The attention for Moral case deliberation has increased over the past years. Previous research on MCD is often written from the perspective of MCD experts or MCD participants and we lack a more distant view to the role of MCD in Dutch health care institutions in general. The purpose of this paper is to provide an overview of the state of the art concerning MCD in the Netherlands. As part of a larger national study on clinical ethics support in the (...) Netherlands, we will focus on the prevalence and characteristics of MCD in Dutch health. A mixed methods design was used in which we combined two survey questionnaires, two focus groups and 17 individual interviews with top managers or ethics support staff. The findings demonstrate that the prevalence of MCD is relatively high in Dutch health care, especially in mental health care. Institutions with MCD differ from institutions without MCD concerning size, kind of problems and importance of ideological background. Characteristic of MCD is that it often exists for 3 years or more, has a high participation of health professionals and middle managers and is both organized scheduled as unscheduled. As well integration in existing policy as key persons emerge as important issues in relation to the positioning of MCD. We conclude that MCD is a part of an integrated ethics policy and serves as a catalyst for such an integrated ethics policy. (shrink)

Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly care. The findings of two surveys, two focus groups and 17 interviews demonstrate that the availability of ethics support is limited. There is a need for ethics support, albeit not unconditionally. Advice-based forms of ethics support (...) are less appropriate as they are removed from practice. Ethics support should be tailored to the often mundane and easily overlooked moral issues that arise in long-term care. Attention should also be given to the learning styles of nurses who favour experiential learning. Raising awareness and developing a climate of openness and dialogue are the most suitable ways to deal with the mundane moral issues in elderly care. (shrink)

Internationally, the prevalence of clinical ethics support (CES) in health care has increased over the years. Previous research on CES focused primarily on ethics committees and ethics consultation, mostly within the context of hospital care. The purpose of this article is to investigate the prevalence of different kinds of CES in various Dutch health care domains, including hospital care, mental health care, elderly care and care for people with an intellectual disability. A mixed methods design was used including two survey (...) questionnaires, sent to all health care institutions, two focus groups and 17 interviews with managing directors or ethics support staff. The findings demonstrate that the presence of ethics committees is relatively high, especially in hospitals. Moral case deliberation (MCD) is available in about half of all Dutch health care institutions, and in two-thirds of the mental health care institutions. Ethics consultants are not very prominent. A distinction is made between explicit CES forms, in which the ethical dimension of care is structurally and professionally addressed and implicit CES forms, in which ethical issues are handled indirectly and in an organic way. Explicit CES forms often go together with implicit forms of CES. MCD might function as a bridge between the two. We conclude that explicit and implicit CES are both relevant for clinical ethics in health care. We recommend research regarding how to combine them in an appropriate way. (shrink)

Clinical ethics support, in particular Moral Case Deliberation, aims to support health care providers to manage ethically difficult situations. However, there is a lack of evaluation instruments regarding outcomes of clinical ethics support in general and regarding Moral Case Deliberation (MCD) in particular. There also is a lack of clarity and consensuses regarding which MCD outcomes are beneficial. In addition, MCD outcomes might be context-sensitive. Against this background, there is a need for a standardised but flexible outcome evaluation instrument. The (...) aim of this study was to develop a multi-contextual evaluation instrument measuring health care providers’ experiences and perceived importance of outcomes of Moral Case Deliberation. (shrink)

Within psychiatry, patients, family, and professionals are involved and interrelated. Yet it is not easy for healthcare professionals to involve family actively in patient care. Taking a feminist perspective, we investigate why health-care professionals experience ambivalence in involving family in attempts to reduce seclusion, suggesting how they can improve family involvement by adopting a relational view on autonomy. Professionals should view patients not only in terms of individual autonomy and rights, but also in terms of relations and dependencies that need (...) to be considered in fostering patient care. (shrink)

Recently, there has been increased interest in the involvement of family members in treating psychiatric patients who are involuntarily admitted into mental hospitals (Goodwin and Happel 2006; Wilkinson and McAndrew 2008). Family is, for instance, expected to be of use in preventing escalations and aggression on the wards by giving information about patient needs and providing support to the patient. Yet, in practice, family is not routinely involved in the treatment process, and is not even regularly informed about situations (Marshall (...) and Solomon 2003). Professionals mention privacy and confidentiality as issues that constrain collaboration with family (Goodwin and Happel 2006; Wynaden and Orb 2005). .. (shrink)

An ethic for wrongdoers -- Repaying moral debts : self-punishment and restitution -- Changing one's heart, changing the past : repentance and moral transformation -- Reforming relationships : the reconciliation theory of atonement -- Forgiveness, self-forgiveness, and redemption -- Making amends for crime : an evaluation of restorative justice -- Collective atonement : making amends to the Magdalen penitents.

The distinction between a type and its tokens is auseful metaphysical distinction. In §1 it is explained what itis, and what it is not. Its importance and wide applicability inlinguistics, philosophy, science and everyday life are brieflysurveyed in §2. Whether types are universals is discussed in§3. §4 discusses some other suggestions for what types are,both generally and specifically. Is a type the sets of its tokens?What exactly is a word, a symphony, a species? §5 asks what atoken is. §6 considers (...) the relation between types and theirtokens. Do the type and all its tokens share the same properties? Mustall the tokens be alike in some or all respects? §7 explains someproblems for the view that types exist, and some problems for the viewthat they don’t. §8 elucidates a distinction often confused withthe type-token distinction, that between a type and anoccurrence of it. It also discusses some problems thatoccurrences might be thought to give rise to, and one way to resolvethem. (shrink)

The distinction between a type and its tokens is a useful metaphysical distinction. In §1 it is explained what it is, and what it is not. Its importance and wide applicability in linguistics, philosophy, science and everyday life are briefly surveyed in §2. Whether types are universals is discussed in §3. §4 discusses some other suggestions for what types are, both generally and specifically. Is a type the sets of its tokens? What exactly is a word, a symphony, a species? (...) §5 asks what a token is. §6 considers the relation between types and their tokens. Do the type and all its tokens share the same properties? Must all the tokens be alike in some or all respects? §7 explains some problems for the view that types exist, and some problems for the view that they don't. §8 elucidates a distinction often confused with the type-token distinction, that between a type (or token) and an occurrence of it. It also discusses some problems that occurrences might be thought to give rise to, and one way to resolve them. (shrink)

The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) requires as a condition of accreditation that every health care institution -- hospital, nursing home, or home care agency -- have a standing mechanism to address ethical issues. Most organizations have chosen to fulfill this requirement with an interdisciplinary ethics committee. The best of these committees are knowledgeable, creative, and effective resources in their institutions. Many are wellmeaning but lack the information, experience, and skills to negotiate adequately the complex ethical (...) issues that arise in clinical and organizational settings. Handbook for Health Care Ethics Committees is the first resource designed to address the range of work performed by ethics committees as part of their multiple responsibilities, including education, case consultation, and policy development. It features an eight-chapter curriculum reviewing the content of contemporary health care bioethics and discussing the ethical foundations of clinical practice, with each subsequent section focusing on a set of ethical issues that commonly arise in the clinical setting. Through case studies, the authors explore issues such as informed consent and refusal, decision making and decisional capacity, truth telling, decision-making concerns of minors, end-of-life issues, palliation, justice in and access to health care services, and organizational ethics. They offer sample policies and procedures, draft guidelines and protocols, and key legal cases. Providing both a strong theoretical foundation and practical applications, this handbook will be essential reading for every member of a health care ethics committee. (shrink)

These books will prove valuable to philosophy teachers and their students as well as to other readers who share a general interest in philosophy.

Next SectionObjective The purpose of this article is to investigate the need for ethics support in Dutch healthcare institutions in order to understand why ethics support is often not used in practice and which factors are relevant in this context. Methods This study had a mixed methods design integrating quantitative and qualitative research methods. Two survey questionnaires, two focus groups and 17 interviews were conducted among board members and ethics support staff in Dutch healthcare institutions. Findings Most respondents see a (...) need for ethics support. This need is related to the complexity of contemporary healthcare, the contribution of ethics support to the core business of the organisation and to the surplus value of paying structural attention to ethical issues. The need for ethics support is, however, not unconditional. Reasons for a lacking need include: aversion of innovations, negative associations with the notion of ethics support service, and organisational factors like resources and setting. Conclusion There is a conditioned need for ethics support in Dutch healthcare institutions. The promotion of ethics support in healthcare can be fostered by focusing on formats which fit the needs of (practitioners in) healthcare institutions. The emphasis should be on creating a (culture of) dialogue about the complex situations which emerge daily in contemporary healthcare practice. (shrink)

In this book, Linda Wetzel examines the distinction between types and tokens and argues that types exist (as abstract objects, since they lack a unique ...

Almost all religions contain a code of morality, and in spite of the factthat there are moral codes and philosophies that do not rely upon anyreligion, it has been traditionally argued that there are at least threeimportant ways in which morality needs religion: the goal of the morallife is unreachable without religious practice, religion is necessary toprovide moral motivation, and religion provides morality with itsfoundation and justification. These three ways in which morality may needreligion are independent, but I argue that (...) there are conceptual connectionsamong the standard arguments for them. I identify reasons for resistance tothe idea that morality needs religion and then turn to arguments for each ofthe three ways in which morality may need religion. All three are related toclassic forms of the moral argument for the existence of God. I conclude bycomparing classic Divine Command Theory with my Divine Motivation Theory andargue that the latter has advantages over the former in the way it providesa theological foundation for ethics. (shrink)

Feminist approaches within the social sciences have expanded enormously since the 1960s. In addition, in recent years, geographic perspectives have become increasingly significant as feminist recognition of the differences between women, their diverse experiences in different parts of the world and the importance of location in the social construction of knowledge has placed varied geographies at the centre of contemporary feminist and postmodern debates. Gender, Identity and Place is an accessible and clearly written introduction to the wide field of issues (...) that have been addressed by geographers and feminist scholars. It combines the careful definition and discussion of key concepts and theoretical approaches with a wealth of empirical detail from a wide-ranging selection of case studies and other empirical research. It is organized on the basis of spatial scale, examining the relationships between gender and place from the body to the nation, although the links between different spatial scales are also emphasized. The conceptual division and spatial separation between the public and private spheres and their association with men and women respectively has been a crucial part of the social construction of gendered differences and its establishment, maintenance and reshaping from industrial urbanization to the end of the millennium is a central linking theme in the eight substantive chapters. The book concludes with an assessment of the possibilities of doing feminist research. It will be essential reading for students in geography, feminist theory, women's studies, anthropology and sociology. (shrink)

Effects of globalization have amplified the magnitude and frequency of corporate abuses, particularly in developing economies where weak or absent rules undermine social norms and principles. Improving multinational enterprises’ (MNEs) ethical conduct is a factor of both the ability of firms to change behaviors in the direction of the moral good, and their willingness to do so. Constraints and enablers of a firm’s ability to act ethically emanate from the external environment, including the industry environment of which the firm is (...) a resident, and the host country environment in which it operates. A firm’s willingness to engage in ethical conduct is determined by the effective bundling of internal resources and the commitment of those resources to social ends. The interaction of external and internal conditions carves out categories of expected firm behaviors and suggests interventions that would push these behaviors in a more positive ethical direction. With reference to integrative social contracts theory (ISCT), these categories of firms are examined, and a conceptual model for analysis is developed to explain the drivers of corporate choices in the adoption and implementation of codes of conduct, and the relative power of relevant communities to the process. (shrink)

Examines the women's movement, discusses feminist theories, and considers the writings of Locke and Marx concerning the separation of family and state.

Effects of globalization have amplified the magnitude and frequency of corporate abuses, particularly in developing economies where weak or absent rules undermine social norms and principles. Improving multinational enterprises’ (MNEs) ethical conduct is a factor of both the ability of firms to change behaviors in the direction of the moral good, and their willingness to do so. Constraints and enablers of a firm’s ability to act ethically emanate from the external environment, including the industry environment of which the firm is (...) a resident, and the host country environment in which it operates. A firm’s willingness to engage in ethical conduct is determined by the effective bundling of internal resources and the commitment of those resources to social ends. The interaction of external and internal conditions carves out categories of expected firm behaviors and suggests interventions that would push these behaviors in a more positive ethical direction. With reference to integrative social contracts theory (ISCT), these categories of firms are examined, and a conceptual model for analysis is developed to explain the drivers of corporate choices in the adoption and implementation of codes of conduct, and the relative power of relevant communities to the process. (shrink)

While most business ethics texts focus exclusively on individual decision making--what should an individual do--this resource presents the whole business ethics story. Highly realistic, readable, and down-to-earth, it moves from the individual to the managerial to the organizational level, focusing on business ethics in an organizational context to promote an understanding of complex influences on behavior. The new Fifth Edition is the perfect text for students entering the workplace, those seeking to become professionals in training, communications, compliance, in addition to (...) chief ethics officers, corporate counsel, heads of human resources, and senior executives. (shrink)

In previous literature, ethicists mention several goals of Clinical Ethics Support (CES). It is unknown what key persons in healthcare institutions see as main–—and sub-goals of CES. This article presents the goals of CES as perceived by board members and members of ethics support staff. This is part of a Dutch national research using a mixed methods design with questionnaires, focus groups and interviews. Quantitative and qualitative data were analyzed and combined in an iterative process. Four main clusters of goals (...) were found: 1) encouraging an ethical climate, 2) fostering an accountable and transparent organization, 3) developing professionalism and a final goal, overarching the previous three, 4) good care. Most important sub-goals of CES were: attention for ethical issues, raising awareness of ethical issues, fostering ethical reflection and supporting employees. The article ends with a discussion on the desirability to further operationalize the general goal of good care, the context-boundedness of our findings and the need to relate goals of CES to the features of organizational cultures to further improve the integration of CES in healthcare institutions. (shrink)

Acknowledgements This volume brings together contributions by Norwegian, German, and French scholars initially presented at the annual "Politics and ...

This accessible book introduces students to perspectives from the field of science and technology studies. Putting forward the thesis that science and democracy share important characteristics, it shows how authority cannot be taken for granted and must continuously be reproduced and confirmed by others. At a time when fundamental scientific and democratic values are being threatened by sceptics and populist arguments, an understanding of the relationship between them is much needed. This is an invaluable resource for all who are interested (...) in the role of scientific knowledge in governance, societal developments and the implications for democracy, concerned publics and citizen engagement. (shrink)

Anthropologists have provided rich field descriptions of the norms and conventions governing behavior and interactions in small-scale societies. Here, we add a further dimension to this work by presenting hypothetical moral dilemmas involving harm, to a small-scale, agrarian Mayan population, with the specific goal of exploring the hypothesis that certain moral principles apply universally. We presented Mayan participants with moral dilemmas translated into their native language, Tseltal. Paralleling several studies carried out with educated subjects living in large-scale, developed nations, the (...) Mayan participants judged harms caused as the means to a greater good as more forbidden than harms caused as a side-effect (i.e., side-effect bias). However, unlike these other populations living in large-scale societies, as well as a more educated and less rural Mayan comparison group, the target rural Mayan participants did not judge actions causing harm as worse than omissions (i.e., omission bias). A series of probes targeting the action-omission distinction suggest that the absence of an omission bias among the rural Mayan participants was not due to difficulties comprehending the dilemmas, using the judgment scale, or in attributing a greater causal role for actions over omissions. Thus, while the moral distinction between means and side-effect may be more universal, the moral distinction between actions and omission appears to be open to greater cross-cultural variation. We discuss these results in light of issues concerning the role of biological constraints and cultural variation in moral decision-making, as well as the limitations of such experimental, cross-cultural research. (shrink)

Two experiments investigated the impact of affect on the working self-concept. Following an affect induction, participants completed the Twenty Statements Test (TST) to assess their working self-concepts. Participants in predominantly happy and angry states used more abstract statements to describe themselves than did participants in predominantly sad and fearful states. Evaluations of the statements that participants generated (Experiment 2) demonstrate that these effects are not the result of (1) participants describing positively and negatively valenced information at different levels of abstraction, (...) or (2) valence-based affective priming. Further, half of the participants in Experiment 2 were led to attribute their affect to the manipulation prior to completing the TST. This manipulation eliminated the influence of affect on the working self-concept. Taken together, these results are consistent with theory and research on the informative functions of affect. (shrink)

Abstract:This field survey focused on two constructs that have been developed to represent the ethical context in organizations: ethical climate and ethical culture. We first examined issues of convergence and divergence between these constructs through factor analysis and correlational analysis. Results suggested that the two constructs are measuring somewhat different, but strongly related dimensions of the ethical context. We then investigated the relationships between the emergent ethical context factors and an ethics-related attitude (organizational commitment) and behavior (observed unethical conduct) for (...) respondents who work in organizations with and without ethics codes. Regression results indicated that an ethical culture-based dimension was more strongly associated with observed unethical conduct in code organizations while climate-based dimensions were more strongly associated with observed unethical conduct in non-code organizations. Ethical culture and ethical climate-based factors influenced organizational commitment similarly in both types of organizations. Normative implications of the study are discussed, as are implications for future theorizing, research and management practice. (shrink)

Space Gender Knowledge is an innovative and comprehensive introduction to the geographies of gender and the gendered nature of spatial relations. It examines the major issues raised by women's movements and academic feminism, and outlines the main shifts in feminist geographical work, from the geography of women to the impact of post-structuralism. In making their selection, the editors have drawn on a wide range of interdisciplinary material, ranging across spatial scales from the body to the globe. The book presents influential (...) arguments for the importance of the intersection between space and gender. Looking both at geography and beyond the discipline, it explores the gendered construction of space and the spatial construction of gender. Divided into a number of conceptual sections, each prefaced by an editorial introduction, this reader includes extracts from both landmark texts and less well-known works, making it an indispensable introduction to this dynamic field of study. (shrink)

What is knowledge? Why do we want it? Is knowledge possible? How do we get it? What about other epistemic values like understanding and certainty? Why are so many epistemologists worried about luck? In ON EPISTEMOLOGY Linda Zagzebski situates epistemological questions within the broader framework of what we care about and why we care about it. Questions of value shape all of the above questions and explain some significant philosophical trends: the obsession with answering the skeptic, the flight from (...) realism, and the debate between naturalism and anti-naturalism. THE WADSWORTH PHILOSOPHICAL TOPICS SERIES (under the general editorship of Robert Talisse, Vanderbilt University) presents readers with concise, timely, and insightful introductions to a variety of traditional and contemporary philosophical subjects. With this series, students of philosophy will be able to discover the richness of philosophical inquiry across a wide array of concepts, including hallmark philosophical themes and themes typically underrepresented in mainstream philosophy publishing. Written by a distinguished list of scholars who have garnered particular recognition for their excellence in teaching, this series presents the vast sweep of today's philosophical exploration in highly accessible and affordable volumes. These books will prove valuable to philosophy teachers and their students as well as to other readers who share a general interest in philosophy. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Cet article analyse un rapport de l’Immigrants’ Protective League à Chicago (1931) qui porte sur le paiement des pensions alimentaires dans des familles séparées par la migration. Rédigé dans le cadre d’un projet de convention internationale sur l’assistance aux étrangers indigents, ce rapport présente les différentes tactiques utilisées par les travailleuses sociales de l’organisation pour réunir les familles afin d’éviter le recours aux tribunaux. L’analyse de la mise en récit des histoires de couples et de familles montre le processus de (...) légitimation du travail social international et met en évidence les pratiques des travailleuses sociales qui s’appuient sur les émotions pour rétablir un modèle social familial fragilisé par la migration. Le document permet aussi de retracer des projets et parcours migratoires qui font face à de nombreuses contraintes administratives et législatives. (shrink)

L’historienne Gerda Lerner était remarquable par son éloquence, sa perspicacité et son courage. Toujours prête à défendre l’importance de l’histoire dans sa quête de justice sociale, elle a consacré sa vie à démontrer que les femmes ont une histoire et que le fait de s’en rendre compte avait un impact sur la conscience collective. « Écrire l’histoire en pensant aux femmes », écrivait-elle dans l’un des essais qui composent le recueil intitulé Why History Matters: Life and Thought (1998), « po...

By focusing on key figures in early years education and care, this book considers the influential thinkers and ground-breaking approaches that have revolutionized practice. With contributions from the leading authorities and researchers in the field, chapters provide an explanation of the approach, an analysis of the theoretical background, case studies from practice and questions and discussion points to facilitate critical thinking. Written in an accessible style and relevant to all levels of early years courses, from undergraduate to graduate degrees, the (...) book asks the reader to engage with debates and to develop their own views and opinions. (shrink)

The term “gender” has played a key role in feminist theory and politics since the late 1960s. Debates over its meaning reflect major turning points within the women's movement of the past thirty years.

Citizenship presents two faces. Within a political community it stands for inclusion and universalism, but to outsiders, citizenship means exclusion. Because these aspects of citizenship appear spatially and jurisdictionally separate, they are usually regarded as complementary. In fact, the inclusionary and exclusionary dimensions of citizenship dramatically collide within the territory of the nation-state, creating multiple contradictions when it comes to the class of people the law calls aliens--transnational migrants with a status short of full citizenship. Examining alienage and alienage law (...) in all of its complexities, The Citizen and the Alien explores the dilemmas of inclusion and exclusion inherent in the practices and institutions of citizenship in liberal democratic societies, especially the United States. In doing so, it offers an important new perspective on the changing meaning of citizenship in a world of highly porous borders and increasing transmigration. As a particular form of noncitizenship, alienage represents a powerful lens through which to examine the meaning of citizenship itself, argues Linda Bosniak. She uses alienage to examine the promises and limits of the "equal citizenship" ideal that animates many constitutional democracies. In the process, she shows how core features of globalization serve to shape the structure of legal and social relationships at the very heart of national societies. (shrink)