Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and c) needs for an (...) ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

This study explores the impact of participation in a series of moral case deliberations (MCD) on the moral craftsmanship (MCS) of Dutch prison staff. Between 2017–2020, ten MCDs per team were implemented in three prisons (i.e., intervention group). In three other prisons (i.e., control group) no MCDs were implemented. We compared the intervention and control group using a self-developed questionnaire, administered before (pre-measurement) and after the series of MCDs (post-measurement). Results After the MCDs, participants scored significantly higher on 7 of (...) the 70 items related to MCS. On some items there were significant impact differences between the various professional disciplines. Discussion Possible explanations for a relatively low impact are discussed. A shorter and validated questionnaire is needed in order to further study the MCS of professionals and the impact of Ethics Support Services (ESS). Conclusions There was a positive development on some elements of MCS after participation in a series of MCDs. (shrink)

A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...) bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation. (shrink)

Prison work creates ethical challenges for which a training program was initiated for Dutch prison staff to foster their Moral Craftsmanship (MCS). The concept of MCS is not yet defined and operationalized in literature. This explorative study aims to 1) define MCS, 2) identify conceptual elements of MCS, and 3) develop a measurement tool for MCS. A document and literature study provided input for the definition and selection of conceptual elements related within DCIA policy documents, identifying three conceptual levels of (...) MCS: individual (cognition, attitude, and actions), team, and leadership. This first MCSQ consists of seventy-one items distributed across the domains: values and norms, judgment and reasoning, consultation, implementation, looking back, interactions, and leadership. We tested its usability via ‘think-aloud interviews.’ Validation of the current version of the MCS-Questionnaire and consensus among experts about what to include or exclude in the concept of MCS are needed for further development. (shrink)

LET ME BEGIN this inquiry with the simple but fundamental fact that the flow of time, or passage, as it is also known, is given in experience, that it is as indubitable an aspect of our perception of the world as the sights and sounds that come in upon us, even though it is not the peculiar property of a special sense. Consider, by way of illustration, that I am now sitting at the desk in my study. This particular event (...) was not present at any earlier time, nor will it be present shortly as I become involved in other activities. The present, as I experience it, is regularly associated with later and later events. It does not hop about capriciously from here to a later time, to a previous time, and then to a much later time, or trace out some other such indiscriminate pattern; instead I find it always in association with the next moment, and as I look backward and inward, so to speak, I find that the prior moment was present and that this next-later moment is present. Quite often this condition is expressed by means of imagery. We are asked to envision either a moving present racing along a fixed track of moments or events from earlier to later, or alternatively a fixed present through which stream a series of moments or events, first the earlier and then the later ones. One is in truth hard-pressed to find references to passage which do not employ quasi-poetical tropes and metaphors, and while these do help in some sense to say what we mean, great caution is required when handling them because of their ready tendency to draw us away from the actual phenomenon requiring explanation. (shrink)

Incessantly cited by critics, Bakhtin's work none the less remains relatively unavailable: partly through lack of suitable editions, partly because no individual text conveys all the key concepts or arguments. This anthology provides in a convenient format a good selection of the writing by Bakhtin and of that attributed to Voloshinov and Medvedev. It introduces readers to the aspects most relevant to literary and cultural studies and gives a focused sense of Bakhtin's central ideas and the underlying cohesiveness of his (...) thinking. (shrink)

Rescued in 1972 from a storeroom in which rats and seeping water had severely damaged the fifty-year-old manuscript, this text is the earliest major work (1919-1921) of the great Russian philosopher M. M. Bakhtin. Toward a Philosophy of the Act contains the first occurrences of themes that occupied Bakhtin throughout his long career. The topics of authoring, responsibility, self and other, the moral significance of "outsideness," participatory thinking, the implications for the individual subject of having "no-alibi in existence," the difference (...) between the world as experienced in actions and the world as represented in discourse--all are broached here in the heat of discovery. This is the "heart of the heart" of Bakhtin, the center of the dialogue between being and language, the world and mind, "the given" and "the created" that forms the core of Bakhtin's distinctive dialogism. A special feature of this work is Bakhtin's struggle with the philosophy of Immanuel Kant. Put very simply, this text is an attempt to go beyond Kant's formulation of the ethical imperative. Toward a Philosophy of the Act will be important for scholars across the humanities as they grapple with the increasingly vexed relationship between aesthetics and ethics. (shrink)

The essays assembled here are all very early and differ in a number of ways from Bakhtin's previously published work.

Next SectionOne of the major concerns about surrogacy is the potential harm that may be inflicted upon the surrogate mother and the child after relinquishment. Even if one were to take the liberal view that surrogacy should be presumptively allowed on the basis of autonomy and/or compassion, evidence of harm must be taken seriously. In this paper I review the evidence from psychological studies on the effect that relinquishing a child has on the surrogate mother and while it appears that (...) many surrogates are able to cope with relinquishment, I argue that there are good reasons, grounded in empirical evidence, to support the view that the subsequent management of the relinquishment necessarily objectifies the surrogate mother. (shrink)

This Book Brings A Clear And Insightful Presentation Of The Wisdom Of Hinduism In All Its Fundamental Principles.

Study in the context of the Hindu philosophical system, with special reference to Vedanta.

AN inquiry into the use of paradeigma in the Iliad must begin with Niobe. At 24. 602 Achilles introduces Niobe in order to encourage Priam to have some food. The dead body of the best of Priam's sons has now been placed on the wagon ready for its journey back to Troy. Achilles says , ‘Now let us eat. For even Niobe ate food, and she had lost twelve children. Apollo and Artemis killed them all; they lay nine days in (...) their blood and there was no one to bury them, because Zeus had turned the people into stone. On the tenth day the gods buried them. But she managed to eat some food, when she was tired of weeping. And now among the mountains, although turned into stone, she still broods over her sorrows. But come, let us also eat. You can weep for your son again later’. (shrink)

Nursing, a scientific and practical discipline, faces continuing challenges of finding new direction in order to decipher its core values and develop current ethical codes for nursing practice. In 2009–10, 28 nurses were purposely selected and interviewed using a semi-structured format in focus groups and individually. Thematic Content Analysis helped explore the perception of Iranian nurses on ethical values in patient care. Seven major themes emerged: respect for dignity, professional integrity, professional commitment, developing human relationships, justice, honesty, and promoting individuals (...) and the nursing profession. Iranian nurses revealed a unique and culture-based set of ethical values. This study found that Iranian nurses place a greater emphasis on preserving the dignity of those accompanying the patient and in showing regard for patients' religious beliefs in a gender appropriate environment. (shrink)

In the long 20th century, modern China experienced perhaps the world’s most radical and systematic secularization process and the decimation of traditional religious and ritual cultures. This article seeks to account for this experience by engaging with postcolonial theory, a body of discourse seldom found relevant to China Studies. The article attempts a two-pronged critique of both state secularization and some aspects of existing Postcolonial Studies/theory. It shows the many ways in which nationalist elites in modern China unwittingly absorbed Western (...) Orientalist discourse even as their words and actions were ostensibly anti-colonial, and much of the article examines the consequences of this native Orientalism upon Chinese religiosities. Finally, the article suggests that one cannot discuss governmentality in modern China without understanding how it is intertwined with a sovereign power that is both archaic and, at the same time, has experienced renewal and expansion in modernity. (shrink)

With a 24-hour news cycle, the desperate need to attract viewers and increase revenue, and the pressure of being the first to print, news organizations have had to undergo a rapid evolution. Whether they've been able to maintain their integrity during this transition is a matter of debate. In this resource, a wide spectrum of contributors addresses the importance of journalistic ethics, the challenges journalists face today, and what's at stake for newspeople when charges of "fake news" are lobbed at (...) them. (shrink)

AN inquiry into the use of paradeigma in theIliadmust begin with Niobe. At 24. 602 Achilles introduces Niobe in order to encourage Priam to have some food. The dead body of the best of Priam's sons has now been placed on the wagon ready for its journey back to Troy. Achilles says, ‘Now let us eat. For even Niobe ate food, and she had losttwelvechildren. Apollo and Artemis killed them all; they lay nine days in their blood and there was (...) no one to bury them, because Zeus had turned the people into stone. On the tenth day the gods buried them. But she managed to eat some food, when she was tired of weeping. And now among the mountains, although turned into stone, she still broods over her sorrows. But come, let us also eat. You can weep for your son again later’. (shrink)

BackgroundMoral Case Deliberation is a specific form of bioethics education fostering professionals’ moral competence in order to deal with their moral questions. So far, few studies focus in detail on Moral Case Deliberation methodologies and their didactic principles. The dilemma method is a structured and frequently used method in Moral Case Deliberation that stimulates methodological reflection and reasoning through a systematic dialogue on an ethical issue experienced in practice.MethodsIn this paper we present a case-study of a Moral Case Deliberation with (...) the dilemma method in a health care institution for people with an intellectual disability, describing the theoretical background and the practical application of the dilemma method. The dilemma method focuses on moral experiences of participants concerning a concrete dilemma in practice. By an in-depth description of each of the steps of the deliberation process, we elucidate the educational value and didactics of this specific method.ResultsThe didactics and methodical steps of the dilemma method both supported and structured the dialogical reflection process of the participants. The process shows that the participants learned to recognize the moral dimension of the issue at stake and were able to distinguish various perspectives and reasons in a systematic manner. The facilitator played an important role in the learning process of the participants, by assisting them in focusing on and exploring moral aspects of the case.DiscussionThe reflection and learning process, experienced by the participants, shows competency-based characteristics. The role of the facilitator is that of a Socratic teacher with specific knowledge and skills, fostering reflection, inquiry and dialogue.ConclusionThe specific didactics of the dilemma method is well suited for teaching bioethics in clinical settings. The dilemma method follows an inductive learning approach through a dialogical moral inquiry in which participants develop not only knowledge but also skills, attitude and character. The role of a trained facilitator and a specific view on teaching and practicing ethics are essential when using the dilemma method in teaching health care professionals how to reflect on their own moral issues in practice. (shrink)

Moral case deliberation is a dialogue among health care professionals about moral issues in practice. A trained facilitator moderates the dialogue, using a conversation method. Often, the facilitator is an ethicist. However, because of the growing interest in MCD and the need to connect MCD to practice, healthcare professionals should also become facilitators themselves. In order to transfer the facilitating expertise to health care professionals, a training program has been developed. This program enables professionals in health care institutions to acquire (...) expertise in dealing with moral questions independent of the expertise of an ethicist. Over the past 10 years, we developed a training program with a specific mix of theory and practice, aiming to foster the right attitude, skills and knowledge of the trainee. The content and the didactics of the training developed in line with the philosophy of MCD: pragmatic hermeneutics, dialogical ethics and Socratic epistemology. Central principles are: ‘learning by doing’, ‘reflection instead of ready made knowledge’, and ‘dialogue on dialogue’. This paper describes the theoretical background and the didactic content of the current training. Furthermore, we present didactic tools which we developed for stimulating active learning. We also go into lessons we learned in developing the training. Next, we provide some preliminary data from evaluation research of the training program by participants. The discussion highlights crucial aspects of educating professionals to become facilitators of MCD. The paper ends with concluding remarks and a plea for more evaluative evidence of the effectiveness and meaning of this training program for doing MCD in institutions. (shrink)

In recent years, outbreaks such as H1N1 have prompted heightened efforts to manage the risk of infection. These efforts often involve the endorsement of personal responsibility for infection risk, thus reinforcing an individualistic model of public health. Some scholars—for example, Peterson and Lupton —term this model the “new public health.” In this essay, I describe how the focus on personal responsibility for infection risk shapes the promotion of hand hygiene and other forms of illness etiquette. My analysis underscores the use (...) of constitutive and stigmatizing rhetoric to depict individual bodies, rather than environments, as prime sources of infection. Common among workplaces, this rhetoric provides the impetus for encouraging individual behavior change as a hedge against infection risk. I argue, though, that the mandating of personal responsibility for infection risk galvanizes a culture of stigma and blame that may work against the aims of public health. (shrink)