Lin Cheng

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.

Cellular reprogramming can manipulate the identity of cells to generate the desired cell types1– 3. The use of cell intrinsic components, including oocyte cytoplasm and transcription factors, can enforce somatic cell reprogramming to pluripotent stem cells4– 7. By contrast, chemical stimulation by exposure to small molecules offers an alternative approach that can manipulate cell fate in a simple and highly controllable manner8– 10. However, human somatic cells are refractory to chemical stimulation owing to their stable epigenome2,11,12 and reduced plasticity13,14; it is therefore challenging to induce human pluripotent stem cells by chemical reprogramming. Here we demonstrate, by creating an intermediate plastic state, the chemical reprogramming of human somatic cells to human chemically induced pluripotent stem cells that exhibit key features of embryonic stem cells. The whole chemical reprogramming trajectory analysis delineated the induction of the intermediate plastic state at the early stage, during which chemical-induced dedifferentiation occurred, and this process was similar to the dedifferentiation process that occurs in axolotl limb regeneration. Moreover, we identified the JNK pathway as a major barrier to chemical reprogramming, the inhibition of which was indispensable for inducing cell plasticity and a regeneration-like program by suppressing pro-inflammatory pathways. Our chemical approach provides a platform for the generation and application of human pluripotent stem cells in biomedicine. This study lays foundations for developing regenerative therapeutic strategies that use well-defined chemicals to change cell fates in humans.

Philosophy of action that is a very important issue is to explore the "action person" Why should action? Michael Gold Theil action in the philosophy of identity is the traditional stance that the actions were the reason for action, he was primarily concerned with the premise that "What is the action by now should be the pursuit of good," followed by " Why was the actual situation faced ", when action in face of the premise of these two items, these premises will bring some action types are the" tips "so who knows how to inhibit the action of their own passion and should do to make action. He criticized contemporary two kinds of mainstream action regardless out of action who does not really know know what to do What is the correct, reasonable; actions were not concerned about making the right behavior in terms of their What are the value and significance; action by not because of law-abiding and happy; even, it will not become a good citizen because of pride. He saw action in the future of the practice of reasonable addition may be legitimate, more important, it should be more in line with ethics, in line with good principles. Because an ethical, the pursuit of good action who must be a spirit of practical management wisdom and moral reasoning carried out, and then actions of people. Tell how the cash wheat, however, described his idea of it regardless? The arguments point why he is reasonable, objective? That this thesis is seeking to explore the subject. One of the important topics of action philosophy is to explore why an actor has to act. In this regard, A. MacIntyre 's action philosophy identifies with the traditional position that the necessity for an actor to act is premised first on the "good that an actor is supposed to be pursue nowadays "and secondly on the" current situation one is confronted with. "These two premises will become some kind of reminders for the actors to restrain their own passions so as to do the right things. MacIntyre's criticizes that the actors belonging to the two mainstream discourses about action don't really know what are the right and reasonable things to do. These actors do not care about how valuable and meaningful it is for them to make the right actions; they are not happy about abiding the law; and they don't even feel proud of being good citizens. For MacIntyre, the practical reason of action should be not only legal, but also, and more importantly, a better principle in terms of ethics and good. Because an ethical and good-pursuing actor is necessarily an actor who makes moral reasoning based on practical reason before he acts. And yet how does A. MacIntyre make his claims? Why is his contention both rational and objective? That is exactly the topic of this paper.

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.

Counter This is a collection of papers on philosophy of science, conceptual history of science, and sociology of science written by Taiwanese scholars. It is perhaps one of the best, written by Taiwanese, in all Chinese-speaking societies. Some works in it show Orientals study topics that are typically Western philosophy of science. Others show how traditional topics in the history of Chinese science (mathematics, optics, and geology) could be studied with high sensitivity to the philosophy and sociology of science. It also touches upon issues of the `autonomous' development of social sciences in Taiwan, a society whose academic researches are greatly influenced by the West. This collection will prove stimulating and valuable to general and scholarly readers alike who are interested in philosophy and history of science, especially as related to East Asia and the West. The book will interest scholars in philosophy of science, philosophy of language and psychology, studies of philosophy of science in the third world, history of Chinese science, history of science in East Asia, and history of mathematics.