates for an integrated three-dimensional model for medical decision-making. Clarifying the relationship among the three elements promotes an ethical framework with a coherent understanding of relational autonomy. This model not only provides a descriptive and normative framework for end-of-life care practice but also reconsiders the nature of the clinician–patient relationship and its normative implications. We further present a case study to illustrate the merits of our proposed model. Altogether, our proposal will help navigate complex medical decision-making, foster trust and negotiate shared values between patients and their significant others, particularly in end-of-life care. (shrink)

This study analyzes the distinctive patterns of educational modernization in East Asia through an analysis of Korean shadow education, specifically focusing on how traditional educational values are integrated with contemporary pedagogical innovations. Drawing on post-oriental theory and educational sociology, a theoretical framework is developed that moves beyond conventional modernization narratives to capture the complex dynamics of educational transformation in non-Western contexts. Discussions of Korean private educational institutions reveal how traditional cultural values and innovative practices can be effectively synthesized, creating unique (...) forms of educational modernity that challenge Western-centric assumptions about educational development. The findings demonstrate specific mechanisms through which traditional educational philosophies enhance rather than impede modern educational practices, offering valuable insights for educational systems worldwide. The broader implications suggest that successful educational development involves neither wholesale adoption of Western models nor rigid adherence to tradition, but rather a thoughtful integration that generates distinctive and effective educational approaches in an increasingly globalized world. (shrink)

Guided by Leininger's Theory of Culture Care, this hermeneutic phenomenological study explored how social and cultural contexts shape engagement in advance care planning (ACP) among people living with cancer in Taiwan. Semi‐structured interviews were conducted with 26 stakeholders, including 8 patients, 7 family caregivers, and 11 healthcare providers, recruited from oncology and ACP outpatient clinics, inpatient wards, and home care services at a tertiary medical center. Data were audio‐recorded, transcribed verbatim, and analyzed using Naeem's six‐step approach. Six interrelated influences on (...) ACP engagement were identified: socioeconomic circumstances, prior experiences and personal background, religious beliefs and life values, relational dynamics with family and significant others, wider social norms, and political and legal requirements. These factors shaped whether ACP was seen as acceptable, when it was introduced, who was involved in decision‐making, and how discussions were negotiated within families and with healthcare professionals. The findings show that ACP engagement in Taiwan is a relational, culturally embedded process. Culturally congruent, nurse‐led ACP approaches that address relational, socioeconomic, and legal structural influences are needed to support family‐centered cancer care. (shrink)

The aim of this paper is to resolve the tension between Kant’s doctrine of the highest good and his entire philosophical system. The concept of the highest good is the first major ambiguity of the doctrine. There are three pairs of ambiguities: immanent-transcendent; justice-perfection; and individual-community. They are able to form eight combinations. Corresponding to the various combinations and conceptions of the highest good, interpreters also conceive different reasons for the necessity of the doctrine as well as various conditions of (...) its applicability. For example, some emphasize its religious dimension, whereas others understand it in the political sense. In this paper, I adopt a different approach in understanding the highest good’s systematic meaning as the moral confirmation, and suggest that only a transcendent, perfect and communal concept of the highest good can provide the most consistent doctrine. Additionally, it explains the importance of the different branches (such as philosophies of religion and of politics) of Kant’s system. (shrink)

Background Ethically complex care exposes nurses to persistent moral distress, harming well-being, integrity, and care quality. Moral resilience offers a targeted response, but intervention evidence is scarce. Because narrative therapy enables meaning-making and identity re-authoring, it may cultivate moral agency and integrity. Aim To develop and refine a narrative therapy–based group intervention for nurses’ moral resilience and to examine its feasibility and acceptability in a pilot study, with exploratory assessment of outcome trends. Design A preliminary group intervention program aimed at (...) supporting nurses’ moral resilience was initially developed through a literature review based on evidence-based principles. The Delphi method and a pilot study were subsequently employed to refine and finalize the intervention program. Participants and research context Eleven experts from seven provinces in China participated in the Delphi process, bringing diverse disciplinary and regional perspectives. Feasibility was examined with five clinical orthopaedic nurses, who completed outcome assessments at baseline, immediately post-intervention, and 1 month later, alongside evaluations of intervention acceptability. Ethical considerations This study was approved by the ethical board of Quanzhou Orthopedic - Traumatological Hospital (Approval No. IRB-2023-047). Findings Nine studies informed the development of the initial intervention draft, which was refined through two rounds of Delphi consultation with eleven experts. The finalized Nurse-MRNT (Moral Resilience Narrative Therapy for Nurses) comprised four thematic modules: Professional Journey, Journey Obstacles I & II, Journey Strategies, and Journey Reflections. In the pilot study, descriptive trends suggested short-term improvements in mental health and occupational burnout and reductions in moral distress. Moral resilience scores increased from pre- to post-intervention; however, the overall change across the three assessment time points was not statistically significant in this small pilot sample. Conclusion The narrative group intervention (Nurse-MRNT) was developed through a rigorous, theory-informed process and showed good feasibility and acceptability in this pilot study. Larger controlled studies are warranted to evaluate its effectiveness and sustainability. (shrink)

This paper examines the philosophical debate on Seng Zhao ’s Thesis on No-Motion of Things, a debate which took place approximately at the turn of the late sixteenth and the early seventeenth centuries. Without doubt the Zhao Treatise is the most precious gem in the early Chinese Madhyamaka legacy. The sterling reputation of this seminal treatise had never been challenged until Zhencheng published the Logical Investigation of the Thesis of No-Motion of Things during 1588–1589. The following focuses on Zhencheng’s WBQZLL (...) to see how he applied hetu-vidyā in his hermeneutical project. How did Zhencheng employ the syllogism in his critique of the Zhao Treatise? Is his critique justifiable? How is the role of syllogism employed as a hermeneutic tool to understand classical Buddhist texts? In highlighting the innovative features in the application of hetu-vidyā in the late Ming Chinese Buddhist scholasticism as showcased in Zhencheng’s WBQZLL, The controversies swirling around Zhencheng’s challenge to traditional doctrinal authority reveal the distinctive contrast between two forms of Buddhist hermeneutics in the late Ming Buddhist scholasticism: experiential hermeneutics and analytical hermeneutics. While the former has long been practiced in the mainstream of Chinese Buddhism, the latter has received little attention. (shrink)

This essay focuses on Nishitani Keiji’s 西谷啟治 early and late thinking, in the discourse on world history and modernity during wartime and the postwar meditation on emptiness and historicity in Religion and Nothingness. Following the first part of the analysis, I will trace Nishitani’s critical indebtedness to Heidegger’s existential-phenomenological analysis of historicity in Being and Time, and thereby analyze how Nishitani attempts to solve the aporia of modernity by recourse to the Buddhist doctrine of emptiness. The essay will conclude with (...) some critical remarks that discern the limits and hidden dangers in Nishitani’s philosophical project. (shrink)

The distinction between judgments of perception and judgments of experience in Kant’s Prolegomena has long been a controversial issue in Kantian studies. On the one hand, this distinction challenges the close connection between the synthetic unity of self-consciousness and the categories. On the other hand, a distinction between the subjective and the objective is unavoidable in our cognitive life. I will show in this paper that the interpretive difficulties arise from the ambiguity of Kant’s use of the concept of perception (...) and his misleading formulation of the judgments of perception. After clarifying these problems and adopting the regulative use of the concept of the I in Kant’s theory of perception, the place of judgments of perception in his transcendental cognitive theory can be clarified, and the consistency of his system can be observed. (shrink)

Extant literature suggested that executive cognitive ability is a critical perspective to answering why and how enterprises perform business model innovation. However, the effect of executive cognitive ability on business model innovation is still insufficiently explored. Drawing on entrepreneurial bricolage theory, we developed a moderated mediation model which takes entrepreneurial bricolage as the mediating mechanism and environmental dynamics as the moderating mechanism to explain how executive cognitive ability influences business model innovation. We collected the data of 316 executives of Chinese (...) start-ups through questionnaires for the model test. Results showed that new venture executives' cognitive ability significantly positively affects business model innovation by mediating with entrepreneurial bricolage. Environmental dynamism positively moderates the effect of executives' cognitive ability on business model innovation. Moreover, environmental dynamism positively moderates the mediating role of entrepreneurial bricolage in executive cognitive ability and business model innovation. This study broadens the research scope of entrepreneurial bricolage theory from the perspective of cognitive ability and provides ideas for new ventures' business model innovation. (shrink)

This chapter attempts to explore Huizhao’s theory of svalakṣaṇa and sāmānyalakṣaṇa on the basis of his works, especially his Treatise on Two Means of Valid Knowledge. In this treatise, the main question regarding the nature of cognition in the context of mental cultivation is addressed as such: Is the cognition of universals or the cognition of particulars capable of guiding the practitioner to attain liberation? According to Abhidharmamahāvibhāṣā, universal is the correct answer to the question, since only the path that (...) takes universal as the object is able to eliminate the defilements. For the Chinese Yogācārins and logicians who followed Dignāga, conversely, only the particular can be taken as the object of valid cognition that leads to the final awakening. In the case of Huizhao, he grounds the ontology of universal in the doctrinal framework of Yogācāra idealism, which leads him to compromise between nominalism and conceptualism. This chapter concludes that, as far as the issue of particular and universal is concerned, the Indian side is more devoted to the debate among different philosophical theories, such as realism, nominalism, and conceptualism, whereas on the Chinese side more interests are directed to contextualizing the issue within the practice of cognitive cultivation. (shrink)

This dissertation examines the connection between Craig's theorem and scientific instrumentalism. The main question to be answered is whether the former can be used to support the latter. A negative answer to this question is defended in the dissertation. ;The first two chapters present a detailed expository account of the proof of Craig's theorem and also of the process by which theoretical terms are to be eliminated from scientific theories according to the method developed by Craig. Emphasis is placed on (...) those points which are relevant to later discussions. ;There have been several arguments against using the Craigian method of eliminating theoretical terms and against replacing a scientific theory by its Craigian revised theory . The third chapter is devoted to two of those arguments. The first is meant to show that the distinction between observational and theoretical terms is untenable and hence that the Craigian method cannot be used to eliminate theoretical terms. The second is intended to show that a Craigian revised theory does not always preserve the whole inductive power of its original theory and hence that it cannot replace the original theory. Both arguments are analyzed in detail and rejected. ;The fourth chapter argues that Craig's theorem cannot be used to support scientific instrumentalism: it is argued that a Craigian revised theory may lack the explanatory power of its original theory. In the course of arguing the above point, ten outstanding theories of explanation are considered. It is argued that no matter which account of explanation is adopted, a Craigian revised theory cannot always preserve the whole explanatory power of its original theory. ;In the fifth chapter, the "theoretician's dilemma" of Carl G. Hempel's is examined. It is argued that, in virtue of the explanatory shortcoming of the Craigian method, the theoretician's dilemma cannot be used to support scientific instrumentalism. (shrink)

This article argues that, as far as the problem of Confucian religiosity is concerned, there is an interpretative turn from Mou Zongsan’s moral metaphysics to Tu Weiming’s religious hermeneutics. Some concluding remarks are made: First, Tu’s hermeneutics is rooted in the ontology of self as interrelatedness, which is completely different from Mou’s theory of true self as transcendental subjectivity. Second, Tu’s hermeneutics of self can be better illuminated with the help of Heidegger’s notion of Dasein as Being-with (Mitsein). For Tu (...) and Heidegger, self cannot be seen as something separate from community. This article also points out that the paradigmatic shift is evidenced in another similarity between the four categories of self, community, nature, and the transcendent in Tu’s hermeneutics on the one hand, and the four symbols of earth, sky, divinities, and mortals employed by Heidegger to interpret the meaning of dwelling, on the other. In such a primordial situation of dwelling, gods are not supposed to be intellectually known; they are rather to be neighbors in community. (shrink)