Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and (...) guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice. (shrink)

Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and (...) triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

Contemporary healthcare practice has been progressively more regulated to increase efficiency, service user safety and practice quality. However, ethical issues in clinical practice that have not been implemented into regulations are undervalued by policymakers and healthcare institutions Considering the issues found by other authors, the use of a simple tool for policymakers to consider recurrent ethical issues could reduce those issues in a policy-driven clinical practice. The lack of tools to support structured ethical assessment of clinical policies was the main (...) reason to create the Clinical Policy Ethics Assessment Tool, but we realised of its possible advantages: limiting ethical dilemmas posed by policies, ensuring ethical practice by the use of policies and developing a consistent process for policymakers, institutions and healthcare professionals. Nonetheless, even if a tool can be implemented and it supports the creation of policies that reduce ethical issues, if the healthcare professionals are not aware of them they will not be implemented and the issues will continue. (shrink)

BackgroundDepression is a prevalent condition that has a significant impact on psychosocial functioning and quality of life. The onset and persistence of depression have been linked to a variety of biological and psychosocial variables. Many of these variables are associated with specific lifestyle characteristics, such as physical activity, diet, and sleep patterns. Some psychosocial determinants have an impact on people’ health-related behavior change. These include personal factors such as sense of coherence, patient activation, health literacy, self-efficacy, and procrastination. This study (...) aims to analyze the association between the severity of depression, lifestyle patterns, and personal factors related to health behavior. It also aims to analyze whether personal factors moderate the relationship between lifestyles and depression.MethodsThis study is a secondary data analysis of baseline data collected at the start of a randomized controlled trial. A sample of 226 patients with subclinical, mild, or moderate depression from primary healthcare centers in two sites in Spain was used, and descriptive, bivariate, multivariate, and moderation analyses were performed. Depression was the primary outcome, measured by Beck II Self-Applied Depression Inventory. Lifestyle variables such as physical exercise, adherence to Mediterranean diet and sleep quality, social support, and personal factors such as self-efficacy, patient activation in their own health, sense of coherence, health literacy, and procrastination were considered secondary outcomes.ResultsLow sense of coherence, poor sleep quality, low patient activation, and sedentarism are predictors of having more depressive symptoms. Moderation analyses were not significant.DiscussionLifestyle and personal factors are related to depressive symptomatology. Our findings reveal that sense of coherence, patient’s activation level, sedentarism, and sleep quality are associated with depression. Further research is needed regarding adherence to Mediterranean diet, minutes walking per week and the interrelationship between lifestyles, personal factors, and depression. (shrink)

We may succed in the fulfilment of our desires but still fail to properly own our practical life, perhaps because we acted as addicts, driven by desires that are alien to our will, or as “wantons,” satisfying the desires that we simply happen to have (Frankfurt, 1988 ). May we equally fail to own the outcomes of our epistemic life? If so, how may we attain epistemic ownership over it? This paper explores the structural parallellism between practical and epistemic rationality, (...) building on Williamson’s ( 2002 ) suggestion that we should commence with successful performances as the foundation for both domains, be it action or knowledge. By highlighting the limitations of higher-order regulative approaches in epistemology, exemplified by Sosa ( 2007, 2011, 2015, 2021 ), the paper introduces a form of teleological epistemic constitutivism inspired by Velleman ( 2000, 2009 ). The proposal is that epistemic ownership is not attained in the mere pursuit of truth or knowledge, but requires furthermore a struggle to understand what we know. (shrink)

Speech Acts, Criteria and Intentions What makes a speech act a speech act? Which are its necessary and sufficient conditions? I claim in this paper that we cannot find an answer to those questions in Austin's doctrine of the infelicities, since some infelicities take place in fully committing speech acts, whereas others prevent the utterance from being considered as a speech act at all. With this qualification in mind, I argue against the idea that intentions—considered as mental states accomplishing a (...) causal role in the performance of the act—should be considered among the necessary conditions of speech acts. I would thus like to deny a merely ‘symptomatic’ account of intentions, according to which we could never make anything but fallible hypotheses about the effective occurrence of any speech act. I propose an alternative ‘criterial’ account of the role of intentions in speech acts theory, and analyse Austin's and Searle's approaches in the light of this Wittgensteinian concept. Whether we consider, with Austin, that speech acts ‘imply’ mental states or, with Searle, that they ‘express’ them, we could only make sense of this idea if we considered utterances as criteria for intentions, and not as alleged behavioural effects of hidden mental causes. (shrink)

Partiendo de un nuevo documento que fecha la conversión de la antigua mezquita de Bāb al-Mardūm en capilla en 1183, un siglo después de la conquista de Toledo por Alfonso VI, se ha tratado de indagar en el proceso de cristianización de las mezquitas urbanas y rurales de Toledo entre los siglos XI y XIII: el papel desempeñado en su reparto y el de sus habices por el Rey, la Iglesia y los diferentes grupos de población, el destino de (...) aquellas mezquitas que no se consagraron, o las semejanzas y las particularidades del proceso toledano respecto al llevado a cabo en otras regiones andalusíes. Para acabar, se plantean algunas preguntas e hipótesis sobre la función y el carácter de la propia mezquita, fundada por Aḥmad ibn al-Ḥadīdī en el año 390/999-1000. (shrink)

La revolución cubana es un proceso en el cual la producción de imágenes es parte fundamental para explicar su desarrollo histórico. A través de una fotografía de Fidel Castro, capturada por el fotorreportero español Enrique Meneses, se muestra la posibilidad de hacer una historia -en apego a la propuesta de John Mraz- con y de fotografías. Dicha representación iconográfica, toma de Fidel Castro en Sierra Maestra en los primeros meses de 1958, y que se integró en la edición de un (...) libro del mismo fotógrafo, ofrece una buena oportunidad para reflexionar sobre los aportes que tiene la iconología en el Circuncaribe, y toda América Latina. (shrink)

La gestación subrogada se ha convertido en los últimos años en un tema de radical actualidad en nuestras sociedades. Son muchas las personas que en los países ricos han aprovechado las nuevas posibilidades de utilizar un “vientre de alquiler” para alcanzar sus anhelos de paternidad o maternidad. No obstante, esta práctica atenta a menudo contra la dignidad de la mujer portadora, sostenida sobre un principio de autonomía basado en un ficticio libre consentimiento propio de la bioética neoliberal, ciego por otro (...) lado al principio bioético de justicia. (shrink)

En este artículo se realiza una relectura de las inscripciones de carácter religioso de las puertas de la Mezquita de Córdoba en época califal. A pesar de que no todas se han conservado, el estudio de conjunto reveló suficientes elementos singulares como para sugerir nuevas hipótesis en torno al sentido y la intencionalidad de los textos coránicos escogidos. Las inscripciones, tanto interiores como exteriores, conforman un programa epigráfico perfectamente coherente y dotado de un complejo significado ligado al contexto político, social (...) y religioso de la época. El programa incluye asimismo alusiones a la polémica anti-cristiana en el siglo x. En ese sentido, la mezquita cordobesa constituye un valioso documento histórico del Califato omeya de al-Andalus. (shrink)

Este artículo analiza una fotografía de Fidel Castro que es muy lejana a la etapa épica del guerrillero, pero que forma parte de la iconografía en torno a este personaje. Se trata de un retrato de Fidel a los tres años, tomado en Birán, en 1929, estudiado con el objeto de comprender los intereses y las inten ciones alrededor de su producción, así como los usos actuales de esa misma imagen. Partiendo de la consideración de la fotografía como una práctica (...) social y cultural que integra significados, ella debe ser incorporada en el estudio de la historia como un documento que permite aportar información de sus contextos de producción y reproducción. A partir de estas consideraciones, se pudo observar el significado de la representación iconográfica de Fidel a los tres años, quien fue fotografiado utilizando convenciones que resaltaban las favorables condiciones económicas de las que gozaba la familia Castro Ruz, sin embargo, la investigación revela que se le han añadido significados en sus posteriores usos, producto de intereses políticos en torno a la trayectoria guerrillera de Fidel. (shrink)

Las definiciones de argumentación son tan variadas como las distintas posiciones existentes en torno a la pregunta de qué hacemos exactamente cuando argumentamos y cuándo estamos, de hecho, argumentando. Incluso el mismo autor puede ofrecer más de una definición de lo que entiende por argumentación; en parte, porque el problema de la argumentación no se circunscribe a un solo ámbito, ni del conocimiento ni de la vida práctica.

El presente artículo tiene como propósito criticar y reformular la teoría de valores del autor y filósofo argentino Risieri Frondizi. Para ello, se someterán a falsacionismo las tesis según las cuales la cualidad estructural es, primero, estructuralista y no analítica y, segundo, empírica, de acuerdo con la metodología holista de la ciencia. La crítica, así, se desarrollará a partir de los siguientes interrogantes. Inicialmente, ¿el autor acude al holismo o al reduccionismo como enfoques metodológicos de desarrollo? Finalmente, ¿cuál es la (...) distinción lógica entre el valor como cualidad sui géneris y el valor como cualidad estructural? (shrink)

Partiendo de un nuevo documento que fecha la conversión de la antigua mezquita de Bāb al-Mardūm en capilla en 1183, un siglo después de la conquista de Toledo por Alfonso VI, se ha tratado de indagar en el proceso de cristianización de las mezquitas urbanas y rurales de Toledo entre los siglos XI y XIII: el papel desempeñado en su reparto y el de sus habices por el Rey, la Iglesia y los diferentes grupos de población, el destino de (...) aquellas mezquitas que no se consagraron, o las semejanzas y las particularidades del proceso toledano respecto al llevado a cabo en otras regiones andalusíes. Para acabar, se plantean algunas preguntas e hipótesis sobre la función y el carácter de la propia mezquita, fundada por Aḥmad ibn al-Ḥadīdī en el año 390/999-1000. (shrink)

En el artículo se recogen los relatos que las fuentes árabes, sobre todo andalusíes, proporcionan sobre las primeras fundaciones religiosas de al-Andalus. Las tradiciones de la Conquista, en este aspecto, muestran similitudes con el modelo de islamización puesto en práctica previamente en otros ámbitos del Mediterráneo islámico y con la historiografía árabe de los Futuh. Por razones de prestigio religioso y de legitimidad política, los autores insisten en aspectos como la orientación de las primeras mezquitas, atribuyéndolas a Musà o a (...) los tabi¿un, o en la destrucción de iglesias para levantar mezquitas sobre ellas. En estas tradiciones encontramos, sin embargo, escasos datos sobre las características arquitectónicas de estos primeros oratorios andalusíes por lo que es imprescindible la información aportada hasta ahora por la arqueología. El caso de la mezquita de Córdoba muestra la importancia de analizar en conjunto ambas aportaciones. (shrink)

«Fortaleza» y «debilidad» son dos adjetivos que se han utilizado prolijamente en la literatura científica sobre institucionalismo para describir la permanencia o, por el contrario, la porosidad y maleabilidad de las reglas y principios rectores en los que están atrincheradas las instituciones que sobreviven en equilibrio y, por tanto, no son alteradas unilateralmente.

El presente artículo tiene como objeto llevar a cabo un estudio pragmático y analítico sobre la acción de valoración, el valor y los valores a la luz de la ciencia semiótica y de la ciencia cibernética. Por ello, se desarrollará un proceso axiológico que ilustre cómo sucede el ingreso, la transición y la salida de códigos morales en función de un esquema cognitivo. Así pues, el proceso axiológico se postula, primero, en fundamento de tres sistemas: de mentalidad, de valores y (...) de biomoralidad y, segundo, conforme a la teoría de la información y de la teoría general de sistemas. (shrink)

This paper addresses some relations between the spatial politics of queer assemblies in spaces of protest and the constitution of collective political subjects. It does so by exploring the spatial politics of queer activism within the global Occupy movements, in the light of Judith Butler’s work on the performative power of assembly and the ambivalences of the Foucauldian concept of heterotopia. Specific challenges faced by queer activists in various encampments will be addressed in order to expose some tensions between the (...) constitutive exclusions inherent to the constitution of spaces of protest and the processes of coalition building needed to effectively overcome those very constitutive exclusions. (shrink)

In this article, I focus on the work of the Movement of Victims of State Crimes in Colombia. The work of Movice, I suggest, is an example of how the category of “victim” from international law discourse is adopted and used from below by victims of mass atrocities. I show that, through this category, Movice attempts to introduce an alternative narrative of the internal armed conflict in which the state is a perpetrator of violence against civilian population as part of (...) a practice of elimination of political opposition through violent means. To do this, I focus on three political opportunities in which Movice deployed the category of victim between 2005 and 2016. I suggest that Movice is an example of how a movement of victims can adopt categories of international law to frame their struggles and, in doing so, infuse them with new contents. (shrink)

Based on his Inclosure Schema and the Principle of Uniform Solution (PUS), Priest has argued that Curry’s paradox belongs to a different family of paradoxes than the Liar. Pleitz (2015, The Logica Yearbook 2014, pp. 233–248) argued that Curry’s paradox shares the same structure as the other paradoxes and proposed a scheme of which the Inclosure Schema is a particular case and he criticizes Priest’s position by pointing out that applying the PUS implies the use of a paraconsistent logic that (...) does not validate Contraction, but that this can hardly seen as uniform. In this paper, we will develop some further reasons to defend Pleitz’ thesis that Curry’s paradox belongs to the same family as the rest of the self-referential paradoxes & using the idea that conditionals are generalized negations. However, we will not follow Pleitz in considering doubtful that there is a uniform solution for the paradoxes in a paraconsistent spirit. We will argue that the paraconsistent strategies can be seen as special cases of the strategy of restricting Detachment and that the latter uniformly blocks all the connective-involving self-referential paradoxes, including Curry’s. (shrink)

Even when they are defined with precision, one can often read and hear judgments about the vagueness of heuristics in debates about heuristic reasoning. This opinion is not just frequent but also quite reasonable. In fact, during the 1990s, there was a certain controversy concerning this topic that confronted two of the leading groups in the field of heuristic reasoning research, each of whom held very different perspectives. In the present text, we will focus on two of the papers published (...) in Psychological Review, wherein the arguments of each of these groups were presented:. (shrink)

In this paper art history and visual studies, the disciplines that study visual culture, are presented as a field whose conjectural paradigm can be used to understand the epistemic problems associated with abduction. In order to do so, significant statements, concepts and arguments from the work of several specialists in this field have been highlighted. Their analysis shows the fruitfulness and potential for understanding the study of visual culture as a field that is interwoven with the assumptions of abductive cognition.

Reductive intellectualists (e.g., Stanley & Williamson 2001; Stanley 2011a; 2011b; Brogaard 2008; 2009; 2011) hold that knowledge-how is a kind of knowledge-that. If this thesis is correct, then we should expect the defeasibility conditions for knowledge-how and knowledge-that to be uniform—viz., that the mechanisms of epistemic defeat which undermine propositional knowledge will be equally capable of imperilling knowledge-how. The goal of this paper is twofold: first, against intellectualism, we will show that knowledge-how is in fact resilient to being undermined by (...) the very kinds of traditional (propositional) epistemic defeaters which clearly defeat the items of propositional knowledge which intellectualists identify with knowledge-how. Second, we aim to fill an important lacuna in the contemporary debate, which is to develop an alternative way in which epistemic defeat for knowledge-how could be modelled within an anti-intellectualist framework. (shrink)

Quoting Flaubert through time, Mieke Bal and Michelle Williams Gamaker’s Madame B brings Madame Bovary’s reflections on love and emotions to the present day, in a productive anachronism. Their work produces an intertemporal space where the past is relevant for the present, and the present enables us to understand the past. Intimacy and routine are central in their exploration of Flaubert’s contemporaneity. Those issues are precisely one of the keys in Karl Ove Knausgård’s project of literary autobiography, where he expands (...) narration foreclosing the ellipsis and giving visibility to small things and emotions; a project with some resonances with Munch’s crude-obscene uses of intimacy. This essay explores how both proposals, Bal and Williams Gamaker in film, and Knausgård in literature, can serve us to connect present and past sensibilities and, more than that, demonstrate resistances to the hegemonic discourses of temporality. (shrink)

La profesión de carpintero de ribera, sus técnicas, las herramientas utilizadas, los productos finales: los barcos, así como los conocimientos necesarios para su fabricación forman parte del patrimonio cultural marítimo universal. La construcción en madera es un oficio milenario que está en peligro de desaparición, y con ella uno de los elementos identitarios más importantes de las regiones costeras europeas. La escasa historiografía académica sobre los carpinteros de ribera como protagonistas es el principal motivo de este trabajo, que se adentra (...) en sus raíces, dando a conocer algunos de los aspectos más relevantes que definen e identifican la importancia del tema, como las principales actividades desarrolladas, su contextualización histórica, las técnicas, herramientas y la lengua franca marinera que compartían. Por ello, el fin último es proporcionar una fuente de referencia a quiénes apuesten, tanto de manera teórica como práctica, por la recuperación y la conservación de esta profesión ancestral sobre la que apenas existe información e investigación. Se concluye que la recuperación y gestión de este patrimonio, con vinculaciones amplias con otras actividades relacionadas, puede abrir perspectivas de consolidación patrimonial y económica en espacios marítimos poco desarrollados, ya que puede servir para sentar las bases de un futuro turismo cultural en el que estas técnicas sean protagonistas y sirvan para potenciar la identidad marítima en las regiones litorales. (shrink)

Para las tradiciones escolásticas budistas, el universo es inseparable de la vida mental de los seres que lo habitan, siendo las acciones de los seres, con sus estados mentales asociados, las que trazan el mapa y calendario cósmico. Algunos investigadores han visto en estas asociaciones entre mente y universo la «contraparte imaginativa, mítica y poética de los estados meditativos». Este artículo intenta mostrar cómo la propia escolástica mantiene cierta ambigüedad sobre si el cosmos debe entenderse como una metáfora de la (...) mente o debe identificarse literalmente con ella. Algunos pasajes establecen una complementariedad que parece afirmar la existencia independiente de ambos. Sea como fuere, contrastar las descripciones de estados mentales con relatos cosmogónicos nos permitirá comprender mejor la idea del cosmos en el budismo antiguo. (shrink)

Este trabajo analiza el lenguaje subjetivo empleado por el intelectual y político andalusí Lisān al-Dīn Ibn al-Ḫaṭīb (m. 1375) en su obra de exilio Nufāḍat al-ǧirāb. El objetivo es explorar la utilidad de un enfoque lingüístico en la comprensión del lugar que ocupa este texto dentro del proceso de transición cultural del Occidente islámico hacia el paradigma moderno europeo. El estudio se divide en tres partes: en la primera, se hace una breve introducción al autor, a su contexto socio-político y (...) al contenido de la obra; en la segunda, se plantea una metodología cuantitativo-cualitativa a través de la cual se estructura el texto misceláneo digitalizado en función de sus géneros y se especifica un esquema de anotación que permite extraer las instancias de los fenómenos lingüísticos más destacados; y en la tercera, se procede al análisis de los datos obtenidos en torno a la acción, la emoción y la evaluación. El análisis muestra una compleja codificación de la subjetividad en la Nufāḍa donde, a diferencia del Taʿrīf de Ibn Ḫaldūn, las marcas de expresión en primera persona, aunque significativas, son escasas. Sin embargo, se identifica un abundante uso de adjetivos evaluativos a lo largo de la obra, con una riqueza léxica que permite revelar de forma explícita el punto de vista del sujeto autor. Este hallazgo demuestra la utilidad de una metodología híbrida en la aproximación a textos histórico-literarios premodernos, así como la necesidad de incorporar el análisis lingüístico, empírico y comparativo al estudio de la transición epistemológica señalada. (shrink)

Desde la conquista española ha existido una dicotomía constante en la identidad peruana, la cual se refleja en el arte y especialmente en la literatura. Es en ella en la que existe un personaje que representa en sus obras de manera magistral los encuentros y desencuentros generados por la interacción constante de esos dos hemisferios culturales presentes en la peruanidad. Es José María Arguedas, quien no solamente retrata dicha realidad, sino que a través del indigenismo logra representar y revalorizar la (...) figura del indio y por consiguiente de lo andino, todo en el marco de la problemática constante que aqueja la búsqueda de lo que consiste ser peruano. Tomando como referencia tres importantes obras de su producción intelectual como son: “Los ríos profundos”, “El Sexto” y “El zorro de arriba y el zorro de abajo”. (shrink)