S. H. Shin

BackgroundAs large language models (LLMs) evolve, assessing their competence in ethically sensitive domains such as medical ethics has become increasingly important. Since medical ethics is a universal component of medical education, disparities in AI performance across languages may result in unequal benefits for learners. Therefore, it is essential to examine performances in non-English contexts. While previous studies have evaluated performance of Chat Generative Pre-trained Transformer(ChatGPT) on English-language multiple-choice questions (MCQs) in medical ethics, none have examined version-based improvements across non-English contexts. This study therefore evaluated ChatGPT versions 3.5, 4.0, and 4.5 for MCQs on Korean medical ethics and their English translations, with a focus on performance trends across versions and languages.MethodsWe selected 36 MCQs from the Korean National Medical Licensing Examination and the Comprehensive Clinical Medicine Evaluation databases. Each question was entered ten times per ChatGPT version (3.5, 4.0, 4.5) and language (Korean, English) for a total of 60 trials. Additionally, to assess the model’s capacity to identify the ethical core without relying on the options provided, 31 of the 36 questions were modified by masking the correct choice. Accuracy was analyzed using independent sample t-tests and Mann Whitney U test, and consistency was assessed using Krippendorff’s alpha.ResultsOverall, the accuracy and consistency of ChatGPT improved with each version. Version 4.5 achieved near-perfect scores and high reliability in both languages, while version 3.5 showed limited performance, particularly in the Korean test. Performance gaps between languages decreased with model upgrades but remained statistically significant in version 4.5 for some questions. In the masked-answer condition, all versions showed notable drops in accuracy and consistency, with version 4.5 still outperforming earlier versions. However, the performance remained below 50%, indicating limitations in the model’s autonomous ethical reasoning.ConclusionsChatGPT demonstrated substantial improvements in medical ethics MCQ performance across versions, particularly in terms of consistency and accuracy. However, performance disparities between languages and reduced accuracy under masked answer conditions highlight the ongoing limitations of non-English ethical reasoning and context recognition. These findings emphasize the need for further research on language-sensitive fine-tuning and the evaluation of LLMs in specialized ethical domains. The findings suggest that advanced LLMs may serve as valuable supplementary tools in medical education and clinical ethics training. At the same time, the observed language disparities call for context-sensitive adaptations to prevent inequities in practice.

이 글은 철학의 현재를 비판적으로 고찰하면서 철학이 현사실성의 해석학을 통해 현재의 철학으로 정립되어야 함을 밝히고자 한다. 이를 위해 철학 자체가 해석학적 특성을 지니고 있음을 논의한 뒤, 이런 논의를 근거짓기 위해 마틴 하이데거가 제시한 현사실성의 해석학에 대한 이해를 모색한다.하이데거는 철학은 그리스적 기원과 특성을 지닌다고 주장한다. 따라서 현사실성의 해석학에 담긴 철학적 특성을 밝히기 위해 이러한 주장을 분석하면서 그 안에 담긴 보편적 철학함에 대해 논의한다. 그에 따르면 철학은 그리스적 기원을 한편으로 벗어나야 하면서도 또한 그리스 철학에 담긴 고유함, 즉 존재 사유의 언어를 다시금 통찰할 수 있어야 한다.이런 비교를 통해 이 글은 현재의 철학이 현사실성의 해석학적 철학으로 정립되어야 함을 밝히고 있다. 그러한 논의는 우리의 철학이 바탕한 현대의 문화적 상황에 대한 해석학적 대답의 모색으로 이어진다. 그것은 들뢰즈가 논의했듯이 전 지구화되며 우리의 실존적 상황을 장악하는 자본주의적 철학에 대한 탈영토화와 재영토화에 대한 사고이다. 그와 함께 현대의 허무주의적 상황에서 현존재는 실존주의적 좌파로 존재해야한다는 슬로터다이크의 논지에 근거하여 현대적 철학함의 지향점을 결론적으로 제시한다.

Background: An association between gaming disorder and the symptoms of common mental disorders is unraveled yet. In this preregistered study, we quantitatively synthesized reliability, convergent and discriminant validity of GD scales to examine association between GD and other constructs.Methods: Five representative GD instruments were chosen based on recommendations by the previous systematic review study to conduct correlation meta-analyses and reliability generalization. A systematic literature search was conducted through Pubmed, Proquest, Embase, and Google Scholar to identify studies that reported information on either reliability or correlation with related variables. 2,124 studies were full-text assessed as of October 2020, and 184 were quantitatively synthesized. Conventional Hedges two-level meta-analytic method was utilized.Results: The result of reliability generalization reported a mean coefficient alpha of 0.86 and a mean test-retest estimate of 0.86. Estimated effect sizes of correlation between GD and the variables were as follows: 0.33 with depression, 0.29 with anxiety, 0.30 with aggression, –0.22 with quality of life, 0.29 with loneliness, 0.56 with internet addiction, and 0.40 with game playtime, respectively. The result of moderator analyses, funnel and forest plots, and publication bias analyses were also presented.Discussion and Conclusion: All five GD instruments have good internal consistency and test-retest reliability. Relatively few studies reported the test-retest reliability. The result of correlation meta-analysis revealed that GD scores were only moderately associated with game playtime. Common psychological problems such as depression and anxiety were found to have a slightly smaller association with GD than the gaming behavior. GD scores were strongly correlated with internet addiction. Further studies should adopt a rigorous methodological procedure to unravel the bidirectional relationship between GD and other psychopathologies.Limitations: The current study did not include gray literature. The representativeness of the five tools included in the current study could be questioned. High heterogeneity is another limitation of the study.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42020219781].

Research-oriented universities are known for prolific research activity that is often supported by students in faculty-guided research. To maintain ethical standards, universities require on-going training of both faculty and students to ensure Responsible Conduct of Research (RCR). However, previous research has indicated RCR-based training is insufficient to address the ethical dilemmas that are prevalent within academic settings: navigating issues of authorship, modeling relationships between faculty and students, minimization of risk, and adequate informed consent. U.S. universities must explore ways to identify and improve RCR concerns for current (faculty) and future researchers (students). This article reports the findings of a self-study (_N_ = 50) of research stakeholders (students and faculty) at a top tier research institution. First, we report on their perceived importance of applying RCR principles. Second, we explore relationships between stakeholder backgrounds (e.g., prior training, field, and position) and how they ranked the degree of ethical concerns in fictitious vignettes that presented different unethical issues university students could encounter when conducting research. Vignette rankings suggested concerns of inappropriate relationships, predatory authorship and IRB violations which were judged as most unethical, which was dissimilar to what sampled researchers reported in practice as the most important RCR elements to understand and adhere to for successful research. Regression models indicated there was no significant relationship between individuals’ vignette ethics scores and backgrounds, affirming previous literature suggesting that training can be ineffectual in shifting researcher judgments of ethical dilemmas. Recommendations for training are discussed.

Appropriate and balanced decision-making is sentinel to goal setting and the provision of appropriate clinical care that are attuned to preserving the best interests of the patient. Current family-led decision-making in family-centric societies such as those in Singapore and other countries in East Asia are believed to compromise these objectives in favor of protecting familial interests. Redressing these skewed clinical practices employing autonomy-based patient-centric approaches however have been found wanting in their failure to contend with wider sociocultural considerations that impact care determinations. Evaluation of a number of alternative decision-making frameworks set out to address the shortcomings of prevailing atomistic and family-centric decision-making models within the confines of end-of-life care prove these alternative frameworks to be little better at protecting the best interests of vulnerable patients. As a result, we propose the Welfare Model that we believe is attentive to the relevant socio-culturally significant considerations of a particular case and better meets the needs of end-of-life care goals of preserving the welfare of patients. Employing a multi-professional team evaluation guided by regnant psychosocial, legal, and clinical standards and the prevailing practical and clinical realities of the particular patient’s setting the Welfare Model provides a clinically relevant, culturally sensitive, transparent, and evidence-based approach to care determinations.

This research explores the relationships between business students’ academic misconduct and their attitudes toward professional ethics, specifically credential embellishment and business unethicality. Based on 135 survey responses from business students in a northwestern university, we tested hypothesized relationships using multiple regression analyses. We found that students’ attitudes toward academic misconduct, especially illicit collaboration and exam cheating, were positively correlated with their attitudes toward credential embellishment, unethical business operations, and unethical employee practices. In addition, gender yielded meaningful differences related to perceptions of both dimensions of business unethicality. We emphasize the importance of ethics education, and suggest actionable remedies including placement of strict policies, promotions of shared norms and cultures, and curriculum redesign guidelines for business educators and administrators.

This paper expands the current business ethics research area by empirically testing the relationships between students’ misconduct including academic dishonesty (i.e., plagiarism/fabrication and/or exam cheating) and undesirable academic behaviors (i.e., disrespectful behaviors and/or slacker behaviors) and their perception of business ethics. Based on 133 surveys from the students in a northwestern regional comprehensive university business program, this study reveals that students who have reported higher frequencies of engaging in exam cheating, disrespectful behavior, or slacker behavior have perceived the given questionable, unethical employee practices as more acceptable conducts than the students who have reported lower frequencies. Students who have more frequently engaged in plagiarism/fabrication are found to be more accepting of both questionable, unethical business operations and employee practices. Gender, age, and cumulative GPA have been additionally explored and found to have correlations with business ethics perception. For ethically-sensitive future practitioners, this paper calls for institutions of higher education (IHEs) to provide clear guidelines on academic conduct/misconduct along with business ethics education in curriculum.

In lieu of an abstract, here is a brief excerpt of the content:Global Health Careers:Serving the Navajo CommunityMaricruz Merino, Jonathan Iralu, and Sonya ShinGallup Indian Medical Center (GIMC) sits on a hilltop in Gallup, New Mexico, a town of 20,000 in the four corners region of the Southwestern United States. From its third story windows one can see the red cliffs of the nearby Navajo Nation, a 27,000 square mile reservation that reaches into Arizona, northern New Mexico, and the southern edges of Utah. It is a vast, rural landscape that houses more than 350,000 Navajos. For many on the reservation, healthcare is provided by Indian Health Service hospitals such as GIMC."Are you going to stay?" is a common question for new doctors at GIMC. The Navajo know that their geographic location, while beautiful and attractive to many young providers, will also be the reason they leave. It is hard for doctors to be away from their own homelands. Aging parents get sick, [End Page 86] educational opportunities arise, and children who need to be near extended family are born. But to the Navajo, the story of an individual provider is not so important or memorable. All they know is that providers come and go."Are you here to experiment on us?" is yet another question. Years of exploitation and efforts to destroy traditional ways and language have made many Navajo wary of healthcare providers, no matter how genuine their intentions. Many are so fearful of the hospital—they regard it as "the place to go die."Yet despite this initial suspicion, the Navajo are welcoming people at heart, and tend to develop relationships of trust with their providers. Parents will begin to talk about their grief over a son that has committed suicide or a daughter who died from alcoholic cirrhosis. The elderly will tell you how they care for their five orphaned grandchildren while they can barely take care of their own diabetes. A carpenter tells you he has not worked in a year and feels worthless. An HIV-positive woman will tell you she has been sleeping in a dry river bed because she has no place to go. It quickly becomes apparent that as a physician you will be treating patients with enormous social challenges in addition to complex medical conditions.The origins of the Federal Government's involvement in the healthcare of American Indians and Alaskan Natives (AI/ANs) in the 19th century arose out of both legal obligation and concern for self- preservation. Health services were promised to AI/ ANs in exchange for land, settlements, and agreements. In addition, infectious diseases endemic on reservations as a consequence of crowding and abject poverty, including smallpox and tuberculosis, were seen as a major public health concern. The responsibility of Native American health was first granted to the War Department, then to the Bureau of Indian Affairs, and finally to the Public Health Service in 1955 under the heading of the IHS, or Indian Health Service (U.S. Commission on Civil Rights, 2004; National Library of Medicine, 1994).Since then, the IHS has had many successes. Vaccination rates have gone up, and rates of pneumonia and tuberculosis have gone down significantly. Maternal and infant mortality have declined, and life expectancy has increased (Indian Health Services, 1999). Nonetheless, these improvements remain overshadowed by glaring health disparities among AI/ANs across a broad spectrum of diseases, both communicable and non-communicable, acute and chronic. Native Americans experience higher rates of obesity, diabetes, and cardiovascular disease than the general United States population. They are also more likely to die from alcohol-related causes and in accidents. Life expectancy remains more than five years less than that of the general U.S. population (U.S. Commission on Civil Rights, 2004; U.S. Department of Health and Human Services, 2000).Underlying these health indicators is the continued impoverished status of most AI/ANs. In Navajo, almost half of the population lives below the poverty line. According to the Navajo Nation, the current unemployment rate is 42% (Navajo Nation Department of Economic Development, 2011). Many Navajo on the reservation do not have running water or electricity. They heat with wood, which they chop and haul themselves—regardless...