In this paper, I develop an approach to population ethics which explains what we are permitted to do in virtue of the possible complaints against our action. This task is made difficult by a serious problem that arises when we attempt to generalize the view from two-option to many-option cases. The solution makes two significant moves – first, accepting that complaints are essentially pairwise comparative, and second, reimagining decision-making as a tournament between options competing two at a time. The right (...) view about when one option defeats another with respect to complaints, paired with the right view about how to pick the winners of the tournament given the relations of defeat, leads to a uniquely attractive view in the person-affecting tradition. (shrink)

Overstretched resources and steady increases in the number of complaints filed with the offices of the Quebec Service Quality and Complaints Commissioner prompted us to investigate the complaint-handling systems of health-related organizations operating in Commonwealth and Western European countries. We also examined guidelines used to identify higher priority files (i.e., urgent files). Urgent files can then be prioritized in terms of the time taken to provide a conclusion as well as the depth of the examination. A system where a (...) small fraction of complaints is deemed “urgent” was preferred over systems where complaints are categorized into three or more priority levels, because files categorized in the lowest of three or more priority levels risk being neglected. Applying lessons from other systems and considering the Service Quality and Complaints Commissioner’s mandate, we identified three guiding criteria for determining whether files warrant urgent status: threat to safety, involvement of vulnerable person(s) and risk of recurrence (but only when coupled with safety issues). Since determining which files should be considered urgent is not straight forward, these broad criteria can be adapted and applied on a case-by-case basis. (shrink)

Several philosophers have defended versions of Minimax Complaint, or MC. According to MC, other things equal, we should act in the way that minimises the strongest individual complaint. In this paper, I argue that MC must be rejected because it has implausible implications in certain cases involving risk. In these cases, we can apply MC either ex ante, by focusing on the complaints that could be made based on the prospects that an act gives to people, or ex (...) post, by focusing on the complaints that could be made based on the actual results that an act has for people. I argue that MC has implausible implications either way. I then defend a view on which, other things equal, we should act in the way that minimizes the sum of complaints. (shrink)

How should contractualists assess the permissibility of risky actions? Both main views on the question, ex ante and ex post, fail to distinguish between different kinds of risk. In this article, I argue that this overlooks a third alternative that I call “objective ex ante contractualism”. Objective ex ante substitutes discounting complaints by epistemic risk in favor of discounting by objective risk. I further argue in favor of this new view. Objective ex ante contractualism provides the best model of justifiability (...) to each. (shrink)

The Analects appears to offer two bodies of testimony regarding the felt, experiential qualities of leading a life of virtue. In its ostensible record of Confucius’ more abstract and reflective claims, the text appears to suggest that virtue has considerable power to afford joy and insulate from sorrow. In the text’s inclusion of Confucius’ less studied and apparently more spontaneous remarks, however, he appears sometimes to complain of the life he leads, to feel its sorrows, and to possess some despair. (...) Where we attend to both of these elements of the text, a tension emerges. In this essay, I consider how Confucius’ complaints appear to complicate any clean conclusion that Confucius wins a good life, particularly where we attend to important pre-theoretical sensibilities regarding what a “good life” ought to include and how it ought to feel for the one who leads it. (shrink)

Introduction: Midwives play an important role in maintaining and increasing women’s health and well-being. Training professional midwives is one of the main policies of any healthcare system. Since the number of complaints against midwives has increased recently, this study was conducted to explore the perspectives of midwives regarding patients’ complaint to authorities and their impacts on the profession of midwifery. Methods: Being conducted in 2013, this qualitative study was the first of its type in Iran. Data were collected through (...) in-depth semi-structured interviews with 14 midwives working in different cities across the country. The participants were selected using a purposive sampling method. Interviews were transcribed verbatim and analyzed following a qualitative content analysis approach. Written text was then coded, and themes were extracted from the data. Ethical considerations: The study was conducted with midwives’ free informed consent and was approved by Ethics Committee of Tehran University of Medical Sciences. Findings: By analyzing the data, four main themes regarding the impact of complaint on midwifery profession were developed. These included the following: “dissatisfied of midwifery, professional deviation, obsession with work, and weakening of the professional status.” Conclusion: The experience of patients’ complaint to legal authorities against midwives was described, by participants, as a painful experience. Lack of midwives’ knowledge about professional rules and litigation process created many problems for them and could negatively affect their practice and the society’s attitude toward midwifery. Thus, we suggest that in order to prevent such problems, midwives and midwifery students should be educated regarding factors that have the potential to create such problems and also prevention strategies. (shrink)

Today, monitoring of patient complaints in healthcare services is being used as a tool for quality assurance systems and in the future development of services. This nationwide register study describes the number of all complaints processed, number of complaints between different state provinces, healthcare services and healthcare professionals, and outcomes of complaints in Finland during the period 2000–2004. All complaints processed at the State Provincial Offices and the National Authority for Medicolegal Affairs were analysed by statistical methods. Complaints about mental (...) healthcare were explored in greater detail. The analysis showed that the number of patient complaints increased considerably during the study period. There were changes in the number of complaints between study years in different provinces. Out of different healthcare services, an especially marked increase was seen in private healthcare. Nearly all complaints were lodged against physicians, and over half of the complaints were made because of medical error. In mental health care, patients more often complained about unsatisfactory certificates and statements and the use of compulsory hospital care. An analysis of the outcomes revealed that in mental health care complaints more seldom led to consequences. The results need to be utilised when planning interventions for advanced supervision, prevention of adverse events and patient safety in healthcare, and especially in mental health care. From the patients’ perspective, it is important to create a culture where most problem situations are handled where the treatment was provided, thus avoiding a complex complaints process. (shrink)

SUMMARYAmong the elements of the modern scientific ethos, as identified by R.K. Merton and others, is the commitment of individual effort to a long-term inquiry that may not bring substantial results in a lifetime. The challenge this presents was encapsulated in the aphorism of the ancient Greek physician, Hippocrates of Kos: vita brevis, ars longa. This article explores how this complaint was answered in the early modern period by Francis Bacon’s call for the inauguration of the sciences over several (...) generations, thereby imagining a succession of lives added together over time. However, Bacon also explored another response to Hippocrates: the devotion of a ‘whole life’, whether brief or long, to science. The endorsement of long-term inquiry in combination with intensive lifetime involvement was embraced by some leading Fellows of the Royal Society, such as Robert Boyle and Robert Hooke. The problem for individuals, however, was to find satisfaction in science despite concerns, in some fields, that current observations and experiments would not yield material able to be extended by future investigations. (shrink)

Background: In their daily practice, Brazilian nurses have been met with complaints from co-workers and patients, as well as bioethical dilemmas intrinsic to the profession, particularly in the context of care delivery. Complaints against nursing professionals have been in the media spotlight. Objective: To examine complaints filed with the Regional Board of Nursing of Mato Grosso do Sul (COREN-MS) in Midwest Brazil. Method: Retrospective, analytical desk research of 111 complaints received by COREN-MS in 2003–2013 was carried out. Characterizations of complainant, (...) professionals investigated, and complaints were the variables investigated. Ethical consideration: The project was approved by the Research Ethics Committee of the Federal University of Mato Grosso do Sul. To ensure confidentiality and anonymity, all documents retrieved were examined in situ and subjects were assigned numbered codes. Results: Most complainants were nursing professionals (40). Most causes of complaint originated in the hospital setting (65). Most allegations were made against nursing technicians and licensed practical nurses (82). Complaints involving interprofessional relationships (85), iatrogenic events (36), and professional liability (20) predominated. Discussion: Bioethical principles were breached, translating to poor-quality nursing care, detrimental to the professional image of nurses among users and nursing professionals alike. Conclusion: The findings can serve as input to guide nursing schools and boards of nursing in developing policies to raise awareness among nursing professionals, sensitizing them to the responsible provision of care in the light of bioethical and legal principles. (shrink)

Bioethicists have long advocated for patients’ rights by deliberating on what physicians should or should not do for the well-being of patients. Part of this advocacy has involved challenging a paternalistic medical model where physicians are seen as authoritative figures above reproach. Through ombudsperson offices, patients can submit complaints that may lead to medical examiners conducting detailed examinations of physicians’ conduct and decision-making. Prior research indicates that complaints can have serious and broad effects on physicians. We conducted a scoping review (...) to explore and evaluate the extent of the quantitative and qualitative literature examining the effects of complaints on physicians in European and Commonwealth countries. We systematically searched electronic databases (CINAHL, MEDLINE and PsycInfo) and grey literature for primary research that collected information directly from physicians on at least one potential effect of formal complaints. After screening the titles/abstracts of 14,913 records and reviewing 137 full-texts, 25 studies were included. The 25 studies reported on several potential effects, including the patient-physician relationship (3 studies), defensive medicine (14 studies), anxiety (8 studies), depression (8 studies), one’s identity as a physician (5 studies), and anger (5 studies). Generally, the effects evaluated in the included studies were negative. Although the existing literature covered a range of possible effects, few studies assessed the same effects via different methods, and in different regions and contexts. The findings of this scoping review suggest that complaints processes can have negative effects on physicians. (shrink)

This essay engages the writings of Erasmus of Rotterdam on the prevalence and practices of deceit, yielding thereby an Erasmian complaint on behalf of truth. The works of Erasmus challenge us to face up to the diverse forms of deceit; to recognize the sundry tricks used by liars and frauds; and to calculate the damaging consequences of their subterfuge. Astutely fixed on the mendacity of tyrants and would-be tyrants, Erasmus proves to be a trenchant critic of such assaults on (...) truth, exposing the manipulation of appearances and uncovering the twisted reversals of language, while subjecting the various perpetrators to criticism in a manner that cleverly banks on its own creative and beneficent dissemblance. Erasmus thereby offers an alternative model of truthfulness designed for the complexities of life in a culture of lies. (shrink)

This up-to-date and comprehensive handbook guides the reader, step-by-step, through all aspects of complaints and grievance management. It includes useful addresses, current codes of ethics from the major organizations, protocols and sample letters.

This study examines the impoliteness strategies employed by Kuwaiti passengers who complain about airline delays and cancellations online on TripAdvisor and X. Using both qualitative and quantitative methods, the study analyzes 50 samples to calculate the frequency of various impoliteness strategies. The study adopts Brown and Levinson (1987. Politeness: Some universals in language usage. Cambridge: Cambridge University Press) and Culpeper (2011. Impoliteness: Using language to cause offence. Cambridge University Press) frameworks to identify the most commonly employed strategies and understand the (...) influence of Kuwaiti cultural norms on these choices. The findings show that Negative impoliteness (50.80 %) and Positive impoliteness (31.74 %) are the most prevalent strategies, indicating a preference for direct and explicit expressions of dissatisfaction. Less frequent strategies, such as Sarcasm, Mock Politeness (3.18 %), and Withholding Politeness (1.58 %), suggest that while indirect methods are occasionally used, they are less favored in this context. The research highlights the implicit use of indirect strategies to preserve social harmony while also emphasizing Kuwaiti communication’s cultural focus on assertiveness and accountability. This study gives an explanation for investigating online complaints in the context of Kuwaiti cultural norms and enhances awareness of the cultural impacts on impoliteness strategies. The study suggests that future research might explore the role of demographic factors to examine the evolution of impoliteness strategies in online complaints. (shrink)

It has been suggested that understanding our obligations to address large-scale moral problems such as global poverty and the threat of severe climate change as fundamentally collective can allow us to insist that a great deal must be done about these problems while denying that there are very demanding obligations, applying to either individuals or collectives, to contribute to addressing them. I argue that this strategy for limiting demandingness fails because those who endorse collective obligations to address large-scale moral problems (...) have no grounds for denying that the relevant collectives are obligated to do what is impartially best. Specifically, I argue that appeals to the claim that collective obligations to do what is impartially best would be objectionably demanding cannot succeed, for two reasons. The first is that demandingness complaints cannot be aggregated across the individual members of a collective. And the second is that demandingness complaints cannot plausibly be asserted on behalf of collectives themselves. I conclude by suggesting some reasons to think that collective obligations to address large-scale problems will tend to imply demanding individual obligations. (shrink)

Objective: The aim of this study was to identify symptoms associated with subjective memory complaints among subjects who are currently on sick leave due to symptoms of chronic pain, fatigue, depression, anxiety and insomnia. Methods: This was a cross-sectional study, subjects (n = 167) who were currently on sick leave were asked to complete an extensive survey consisting of the following: items addressing their sociodemographics, one item from the SF-8 health survey measuring pain, Chalder Fatigue Questionnaire, Hospital Anxiety and Depression (...) Scale, Insomnia Severity Index and Everyday Memory Questionnaire – Revised. General linear modeling (GLM) was used to analyze variables associated with SMCs. Results: Symptoms of fatigue (p-value <= 0.001) and anxiety (p-value = 0.001) were uniquely and significantly associated with perceived memory failures. The associations with symptoms of pain, depression and insomnia were not statistically significant. Conclusions: Subjective memory complaints should be recognized as part of the complex symptomatology among patients who report multiple symptoms, especially in cases of fatigue and anxiety. Self-report questionnaires measuring perceived memory failures may be a quick and easy way to incorporate and extend this knowledge into clinical practice. (shrink)

Fourth-year medical students at the University of Colorado School of Medicine distributed cards to patients in the emergency department asking, "What Worries You Most?" The patients' responses provided insight about their most pressing concerns, often unrelated to their "chief complaints.".

Many believe that relationships can make a constitutive difference to the moral status of paternalistic treatment. For example, it is often assumed that it's easier to justify paternalizing a spouse than a stranger. But although this thought is widespread, there exists no detailed account of how relationships could mitigate paternalistic complaints. The aim of this paper is to develop an account of this phenomenon, drawing on the work of Margaret Gilbert and the notion of joint commitments. According to the resulting (...) view, close relations can constitutively mitigate paternalistic complaints by rendering paternalistic interference consistent with the will of the paternalized agent. (shrink)

In recent decades, academic science has increasingly been directed toward commercializable ends by neoliberal governments. In this article, I outline a concern that academic scientists have not been consulted about the transformation of science, but nevertheless, in some ways accept commercialization as the way things are done. I focus on the ways in which academic scientists attempt to exercise agency, albeit within the parameters of the neoliberal knowledge economy. In this economy, scientific inquiry has transformed to be focused more on (...) producing marketable products. In order to explore the parameters of scientists’ agency in the context of that transformation, I first elaborate on the idea of agency’s “parameters” and argue that the literature on commercialization lacks attention to how researchers’ agency is encouraged and discouraged in the context of academic research in the United States and Canada; second, I make a case for using the concept of hegemony to understand the ideas and practices of contemporary science; third, I propose a methodological direction that can attend to researchers’ agency in the contemporary context of the neoliberal knowledge economy. (shrink)

When may someone complain, morally? And what, if any, is the relationship between legitimate moral complaint and one's own behaviour? I point out a perplexity about a certain class of moral complaints. Two very different conceptions of moral complaint seem to be operating, and they often have contrary implications. Moreover, both seem intuitively compelling. This is theoretically and practically troubling, but has not been sufficiently noticed. The Paradox of Moral Complaint seems to point to an inherent difficulty (...) in our reflective moral intuitions. Given the legislative nature of moral agency, the plausible limitations upon reasonable moral complaint seem to contradict the inviolability of central moral constraints and the complaints they allow. In the sort of cases under discussion, morality seems at once both to insist upon the possibility of moral complaint, and to deny it. (Published Online August 21 2006). (shrink)

Malpractice issues in psychotherapy and psychological treatments refer to the unethical behavior of a psychologist or psychotherapist toward the patient. The current study reviewed complaints directed at psychologists and psychotherapists in Sweden with regard to possible incidents of malpractice. Eligible cases were retrieved from a database managed by the Health and Social Care Inspectorate [Inspektionen för vård och omsorg (IVO)], an administrative authority responsible for the safety and quality of healthcare and social services delivery. These cases were analyzed using thematic (...) analysis. In total, 33 complaints matched the keywords proposed by IVO, and were scrutinized in detail. The cases primarily involved psychiatric care by a psychologist in outpatient settings, although many cases comprised multiple healthcare providers responsible for the patient’s care, or targeted the healthcare unit as a whole. The results demonstrated that different forms of malpractice occur, and can be classified in two general themes, Incorrect administration and implementation and Attitude and behavior, which involve organizational aspects as well as examples of malpractice and unethical behavior. Implications for clinical practice and future research include further training in ethics and malpractice, video recording or auditing sessions, routine outcome monitoring, and providing patients with information on how to file complaints. (shrink)

Famously, Saul Kripke proposes that there are contingent a priori truths, and has offered a number of examples to illustrate his claim. The most well-known example involves the standard meter bar in Paris. Purportedly, a certain agent knows a priori that the bar is one meter long. However, in response to a long-standing objection to such examples - the "existential complaint" - generally only modified examples having a conditional form are now considered candidates for the contingent a priori. Gareth (...) Evans argues that these conditionals must be understood free-logically, and on this basis argues against Keith Donnellan's analysis of the contingent a priori. I show Evans' argument mistaken. I also take issue with the existential complaint, and suggest a way of understanding Kripke's original examples that is not subject to it. My approach focuses the debate in its right place, and allows us to take Kripke's original examples seriously. (shrink)

Health practitioners run the risk of ethical board complaints or legal action against them in their professional careers. This experience can have a detrimental impact on personal wellness and professional practice. This study reports on the subjective experience of ten South African psychologists who received complaints. Semi structured interviews were conducted, and the transcripts analyzed using interpretative phenomenological analysis (IPA). The data indicates that (1) the participants experienced the effects of a complaint on an intensely personal level and (2) (...) the experience of a complaint highlighted the challenging nature of working in the modern health care arena. The researchers hope to inform the psychological community of the emotional challenges experienced during a complaint process, to encourage a transparent discourse about the subject and muster support for practitioners during an often-isolating professional incident. (shrink)

The fascinating Journey of the Renaissance Medicine.

In this case study, we describe an approach to dealing with a complicated, systemic, and multi-faceted organizational issue: the continuum of maternal care from antepartum care, birthing, to post-natal care.

Many believe that relationships can make a constitutive difference to the moral status of paternalistic treatment. For example, it is often assumed that it’s easier to justify paternalizing a spouse than a stranger. But although this thought is widespread, there exists no detailed account of how relationships could mitigate paternalistic complaints. The aim of this paper is to develop an account of this phenomenon, drawing on the work of Margaret Gilbert and the notion of joint commitments. According to the resulting (...) view, close relations can constitutively mitigate paternalistic complaints by rendering paternalistic interference consistent with the will of the paternalized agent. (shrink)

Music performance anxiety (MPA) is a multifaceted phenomenon occurring on a continuum of severity. In this survey study, we investigated to what extent the affective (anxiety), cognitive (catastrophizing), and somatic (bodily complaints) components of MPA prior to solo performances vary as a function of age, gender, instrument group, musical experience, and practice as well as how these MPA components relate to self-rated change in performance quality from practice to public performance. The sample comprised 75 male and 111 female classical music (...) university students, aged 15–45 years. Age was positively associated with anxious feelings and bodily complaints. Compared to male students, female students reported significantly more anxious feelings and catastrophizing. Singers reported less anxious feelings and catastrophizing than instrumentalists. Breathing-, mouth- and throat-related complaints were highest among singers and wind players; hand- and arm-related complaints were highest among string players and pianists. The indices of musical experience and practice had marginal effects. An average of four bodily complaints bothered the participants strongly to very strongly. Worsening in performance quality from practice to public performance was reported by almost half of the participants and was best predicted by anxious feelings and breathing-related complaints. We conclude that age, gender and instrument play a significant role in understanding the phenomenology of MPA. Musicians should be examined according to these characteristics rather than as one homogenous population. In particular, it might be valuable to develop assessment tools for MPA that incorporate items related to the bodily complaints that are most relevant to the different instrument groups. Breathing-related complaints could add an important dimension to the investigation of MPA and music performance. Finally, the high percentage of students reporting worsening of their performance quality from practice to public performance highlights the need of professional support to help music students be able to perform at their best and thrive as artists. (shrink)

인식적 양상 및 취향에 대한 참 상대주의에 따르면, “p이다”와 같이 어떤 기준도 명시적으로 제시되지 않은 문장은 〈p이다〉는 명제를 표현하며, 이것은 판정자 혹은 판단자 상대적으로 진리치가 결정될 수 있다. 이런 참 상대주의 중에서 현재 가장 많은 학자들에 의해서 지지를 받고 있는 두 입장은 맥팔레인의 참 상대주의와 스티븐슨의 참 상대주의이다. 이들의 두드러진 차이점중에 하나는 그것들이 각각 ‘판정의 시간에서의 판정자’ 제한조건과 ‘평가상황의 시간에서의 판단자’ 제한조건을 갖는다는 점이다. 하지만 나는 ‘판정[단]자 중심성이라는 참 상대주의의 중요한 직관이 보다 널리 인정받는 데 있어서, 이들 제한조건이 불필요한 걸림돌이 (...) 된다’고 생각한다. 따라서 이들은 약화되거나 혹은 거부되어야 한다. (shrink)

Advances in the understanding of genetics have led to the belief that it may become possible to use genetic engineering to manipulate the DNA of humans at the embryonic stage to produce certain desirable traits. Although this currently cannot be done on a large scale, many people nevertheless object in principle to such practices. Most often, they argue that genetic enhancements would harm the children who were engineered, cause societal harms, or that the risks of perfecting the procedures are too (...) high to proceed. However, many of these same people do not have serious objections to what is called ‘genetic planning’ procedures (such as the selection of sperm donors with desirable traits) that essentially have the same ends. The author calls the view that genetic engineering enhancements are impermissible while genetic planning enhancements are permissible the ‘popular view’, and argues that the typical reasons people give for the popular view fail to distinguish the two practices. This paper provides a principle that can salvage the popular view, which stresses that offspring from genetic engineering practices have grounds for complaint because they are identical to the pre-enhanced embryo, whereas offspring who are the result of genetic planning have no such grounds. (shrink)

Drawing on an analysis of complaint files that we conducted for the Irish Medical Council, this paper offers three possible explanations for the gap between the ubiquity of official commitments to taking patients’ complaints seriously and medical professional regulators’ dismissal—as not warranting an inquiry—of the vast majority of complaints submitted by members of the public. One explanation points to the “regulatory illiteracy” of many complainants, where the remit and threshold of seriousness of regulators is poorly understood by the general (...) public. Another points to possible processes of “institutional epistemic injustice” that unjustly undermine the credibility of certain complainants, such as those with low levels of formal education. A third explanation highlights the marginalization of the general public from “symbolic power” to define what matters in medical professional regulation. The paper is offered in a spirit of ideas in progress and raising questions rather than definitive insights into the regulatory process. (shrink)

Tziporah Kasachkoff received her doctorate in philosophy from New York University, teaches at The City University of New York, and has been a visiting professor at Ben Gurion University in the Negev, in Israel. Dr. Kasachkoff has published widely in applied philosophy and, since 1986, has been the editor of the American Philosophical Association Newsletter on Teaching Philosophy.

Reference groups and complaints about inequality Although influence of reference population on assessment of individual position is well recognized on the ground of sociology, its impact is rarely taken into account in economic analysis of inequality. Few analyses that are concerned with issue of reference groups in the context of inequality and relative deprivation measurement deal, however, with single reference group. The aim of the paper is consideration on how concept of reference populations of different kind (reference groups and reference (...) categories) may be applied to assessment of aggregated complaint that results from inequality in income (wealth) distribution. (shrink)

In her final fragmentary novel Sanditon, Jane Austen develops a theme that pervades her work from her juvenilia onward: illness, and in particular, illness imagined, invented, or self-inflicted. While the “invention of odd complaints” is characteristically a token of folly or weakness throughout her writing, in this last work imagined illness is also both a symbol and a cause of how selves and societies degenerate. In the shifting world of Sanditon, hypochondria is the lubricant for a society bent on turning (...) health into a commodity. As a result, people’s rationality and their moral character come under attack. Catherine Belling’s recent subtle study, A Condition of Doubt: The Meanings of Hypochondria, unveils hypochondria’s discursive and cultural character. Running sharply against the tenor of Austen’s treatment, however, she argues in defense of the rationality of hypochondriacs; the notion that the condition may involve morally significant defects is not entertained; any connection to the commercialization of health care is muted. Here, I contrast Austen’s morally and epistemically negative rendering of her hypochondriacal characters in Sanditon with Belling’s efforts to create a sympathetic understanding of people with hypochondria. I will argue that, despite time gaps and genre differences, joint consideration of these texts can help bioethicists better appreciate how medicine can intensify, pathologize, and exploit anxieties about illness and death, thus adding to the challenges of living well in the face of mortality and morbidity. (shrink)