In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses (...) can use self‐reflection to create an awareness of nursing, caring and ethical inner values in caring. (shrink)

Paediatric cancer care poses ethically difficult situations that can lead to value conflicts about what is best for the child, possibly resulting in moral distress. Research on moral distress is lacking in paediatric cancer care in Sweden and most questionnaires are developed in English. The Moral Distress Scale-Revised is a questionnaire that measures moral distress in specific situations; respondents are asked to indicate both the frequency and the level of disturbance when the situation arises. The aims of this study were (...) to translate and culturally adapt the questionnaire to the context of Swedish paediatric cancer care. In doing so we endeavoured to keep the content in the Swedish version as equivalent to the original as possible but to introduce modifications that improve the functional level and increase respondent satisfaction. The procedure included linguistic translation and cultural adaptation of MDS-R’s paediatric versions for Physicians, Nurses and Other Healthcare Providers to the context of Swedish paediatric cancer care. The process of adjustment included: preparation, translation procedure and respondent validation. The latter included focus group and cognitive interviews with healthcare professionals in paediatric cancer care. To achieve a Swedish version with a good functional level and high trustworthiness, some adjustments were made concerning design, language, cultural matters and content. Cognitive interviews revealed problems with stating the level of disturbance hypothetically and items with negations caused even more problems, after having stated that the situation never happens. Translation and cultural adaptation require the involvement of various types of specialist. It is difficult to combine the intention to keep the content as equivalent to the original as possible with the need for modifications that improve the functional level and increase respondent satisfaction. The translated and culturally adapted Swedish MDS-R seems to have equivalent content as well as improved functional level and respondent satisfaction. The adjustments were made to fit paediatric cancer care but it could be argued that the changes are relevant for most areas of paediatric care of seriously ill patients. (shrink)

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by (...) responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity. (shrink)

BackgroundMoral distress has been described as an emotionally draining condition caused by being prevented from providing care according to one’s convictions. Studies have described the impact of moral distress on healthcare professionals, their situations and experiences. The Measure of Moral Distress for Healthcare Professionals (MMD-HP) is a questionnaire that measures moral distress experienced by healthcare professionals at three levels: patient, system and team. The aim of this project was to translate and make a cultural adaption of the MMD -HP to (...) the Swedish context.MethodsThe questionnaire comprises 27 items, rated according to frequency and intensity on a five-point Likert scale (0–4). The procedure for translating MMD-HP followed WHO guidelines (2020). These entailed a forward translation from English to Swedish, a back translation, expert panel validation, pretesting and cognitive face-to-face interviews with 10 healthcare professionals from various professions and healthcare contexts.ResultsThe Swedish version of MMD-HP corresponds essentially to the concept of the original version. Parts of some items’ had to be adjusted or removed in order to make the item relevant and comprehensible in a Swedish context. Overall, the cognitive interviewees recognized the content of the items which generally seemed relevant and comprehensible.ConclusionThe Swedish version of MMD-HP could be a useful tool for measuring moral distress among healthcare professionals in a Swedish healthcare context. (shrink)

The paediatric Moral Distress Scale-Revised was previously translated and adapted to Swedish paediatric oncology. Cognitive interviews revealed five not captured situations among the 21 items, resulting in five added items: 22) Lack of time for conversations with patients/families, 23) Parents’ unrealistic expectations, 24) Not to talk about death with a dying child, 25) To perform painful procedures, 26) To decide on treatment/care when uncertain. The aim was to explore experiences of moral distress in the five added situations in the Swedish (...) paediatric MDS-R, among healthcare professionals in paediatric oncology. In this national cross-sectional survey, the Swedish paediatric MDS-R, including five added items, were used. Descriptive statistics, non-parametric analysis of differences between professions and a MDS-R score for each item were calculated. Internal consistency was tested using Cronbach’s alpha and inter-item correlation test. HCPs at all six Swedish paediatric oncology centres participated. The Regional Ethical Review Board had no objections. Consent was assumed when the survey was returned. Nursing assistants reported higher intensity and lower frequency on all added items; registered nurses reported a higher frequency on item 22–25; medical doctors reported higher MDS-R score on item 26. On item 22, intensity was moderate for RNs and MDs and high for NAs, and frequency was high among all. Item 22, had the second highest MDS-R score of all 26 for all professional groups. On item 23, the level of disturbance was low but it occurred often. The 26-item version showed good internal consistency for the overall sample and for all professional groups. However, item 22 and 24 could be viewed as redundant to two of the original 21. In accordance with other studies, the intensity was higher than the frequency, however, the frequency of the added items was higher than of the original items. In line with previous research, item 22 and 23 are important elements of moral distress. RNs experience the situations more often while NAs find them more disturbing. The results indicate that the added items are important in capturing moral distress in paediatric oncology. (shrink)

As the distance between science and society is collapsed with the growth of contemporary knowledge societies, so a range of different approaches to the democratic governance of science superseding its Enlightenment government is emerging. In light of these different approaches, this article focuses on the figure of the scientific citizen and the variable dimensions of a new scientific citizenship. Three models of democracy - advanced consumer, deliberative and radical/pluralist - are put forward as both partly competing and partly complementary frameworks (...) within which the new rights and responsibilities of the scientific citizen can be articulated and discussed. In each case the theory and practice of scientific citizenship are viewed against the background of contemporary developments within the field of science communication; the rise of the public understanding of science movement; the new enthusiasm for advancing public engagements with science, and the legitimate place of different forms of public protest and dissent within new designs for democratic governance. (shrink)

The article is based on the argument that labour market segregation is an important factor contributing to women’s inequality in the labour market. Therefore, any equal opportunities policy has to be combined with a policy to reduce segregation. But up to now segregation has been extremely persistent, as is shown in a short empirical overview of segregation in the Austrian labour market. It is argued that the roots of this phenomenon lie in the assignment of men and women to the (...) market area and the reproduction area according to the breadwinner model. Labour market segregation by sex can be seen as a transformation and continuation of the asymmetrical gender relation in the family to the labour market. Most of the mechanisms and processes that occur every day in the labour market work together to preserve sex segregation. Strategies to reduce segregation should look at these historical roots of segregation and at the connection with the overall gender division of labour. Different perspectives on a reduction of labour market segregation are presented. (shrink)

The aim of this study was to understand how mothers experienced midwives' uncaring behaviour and actions during birth. Sixty-seven first-time mothers took part in the study, in which data were collected through interview. The interview text was analysed using hermeneutic text analysis. Nearly half of the mothers interviewed (n = 32) said that midwives did not care for them. The findings show that midwives' behaviour was humiliating when they ignored mothers and held them in contempt. The mothers felt further humiliated (...) when the midwives did not believe them, treated their bodies in a careless manner and tended to put blame on them. Through their behaviour and actions, some midwives have shown that they no longer have a caring attitude as an element of their professional practice and that they have ignored ethics by offending mothers' sense of dignity. (shrink)

Applying Fineman’s vulnerability theory, this paper will explore the role of emotions within the legal profession and the specific vulnerabilities that arise from their traditional and contemporary treatment within law. It will consider how the notion of professionalism in law has traditionally disregarded or excluded emotions as irrelevant or even dangerous in a manner which is philosophically and psychologically flawed as well as damaging to mental health and wellbeing. This approach has created longstanding unacknowledged vulnerabilities for the profession as a (...) whole and individual practitioners. It will then explore how the shifting legal services landscape, and the resultant evolution of the profession, has led to a growing contemporary interest in the use of emotional competencies (often characterised as ‘soft skills’ or ‘emotional intelligence’). These are now increasingly exploited as tools to enhance profitability. However, this leads to a dichotomy as, despite their increasing utilisation, emotions are still not fully acknowledged or incorporated within law’s core professional values. This generates further individual and institutional vulnerabilities around mental health and wellbeing which require urgent attention to ensure the health of the contemporary profession. The paper concludes with suggestions for reforms to alleviate these vulnerabilities and promote greater future resilience within law. (shrink)

Sujetos y subjetividad en la construcción metodológica / Hugo Zemelman / - El magma constitutivo de la historicidad / Emma León / - Trabajo y mundo de vida / Enrique de la Garza Toledo / - Subjetividades emergentes, psiquismo y proyecto colectivo / Lidia Fernández / - Hacia una sociedad del sujeto : democracia y sociedad civil / Carlos Guerra Rodríguez / - Medios de comunicación, gobierno de la población y sujetos / María del Carmen de la Peza C. (...) / - El espacio íntimo en la construcción intersubjetiva / Medardo Tapia Uribe. (shrink)

Feeling old: being in a phase of transition in later life The aim of the study was to illuminate very old persons’ experiences of feeling old in order to get a nuanced understanding of the ageing process in later life. Fifteen persons 85–96 years of age, living in their own homes, were interviewed in‐depth. Data were analysed utilising a phenomenological‐hermeneutic approach. Eight persons reported that they felt old. The experience of feeling old entailed four characteristics: being able to date the (...) beginning of feeling old, fear of helplessness and of being unable to manage one’s life situation, not recognising one’s former self, and feeling different from others. These characteristics corresponded to the main properties of a transition process. The comprehensive understanding was that the very old persons who also felt old were in a phase of transition. The distinguishing qualities of those that felt old were also found to be in line with the dystonic dominance in the ninth stage designated by Joan Erikson of the previously described life cycle. Knowledge about transition processes and sensitivity to very old people’s experiences of feeling old are of great importance to nursing in order to provide adequate health care services and prevent unhealthy transitions. (shrink)

This chapter explores the concept of knowing as a contested terrain within the education. It takes, as its starting point, the classical philosophical distinction between knowing how, knowing that and the lesser-attended-to notion of knowing by acquaintance. Charting key historical debates pertaining to knowing that and knowing how, the chapter considers the extent to which conceptions of these forms of knowing evident in educational policy and practice are often limited and reductive. The chapter then explores how contemporary work within the (...) philosophy of education has served to challenge too-stringent conceptions of propositional and practical knowledge – often by reference to the Aristotelian conception of phronesis. With a view to building on this literature and taking it in a new direction, the chapter ends by exploring what might need to be at stake in a richer conception of knowledge for education. In connection with this, it offers a sketch of a renewed account of knowing by acquaintance, developed in relation to the phenomenological philosophy of Martin Heidegger. (shrink)

Blackshaw and Hendricks have recently developed and defended the impairment argument against abortion, arguing that the immorality of giving a child fetal alcohol syndrome (FAS) provides us with reason to believe that abortion is immoral. In this paper, we forward two criticisms of the impairment argument. First, we highlight that, as it currently stands, the argument is very weak and accomplishes very little. Second, we argue that Blackshaw and Hendricks are fundamentally mistaken about what makes giving a child FAS immoral. (...) Once we acknowledge this, it is clear that our intuitions about giving a child FAS provide no support for the supposed immorality of abortion. (shrink)

This thesis examines the claim that the sciences are disunified. Chapter 1 outlines and introduces different accounts of the stratification of the sciences in the literature, in particular, Unificationism, Disunificationism, Eliminativism and Human Science Disunificationism. I argue that all of these competing views are informed by an ideal model for successful science. In particular, all of the views discussed are committed to the claim that a science requires laws to be considered scientifically legitimate. At the end of this chapter, the (...) narrower topic of the thesis is revealed: do the special sciences have real legitimate ceteris paribus laws? (shrink)

Scientists, philosophers, and policymakers disagree about how to define microaggression. Here, we offer a taxonomy of existing definitions, clustering around (a) the psychological motives of perpetrators, (b) the experience of victims, and (c) the functional role of microaggression in oppressive social structures. We consider conceptual and epistemic challenges to each and suggest that progress may come from developing novel hybrid accounts of microaggression, combining empirically tractable features with sensitivity to the testimony of victims.

This chapter examines the way the two main philosophies of Heidegger and Derrida, come into critical contact with each other. Derrida represents his own thinking as a development of Heideggerian thought. The chapter discusses Derrida's engagement with Heidegger spanned nearly his entire philosophical career. Derrida's exploration of Heidegger's spiritual idiom, while somewhat unusual, is not unconnected with his other writings on Heidegger. Through tracing Heidegger's spiritual idiom, Derrida seeks to bring out what is at stake in those aspects of Heidegger's (...) thought he finds uncertain or, to put it more bluntly, questionable. In tracing Derrida's reading of Heidegger in Of Spirit, then, one shall in effect be crossing two pathways. One uses the medium of spirit to introduce certain critical questions for Heideggerian philosophy, specifically questions that relate to the political and geo political aspects of Heidegger's work. (shrink)

In this article, we aim to map out the complexities which characterise debates about the ethics of vaccine distribution, particularly those surrounding the distribution of the COVID-19 vaccine. In doing so, we distinguish three general principles which might be used to distribute goods and two ambiguities in how one might wish to spell them out. We then argue that we can understand actual debates around the COVID-19 vaccine – including those over prioritising vaccinating the most vulnerable – as reflecting disagreements (...) over these principles. Finally, we shift our attention away from traditional discussions of distributive justice, highlighting the importance of concerns about risk imposition, special duties, and social roles in explaining debates over the COVID-19 vaccine. We conclude that the normative complexity this article highlights deepens the need for decision-making bodies to be sensitive to public input. (shrink)

Minimal Semantics asks what a theory of literal linguistic meaning is for - if you were to be given a working theory of meaning for a language right now, what would you be able to do with it? Emma Borg sets out to defend a formal approach to semantic theorising from a relatively new type of opponent - advocates of what she call 'dual pragmatics'. According to dual pragmatists, rich pragmatic processes play two distinct roles in linguistic comprehension: as (...) well as operating in a post-semantic capacity to determine the implicatures of an utterance, they also operate prior to the determination of truth-conditional content for a sentence. That is to say, they have an integral role to play within what is usually thought of as the semantic realm. Borg believes dual pragmatic accounts constitute the strongest contemporary challenge to standard formal approaches to semantics since they challenge the formal theorist to show not merely that there is some role for formal processes on route to determination of semantic content, but that such processes are sufficient for determining content. Minimal Semantics provides a detailed examination of this school of thought, introducing readers who are unfamiliar with the topic to key ideas like relevance theory and contextualism, and looking in detail at where these accounts diverge from the formal approach. Borg's defence of formal semantics has two main parts: first, she argues that the formal approach is most naturally compatible with an important and well-grounded psychological theory, namely the Fodorian modular picture of the mind. Then she argues that the main arguments adduced by dual pragmatists against formal semantics - concerning apparent contextual intrusions into semantic content - can in fact be countered by a formal theory. The defence holds, however, only if we are sensitive to the proper conditions of success for a semantic theory. Specifically, we should reject a range of onerous constraints on semantic theorizing (e.g., that it answer epistemic or metaphysical questions, or that it explain our communicative skills) and instead adopt a quite minimal picture of semantics. (shrink)

Nietzsche was struck by the similarities between Greek and Indian philosophy. From the perspective elaborated in On the Genealogy of Morality - in which values are derived from the physiological, psychological, and social domains - we would expect the similarities of thought to derive from similarities in the conditions of the two cultures. A role is played here by the agonal spirit manifest in the Iliad, Hesiod, and Heraclitus as well as in Indian philosophy and in the Mahabharata and Ramayana. (...) Nietzsche found in both cultures viable models of self and state, born from an agonal context, that provided for him modes of being alternative to the Christian slave morality that he despised. (shrink)

(1998). A note on ‘The idea of the university in the global era: From knowledge as an end to the end of knowledge’. Social Epistemology: Vol. 12, Sites of Knowledge Production: The University, pp. 85-88. doi: 10.1080/02691729808578865.

This paper examines the concept of medical necessity as it relates to mental health care rationing, arguing that the normal functioning model of medical necessity is insufficient because it fails to cohere with an important aim and function of mental health care, which is to provide support for individuals in abusive or otherwise difficult personal relationships.

Microaggressions are seemingly negligible slights that can cause significant damage to frequently targeted members of marginalized groups. Recently, Scott O. Lilienfeld challenged a key platform of the microaggression research project: what’s aggressive about microaggressions? To answer this challenge, Derald Wing Sue, the psychologist who has spearheaded the research on microaggressions, needs to theorize a spectrum of aggression that ranges from intentional assault to unintentional microaggressions. I suggest turning to Bonnie Mann’s “Creepers, Flirts, Heroes and Allies” for inspiration. Building from Mann’s (...) richer theoretical framework will allow Sue to answer Lilienfeld’s objection and defend the legitimacy of the concept, ‘microaggression’. (shrink)

Understanding in Epistemology Epistemology is often defined as the theory of knowledge, and talk of propositional knowledge has dominated the bulk of modern literature in epistemology. However, epistemologists have recently started to turn more attention to the epistemic state or states of understanding, asking questions about its nature, relationship … Continue reading Understanding in Epistemology →.

This Introduction has two foci: the first is a discussion of the motivation for and the aims of the 2014 conference on New Thinking about Scientific Realism in Cape Town South Africa, and the second is a brief contextualization of the contributed articles in this special issue of Synthese in the framework of the conference. Each focus is discussed in a separate section.

At first glance, hate speech and microaggressions seem to have little overlap beyond being communicated verbally or in written form. Hate speech seems clearly macro-aggressive: an intentional, obviously harmful act lacking the ambiguity (and plausible deniability) of microaggressions. If we look back at historical discussions of hate speech, however, many of these assumed differences turn out to be points of similarity. The harmfulness of hate speech only became widely acknowledged after a concerted effort by critical race theorists, feminists, and other (...) activists. Before the 1990s, slurs were widely considered socially acceptable behavior: mere jokes that weren’t intended to be harmful. Authors like Richard Delgado, Mari Matsuda, and Charles Lawrence pushed back against this dismissal. In this chapter, I show that their arguments for the serious harmfulness of hate speech prefigure and provide support for current debates about the serious harmfulness of microaggressions. Exploring resonances with the 1980s hate speech debate will allow us to explain why microaggressions fall below the cutoff for legal liability but remain apt targets for moral blame. (shrink)

In this study, we analyzed the academic integrity policies of colleges in Ontario, Canada, casting a specific lens on contract cheating. We extracted data from 28 individual documents from 22-publicly-funded colleges including policies and procedures (n = 27) and code of conduct (n = 1). We analyzed the characteristics of the documents from three perspectives: (a) document type and titles; (b) policy language; and (c) policy principles. Then we examined five core elements of the documentation including (a) access; (b) approach; (...) (c) responsibility; (d) detail; and (e) support. Key findings revealed that specific and direct language pertaining to contract cheating was largely absent from the policy documents, that underlying policy principles lacked clear definition, and that exemplary policy has yet to be developed in this context. We conclude with recommendations for increased policy research in the area of academic integrity and a call for policy revision in Canadian higher education institutions to more explicitly address the issue of contract cheating, as well as provide more support to students and other campus stakeholders to better understand how contract cheating impacts and impedes teaching and learning. (shrink)

While human genetic research promises to deliver a range of health benefits to the population, genetic research that takes place in Indigenous communities has proven controversial. Indigenous peoples have raised concerns, including a lack of benefit to their communities, a diversion of attention and resources from non-genetic causes of health disparities and racism in health care, a reinforcement of “victim-blaming” approaches to health inequalities, and possible misuse of blood and tissue samples. Drawing on the international literature, this article reviews the (...) ethical issues relevant to genetic research in Indigenous populations and considers how some of these have been negotiated in a genomic research project currently under way in a remote Aboriginal community. We consider how the different levels of Indigenous research governance operating in Australia impacted on the research project and discuss whether specific guidelines for the conduct of genetic research in Aboriginal and Torres Strait Islander communities are warranted. (shrink)

Environmental epigenetics is increasingly employed to understand the health outcomes of communities who have experienced historical trauma and structural violence. Epigenetics provides a way to think about traumatic events and sustained deprivation as biological “exposures” that contribute to ill-health across generations. In Australia, some Indigenous researchers and clinicians are embracing epigenetic science as a framework for theorising the slow violence of colonialism as it plays out in intergenerational legacies of trauma and illness. However, there is dispute, contention, and caution as (...) well as enthusiasm among these research communities.In this article, we trace strategies of “refusal” (Simpson, 2014) in response to epigenetics in Indigenous contexts. Drawing on ethnographic fieldwork conducted in Australia with researchers and clinicians in Indigenous health, we explore how some construct epigenetics as useless knowledge and a distraction from implementing anti-colonial change, rather than a tool with which to enact change. Secondly, we explore how epigenetics narrows definitions of colonial harm through the optic of molecular trauma, reproducing conditions in which Indigenous people are made intelligible through a lens of “damaged” bodies. Faced with these two concerns, many turn away from epigenetics altogether, refusing its novelty and supposed benefit for Indigenous health equity and resisting the pull of postgenomics. (shrink)

_Antisemitism, Islamophobia, and Interreligious Hermeneutics: Ways of Seeing the Religious Other_ examines the hermeneutics of interreligious encounter, investigating the implicit judgments of Judaism and Islam that often arise in contexts of conflict.

This chapter offers a brief analysis of the problems facing Bonnett's attempt to articulate a richer conception of thinking. Bonnett states, authentic thinking and understanding require that one become the originators and authors of their own thinking, as against merely reflecting the thoughts of others. In order to deflect the criticism that the account is promoting a self‐centred view of thinking, Bonnett introduces the concept of self referencing, which he describes as the determination to understand what one learns in terms (...) of one's own experiences. Bonnett states, the discipline and rigour of poetic thinking are rooted in the underlying sense of personal responsibility. One of the main flaws with Bonnett's account is that he simply does not engage in a careful enough reading of the philosophical accounts of thinking he draws upon, especially the Heideggerian accounts of being in the world and truth. (shrink)

This chapter explores the similarities that exist between two accounts of thinking presented by philosophers who are usually held to belong to differing, even conflicting, philosophical traditions. These are the accounts of Gilbert Ryle and Martin Heidegger. By situating Ryle in relation to Heidegger, the chapter seeks to show that there is an alternative reading of Ryle and one that problematises any straightforward understanding of him as a partisan of the rationalistic account. Ryle's first criticism takes issue with the way (...) Heidegger turns knowledge into a derivative mode of experience through his account of being in the world. According to Ryle, Heidegger is fundamentally mistaken in doing so, quite simply because knowledge is in fact a precondition for having a relation to things in the world in the first place. Heidegger draws a distinction between two differing conceptions of truth: aletheia and adequatio. (shrink)

This chapter demonstrates how Heidegger's philosophy works to disrupt in a radical sense, the assumptions of traditional philosophy. It seeks to attend to the way Heidegger's later thought (that is, his writings from 1930 onwards) works to develop the reconceptualization of thinking and human existence that was instigated by his early philosophy. The more direct attention Heidegger gives to the nature of language allows a concrete and robust account of the conditions of thought to come to the fore and one (...) that moves us more radically beyond the model of the active, towards a conception of human existence. The duality of concealing, revealing, and the historical nature of language, is a condition of language doing the work it does in the first place. Through Heidegger's account of language, then, one can able to understand something important about the conditionality of human experience that Heidegger gestures towards in his earlier work. (shrink)

This chapter discusses the predominant picture of thinking in education, rationalistic conception. It combines the author's practical analysis of current thinking education with the philosophical account. Certain standards for thinking education are set on the basis of a certain understanding of thinking‐ hence; the two mutually reinforce each other. In questioning the rationalistic account of thinking one can question the current aims of thinking education and many of the educational discourses that go hand in glove with such aims. The rationalistic (...) account is rooted in the assumption that the self‐sufficient, autonomous human being who independently ‘deals’ with problems is both possible and desirable. The particular reason for invoking Derrida was that, he was a thinker profoundly influenced by Heideggerian thought and its attempt to think outside metaphysics and the conceptual categories of the ‘thinking subject’. (shrink)