Background Older patients in emergency care often have complex needs and may have limited ability to make their voices heard. Hence, there are ethical challenges for healthcare professionals in establishing a trustful relationship to determine the patient’s preferences and then decide and act based on these preferences. With this comes further challenges regarding how the patient’s autonomy can be protected and promoted. Aim To describe nurses’ experiences of dealing with older patients’ autonomy when cared for in emergency departments (EDs). Research (...) design This study adopted reflective lifeworld theory and a phenomenological design. Participants and research context A total of 13 open-ended interviews were performed with nurses working at two EDs in Sweden. Ethical considerations The study was reviewed by the Ethical Advisory Board in South East Sweden and conducted according to the Declaration of Helsinki. All participants gave consent. Findings Nurses’ experiences of dealing with older patients’ autonomy in EDs are characterized by moving in a conflicting uphill struggle, indicating obscure thoughts on how patient autonomy can be protected in an ethically challenging context. The phenomenon is further described with its meaning constituents: ‘Being hampered by prioritization under stress’, ‘Balancing paternalism and patient autonomy’, ‘Making decisions without consent in the patient’s best interests’ and ‘Being trapped by notions of legitimate care needs’. Conclusion Stressful work conditions and lacking organizational strategies in EDs contribute to nurses maintaining unjustified paternalistic care, regardless of the patient’s ability and medical condition, and questioning who has legitimacy for participating in decisions about care. The nurses’ protection and promotion of older patients’ autonomy is dependent on the opportunity, ability and willingness to create a patient relationship where the patient’s voice and preferences are valued as important. Consequently, strategies are needed to improve patient autonomy in EDs based on the idea of ‘relational autonomy’. (shrink)

Background It is a common ethical challenge for ambulance clinicians to care for patients with impaired decision-making capacities while assessing and determining the degree of decision-making ability and considering ethical values. Ambulance clinicians’ ethical competence seems to be increasingly important in coping with such varied ethical dilemmas. Ethics rounds is a model designed to promote the development of ethical competence among clinicians. While standard in other contexts, to the best of our knowledge, it has not been applied within the ambulance (...) service context. Thus, the aim of this study was to describe ambulance clinicians’ experiences of participating in ethics rounds. Methods This was a qualitative descriptive study, evaluating an intervention. Data were collected through sixteen interviews with ambulance clinicians who had participated in an intervention involving ethics rounds. The analysis was performed by use of content analysis. Results Two themes describe the participants’ experiences: (1) Reflecting freely within a given framework, and (2) Being surprised by new insights. The following categories form the basis of the themes; 1a) Gentle guidance by the facilitator, 1b) A comprehensible structure, 2a) New awareness in the face of ethical problems, and 2b) Shared learning through dialogue. Conclusion Incorporating structured ethics rounds seems to create a continuous development in ethical competence that may improve the quality of care in the ambulance service. Structured guidance and facilitated group reflections offer ambulance clinicians opportunities for both personal and professional development. An important prerequisite for the development of ethical competence is a well-educated facilitator. Consequently, this type of ethics rounds may be considered a useful pedagogical model for the development of ethical competence in the ambulance service. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Die {raquo}Revolution der Denkart{laquo} hat nicht nur den Anlauf genommen, welchem sie ihren Namen verdankt.! Gezahlt werden noch weitere Umstellungen der Theorie bildung als bloG die kopernikanische Kants. Hier interessieren gleich zwei. Die eine liefert den Gegenstand, die entsprechende, RevolutionPhanomenologie.

Does the universe embody beautiful ideas? Artists as well as scientists throughout human history have pondered this "beautiful question." With Nobel laureate Frank Wilczek as your guide, embark on a voyage of related discoveries, from Plato and Pythagoras up to the present. Wilczek's groundbreaking work in quantum physics was inspired by his intuition to look for a deeper order of beauty in nature. In fact, every major advance in his career came from this intuition: to assume that the universe (...) embodies beautiful forms, forms whose hallmarks are symmetry--harmony, balance, proportion--and economy. There are other meanings of "beauty," but this is the deep logic of the universe--and it is no accident that it is also at the heart of what we find aesthetically pleasing and inspiring. As he reveals here, this has been the heart of scientific pursuit from Pythagoras, the ancient Greek who was the first to argue that "all things are number," to Galileo, Newton, Maxwell, Einstein, and into the deep waters of twentieth-century physics. Gorgeously illustrated, A Beautiful Question is a mind-shifting book that braids the age-old quest for beauty and the age-old quest for truth into a thrilling synthesis. Yes: the world is a work of art, and its deepest truths are ones we already feel, as if they were somehow written in our souls.--From publisher description. (shrink)

One of our great contemporary scientists presents ten insights that illuminate what every thinking person needs to know about what the world is and how it works. Nobel Prize winner Frank Wilczek's Fundamentals is built around a simple but profound idea: the models of the world we construct as children are practical and adequate for everyday life, but they do not bring in the surprising and mind-expanding revelations of modern science. To do that, we must look at the world (...) anew, combining clear thinking with an openness to wonder. This "born again" world is in many ways larger, fuller, and much stranger than it appears. Through an exploration of space, time, matter, and ideas--and equipped with facts, questions, and brilliant speculations--Wilczek guides us through the past, present, and future of fundamental science. Readers will emerge with an expanded vision of our universe. Author Bio: Frank Wilczek won the Nobel Prize in Physics in 2004 for work he did as a graduate student. He was among the earliest MacArthur fellows, and has won many awards both for his scientific work and his writing. He is the author of A Beautiful Question, The Lightness of Being, Fantastic Realities, Longing for the Harmonies, and hundreds of articles in leading scientific journals. His "Wilczek's Universe" column appears regularly in the Wall Street Journal. Wilczek is the Herman Feshbach Professor of Physics at the Massachusetts Institute of Technology, founding director of the T. D. Lee Institute and chief scientist at the Wilczek Quantum Center in Shanghai, China, and a distinguished professor at Arizona State University and Stockholm University. (shrink)

Neuroscientific research in relation to antisocial behavior has strongly grown in the last decades. This has resulted in a better understanding of biological factors associated with antisocial behavior. Furthermore several neuroscientific instruments and interventions have been developed that have a relatively low threshold for use in the criminal justice system to contribute to prevention or reduction of antisocial and criminal behavior. When considering implementation in the criminal justice system, ethical aspects of the use of neuroscientific instruments and interventions need to (...) be taken into account. With respect to ethics in relation to neurocriminology much of the literature focuses on identifying and debating risks and value conflicts. This is important and necessary, but the positive contribution of neuroscientific applications may therefore get less attention in the ethical literature. Yet, ethicists can help criminal justice researchers and practitioners to identify ways in which neuroscience could add positively to important values in (young) offender rehabilitation. It is argued that this role of ethicists in interdisciplinary teams deserves more emphasis. As an illustration, this contribution focuses on how neuroscientific knowledge, instruments and interventions may contribute to autonomy of (young) offenders. (shrink)

Traces the development of the samurai, both in the way they regarded themselves and their role in society.

A bold and visionary book that reveals the false and catastrophically damaging images at the root of the oppression of women and the rape of Earth's resources, ...

This article argues that the influence of heteronormativity on the conceptualization of women and technology in feminist constructivist technology studies creates serious problems for the analysis. This research aims to understand the coproduction of gender and technology in society, but does not approach the two elements in a symmetrical fashion. Hence, ethnographic studies can only exemplify how the gender of technology producers is reflected in the technology created. Masculine gender identity is stabilized as a cause for the masculinity of a (...) technology that is shaped by social relationships. The criticism is fleshed out in a close examination of case study accounts of ethnographies among producers and users of technology. It is argued that a habitual reproduction of heteronormativity, present in the surrounding culture and in the technological communities studied, has prevented the adoption of approaches to the subject conducive to the objective of this feminist research. Acknowledging that destabilizing gender can undermine the critical thrust of feminist critique, the paper turns towards queer theory for ideas about how to produce criticism that does not rely on the stability of identity. The article closes with suggesting how a queer feminist approach could contribute to different readings of life with technology. (shrink)

A large number of Swedish public authorities produce ‘platform of values’ texts that present core values. This article presents a study of how such texts and practices, including the core values they revolve around, are legitimized. Using Van Leeuwen’s legitimation framework, three different data sets are analysed: 47 ‘platform of values’ texts, a focus group discussion with seven senior HR officers, and a quantitative questionnaire study answered by civil servants at three public authorities. The analysis shows how the existence of (...) ‘platform of values’ texts and practices is legitimized through rationalizations, above all by describing the texts as concrete means for reaching specific ends and, with regard to the choice of core values, through a custom-conformity type of authority. Thus, this article addresses discursive transformations of contemporary organizations with a particular focus on available discursive space for critical thinking in the wake of New Public Management and related developments. (shrink)

An argument for the inclusion of the human perspective within science and how it makes science possible.

**** Reprint of the Indiana U. Press edition of 1966--which is cited in BCL3. Annotation copyright by Book News, Inc., Portland, OR.

Although declarations of the death of God seem to be provocations announcing the end of the era of theology, this announcement is actually central to the Christian revelation in its most classic forms, as well as to its reworkings in contemporary religious thought. Indeed provocative new possibilities for thinking theologically open up precisely in the wake of the death of God. Already Hegel envisaged a revolutionary new realization of divinity emerging in and with the secular world through its establishment of (...) a total order of immanence. However, in postmodern times this comprehensive order aspired to by modern secularism implodes or cracks open towards the wholly Other. A hitherto repressed demand for the absolute difference of the religious, or for “transcendence”, returns with a vengeance. This difference is what could not be stated in terms of the Hegelian System, for reasons that poststructuralist writers particularly have insisted on: all representations of God are indeed dead. Yet this does not mean that they cannot still be powerful, but only that they cannot assign God any stable identity. Nietzsche’s sense of foreboding concerning the death of God is coupled with his intimations of the demise of representation and “grammar” as epistemologically bankrupt, but also with his vision of a positive potential for creating value in the wake of this collapse of all linguistically articulated culture. He points the way towards the emergence of a post-secular religious thinking of what exceeds thought and representation. (shrink)

Der Übergang vom Verhältnisbewußtsein zum Selbstbewußtsein kann unmöglich nur vom Verhältnisbewußtsein aus gedacht werden, weil wir uns eine Welt, in der das Bewubtsein unserer selbst verteilt ist auf die Dimensionen der Handlung vor deren Zentrierung in uns, gar nicht vorstellen können. Jedes Tableau der Handlungsmöglichkeiten, so abstrakt es auch abgefaßt sein mag, ist gebunden an Vorstellungen möglicher Handlungssubjekte, denen wir Handlungsmöglichkeiten zuschreiben. Handlungstheorie ist daher notwendig Reflexion unserer Praxis, in der wir uns selbst als Selbstbewußtsein erfahren, das seinem Verhältnisbewubtsein enthoben (...) ist, ohne dieses dadurch selbst schon aufzuheben zu können. Daß uns Freiheit im Handeln unaufhebbar prekär und problematisch bleiben mub, ist die Grundvoraussetzung dafür, dab wir Handlungstheorien historisch und bereichsbezogen ständig neu entwerfen müssen. Das Verhältnis von Handlungsphilosophie zu Handlungstheorien kann daher so gefaßt werden, daß Handlungsphilosophie die Grundbegrifflichkeit in kritischer Absicht bereitstellt, die den bereichsorientierten, mehr oder weniger deskriptiven Handlungstheorien abgehen muß. Dazu muß die ontologische Differenz von Handlung und Interpretation methodologisch ernst genommen werden. Die radikale Andersheit der hier zu begründenden Konzeption liegt vor allem in der Ansicht, daß Handlungen nicht als isolierbare Ereignis-Entitäten aufgefaßt werden können, die gegenüber der »Welt der Tatsachen des Bewußtseins« eine kausale, d.h. von der Welt des Bewußtseins abgetrennte Rolle übernehmen. (shrink)

Interpersonal respect can be differentiated into two kinds: horizontal respect, i.e. treating someone with dignity; and vertical respect, i.e. genuinely honoring someone’s merits. With the present research, we draw on motivation theory to explore their interplay in leadership relations. Specifically, we argue for a moderated mediation hypothesis in that leaders’ horizontal respect for their subordinates fundamentally speaks to subordinates’ self-determination and that the message of respectful leadership is enhanced by the vertical respect subordinates have for their leaders. As a result, (...) subordinates are more satisfied with their jobs, which should also show in a decreased willingness to leave. The proposed model was supported in two survey studies and an experimental scenario study —thus suggesting that perceived leader behavior needs to be complemented by leader standing. (shrink)

Research integrity climate is an important factor that influences an individual’s behavior. A strong research integrity culture can lead to better research practices and responsible conduct of research. Therefore, investigations on organizational climate can be a valuable tool to identify the strengths and weaknesses of each group and develop targeted initiatives. This study aims to assess the perceptions on integrity climate in three universities in Hungary. A cross-sectional study was conducted with PhD students, postdocs, and professors from three Hungarian universities. (...) The survey included demographic questions, such as gender, age, scientific field, academic rank, and the Survey of Organizational Research Climate. A total of 432 participants completed the survey. Our results show that postdocs and assistant professors perceived integrity climate more negatively than PhD students and full professors in every survey scale. Contrarily, PhD students perceive more positively than the other groups. Disciplinary differences show that researchers in the Biomedical sciences perceive regulatory bodies to be fairer when evaluating their projects than those in the Natural sciences. Natural sciences also perceive more negatively how the department values integrity when compared to Humanities. Humanities perceive more positively Advisor/Advisee Relations than Biomedical Sciences. Our results suggest that institutions should pay more attention to early career researchers, especially insecure and temporary positions like postdocs and assistant professors. They should provide RCR resources, socialize them in RCR, and set more reasonable expectations. Moreover, department leaders should develop initiatives to foster better integrity climates. (shrink)

First published in 2000. Routledge is an imprint of Taylor & Francis, an informa company.

ArgumentThis paper challenges three assumptions common in the literature on expertise: that expertise is linearly derived from scientific knowledge; that experts always align with the established institutional order; and that expertise is a property acquired by individuals. We criticize these ideas by juxtaposing three distinct expert practices involved with flood risk management in England. Virtual engineering is associated with commercial consultancy and relies on standardized software packages to assess local flood inundation. Mathematical experimentation refers to academic scientists creating new digital (...) renderings of the physical dynamics of flooding. Participatory modeling denotes research projects that aim to transform the relationships between experts and local communities. Focusing on different modes of modeling we contribute an analysis of how particular models articulate with specific politics of knowledge as experts form relationships with flood risk management actors. Our empirical study also shows how models can contribute to re-distribution of expertise in local flood risk management. (shrink)

The mind-body problem lies at the heart of the clinical practice of both psychiatry and psychosomatic medicine. In their recent publication, Schwartz and Wiggins address the question of how to understand life as central to the mind-body problem. Drawing on their own use of the phenomenological method, we propose that the mind-body problem is not resolved by a general, evocative appeal to an all encompassing life-concept, but rather falters precisely at the insurmountable difference between.

Defining the lives of a majority of the world's population, the question of 'the city' has risen to the fore as one the most urgent issues of our time "e; uniting concerns across the terrain of climate policies, global financing, localised struggles and multi-disciplinary research. Deleuze and the City rests on a conviction that philosophy is crucially important for advancing knowledge on cities, and for allowing us to envisage new forms of urban life toward a more sustainable future. It gathers (...) some of the most original thinkers and accomplished scholars in contemporary urban studies, showing how Deleuze and Guattari's philosophical project is essential for our thinking through the multi-scalar, uneven and contested landscapes that constitute 'the city' today. Case studies range from the 'laboratory urbanism' of an Austrian ski resort and a 'sustainable' Swedish shopping mall to the 'urbicidal' refurbishments of Haifa. (shrink)

PurposeMāori culture is a central aspect inAotearoa/New Zealand's national identity. Beginning in the 1970s biculturalism saw the indigenous culture and values acknowledged and incorporated in wider public discourse and policy. The purpose of this paper is to investigate whether New Zealand's cyberspace accommodates Māori. It explores how the web space is influenced by biculturalism and in turn what an understanding of this web space can tell us about biculturalism inAotearoa.Design/methodology/approachA brief introduction to biculturalism in New Zealand provides the background to (...) the investigation of the country's web space. Recent access statistics enquire whether Māori are actually connected to the internet. The exploration of the structure of the internet is informed by newspaper articles and online documents relating to the development of two Māori specific second‐level domain name spaces. A word‐frequency analysis within a sample of 21 websites provides an overview into the use of the Māori language in cyberspace.FindingsThe paper shows that although Māori have the lowest access rate to the internet compared to other ethnic groups in New Zealand, their influence on the country's web space is nonetheless far‐reaching. Developments regarding Māori language uses over the last years are generally progressive. Māori culture and ongoing social changes are increasingly accommodated on the internet – Māori have been actively shaping the web space. However, these efforts do require the support and acceptance of the wider Internet community. The linguistic and structural developments taking place online since the mid 1990s were influenced by the bicultural thinking, public discourse and practice of the time.Originality/valueThis paper draws together the Māori success‐stories in their endeavour to assert their cultural needs in New Zealand's cyberspace. It highlights that the understanding ofAotearoaas being a bicultural country influenced developments taking place online potentially will lead to a truly bicultural web space in the near future. (shrink)

Frank Ramsey was the greatest of the remarkable generation of Cambridge philosophers and logicians which included G. E. Moore, Bertrand Russell, Ludwig Wittgenstein and Maynard Keynes. Before his tragically early death in 1930 at the age of twenty-six, he had done seminal work in mathematics and economics as well as in logic and philosophy. This volume, with a new and extensive introduction by D. H. Mellor, contains all Ramsey's previously published writings on philosophy and the foundations of mathematics. The (...) latter gives the definitive form and defence of the reduction of mathematics to logic undertaken in Russell and Whitehead's Principia Mathematica; the former includes the most profound and original studies of universals, truth, meaning, probability, knowledge, law and causation, all of which are still constantly referred to, and still essential reading for all serious students of these subjects. (shrink)

In this paper, I consider the relationship between Inference to the Best Explanation and Bayesianism, both of which are well-known accounts of the nature of scientific inference. In Sect. 2, I give a brief overview of Bayesianism and IBE. In Sect. 3, I argue that IBE in its most prominently defended forms is difficult to reconcile with Bayesianism because not all of the items that feature on popular lists of “explanatory virtues”—by means of which IBE ranks competing explanations—have confirmational import. (...) Rather, some of the items that feature on these lists are “informational virtues”—properties that do not make a hypothesis \ more probable than some competitor \ given evidence E, but that, roughly-speaking, give that hypothesis greater informative content. In Sect. 4, I consider as a response to my argument a recent version of compatibilism which argues that IBE can provide further normative constraints on the objectively correct probability function. I argue that this response does not succeed, owing to the difficulty of defending with any generality such further normative constraints. Lastly, in Sect. 5, I propose that IBE should be regarded, not as a theory of scientific inference, but rather as a theory of when we ought to “accept” H, where the acceptability of H is fixed by the goals of science and concerns whether H is worthy of commitment as research program. In this way, IBE and Bayesianism, as I will show, can be made compatible, and thus the Bayesian and the proponent of IBE can be friends. (shrink)

In this paper, I offer an analysis of the radical disagreement over the adequacy of string theory. The prominence of string theory despite its notorious lack of empirical support is sometimes explained as a troubling case of science gone awry, driven largely by sociological mechanisms such as groupthink (e.g. Smolin 2006). Others, such as Dawid (2013), explain the controversy by positing a methodological revolution of sorts, according to which string theorists have quietly turned to nonempirical methods of theory assessment given (...) the technological inability to directly test the theory. The appropriate response, according to Dawid, is to acknowledge this development and widen the canons of acceptable scientific methods. As I’ll argue, however, the current situation in fundamental physics does not require either of these responses. Rather, as I’ll suggest, much of the controversy stems from a failure to properly distinguish the “context of justification” from the “context of pursuit”. Both those who accuse string theorists of betraying the scientific method and those who advocate an enlarged conception of scientific methodology objectionably conflate epistemic justification with judgements of pursuit-worthiness. Once we get clear about this distinction and about the different norms governing the two contexts, the current situation in fundamental physics becomes much less puzzling. After defending this diagnosis of the controversy, I’ll show how the argument patterns that have been posited by Dawid as constituting an emergent methodological revolution in science are better off if reworked as arguments belonging to the context of pursuit. (shrink)

We develop a Bayesian framework for thinking about the way evidence about the here and now can bear on hypotheses about the qualitative character of the world as a whole, including hypotheses according to which the total population of the world is infinite. We show how this framework makes sense of the practice cosmologists have recently adopted in their reasoning about such hypotheses.

This article rebuts Ramsey's earlier theory, in 'Universals of Law and of Fact', of how laws of nature differ from other true generalisations. It argues that our laws are rules we use in judging 'if I meet an F I shall regard it as a G'. This temporal asymmetry is derived from that of cause and effect and used to distinguish what's past as what we can know about without knowing our present intentions.