Using three paradigm cases of persons living with Parkinson's Disease (PD) the authors make a case for augmenting and enriching a Cartesian medical account of the pathophysiology of PD with an enriched understanding of the lived body experience of PD, the lived implications of PD for a particular person's concerns and coping with the illness. Linking and adding a thick description of the lived experience of PD can enrich caregiving imagination and attunement to the patient's possibilities, concerns and constraints. The (...) work of Merleau-Ponty is used to articulate the middle terms of the lived experience of dwelling in a lifeworld. Examining lived experience of embodied intentionality, skilled bodily capacities as highlighted in Merleau-Ponty's non-mechanistic physiology opens new therapeutic, coping and caregiving possibilities. Matching temporal rhythms can decrease the stress of being assisted with activities of daily living. For example, caregivers and patients alike can be taught strategies for extending their lived bodily capacities by altering rhythms, by shifting hyperactivity to different parts of the body and other strategies that change the perceptual experience associated with walking in different environment. A medical account of the pathophysiology of PD is nessessary and useful, but not sufficient for designing caregiving in ways that enrich and extend the existential skills of dwelling of persons with PD. The dominance of mechanistic physiology makes caregivers assume that it is the 'real discourse' about the disease, causing researchers and caregivers alike to overlook the equally real lived experience of the patient which requires different descriptive discourses and different sources of understanding. Lack of dialogue between the two discourses is tragic for patients because caregivers need both in order to provide attuned, effective caregiving. (shrink)

This paper responds to the contributions by Alexander Bird, Nathan Wildman, David Yates, Jennifer McKitrick, Giacomo Giannini & Matthew Tugby, and Jennifer Wang. I react to their comments on my 2015 book Potentiality: From Dispositions to Modality, and in doing so expands on some of the arguments and ideas of the book.

Dispositionalism about modality is the view that metaphysical modality is a matter of the dispositions possessed by actual objects. In a recent paper, David Yates has raised an important worry about the formal adequacy of dispositionalism. This paper responds to Yates’s worry by developing a reply that Yates discusses briefly but dismisses as ad hoc: an appeal to a ’plenitude of powers’ including such powers as the necessarily always manifested power for 2+2\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} (...) \begin{document}$$2+2$$\end{document} to be 4. I argue that the reply is not ad hoc at all, by defending the metaphysics of dispositions that should underly it. I then argue, first, that a proper understanding of dispositions’ degrees provides us with an argument for such necessarily always manifested dispositions; second, that all the natural attempts to block that argument can be resisted without being ad hoc; and third, that pragmatic considerations explain our intuitive resistance to the ascription of necessarily always manifested dispositions. Dispositionalism can be formally adequate after all. (shrink)

This paper explores the prospects for dispositional accounts of abilities. According to so-called new dispositionalists, an agent has the ability to Φ iff they have a disposition to Φ when trying to Φ. We show that the new dispositionalism is beset by some problems that also beset its predecessor, the conditional analysis of abilities, and bring up some further problems. We then turn to a different approach, which links abilities not to motivational states but to the notion of success, and (...) consider ways of implementing that approach. Our results suggest that there are principled disanalogies between abilities and disposition which prevent any dispositional account of abilities from succeeding. (shrink)

Some of the series' finest lectures have been lost for many years, unavailable to the public in any form -- until now.

Objective: To report results from a national survey of coordinators and managers of clinical research studies in the US on their perceptions of and experiences with scientific misconduct.Methods: Data were collected using the Scientific Misconduct Questionnaire-Revised. Eligible responses were received from 1645 of 5302 surveys sent to members of the Association of Clinical Research Professionals and to subscribers of Research Practitioner, published by the Center for Clinical Research Practice, between February 2004 and January 2005.Findings: Overall, the perceived frequency of misconduct (...) was low. Differences were noted between workplaces with regard to perceived pressures on investigators and research coordinators, and on the effectiveness of the regulatory environment in reducing misconduct. First-hand experience with an incident of misconduct was reported by 18% of respondents. Those with first-hand knowledge of misconduct were more likely to report working in an academic medical setting, and to report that a typical research coordinator would probably do nothing if aware that a principal investigator or research staff member was involved in an incident of misconduct.Conclusion: These findings expand the knowledge on scientific misconduct by adding new information from the perspective of research coordinators. The findings provide some data supporting the influence of workplace climate on misconduct and also on the perceived effectiveness of institutional policies to reduce scientific misconduct. (shrink)

The paper aims to investigate the effects of corporate social performance (CSP) on bankruptcy likelihood in times of economic upswing. This is important because prior related literature focused on data containing times of economic crises. We measure bankruptcy likelihood with the Altman Z score and CSP with Refinitiv ESG scores. By applying static panel data regressions and instrumental variable regressions on a sample of 6696 US-firm-year observations from 2010 to 2019 our main findings are: (i) In contrast to existing research, (...) the level of firms’ CSP seems to have no (positive) effect on the likelihood of bankruptcy during times of economic upswing. (ii) Increasing a firm’s CSP in times of economic upswing leads to a rise in bankruptcy likelihood. We conclude that the positive effects of CSP on stakeholder relationships fail to materialize in flourishing business environments. The costs of increasing CSP, thus, exceed their immediate positive effects and raise bankruptcy likelihood. However, as they reduce financial default risk in subsequent crises, CSP investments can be seen as a balancing measure. Our findings bear implications for scholars, practitioners, and policymakers. (shrink)

Presenteeism—going to work while ill—is a widespread phenomenon worldwide. Previous research has concentrated mainly on its negative effects. This study investigates the positive consequences of presenteeism derived from a comprehensive content model of presenteeism that was developed on the basis of negative effects. In a quantitative online-survey employees rated the degree of experienced or potential positive effects depending on whether they had worked while ill or not during the previous year. Results revealed that all postulated positive effects described in the (...) content model were relevant. Most positive effects were rated significantly higher by participants who had shown presenteeism in comparison to those who had not. The positive effects significantly predicted presenteeism propensity for participants having shown presenteeism. In addition, an overall rating of positive effects was significantly related to presenteeism, however, to a lesser degree. Overall, the results demonstrate the applicability of the content model to positive effects of presenteeism. They point to the need for further investigation of them and their consideration for the management of presenteeism. (shrink)

Zusammenfassung: Der Beitrag systematisiert, kontextualisiert und evaluiert den eigentumstheoretischen Hintergrund der derzeit breit geführten Debatte um bezahlbaren Wohnraum in deutschen Großstädten. Ausgehend von der These, dass hinter der sogenannten ‚Wohnungskrise‘ eigentlich eine ‚Bodenkrise‘ steht, werden drei zentrale Konflikte um die politische Rahmung des Eigentums an Boden diskutiert: die Frage nach dem Gebrauch, der Verwertung und dem Eigentumsschutz. Dabei werden die normativen Potentiale eines immanenztheoretischen, apriorisch pflichtgebundenen Eigentumsverständnisses für eine zeitgemäße Wohnraum- und Bodenpolitik ausgelotet.

Welche Bücher sollte man lesen, wenn man sich für die Idee der Freiheit interessiert? Welchen Beitrag haben etwa Aristoteles, Konfuzius, Mises, Ortega y Gasset, Röpke oder Schumpeter geleistet? 111 Beiträge sollen helfen, Antworten auf diese Fragen zu geben.

How does thinking affect doing? There is a widely held view that thinking about what you are doing, as you are doing it, hinders performance. Once you have acquired the ability to putt a golf ball, play an arpeggio on the piano, or parallel-park, reflecting on your actions leads to inaccuracies, blunders, and sometimes even utter paralysis--that's what is widely believed. But is it true? After exploring some of the contemporary and historical manifestations of the idea, Barbara Gail Montero (...) develops a theory of expertise which emphasizes the role of the conscious mind in expert action. She aims to dispel various myths about experts who proceed without any understanding of what guides their action, and she analyzes research in both philosophy and psychology that is taken to show that conscious control and explicit monitoring of one's movements impedes well practiced skills. Montero explores a wide range of real-life examples of optimal performance, in sports, the performing arts, healthcare, the military, and other fields, and draws from psychology, neuroscience, and literature to offer a refreshing and persuasive view of expertise, according to which expert action generally is and ought to be thoughtful, effortful, and reflective. (shrink)

We argue that dominant research approaches concerning mental illness, which are centered on traditional categories of psychiatric classification as codified in the DSM-IV, have serious empirical, conceptual, and foundational problems. These problems have led to a classification scheme and body of research findings that provide a very poor map of the domain of mental illness, a map that, in turn, undermines clinical and research pursuits. We discuss some current efforts to respond to these problems and argue that the DSM-5 revision (...) process is not very promising, whereas the NIMH Research Domain Criteria initiative and some recent research in cognitive neuroscience fares better, although the latter remains potentially compromised by residual influences of the DSM-based approach. We conclude with some lessons and suggestions for the pursuit of alternative research pathways. (shrink)

Within the ever-growing body of research on sickness presenteeism, studies of perceived consequences are scarce and equally rare are joint considerations of beneficial and harmful effects. This study examined how experienced and expected consequences of the behavior are related to presenteeism. Positive and negative effects were considered simultaneously and comprehensively. This approach allowed us to capture the trade-off process of individuals in deciding to work or call in sick when ill. In a cross-sectional online survey, 591 working adults in Germany (...) rated a thoroughly developed pool of specific experienced or potential consequences of working while sick and gave an overall judgment of effects. The results show that perceptions of effects are consistent with behavior. Individuals who exhibit presenteeism do so primarily because of work-related effects such as the completion of one’s work tasks and the meeting of deadlines. Few specific effects stand out and can largely explain attendance behavior and the overall assessment of effects. The findings are consistent with the assumptions of the health belief model and the expectancy value theory of work motivation and they relate to the health-performance framework. They demonstrated that benefits and costs of the behavior are simultaneously weighed in the decision to engage in presenteeism or not. (shrink)

This book presents the most important problems of reference and considers their solution. It presupposes no technical knowledge, presents analyses from first principles, illustrates every stage with examples, and is written with verve and clarity. This is the ideal introduction to reference for students of linguistics and philosophy of language.

Combining knowledge of social policy and practice with insights from poststructural and feminist theory, the text demonstrates how democratic citizens and the political are continually recreated.

In this paper I develop a framework for environmental philosophy on the ground of what I call a radical relationalism based on Whitehead’s thought. Accordingly, relations are ontologically prior to and constitutive of entities rather than being conceived as external link(ing) between them. On this ground an alternative, relational axiology can be developed that challenges the current environmental ethics debate and its dichotomy between intrinsic and instrumental values. In the last section, I show how such an axiology can become an (...) important ally for global environmental justice struggles and help support what the anthropologist Arturo Escobar calls a “decolonial view of nature.”. (shrink)

Ulrich Beck's best selling Risk Society established risk on the sociological agenda. It brought together a wide range of issues centering on environmental, health and personal risk, provided a rallying ground for researchers and activists in a variety of social movements and acted as a reference point for state and local policies in risk management. The Risk Society and Beyond charts the progress of Beck's ideas and traces their evolution. It demonstrates why the issues raised by Beck reverberate widely throughout (...) social theory and covers the new risks that Beck did not foresee, associated with the emergence of new technologies, genetic and cybernetic. The book is unique because it offers both an introduction to the main arguments in Risk Society and develops a range of critical discussions of aspects of this and other works of Beck. (shrink)

One main issue within environmental ethics is the so-called Demarcation Problem, i.e. the question of which entities are members of the moral community and hold intrinsic value. I argue that the demarcation problem relies mainly on Kantian moral philosophy. While the Kantian framework offers a strong and immediately deontological argument for moral agents holding inherent moral values, it presents problems when stretched beyond its original scope and lacks an adequate ground for addressing relational complexity and the moral significance of collectives. (...) In this paper I outline an alternative axiological framework ('map of moral significance') that relies on a relational ontology and encompasses intrinsic and relational values as the two equipollent axes of a matrix in which to embed the question posited by the Demarcation Problem. (shrink)

The article argues that the relationship to time is at the root of what makes us human and that culture arises with and from efforts to transcend death, change and the rhythmicity of the physical environment. Time can be tracked through systems of time measurement and later transformed from a process of nature into clock time, a time to human design that is abstracted from context and content. In this form time can be traded with all other times. With contemporary (...) science and new information and communications technologies, which operate in a new all-encompassing temporal spectrum that extends from nanoseconds to millennia, clock time is no longer appropriate to the associated present-oriented transactions and futures are traversed in the dual sense of the word. By historically locating temporal relations, the article provides both a new understanding of socio-cultural relations and a perspective on social change. (shrink)

Some presuppositions seem to be weaker than others in the sense that they can be more easily neutralized in some contexts. For example some factive verbs, most notably epistemic factives like know, be aware, and discover, are known to shed their factivity fairly easily in contexts such as are found in (1). (1) a. …if anyone discovers that the method is also wombat-proof, I’d really like to know! b. Mrs. London is not aware that there have ever been signs erected (...) to stop use of the route… c. Perhaps God knows that we will never reach the stars…. (The examples in (1) are all naturally occurring ones, discovered by David Beaver with the aid of Google; cf. Beaver 2002, exx. 32, 43, and 51, respectively.) On the other hand some other factives, e.g. regret, matter, and be surprised, do not exhibit the same type of behavior: (2) a. If any of the students regrets behaving badly, they’ll let us know. b. It doesn’t matter that the chimpanzees escaped. c. Was Bill surprised that spinach was included? Unlike the examples in (1), those in (2) could not be used appropriately in contexts where the speaker was not assuming that the complement clause was true. Our main concern will be trying to find the cause of this difference. However, before we get to that, we will look more closely at the concept “presupposition” itself, as well as its close neighbor in the linguistic literature, “conventional implicature” (section 2), and also at various ways of getting rid of presuppositions (section 3). In section 4 we will investigate two possible explanations for differences in presupposition triggering – the “lexical alternative” approach of Abusch (2002, 2005), and a suggestion of Ladusaw’s involving detachability of presuppositions. The final section contains concluding remarks. (shrink)

The prototypes of definiteness and indefiniteness in English are the definite article the and the indefinite article a/an, and singular noun phrases (NPs)1 determined by them. That being the case it is not to be predicted that the concepts, whatever their content, will extend satisfactorily to other determiners or NP types. However it has become standard to extend these notions. Of the two categories definites have received rather more attention, and more than one researcher has characterized the category of definite (...) NPs by enumerating NP types. Westerståhl (1985), who is concerned only with determiners in the paper cited, gives a very short list: demonstrative NPs, possessive NPs, and definite descriptions. Prince (1992) lists proper names and personal pronouns, as well as NPs with the, a demonstrative, or a possessive NP as determiner. She notes, in addition, that “certain quantifiers (e.g. all, every) have been argued to be definite” (Prince 1992: 299). This list, with the quantifiers added, agrees with that given by Birner & Ward (1998, 114). Ariel (1988, 1990) adds null anaphoric NPs. (shrink)

Fundamental to spatial knowledge in all species are the representations underlying object recognition, object search, and navigation through space. But what sets humans apart from other species is our ability to express spatial experience through language. This target article explores the language ofobjectsandplaces, asking what geometric properties are preserved in the representations underlying object nouns and spatial prepositions in English. Evidence from these two aspects of language suggests there are significant differences in the geometric richness with which objects and places (...) are encoded. When an object is named (i.e., with count nouns), detailed geometric properties – principally the object's shape (axes, solid and hollow volumes, surfaces, and parts) – are represented. In contrast, when an object plays the role of either “figure” (located object) or “ground” (reference object) in a locational expression, only very coarse geometric object properties are represented, primarily the main axes. In addition, the spatial functions encoded by spatial prepositions tend to be nonmetric and relatively coarse, for example, “containment,” “contact,” “relative distance,” and “relative direction.” These properties are representative of other languages as well. The striking differences in the way language encodes objects versus places lead us to suggest two explanations: First, there is a tendency for languages to level out geometric detail from both object and place representations. Second, a nonlinguistic disparity between the representations of “what” and “where” underlies how language represents objects and places. The language of objects and places converges with and enriches our understanding of corresponding spatial representations. (shrink)

In this article, the author argues that we need to conceptualize gender as a social structure, and by doing so, we can better analyze the ways in which gender is embedded in the individual, interactional, and institutional dimensions of our society. To conceptualize gender as a structure situates gender at the same level of general social significance as the economy and the polity. The author also argues that while concern with intersectionality must continue to be paramount, different structures of inequality (...) have different constructions and perhaps different influential causal mechanisms at any given historical moment. We need to follow a both/and strategy to understand gender structure, race structure, and other structures of inequality as they currently operate while also systematically paying attention to how these axes of domination intersect. Finally, the author suggests we pay more attention to doing research and writing theory with explicit attention to how our work can indeed help transform as well as inform society. (shrink)

The origins of Vico's social theory : Vichian reflections on the Neapolitan Revolt of 1701 and the politics of the metropolis -- Vico's cosmopolitanism : global citizenship and natural law in Vico's pedagogical thought -- Vico's social theory : the conundrum of the Roman metropolis and the struggle of humanity for natural rights -- From social theory to philosophy : Vico's disillusions with the Neapolitan magistracy and the new frontier of philosophy.

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care (...) left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. (shrink)

This paper presents problems for Stalnaker’s common ground theory of presupposition. Stalnaker (Linguist and Philos 25:701–721, 2002) proposes a 2-stage process of utterance interpretation: presupposed content is added to the common ground prior to acceptance/rejection of the utterance as a whole. But this revision makes presupposition difficult to distinguish from assertion. A more fundamental problem is that the common ground theory rests on a faulty theory of assertion—that the essence of assertion is to present the content of an utterance as (...) new information. Many examples are presented of utterances which are felicitous but not informative in this way. (shrink)

This paper takes a critical look at the idea that evolutionary theory is a statistical theory. It argues that despite the strong instrumental motivation for statistical theories, they are not necessary to explain deterministic systems. Biological evolution is fundamentally a result of deterministic processes. Hence, a statistical theory is not necessary for describing the evolutionary forces of genetic drift and natural selection, nor is it needed for describing the fitness of organisms. There is a computational advantage to the statistical theory (...) of population genetics, but population genetics succeeds only by eliminating causes from its account of evolutionary change. (shrink)

Whistleblowing is a controversial yet socially significant topic of interest due to its impact on employees, organizations, and society at large. The purpose of this paper is to integrate knowledge of whistleblowing with theoretical advancements in the broader domain of business ethics to propose a novel approach to research and practice engaged in this complex phenomenon. The paper offers a conceptual framework, i.e., the wheel of whistleblowing, that is developed to portray the different features of whistleblowing by applying the whistleblower’s (...) perspective. The framework is based on five “W” questions: Who, What, hoW, Why, and to Whom? The answers to the proposed questions clarify the main aspects of whistleblowing, provide insights into existing studies of the subject, and identify relevant gaps in the literature which, in turn, offer opportunities for future research. (shrink)

In this essay I defend functional explanations in sociobiology against the charge that they are exercises in speculative story-telling. I distinguish proximate and ultimate biological functions, and discuss their role in functional explanations. I characterize functional explanations as a kind of "consequence explanation", and argue that sociobiologists need to justify a "functional fact" in addition to a "consequence law". Two methods used to supply evidence for functional hypotheses, the technique of optimality analyses and the comparative method, are discussed and illustrated (...) with examples. I argue that adequate evidence for hypothesis about the function of a trait can be provided by the method of comparison, but not by optimality analyses. The comparative method contains an inductive phase that provides independent warrant for, and so serves to establish the high probability of, functional hypotheses. Independent warrant cannot be provided by optimality analyses alone: the model-building approach itself mandates the sacrifice of the truth of a hypothesis to its predictive power. I conclude that while the sociobiologist may wish to employ the optimality analysis as a heuristic strategy, reliable functional explanations are better sought through the use of the comparative method. (shrink)

Essays discuss the division of household labor, anti-semitism, violence against women, reproductive freedom, parenting, friendship between women, and feminist theology.

In the special section ‘Body Hacking: Self-Made Cyborgs and Visions of Transhuman Corporeality’, attention is drawn to cyborgism, a set of cultural and very personal practices of experimentation with the human body that often take place outside the confines of institutionalised technoscience. Known, for example, as ‘body hackers’, ‘grinders’ or ‘self-made cyborgs’ and engaging in unusual forms of body modification, the practitioners are enthusiasts who do not necessarily have any ‘disability’ in the conventional sense of the term. They consider the (...) body a highly malleable material, a transformable, improvable, augmentable entity. The collection of papers in this special section encompasses first-hand accounts of cyborg practices as well as intellectual reflections on their implications. (shrink)

This essay develops its idiosyncrasy by concentrating primarily on the trend of body hacking. The practitioners, self-defined as body hackers, self-made cyborgs or grinders, work in different ways to develop functional and physiological modifications through the contributions of technology. Their goal is to develop by themselves an empirically man-technique fusion. These dynamic “scientific” subcultures are producing astonishing innovations. From pocket-sized kits that sample human DNA, microchip implants that keep tabs on our internal organs, blood sugar levels or moods, and even (...) 3D printers that produce tailored hip replacements, the technical innovations of the body hacking trend are beginning to filter into mainstream use, and the repertoire increases every day. These physical transformations with intersecting techniques actively challenge long-held normative beliefs about what bodies do, what they should look like and how they should behave. They provide an alternative discourse on man’s correlation with the world and its biocenosis. Sculpting oneself has become an existential data. Medical technoscience crystallizes the effectiveness of new powers over the organism. Scientific temptation to recreate and enhance the human according to its normative principles has brought up experimental practices that have become the edge of a radical activism operating in the core of western societies, which will be the theme of this paper. (shrink)

This paper makes a plea for more reflexive attempts to develop and anchor the emerging concept of responsible research and innovation. RRI has recently emerged as a buzzword in science policy, becoming a focus of concerted experimentation in many academic circles. Its performative capacity means that it is able to mobilise resources and spaces despite no common understanding of what it is or should be ‘made of’. In order to support reflection and practice amongst those who are interested in and (...) using the concept, this paper unpacks understandings of RRI across a multi-disciplinary body of peer-reviewed literature. Our analysis focuses on three key dimensions of RRI that remain particularly opaque. A total of 48 publications were selected through a systematic literature search and their content was qualitatively analysed. Across the literature, RRI is portrayed as a concept that embeds numerous features of existing approaches to govern and assess emerging technologies. Our analysis suggests that its greatest potential may be in its ability to unify and provide political momentum to a wide range of long-articulated ethical and policy issues. At the same time, RRI’s dynamism and resulting complexity may represent its greatest challenge. Further clarification on what RRI has to offer in practice—beyond what has been offered to date—is still needed, as well as more explicit engagement with research and institutional cultures of responsibility. Such work may help to realise the high political expectations that are attached to nascent RRI. (shrink)

The purpose of this article is to report what can be learned about nurses’ ethical conflicts by the systematic analysis of methodologically similar studies. Five studies were identified and analysed for: (1) the character of ethical conflicts experienced; (2) similarities and differences in how the conflicts were experienced and how they were resolved; and (3) ethical conflict themes underlying four specialty areas of nursing practice (diabetes education, paediatric nurse practitioner, rehabilitation and nephrology). The predominant character of the ethical conflicts was (...) disagreement with the quality of medical care given to patients. A significant number of ethical conflicts were experienced as ‘moral distress’, the resolution of which was variable, depending on the specialty area of practice. Ethical conflict themes underlying the specialty areas included: differences in the definition of adequacy of care among professionals, the institution and society; differences in the philosophical orientations of nurses, physicians and other health professionals involved in patient care; a lack of respect for the knowledge and expertise of nurses in specialty practice; and difficulty in carrying out the nurse’s advocacy role for patients. (shrink)