Background:Nursing as an ethical practice requires courage to be moral, taking tough stands for what is right, and living by one’s moral values. Nurses need moral courage in all areas and at all levels of nursing. Along with new interest in virtue ethics in healthcare, interest in moral courage as a virtue and a valued element of human morality has increased. Nevertheless, what the concept of moral courage means in nursing contexts remains ambiguous.Objective:This article is an analysis of the concept (...) of moral courage in nursing.Design:Rodgers’ evolutionary method of concept analysis provided the framework to conduct the analysis.Data sources:The literature search was carried out in September 2015 in six databases: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and The Philosopher’s Index. The following key words were used: “moral” OR “ethical” AND “courage” OR “strength” AND “nurs*” with no time limit. After applying inclusion and exclusion criteria, 31 studies were included in the final analysis.Ethical considerations:This study was conducted according to good scientific guidelines.Results:Seven core attributes of moral courage were identified: true presence, moral integrity, responsibility, honesty, advocacy, commitment and perseverance, and personal risk. Antecedents were ethical sensitivity, conscience, and experience. Consequences included personal and professional development and empowerment.Discussion and conclusion:This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. (shrink)

Background:The ethics and value bases in healthcare are widely acknowledged. There is a need to improve and raise awareness of ethics in complex systems and in line with competing needs, different stakeholders and patients’ rights. Evidence-based strategies and interventions for the development of procedures and practice have been used to improve care and services. However, it is not known whether and to what extent ethics can be developed using interventions.Objectives:To examine ethics interventions conducted on healthcare professionals and healthcare students to (...) achieve ethics-related outcomes.Research design:A systematic review.Methods:Five electronic databases were searched: CINAHL, the Cochrane Library, Philosopher’s Index, PubMed and PsycINFO. We searched for published articles written in English without a time limit using the keywords: ethic* OR moral* AND intervention OR program OR pre-post OR quasi-experimental OR rct OR experimental AND nurse OR nursing OR health care. In the four-phased retrieval process, 23 full texts out of 4675 citations were included in the review. Data were analysed using conventional content analysis.Ethical consideration:This systematic review was conducted following good scientific practice in every phase.Findings:It is possible to affect the ethics of healthcare practices through professionals and students. All the interventions were educational in type. Many of the interventions were related to the ethical or moral sensitivity of the professionals, such as moral courage and empowerment. A few of the interventions focused on identifying ethical problems or research ethics.Conclusion:Patient-related outcomes followed by organisational outcomes can be improved by ethics interventions targeting professionals. Such outcomes are promising in developing ethical safety for healthcare patients and professionals. (shrink)

This edition contains quaestiones 1-5 of book III of the commentary on the Sentences, by Marsilius of Inghen (†1396), the founding rector and first doctor of theology of the University of Heidelberg. These questions are devoted to the Christology, Mariology, and Trinitology, and deal with the issue of the Incarnation of Christ, with quaestiones 1-3 considering it in relation to the individual Persons of the Trinity, and quaestiones 4-5 in relation to the Blessed Virgin Mary. In all questions, Marsilius advocates (...) the _via media_ of sound faith, even above any school traditions. (shrink)

An observation of Hume’s has received a lot of attention over the last decade and a half: Although we can standardly imagine the most implausible scenarios, we encounter resistance when imagining propositions at odds with established moral (or perhaps more generally evaluative) convictions. The literature is ripe with ‘solutions’ to this so-called ‘Puzzle of Imaginative Resistance’. Few, however, question the plausibility of the empirical assumption at the heart of the puzzle. In this paper, we explore empirically whether the difficulty we (...) witness in imagining certain propositions is indeed due to claim type (evaluative v. non-evaluative) or whether it is much rather driven by mundane features of content. Our findings suggest that claim type plays but a marginal role, and that there might hence not be much of a ‘puzzle’ to be solved. (shrink)

Contents - Introduction; The Problem of Thomas Hobbes; Formalistic Views of Representation; 'Standing For' - Descriptive Representation; 'Standing For' - Symbolic Representation; Representing as 'Acting For' - The Analogies; The Mandate ...

The financial sector has seen a transformation towards ‘sustainable’ finance particularly in Europe, driven also by unprecedented regulatory reforms. At the same time, many are sceptical about the real impact of these reforms, fearing that they are triggering a paradoxical financialisation of sustainability. Building on recent research on institutional logics and institutional fields formation, we examine changes in the EU regulatory dynamics as characterised by shifts in framing the relationship between sustainability and finance. Deploying a longitudinal approach, consisting of archival (...) data and semi-structured interviews, we explore the development of EU sustainable finance regulation as an extended, interactive and contested process. Specifically, we suggest that regulatory dynamics depend on the hybrid configuration of the social constituencies supporting sustainable finance reforms and on shifts in the overall prevalence of the financial logic in society. Our paper sheds light on the inherent contradictions and limitations of sustainable finance as a means for transformative sustainability reforms. (shrink)

Addiction is standardly characterized as a neurobiological disease of compulsion. Against this characterization, I argue that many cases of addiction cannot be explained without recognizing the value of drugs to those who are addicted; and I explore in detail an insufficiently recognized source of value, namely, a sense of self and social identity as an addict. For people who lack a genuine alternative sense of self and social identity, recovery represents an existential threat. Given that an addict identification carries expectations (...) of continued consumption despite negative consequences, there is therefore a parsimonious explanation of why people who identify as addicts continue to use drugs despite these consequences: they self‐identify as addicts and that is what addicts are supposed to do. I conclude by considering how it is nonetheless possible to overcome addiction despite this identity, in part by imagining and enacting a new one. Importantly, this possibility requires the availability of social support and material resources that are all too frequently absent in the lives of those who struggle with addiction. (shrink)

ABSTRACTDespite advances in the conceptualisation of facial mimicry, its role in the processing of social information is a matter of debate. In the present study, we investigated the relationship b...

Drug use and drug addiction are severely stigmatised around the world. Marc Lewis does not frame his learning model of addiction as a choice model out of concern that to do so further encourages stigma and blame. Yet the evidence in support of a choice model is increasingly strong as well as consonant with core elements of his learning model. I offer a responsibility without blame framework that derives from reflection on forms of clinical practice that support change and recovery (...) in patients who cause harm to themselves and others. This framework can be used to interrogate our own attitudes and responses, so that we can better see how to acknowledge the truth about choice and agency in addiction, while avoiding stigma and blame, and instead maintaining care and compassion alongside a commitment to working for social justice and good. (shrink)

This book is thus a battle of wits. . . . [A] vivid sketch of the conflict between two basic outlooks."—Library Journal "[O]ne leaves this book feeling enriched and challenged.

I clarify some ambiguities in blame-talk and argue that blame's potential for irrationality and propensity to sting vitiates accounts of blame that identify it with consciously accessible, personal-level judgements or beliefs. Drawing on the cognitive psychology of emotion and appraisal theory, I develop an account of blame that accommodates these features. I suggest that blame consists in a range of hostile, negative first-order emotions, towards which the blamer has a specific, accompanying second-order attitude, namely, a feeling of entitlement—a feeling that (...) these hostile, negative first-order emotions are what the blamed object deserves. (shrink)

This study examines the situated use of rules and the social practices people deploy to correct projectable rule violations in pétanque playing activities. Drawing on Ethnomethodology and Conversation Analysis, and using naturally occurring video recordings, this article investigates socially organized occasions of rule use, and more particularly how rules for turn-taking at play are reflexively established in and through interaction. The alternation of players in pétanque is dependent on and consequential for the progressivity of the game and it is a (...) practical problem for the players when a participant projects to break a rule of “who plays next”. The empirical analysis shows that formulating rules is a practice for indicating and correcting incipient violations of who plays next, which retrospectively invoke and establish the situated expectations that constitute the game as that particular game. Focusing on the anticipative corrections of projectable violations of turn-taking rules, this study revisits the concept of rules, as they are played into being, from a social and interactional perspective. We argue and demonstrate that rules are not prescriptions of game conduct, but resources that reflexively render the players’ conducts intelligible as playing the game they are engaging in. (shrink)

Introduction It is by no means obvious that someone interested in politics and society needs to concern himself with philosophy; nor that, in particular, ...

My first experience as a clinician was in a Therapeutic Community for service users with personality disorder. As well as having personality disorder, many of the Community members also suffered from related conditions, such as addiction and eating disorders. Broadly speaking, these conditions are what we might call ‘disorders of agency’. Core diagnostic symptoms or maintaining factors of disorders of agency are actions and omissions: patterns of behaviour central to the nature or maintenance of the condition. For instance, borderline personality (...) disorder is diagnosed in part via deliberate self-harm and attempted suicide, reckless and impulsive behaviour, substance use, violence, and outbursts of anger; addiction is diagnosed via maladaptive patterns of drug consumption; eating disorders involve eating too much or too little. If a service user is to improve let alone recover from these disorders, they must change the diagnostic or maintaining pattern of behaviour (cf. Pearce and Pickard, 2010). For instance, service users with borderline personality disorder must stop self-harming; addicts need to quit using drugs or alcohol; anorexics must eat. (shrink)

The study aims to lay the groundwork for systematically investigating children’s peer discourse at different age levels with a view to delimiting the role of peer talk for pragmatic development. An interdisciplinary stance to the study of children’s peer talk is argued for, considering it simultaneously as the arena for the co-construction of childhood cultures as well as an arena for development. We propose a four-dimensional model of discursive events, meant to capture both dimensions simultaneously. The model takes into account (...) the dynamic interplay among the type of activity children are engaged in, the overall thematic frame of the event, its internal framing by the children themselves and the genre used. The model is applied to the analysis of natural peer talk at two age levels, preschoolers and fourth graders, focusing mainly on variation along the dimension of keying. The two age groups studied are shown to share a rich repertoire of keyings and genres, but to differ in their relative salience and modes of realization by age. Our analysis suggests that peer talk offers children ample opportunities to listen in, practice and display conversational as well as academic discursive skills, and hence may very well prove a crucial site for pragmatic development. (shrink)

This article argues that Judith Butler’s neglect of biopolitics in her reading of Michel Foucault’s work on sexuality leads her to propose a genealogy of gender ontology rather than conduct a genealogy of gender itself. Sex was not an effect of a cultural system for Foucault, but an apparatus of biopower that emerged in the eighteenth century for the administration of life. Butler, however, is interested in uncovering how something we call or identify as gender manifests itself in different times (...) and contexts, rather than asking what relations of power made necessary the emergence of gender as a discourse. After examining the theoretical configurations underpinning Butler’s engagement with Foucault’s Herculine Barbin, I suggest a more biopolitically informed reading of how the material body becomes captured by the discourses of sexuality and sex. Finally, the article sets out preliminary questions with which a more strictly Foucauldian genealogy of gender might be conducted. (shrink)

When philosophers want an example of a person who lacks the ability to do otherwise, they turn to psychopathology. Addicts, agoraphobics, kleptomaniacs, neurotics, obsessives, and even psychopathic serial murderers, are all purportedly subject to irresistible desires that compel the person to act: no alternative possibility is supposed to exist. I argue that this conception of psychopathology is false and offer an empirically and clinically informed understanding of disorders of agency which preserves the ability to do otherwise. First, I appeal to (...) standard clinical treatment for disorders of agency and argue that it undermines this conception of psychopathology. Second, I offer a detailed discussion of addiction, where our knowledge of the neurobiological mechanisms underpinning the disorder is relatively advanced. I argue that neurobiology notwithstanding, addiction is not a form of compulsion and I explain how addiction can impair behavioural control without extinguishing it. Third, I step back from addiction, and briefly sketch what the philosophical landscape more generally looks like without psychopathological compulsion: we lose our standard purported real-world example of psychologically determined action. I conclude by reflecting on the centrality of choice and free will to our concept of action, and their potency within clinical treatment for disorders of agency. (shrink)

I argue that addiction is not a chronic, relapsing, neurobiological disease characterized by compulsive use of drugs or alcohol. Large-scale national survey data demonstrate that rates of substance dependence peak in adolescence and early adulthood and then decline steeply; addicts tend to “mature out” in their late twenties or early thirties. The exceptions are addicts who suffer from additional psychiatric disorders. I hypothesize that this difference in patterns of use and relapse between the general and psychiatric populations can be explained (...) by the purpose served by drugs and alcohol for patients. Drugs and alcohol alleviate the severe psychological distress typically experienced by patients with comorbid psychiatric disorders and associated problems. On this hypothesis, consumption is a chosen means to ends that are rational to desire: Use is not compulsive. The upshot of this explanation is that the orthodox view of addiction as a chronic, relapsing neurobiological disease is misguided. I delineate five folk psychological factors that together explain addiction as purposive action: strong and habitual desire; willpower; motivation; functional role; and decision and resolve. I conclude by drawing lessons for research and effective treatment. (shrink)

I argue that denial plays a central but insufficiently recognized role in addiction. The puzzle inherent in addiction is why drug use persists despite negative consequences. The orthodox conception of addiction resolves this puzzle by appeal to compulsion; but there is increasing evidence that addicts are not compelled to use but retain choice and control over their consumption in many circumstances. Denial offers an alternative explanation: there is no puzzle as to why drug use persists despite negative consequences if these (...) consequences are not straightforwardly known. I describe the nature of the causal knowledge that one's drug use is causing negative consequences; map the conceptual landscape of denial and explain how it can block such knowledge; and explore some of the processes and mechanisms that have been studied by philosophy and the cognitive sciences and which may underpin denial in addiction, including well-established information-processing biases, motivational influences on belief formation and self-deception, and cognitive deficits with respect to insight and self-awareness. I conclude by suggesting that addiction is as much a disorder of cognition as a disorder of conation. (shrink)

It is traditionally held that our knowledge of necessity is a priori; but the familiar theories of a priori knowledge – platonism and conventionalism – have now been discredited, and replaced by either modal skepticism or a posteriori essentialism. The main thesis of this paper is that Kant's theory of a priori knowledge, when detached from his transcendental idealism, offers a genuine alternative to these unpalatable options. According to Kant's doctrine, all epistemic necessity (which he calls “conviction” (Ueberzeugung) is grounded (...) directly or indirectly on our capacity for clear and distinct rational intuition (which he calls “insight” (Einsicht). Insight, in turn, depends upon functions of the imagination for creating “mental models” of necessary truths. This doctrine is well exemplified by Kant's account of our knowledge of simple analytic truths. (shrink)

One of the most brilliant political theorists of our time, Hannah Arendt intended her work to liberate, to convince us that the power to improve our flawed arrangements is in our hands. At the same time, Arendt developed a metaphor of "the social" as an alien, appearing as if from outer space to gobble up human freedom; she blamed it—not us—for our public paralysis. In _The Attack of the Blob_, Hanna Pitkin seeks to resolve this seeming paradox by tracing (...) Arendt's notion of "the social" throughout her writings. Doing this, Pitkin developes a resolution that considers everything from language to the nature of political theory itself. (shrink)

This article is based on a qualitative longitudinal study that followed the subjective experiences of both people living with dementia and their family members during the early stages of the illness. The purpose of this article is to describe and reflect on the ethical and methodological issues that occurred during data collection. The article focuses on the situation of the person with dementia and the family member and the role of the researcher when conducting the research interviews. Based on the (...) results of this study, conducting research interviews with people with dementia and their family members poses several ethical and methodological challenges that must be addressed. In doing so, ethically sound dementia-specific research methods will be actively developed enhancing our understanding of living with dementia and providing new insights into the care of people with dementia and their family members. (shrink)

Hanna Pitkin argues that Wittgenstein's later philosophy offers a revolutionary new conception of language, and hence a new and deeper understanding of ourselves and the world of human institutions and action.