Might the bioethical principle of individual decisional autonomy have a politically liberalizing effect on soft authoritarian communities?

According to the bioethical principle of individual decisional autonomy, the patient has a right of informed consent to any medical or experimental procedure. The principle is politically liberal by advocating significant individual freedom as guaranteed by law and secured by civil liberties. When practiced in illiberal communities, might it have a political liberalizing effect? I respond first by analyzing cross-national norms of individual decisional autonomy to identify tensions with illiberal community; second, by examining examining Singapore in a single case study to show that liberal bioethics does not promote political liberalization; and third, by showing that the possibility of practicing liberal bioethics in research, clinically as well as in education, does not require a democratic order, and that liberal bioethics is unlikely to encourage the liberalization of illiberal political communities. Hence, it may never contribute to the development of globally effective cross-national norms for the legal regulation of bioethical research and clinical practice. Fourth, to bolster this analysis, I anticipate several possible objections to various of its aspects.

Cultivating Vital Conditions For Perinatal Well-Being And A Sustained Commitment To Reproductive Justice.

Perinatal mental illness is a leading cause of death during pregnancy and the first postpartum year in the United States. Although better acute care services for mental health conditions are desperately needed, urgent services alone cannot create the conditions to thrive. Cultivating well-being requires a sustained commitment to reproductive justice, "the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities." To support reproductive justice for pregnant and birthing people, the Rippel Foundation's Vital Conditions for Health and Well-Being framework offers a holistic approach comprising seven domains: a thriving natural world; basic needs for health and safety; humane housing; meaningful work and wealth; lifelong learning; reliable transportation; and, central to all of these, belonging and civic muscle. Here we review the evidence for each of the vital conditions as key drivers of perinatal mental health, and we outline how this public health approach can advance well-being across generations.

Predicting adolescents' continuation in club sports: A prospective cohort study of the importance of personal and contextual motivational factors in five sports in Denmark.

PURPOSE: The purpose of this prospective cohort study was to investigate the influence of types of motivation, basic psychological needs satisfaction and of a coach-created motivational climate on continued participation in youth sports across types of sport, competitive levels, ages, and gender. METHODS: Participants were 7110 adolescent (age 12-20 years) members of leisure time club organized in basketball, handball, football, badminton, and gymnastics in Denmark. Motivational regulation was measured with BRSQ-6, basic psychological needs satisfaction and frustration were measured with PNSS-S, and coach-created climate was measured with the EDMCQ-C. The participants' continuation or dropout was measured at the beginning of the following season with a short electronic questionnaire. RESULTS: Intrinsic motivation, identified behavior regulation, experiences of competence, relatedness, and autonomy, as well as a coach-created empowering motivational climate, were associated with continuation both in the sport and in the club the following season across different sports, genders, age groups, and competitive levels. Introjected and external behavior regulation, frustrations with the need to experience competence, relatedness, and autonomy, as well as a disempowering coach-created climate, were associated with dropout. CONCLUSION: In Danish youth sports, autonomous motivation, satisfaction of basic psychological needs, and an empowering coach-created motivational climate have a positive impact on the continuation of the sport and the club the following season. In contrast, controlled types of motivation, needs frustration, and a disempowering coach-created climate are associated with dropout. This is the case at both elite and recreational levels, for boys and girls, adolescents, and youth.

Linking undergraduates' future work self and employability: a moderated mediation model.

BACKGROUND: The career intentions of students play a crucial role in shaping the growth of the hospitality and tourism industry. Previous research underlines the significance of future work self in predicting outcomes related to one's career. However, there is limited knowledge regarding the precise ways, timing, and conditions under which the future work self of undergraduate students can enhance their employability. METHODS: This paper aims to address the existing research gap by employing career construction theory and self-determination theory to propose a moderated mediation model-i.e., career exploration serves as a mediator and job market knowledge functions as a moderator in the relationship between future work self and employability. We conducted two independent studies (i.e., an experimental study and a time-lagged field study) to test the proposed model. Specifically, in Study 1 we employed an experimental research design to recruit 61 students majoring in tourism management to participate. They were randomly assigned to two scenarios (future work self: high vs. low), and we manipulated different levels of future work self by means of scenario descriptions. In Study 2, we used the time-lagged research design to collect data via submitting questionnaires among 253 Chinese undergraduates who majored in hospitality and tourism at a university in the middle area of China. RESULTS: The results indicate a positive correlation between undergraduates' future work self and their employability. Furthermore, this relationship is mediated by a mediator of career exploration. It is important to note that this mediating relationship is also contingent upon the moderator variable of undergraduates' job market knowledge when considering the impact of career exploration on employability. CONCLUSION: The findings contribute to enriching the current understanding of the positive effects of future work self on undergraduates' desirable outcomes in employability.

Towards improving online learning in physical education: Gender differences and determinants of motivation, psychological needs satisfaction, and academic achievement in Saudi students.

Studies on students' perceptions and expectations during physical education (PE) online learning remain scarce. Centered on self-determination theory, the present cross-sectional study aims to identify gender differences and predictors affecting motivation, psychological needs satisfaction (PNS), and academic achievement during PE online learning. Data were collected from Saudi students' (N = 308, 161 females and 147 males) responses to the PE autonomy, relatedness, competence, and motivation questionnaires. Welch's t-test for unequal sample sizes, multiple linear regression, and binary logistic regression were used to compare means and to predict the relationships between the independent and dependent variables. The results showed higher autonomy and competence perceptions in female than in male students, but no differences were observed in relatedness. Female students presented higher intrinsic motivations, lower amotivation perceptions than males. However, no gender differences were recorded in extrinsic motivation. Students with less experience in online learning and weak grade point averages (GPAs) are more susceptible to having a high level of amotivation. Gender, GPA, and prior experience with online learning are the common predictors for all PNS and amotivation, while GPA and prior experience with online learning are the determinants of intrinsic motivation. GPA is affected by prior experience with online learning, autonomy, competence, intrinsic motivation, and amotivation. Therefore, teachers are encouraged to adapt their didactic-pedagogical behaviors during PE online learning according to students' motivation and autonomy perceptions. Structuring teaching activities with more individualized support for autonomy, competence, intrinsic motivation, and students' online skills/competencies ensures better learning efficiency and academic achievements.

Exploring basic psychological needs within and across domains of physical activity.

PURPOSE: This study explored variations in adults' experience of satisfaction, unfulfilment and frustration of basic psychological needs within and across four domains of physical activity: Transport, household, occupation, and recreation. METHODS: We utilized a qualitative approach, conducting semi-structured interviews with a diverse group of 42 Danish adults. The participants ranged in age from 16 to 79 years (mean age 49 years, SD 21 years), gender (45% men, 55% women), and physical activity levels (38% low, 33% average, 29% high). Data were analysed using a thematic analysis, applying Self-Determination Theory as the guiding framework. RESULTS: In the Transport domain, while most activities were seen as utilitarian necessities, autonomy satisfaction emerged for some through control over their means of transport. In Household domain, tasks were generally viewed as obligatory; however, activities with personal significance led to autonomy satisfaction and skill development. Occupation-wise, physical activity satisfaction varied, with the nature of the job impacting feelings of autonomy and competence. For Recreation domain, personal choice dictated autonomy satisfaction, with competence and relatedness varying according to goal achievement and social interactions. CONCLUSION: The variations in the findings across domains indicate the effectiveness of applying strategies tailored to specific domains for enhancing need satisfaction.

Culturally competent respect for the autonomy of Muslim patients: fostering patient agency by respecting justice.

Although Western biomedical ethics emphasizes respect for autonomy, the medical decision-making of Muslim patients interacting with Western healthcare systems is more likely to be motivated by relational ethical and religious commitments that reflect the ideals of equity, reciprocity, and justice. Based on an in-depth cross-cultural comparison of Islamic and Western systems of biomedical ethics and an assessment of conceptual alignments and differences, we argue that, when working with Muslim patients, an ethics of respect extends to facilitating decision-making grounded in the patient's justice-related customs, beliefs, and obligations. We offer an overview of the philosophical contestations of autonomy-enhancing practices from the Islamic tradition of biomedical ethics, and examples that demonstrate a recommended shift of emphasis from an autonomy-centered to a justice-focused approach to culturally competent agency-promotion.

Theories of motivation: A comprehensive analysis of human behavior drivers.

This paper explores theories of motivation, including instinct theory, arousal theory, incentive theory, intrinsic theory, extrinsic theory, the ARCS model, self-determination theory, expectancy-value theory, and goal-orientation theory. Each theory is described in detail, along with its key concepts, assumptions, and implications for behavior. Intrinsic theory suggests that individuals are motivated by internal factors like enjoyment and satisfaction, while extrinsic theory suggests that external factors like rewards and social pressure drive behavior. Arousal theory says that to feel motivated, people try to keep an optimal level of activation or excitement. Incentive theory suggests that behavior is driven by the promise of rewards or the threat of punishment. The ARCS model, designed to motivate learners, incorporates elements of attention, relevance, confidence, and satisfaction. Self-determination theory proposes that individuals are motivated by their needs for autonomy, competence, and relatedness. The expectation-value theory suggests that behavior is influenced by individuals' beliefs about their ability to succeed and the value they place on the task. The goal-orientation theory suggests that individuals have different goals for engaging in a behavior. By understanding these different theories of motivation, educators, coaches, managers, and individuals may analyze what drives behavior and how to harness it to achieve their goals. In essence, a nuanced comprehension of these diverse motivation theories equips individuals across varied domains with a strategic toolkit to navigate the complex landscape of human behavior, fostering a more profound understanding of what propels actions and how to channel these insights toward the attainment of overarching goals.

Daily Dynamics of Awareness of Aging and Basic Psychological Need Satisfaction and Frustration in Middle and Older Adulthood.

OBJECTIVES: This daily diary study examined associations between awareness of age-related change (AARC) and satisfaction/frustration of basic psychological needs of autonomy, competence, and relatedness in a sample of midlife and older adults. We expected that greater satisfaction and lower frustration of needs would be associated with higher AARC-gains and lower AARC-losses. We also examined whether within-person associations of need satisfaction/frustration with AARC were moderated by age. METHODS: Participants (N = 152; aged 53+) completed measures of AARC and basic psychological need satisfaction and frustration on their smartphones for 10 consecutive days. Data were analyzed using multilevel models, with time-varying basic need satisfaction/frustration variables disaggregated into between-person and within-person components. RESULTS: On days participants reported higher than usual overall satisfaction of needs, and lower than usual frustration of needs, AARC-gains was higher, and AARC-losses was lower. Analysis of individual needs showed that autonomy and competence were more consistently related to higher AARC-gains and lower AARC-losses than relatedness. Within-person autonomy satisfaction was more strongly (negatively) associated with AARC-losses at older ages. DISCUSSION: Findings suggest that daily experiences related to satisfaction and frustration of goals related to autonomy and competence in particular may be proximal antecedents of short-term variation in AARC.

How One Health Instrumentalizes Nonhuman Animals.

This article interrogates anthropocentrism and nonhuman animal instrumentalization in One Health (OH). It argues that OH's approach to human health and zoonosis focuses too narrowly on furthering certain human interests at the expense of nonhuman animals, which is not sustainable, just, or compassionate. This article also offers an alternative vision for protecting and promoting health for all over the long term that includes the human right to self-determination and the nonhuman animal right to not be exploited or abused. This rights-based approach recognizes that the root causes of zoonosis should be identified and addressed via policies and actions that challenge nonhuman animal exploitation.

Unpacking the effects of socialization programs on newcomer retention: A meta-analytic review of field experiments.

Decades of research conducted using field experiments and quasi-experiments have enabled us to accumulate causal evidence on the effectiveness of onboarding and socialization programs (SPs) across various contexts including employment, higher education, and military services. However, the literature is devoid of an integrated conceptual framework and a quantitative review evaluating the effect of such SPs on reducing newcomer turnover and its boundary conditions. In this study, we draw from a configurational approach to categorize strategic components of SPs, propose bundles of these components based on extant theories in the socialization literature, and examine the moderating effects of these bundles on the retention benefits of SPs. Combining 168 effect sizes from 83 field experiments, our meta-analysis reveals a significant overall effect size of OR = 1.46, suggesting that, on average, the odds of retention are 1.46 times higher for newcomers participating in a SP compared to newcomers in the control group. Our results also indicate that SPs' beneficial effects on newcomer retention are greater when they include the components of identifying effective task behaviors, encouraging proactivity, and facilitating social integration, a bundle aimed at satisfying key psychological needs identified by self-determination theory. We further demonstrate that the retention benefits associated with SP participation increase when the SPs are delivered in-person and in a staggered mode but remain intact across different sample types and study design features. We conclude by discussing how our study expands and develops theoretical understanding within the socialization literature and offers practical implications for managing newcomer retention that go beyond our current knowledge. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

First Case of Medically Assisted Suicide in Italy Set New Legal Perspectives.

Abstract: The first act of assisted suicide in Italy was recently carried out. This event is an absolute novelty for the country, affected by recent legislative changes aimed only at introducing the right to interrupt health treatments and, therefore, carry out exclusively omissive end-of-life acts. These normative provisions lay their foundations in a cultural context centered on the protection of the right to life and health; however, the cases that have occurred over time, including the famous story of DJ Fabo, have led the Constitutional Court to re-evaluate these dictates, introducing in 2019 the right to resort to assisted suicide procedures within well-defined areas, including incurability of the condition, the serious suffering of the individual and the retained ability to stand trial. The case addressed concerns a quadriplegic subject who was the victim of a road accident. Following consultation with a specialized institution, the subject made the decision to undergo an assisted sui-cide procedure in Italy. Having obtained the authorization from the competent authorities, he started a fundraiser to finance the devices and drugs required and, finally, he died. The opening by Italy towards the assisted suicide procedure represents a great step towards a broad context, as well as a decisive act for the purpose of protecting the right to self-determination of the individual. However, the current legislative framework presents significant criticalities and shortcomings. In first place, the dissonance between the laws in force and the judicial sentences is likely to generate problems of uneven application of the rules in a country dominated by the principle of Civil Law. Furthermore, the need for the applicant to fully self-finance the procedure clearly clashes with the constitutional principle of free access to care. Then emerges the need for a guideline document regarding the completion of the procedure itself, the times, methods and drugs implied, in order to significantly reduce the decision-making process by the ethics committees that still weighs on each individual case. Finally, conside-ring what has been observed on the subject of voluntary termination of pregnancy, it is necessary to ask what will be the general orientation of the doctors called to perform the act and whether they will be given the opportunity to express their refusal. The case analyzed could represent the beginning of a new era for Italian culture, but the large-scale application of assisted suicide procedures requires the introduction of legislative provisions that definitively eliminate the critical issues that have emerged so far.

The bumpy ride to a medical PhD degree: a qualitative study on factors influencing motivation.

INTRODUCTION: In parallel with a tremendous increase in medical PhD enrolments, concerns have risen about PhD candidates' poor well-being, increasing attrition rates for PhD programmes, and, eventually, a decline in clinician-scientists. According to the Self-Determination Theory, autonomous motivation is strongly linked to positive aspects of well-being and other positive outcomes such as study completion and success. In this way, motivation has a pivotal role in successful completion of medical doctoral programmes. In this study we explored factors affecting motivation during the PhD journey and aimed to contribute to engaging doctoral education environments, and, eventually, a sustainable clinician-scientist workforce. METHODS: This constructivist qualitative interview study was conducted among ten medical PhD candidates in the final phase of their PhD. We used timeline assisted interviews to identify meaningful experiences throughout their PhD journey. Thematic analyses as an iterative process resulted in overarching themes. RESULTS: We identified six themes influencing autonomous and controlled motivation along the challenging PhD journey: (1) Initial motivation to start a PhD matters; (2) Autonomy as a matter of the right dose at the right time; (3) PhD as proof of competence and/or learning trajectory?; (4) It takes two to tango; (5) Peers can make or break your PhD; (6) Strategies to stay or get back on track. CONCLUSION: This study revealed factors that contribute positively and/or negatively to autonomous and controlled motivation. Some factors impacted motivation differently depending on the PhD phase and individual strategies. Additionally, some factors could coincide and change from positive to negative and vice versa, showing that a successful journey cannot simply be reduced to an absence of negative experiences.

Is food preference innate instinct driven or human's free will?

The question whether food preference decisions are controlled by innate instincts, or a conscious decision-making process is still open. The answer to this question is important not only for neuroscientists, psychologists, and philosophers but also for food scientists and developers. Looking from different perspectives involved in food preference decisions could not only settle a long ongoing debate but also pave the way to understand why people prefer to eat what they eat.

Student-Led Individualized Education Programs: A Gateway to Self-Determination.

PURPOSE: The purpose of this study was to explore the experiences of I'm Determined youth leaders with learning disability who have enrolled in higher education within 1 year of graduating high school to better understand if and how their experience participating in the I'm Determined project led to their participation in their Individualized Education Program (IEP) meetings. METHOD: The intent of the narrative inquiry methodology applied to this study was to create a unified story of collective experiences that described or explained the factors leading to participation in their IEP meeting. Although each of the eight narratives is unique to the individual, common themes emerged that were reflected in the literature and consistent across the time continuum of life before and life during participation in I'm Determined. RESULTS: One experience that was consistent was the importance of participating in and leading their IEP meeting. A narrative timeline led to our findings presented here within a continuum of experiences before and during participation in I'm Determined. We made the decision to present the findings in such a way that highlights common themes specific to IEP participation across moments in time while honoring individual narratives through supportive text from the data. This is a study of people's perceptions of their experiences best told by direct quotes from the participants. The IEP experience is just one component of the self-determination experience. CONCLUSIONS: This study provided insight into the educational experiences of the eight I'm Determined youth leader participants and examined the importance of both their participation in I'm Determined and the development of self-determination skills deemed essential to participate and lead their IEP meeting. Their unique perspective documented in this study served to both inform and push the field forward.

[Constraint during care in elderly people with cognitive disorders]. / La contrainte lors des soins chez le sujet âgé atteint de troubles cognitifs.

Constraints in the care of vulnerable elderly people are part of the daily life of services. This practice must not avoid multidisciplinary reflection by preserving the autonomy of patients' decisions despite cognitive disorders. The search for consent and reasons for refusing care must be the leitmotif and coercion the exception and must be supported.

The role of basic psychological needs in the relationships between identity orientations and adolescent mental health: A protocol for a longitudinal study.

Research into the role of identity orientations (the relative importance an individual places on different personal and social attributes and characteristics when defining her or his identity) in adolescent mental health is extremely limited. Furthermore, the potential mechanisms that might explain the associations between identity orientations and adolescent mental health are poorly understood. This study protocol describes a one-year longitudinal study across three time points to be initiated with the purpose of investigating the mediating role of basic psychological needs satisfaction and frustration in the relationship between identity orientations and various mental health indicators in adolescence. We aim to recruit a large sample of Serbian adolescents (N = 2,000 at Time 1), using a two-stage stratified random sampling. The data will be analyzed using the random intercept cross-lagged panel model (RI-CLPM), and the results will be contrasted with the traditional CLPM. The goal of this study is to make a theoretical contribution to research in the fields of identity, self-determination theory, and adolescent mental health, as well as to provide insights towards the development of evidence-based recommendations for creating prevention and promotion programs aimed at improving the well-being of adolescents.

From a critique of the principle of autonomy to an ethic of heteronomy.

Etymologically, autonomy is the ability to give oneself rules and follow them. It is an important principle of medical ethics, which can sometimes raise some tensions in the care relationship. We propose a new definition of ethics, the ethics of heteronomy: a self-normative, discursive and responsible autonomy. Autonomy cannot be considered without the responsibility each person must have towards others. In the care relationship, autonomy would be more the ability of each person to reach out to others than the ability to decide alone. The care relationship must be seen as an accompaniment of equals where each person allows the other to be rephrased. Autonomy would then no longer be absolute but relative to each situation. Being autonomous would become an ability for adaptation of the patient-doctor pair. The accompaniment allows the birth of a relationship of trust, giving the patient and the doctor the ability to touch and let themselves be touched, thus making each one progress in this reciprocal dialectic. The care relationship becomes the possibility of considering autonomy as a collective and not as an individual notion only. Paradoxically, by promoting the autonomy of the patient-doctor pair, they both develop their own autonomy.