Practical Reasons Research Articles

Beyond thinking fast and slow: a Bayesian intuitionist model of clinical reasoning in real-world practice.

Clinical reasoning is a quintessential aspect of medical training and practice, and is a topic that has been studied and written about extensively over the past few decades. However, the predominant conceptualisation of clinical reasoning has insofar been extrapolated from cognitive psychological theories that have been developed in other areas of human decision-making. Till date, the prevailing model of understanding clinical reasoning has remained as the dual process theory which views cognition as a dichotomous two-system construct, where intuitive thinking is fast, efficient, automatic but error-prone, and analytical thinking is slow, effortful, logical, deliberate and likely more accurate. Nonetheless, we find that the dual process model has significant flaws, not only in its fundamental construct validity, but also in its lack of practicality and applicability in naturistic clinical decision-making. Instead, we herein offer an alternative Bayesian-centric, intuitionist approach to clinical reasoning that we believe is more representative of real-world clinical decision-making, and suggest pedagogical and practice-based strategies to optimise and strengthen clinical thinking in this model to improve its accuracy in actual practice.

The Neural Basis of Moral Decision-Making. Bridging Neurobiology and Theology

This study sightsees the complex relationship between neurobiology and theology in the context of moral decision-making, by utilizing a multidisciplinary approach, the research integrates findings from cognitive neuroscience, neuroimaging studies, and theological analysis to examine the neural pathways that lie beneath ethical judgments. Our paper also investigates the role of cognitive heritage in shaping moral reasoning and how neuroplasticity influences the development and adaptation of ethical frameworks. Theological perspectives are considered to offer deeper insights into human moral behaviour and in addition, the paper addresses the ethical implications of neurobiological research, emphasizing the importance of bridging scientific and religious perspectives. Through a synthesis of empirical data and theological discourse, this work tries to underwrite to a more comprehensive understanding of moral decision-making, offering insights that are both scientifically grounded and spiritually informed.

Agency and theoretical reason in The Practical Self

ABSTRACT My comments focus on the relation between theoretical reason and agency in Gomes’ account. I argue that, while Gomes is right that agency plays a role in relating us to an objective world, accounting for it does not require us to exclude theoretical reason in advance by requiring that the propositions to which we practically assent be theoretically undecidable. There are both theoretical and practical grounds for taking ourselves to have agency in thinking, and we should prefer an account of reason which allows both kinds of grounds to play a role in rationalizing our commitments. Gomes should, therefore, weaken the dualism of theoretical and practical reason which he takes over from Kant. This dualism is in any event hard to sustain outside the context of transcendental idealism; weakening it allows for what I suggest is a better account of the interaction between theoretical and practical reason.

Applying AlAfnan Taxonomy to English Composition Courses: Structuring Learning Outcomes for Effective Teaching

The article explores the significance of adopting AlAfnan’s (2024a) educational taxonomy in teaching composition courses. Moving beyond the traditional focus on technical writing skills, this framework incorporates foundational knowledge, critical thinking, ethical reasoning, practical application, creativity, and adaptability. The aim is to cultivate proficient writers and holistic communicators equipped to navigate the complexities of the dynamic 21st-century landscape. The foundation of the educational taxonomy lies in acknowledging that composition courses are more than exercises in mastering mechanics; they represent a journey into ideas. By infusing foundational knowledge and comprehension, students gain a profound understanding of the subjects they engage with, ensuring clarity and coherence in their expression. Evaluation and synthesis go beyond the transmission of information to foster intellectual rigor and depth in student writing. Integrating ethical and moral reasoning into the taxonomy prompts students to consider the societal implications of their language choices, instilling a sense of responsibility in communication. Practical application and strategic thinking are deemed indispensable for effective writing. The framework prepares students for the diverse challenges of the professional world to transcend the boundaries of academic writing. Creativity and innovation are embraced to create an environment where original ideas and innovative writing approaches are encouraged and celebrated. In recognition of the rapid changes characterizing the modern era, AlAfnan’s educational taxonomy incorporates lifelong learning and adaptability elements. This ensures that students view writing skills as dynamic tools requiring continuous refinement, cultivating a mindset essential for success in an ever-evolving global environment. The achievement of the learning outcomes in this study shall transform composition courses into transformative experiences that shape students into adept communicators prepared for the multifaceted demands of a rapidly evolving world.

Navigating uncertainty: a reflexive thematic analysis of rehabilitation staff’s perception of communicative interactions in Disorders of Consciousness and Posttraumatic Amnesia

Purpose This study aims to improve our understanding of how communicative interaction is perceived by experienced rehabilitation staff working with patients with Disorders of Consciousness (DoC) and Posttraumatic Amnesia (PTA). Method This qualitative study involved five workshops guided by modified Nominal Group Technique with 22 professionals from six disciplines. Reflexive thematic analysis was employed for analysis. Results Four main themes were developed: (1) Watching carefully for any reaction, (2) The Challenge of careful interpretation, (3) Framing the interaction, and (4) Valued knowledge for involving and communicating with the patient. Rehabilitation professionals exhibited awareness of minimal communicative behaviors but reported regular focus shifts from natural interactions to testing and validating behaviors as part of their clinical reasoning. The emphasis on reliability reflected insecurity in their interpretations. Although spontaneous interactions were recognized, they were often undervalued in favor of reproducible behaviors. Participants also stressed the importance of sharing communicative strategies to ensure consistent patient care. Conclusion The findings highlight the tension between ethical awareness and clinical reasoning, with staff prioritizing reliability over spontaneous communication. Structured support, training, and interprofessional collaboration are essential to help rehabilitation professionals navigate the complexities of DoC and PTA, ensuring that communicative interactions are effectively supported throughout recovery.

A generational study in Iranian University students' moral changes at post-COVID atmosphere

Since the COVID-19 pandemic began in 2020, some psychological changes have been tracked and reported across the world. Post-COVID-19 freshman university students can be classified as generation Z. The aim of this study was to examine changes in moral and moral-related variables among Iranian Freshman University students in generation Z compared with generation Y, in the post-COVID-19 era. Variables, including prosocial behaviors, types of prosocial moral reasoning, dimensions of moral identity and religiosity, identity styles, empathy, and social desirability, were assessed among 212 freshman students at Salman Farsi University of Kazerun in 2014. However, another assessment of those variables by the same measures and methods was performed among 114 similar students in 2022. Social desirability and lie/nonsense responses were statistically controlled by multiple analysis of covariance and partial correlation methods. Among the post-COVID group, there was less total prosocial moral reasoning, hedonistic, approval-oriented and internalized prosocial moral reasoning, normative identity, symbolization of moral identity, public prosocial behavior, and total, ideological and experimental religiosity; additionally, there was more needs-oriented and stereotypic prosocial moral reasoning, informational identity, altruistic prosocial behaviors, consequential and ritualistic religiosity and empathy. There were different correlations among the two groups, whereas religiosity and its dimensions were positively correlated with many moral variables in the 2014 group, the correlations were negative in the 2022 group. The findings indicate that in this Iranian post-COVID-19 generation Z, sentimental aspects (e.g., empathy and altruism) of morality increased and that rational (e.g., prosocial moral reasoning) or traditional (e.g., religiosity) aspects decreased.

Kant’s Reliance on Reason Rejects the Essence of Sympathy and Empathy in Any Moral Choice

Kant is noted to have pioneered the deontological position when he argued in defence of reason and duty in moral decision-making. Kant’s use of reason in moral decision-making has made him an ethical rationalist. As moral agents, our theories must be based on rational cognition. This can be said to have dominated Western philosophy since the time of Plato. During Plato’s time, the tradition believed that one must know the object and possess the cognitive principles of practical reason. This must be exercised by the will or rational capacity guided by the categorical imperative. It is only when this is accomplished that it can be said that an action is morally worthy or morally permissible. This paper argues that Kant’s reliance on reason rejects the essence of sympathy and empathy in any moral decision-making endeavour. To act justly there is the need to employ reason so that such action could be attractive as well.

Digital interventions to support morality: A scoping review.

Morality and moral reasoning develop over the course of life, but such development may encounter obstacles. Psycho-educational interventions could be designed to improve moral reasoning and attitude towards prosociality. In the last decades, many interventions employed digital technologies ranging from multicomponent online platforms to serious games and virtual reality, making use of interactivity and immersive properties that could make moral stimuli more engaging. This study aimed at reviewing the literature on digital interventions to support morality and moral reasoning, carried out with subjects of all age groups. Two electronic databases were searched with a systematic approach, and retrieved publications were scanned by authors against inclusion criteria. Twenty-three articles were reviewed. In general, the literature describes encouraging results of digital interventions to support morality. Moreover, a huge variety of morality conceptualizations emerged across various contexts (e.g., professional, school and sports) as well as various outcome measurements (e.g., change in attitudes and change in behaviour). Effectiveness of digital interventions may relate to immersive and interactive simulations in particular, in that they allow participants not only to learn about moral rules and principles but also to actively exercise their own morality to make decisions. Future research may build on the present scoping review to analyse specific types of interventions' effectiveness with a meta-analytical approach.

Moral, conventional, personal: reasons for action as dimensions of normativity

ABSTRACT Human life is infused with different kinds of normativity (e.g. instrumental, epistemic, conventional, moral). Different theorists have proposed vastly differing views on how to conceptualize the different kinds of normativity. Whereas social domain theorists have asserted that moral, conventional, and personal kinds of normativity constitute distinct thematic domains and are viewed as such even by young children, other theorists have denied that moral and nonmoral kinds of normativity are thematically distinguishable. The current paper proposes a third approach that may show a way out of the controversy. Instead of viewing normative issues as belonging to one or more distinct thematic domains, it would be more accurate, both philosophically and psychologically speaking, to recognize that any given action may be grounded in multiple, non-exclusive reasons for action. Moral, conventional, and personal reasons for action may be defined in terms of what one believes one can respectively justify to all rational interlocutors, particular social partners, and oneself. The three kinds of reasons for action may accordingly be visualized as dimensions of normativity that together comprise a three-dimensional coordinate “space of reasons.” To illustrate the dimensions approach, 16 examples are given of actions whose values vary independently on each of the three dimensions.

The fuzzy MAD stroke conjecture, using fuzzy C means to classify multimodal apparent diffusion for ischemic stroke lesion stratification

BackgroundIn conjunction with an epidemiologically determined treatment window, current radiological acute ischemic stroke practice discerns two lesion (stage) types: core (dead tissue, identified by diffusion-weighted imaging (DWI)) and penumbra (tissue region receiving just enough blood flow to be potentially salvageable, identified by the perfusion diffusion mismatch). However, advancements in preclinical and clinical studies have indicated that this approach may be too rigid, warranting a more fine-grained patient-tailored approach. This study aimed to demonstrate the ability to noninvasively provide insights into the current in vivo stroke lesion cascade. MethodsTo elucidate a finer-grained depiction of the acute focal ischemic stroke cascade in vivo, we retrospectively applied our multimodal apparent diffusion (MAD) method to multi-b-value DWI, up to a b-value of 10,000 s/mm2 in 34 patients with acute focal ischemic stroke. Fuzzy C Means was used to cluster the MAD parameters. ResultsWe discerned 18 clusters consistent with normal appearing tissue (NAT) types and 14 potential ischemic lesion (stage) types, providing insights into the variability and aggressiveness of lesion progression and current anomalous stroke-related imaging features. Of the 529 ischemic stroke lesion instances previously identified by two radiologists, 493 (92 %) were autonomously identified; 460 (87 %) were identified as efficaciously or better than the radiologists. ConclusionsThe data analyzed included a small number of clinical patients without follow-up or contemporaneous histology; therefor, the findings and theorizing should be treated as conjecture. Nevertheless, each identified NAT and lesion type is consistent with the known underpinnings of physiological tissues and pathological ischemic stroke lesion (stage) types. Several findings should be considered in current clinical imaging: WM fluid accumulation, BBB compromise conundrum, b1000 identified core may not be dead tissue, and a practical reason for DWI (pseudo) normalization.

DRAMATIZATION OF MORALITY AND LEGALITY IN TURKISH MEDIA: THE WORLD OF TV SERIES AND CRIME REALITY SHOWS

Understanding the representations of justice and law in different media texts requires evaluating a web of multidimensional themes and issues, and their intersections, in a relational manner. Media portrayal of the world of law-making, as well as forms of ‘doing the right thing’, vary across media genres. The representations of law are revelatory products of political and popular cultural practices which intersect in unexpected ways. Codes of morality and legality in media are two ‘worlds of evaluation’ (Dromi and Illouz, 2010) where such a complicated intersection can be observed. Due to the ways in which narratives on formal legal criteria of judgements and moral argumentation styles are intertwined, one can clearly derive a series of validity claims (Habermas) in different genres in popular culture. This paper tackles the question of moral reasoning embedded in two genres in an evaluation of the representations of legality as part of moral universe.

Assessment of the organ function as the primary intention of clinical reasoning applied to the critically ill patient.

This article examines how clinical reasoning about the critical patient is currently treated and draws attention to some critical issues already often highlighted in the literature. Traditional approaches to clinical reasoning, even when applied to critical patients, prioritize identifying structured diseases. In contrast, the critical care setting demands an alternative approach that aligns with the intensivist's goal of supporting or substituting vital organ functions. In this manuscript, we emphasized the reasons that make it primary for intensivists to obtain a diagnosis of function in order to act therapeutically. Moreover, we highlighted the challenges posed by diagnostic errors, often attributed to cognitive biases and shortcomings in clinical reasoning, which can adversely affect patient outcomes and resource utilization. We also discussed the complexities of clinical decision-making in emergency medical services, where physicians must perform rapid actions in the face of incomplete information and high uncertainty. We underscore the limitations of traditional information technology tools in facilitating practical clinical reasoning, advocating for the integration of relevant data that directly informs on organ function and pathophysiological mechanisms. This discourse emphasizes a deep understanding of physiology and pathophysiology as foundational for practical clinical reasoning in critical care. Finally, we propose a structured assessment method that prioritizes pinpointing the compromised organ function, elucidating the pathophysiological mechanism responsible, hypothesizing potential causes, and testing these hypotheses to guide therapeutic interventions. This approach aligns clinical reasoning with the intensivist's goal: supporting and restoring vital functions in the critically ill patient.

Ethical reasoning in technology: using computational approaches to integrate ethics into AI systems

Purpose This paper does not concern with the “why” of ethics. Such questions are typically of interest to philosophers and are outside the scope of this work. In the next section, the authors offer a look into “what” of ethics, i.e. various types and subtypes of ethics. Subsequently, the authors explore “how” of ethics, by summarising various computational approaches to ethical reasoning offered by researchers in the field. Design/methodology/approach The approaches are classified based on the application domain, ethical theory, agent type and design paradigm adopted. Moreover, promising research directions towards ethical reasoning are also presented. Findings Since the field is essentially interdisciplinary in nature, collaborative research from such areas as neuroscience, psychology, artificial intelligence, law and social sciences is necessary. It is hoped that this paper offers much needed insight into computational approaches for ethical reasoning paving way for researchers to further engage with the question. Originality/value In this paper, the authors discussed vaious computational approaches proposed by researchers to implement ethics. Although none of the approaches adequately answer the question, it is necessary to engage with the research effort to make a substantial contribution to the emerging research area. Though some effort has been made in the design of logic-based systems, they are largely in stages of infancy and merit considerable research.

Are earnings management practices normalised within accounting education? A study of students’ perceptions in Colombia

ABSTRACT From an ethical perspective, the exploration of earnings management remains insufficiently examined within the Latin American accounting landscape. To address this gap, this study explores the perceptions of accounting students at Colombian universities regarding earnings management practices that potentially deceive stakeholders. A questionnaire containing scenarios depicting earnings management was distributed to 261 accounting students across various cities. Through multivariate techniques and a logit model, the study finds that students from higher socioeconomic backgrounds and those with work experience are more inclined to perceive such practices as acceptable. Furthermore, students attending public universities perceive greater acceptance of earnings management among their peers and professors compared to those attending private universities. These findings suggest that accounting education appears to reinforce an ‘economic ethic’ that prioritises the interests of the capitalist model over ethical considerations. The study highlights the need to strengthen ethical education within accounting curricula, fostering moral reasoning development beyond merely adhering to professional ethical codes.

Validation of the Italian version of the Eating-Related Eco-Concern Questionnaire: insights into its relationship with orthorexia nervosa

IntroductionUrgent calls for research on the relationship between climate change concerns and eating disorder risk have been made. This study aimed to validate an Italian version of the Eating-Related Eco-Concern Questionnaire (EREC), a brief unidimensional measure of eating behaviors related to eco-concern.MethodsSix hundred and sixty-three adults (85% females, mean age 37 ± 12 years) completed the EREC, Climate Change Worry Scale (CCWS), Eating Disorder Examination-Questionnaire (EDE-Q), Eating Habits Questionnaire for orthorexia nervosa symptoms (EHQ-21), and questions on dietary habits and motivations, and past experiences of extreme climate events.ResultsConfirmatory factor analysis results indicated that the original one-factor model showed acceptable fit to the data after including the error covariation between two pairs of items. Internal consistency was adequate, and EREC scores correlated positively and strongly with CCWS scores. Participants scored significantly lower in EREC than in CCWS, indicating greater climate-related concerns in general terms than relating specifically to eating. While EREC was unrelated to EDE-Q scores, weak-to-moderate correlations were observed with EHQ-21 subscale and total scores. Pro-environmental and/or ethical reasons for current diet and personal experience of extreme climate events were associated with significantly higher EREC scores.DiscussionThe Italian EREC appears to be a valid and reliable tool for the screening of eating-related concerns and behaviors related to climate change. Ecological concerns may represent a healthy adaptive response, but the EREC can serve as a valuable tool to identify individuals whose eating behaviors related to eco-concern might warrant further clinical attention due to potential risks of developing rigid or unhealthy patterns.

Empathy’s Role in Engineering Ethics: Empathizing with One’s Self to Others Across the Globe

Engineers make decisions with global impacts and empathy can motivate ethical reasoning and behavior that is sensitive to the needs and perspectives of stakeholders across the globe. Microethics and macroethics offer two frames of reference for engineering ethics education, but different dimensions of empathy play distinct roles in micro- and macroethics. Microethics emphasizes individual responsibility and interpersonal relationships whereas macroethics emphasizes societal obligations and impacts. While empathy can support ethical reasoning and behavior for each, in this paper I argue that affective empathy plays a primary (but not exclusive) role in microethics whereas cognitive empathy plays a primary role in macroethics. Gilligan’s and Kohlberg’s theories of moral development are used to further depict how affective empathy aligns with care (depicted as an interpersonal phenomenon) and how cognitive empathy aligns with justice (depicted as a systems-focused phenomenon), thus positioning these ethical principles as playing primary (but again, not exclusive) roles in micro- and macro-ethics, respectively. Building on these ideas, this study generates a framework that describes and visualizes how empathy manifests across six frames of reference, each of which are increasingly macro-ethical in nature: self, team, operators, participants, bystanders, and future generations. The paper describes how proxy stakeholders can be identified, developed, and leveraged to empathize with stakeholder groups. Taken together, the manuscript seeks to clarify the role of empathy in engineering ethics and can enable engineering students to better empathize with the range of stakeholders impacted by engineering decisions, ranging from one’s self to stakeholders across the globe. The intrapersonal understandings and motivations that students generate by empathizing across six frames of reference can facilitate ethical reasoning processes and behaviors that are more inclusive and comprehensive.

Relasi Filsafat dan Ilmu Pengetahuan dan Realisasinya di Era Super Smart Society

The relationship between the philosophy of science and education plays a crucial role in shaping the capacity of future generations to think critically and solve problems effectively. Philosophy of science, as a discipline that explores the foundations, methods, and implications of scientific knowledge, offers a framework for understanding how knowledge is constructed and how it can be applied in solving real-world problems. In the context of education, it serves as a cornerstone for fostering analytical thinking, logical reasoning, and reflective inquiry. This paper examines how philosophical perspectives on science can inform educational practices that nurture critical and solution-oriented thinking. By integrating philosophical insights into the curriculum, educators can promote an environment that encourages students to question assumptions, evaluate evidence, and develop innovative solutions to contemporary challenges. Ultimately, the integration of philosophy of science into education not only enhances intellectual growth but also equips students with the tools needed to address the complex issues facing society today. This relationship is essential in preparing a generation that is capable of navigating the rapidly changing world with a mindset grounded in inquiry, adaptability, and ethical reasoning.

Are Corporations Like Psychopaths? Lessons On Moral Responsibility From Rio Tinto's Juukan Gorge Disaster

ABSTRACTThere seems to be a striking parallel between the features of psychopaths and those of agential groups, including states and corporations. Psychopaths are often thought to lack some of the capacities that are constitutive of moral agency. Two features of psychopaths are commonly identified as grounds for limiting their moral responsibility: (i) their lack of relevant emotional capacities and (ii) their flawed rational capacities. Roughly, the first argument is that the lack of moral emotions such as sympathy, guilt, or shame negatively impacts moral perception and therewith an agent's capacity for moral reasoning. The second argument is that psychopaths are diminished in their agency as such, not just in their moral agency; they are erratic and impulsive and show other significant failures of rationality. Using the 2020 Juukan Gorge disaster in Western Australia as a case study, I conclude that deliberate or reckless corporate irrationality cannot be grounds for diminished corporate moral responsibility. Corporate agents are chiefly responsible for core aspects of their moral agency, including their internal epistemic structures and decision‐making processes. They have obligations to establish or maintain internal epistemic integrity and consistency.

Investigation on Tattoo Ink (Hexadecachlorinate Copper Phthalocyanine) Removal: Novel Chemical and Biological Approach

Tattoos have been a ubiquitous phenomenon throughout history. Now, the demand for tattoo removal for aesthetic or practical reasons is growing rapidly. This study outlines the results of field investigations into the chemical and biological removal of tattoo inks (Hexadecachlorinate copper phthalocyanine—C32Cl16CuN8—CAS no° 1328-53-6). FTIR, Py-GC/MS, and NMR analyses yielded intriguing profiles pertaining to the primary chemical constituents, along with others of an ambiguous nature. A bioremoval protocol was developed on a pork rind surface to simulate human tattooing. Two previously studied microbial strains were included in this analysis: (i) a bacterial culture of Pseudomonas stutzeri 5190 DSMZ viable cells and (ii) a fungal culture of Alternaria infectoria strain NIS4, the latter already isolated and identified. A combination of physical, chemical, and microbiological analyses, along with microscopic observations, was conducted. In our experimental conditions, inocula from environmental samples (soil and compost) were capable of inducing changes in even trace organic matter (glycerin and additives in pigments) used as a binder in emulsifiers in tattoo inks. Furthermore, the two microbial strains demonstrated promising potential for removing green tattoo ink. Finally, wastewater effluents containing green ink were recovered via electrochemical treatment, and the environmental impact in terms of the CO2 equivalent of our experiments was assessed. The results are promising and warrant further investigation into the innovative biological and chemical removal of tattoo inks from human skin and wastewater, respectively.

Property Rights, Fossil Fuel Imports, and Climate Change

Abstract Shmuel Nili claims that when a country buys fossil fuels from dictatorships it becomes complicit with property rights violations in those dictatorships. Thus, Nili argues, people who have a strong commitment to property rights should support a ban on fossil fuel imports from dictatorships, and a transition to renewable energy. This article critically discusses Nili’s argument. The argument fails to consider competing moral reasons that some people may have to oppose a ban on fossil fuel imports from dictatorships, such as moral preference for family and compatriots. The argument also mistakenly assumes that renewable energy would be overwhelmingly economically attractive when fossil fuel imports are forbidden, and that switching to renewable energy would not involve importing stolen goods too. The article ends more propositively, by elaborating an alternative argument that Nili dismisses too quickly, and which may help persuade those who are strongly committed to property rights of transitioning to renewable energy: the argument that transitioning would help avoid violating those rights through contributions to harmful climate change.