Background:Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context.Aim:To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom.Design:Exploratory, sequential, mixed-methods design.Methods:Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in (...) palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress arising from ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015.Ethical considerations:Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager.Findings:The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress.Conclusion:The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for global change. (shrink)

Background:Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.Objectives:The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs’ experiences of ethical issues.Methods:Using a systematic (...) approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.Findings:The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.Conclusions:The review highlighted a need for improved ethics education for care-providers. (shrink)

The paper is divided into two parts, each with subsections. In the first part, I shall discuss some matters that have been extensively examined by Kim, namely what the basic types of supervenience are and how they are pairwise logically related; in the course of this discussion, I shall distinguish a weak from a strong notion of global supervenience. In the second part, I shall examine supervenience in a context in which Kim has not: I shall attempt to solve a (...) puzzle that arises when we consider supervenience relations involving vague properties and/or predicates. This is, of course, not a special case of property/predicate super- venience, but the typical one: for virtually all properties/predicates are vague. The two parts of the paper stand independently of each other. Of the discussion in the first part, essentially all that is presupposed in the second is the notion of “world strong supervenience” defined in section 1 of part I. (shrink)

Citizenship education is being formally introduced into schools in England as a matter of national policy for the first time. This article offers a critical evaluation of the report of the Advisory Group on Education for Citizenship and the Teaching of Democracy in Schools which was chaired by Professor Bernard Crick, and which has been influential in shaping current educational policy in relation to these matters. An assessment is also offered of the challenges and prospects which confront citizenship education in (...) England in the light of these developments. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

The question of when and how the basic concepts that characterize modern science arose in Western Europe has long been central to the history of science. This book examines the transition from Renaissance engineering and philosophy of nature to classical mechanics oriented on the central concept of velocity. For this new edition, the authors include a new discussion of the doctrine of proportions, an analysis of the role of traditional statics in the construction of Descartes' impact rules, and go deeper (...) into the debate between Descartes and Hobbes on the explanation of refraction. They also provide significant new material on the early development of Galileo's work on mechanics and the law of fall. (shrink)

This volume illustrates how the methodology of metaphysics can be enriched with the help of cognitive science. Few philosophers nowadays would dispute the relevance of cognitive science to the metaphysics of mind, but this volume mainly concerns the relevance of metaphysics to phenomena that are not themselves mental. The volume is thus a departure from standard analytical metaphysics. Among the issues to which results from cognitive science are brought to bear are the metaphysics of time, of morality, of meaning, of (...) modality, of objects, and of natural kinds, as well as whether God exists. A number of chapters address the enterprise of metaphysics in general. In traditional analytical metaphysics, intuitions play a prominent role in the construction of, and assessment of theories. Cognitive science can be brought to bear on the issue of the reliability of intuitions. Some chapters point out how results from cognitive science can be deployed to debunk certain intuitions, and some point out how results can be deployed to help vindicate certain intuitions. (shrink)

Students of philosophy, psychology, sociology, and literature will welcome this collection of original essays on self-deception and related phenomena such as wishful thinking, bad faith, and false consciousness. The book has six sections, each exploring self-deception and related phenomena from a different perspective.

Clinical ethics committees (CECs) have been developing in many countries since the 1980s, more recently in the transitional countries in Eastern Europe. With their increasing profile they are now faced with a range of questions and challenges regarding their position within the health care organizations in which they are situated: Should CECs be independent bodies with a critical role towards institutional management, or should they be an integral part of the hospital organization? In this paper, we discuss the organizational context (...) in which CECs function in Europe focusing on five aspects. We conclude that in Europe clinical ethics committees need to maintain a critical independence while generating acceptance of the CEC and its potential benefit to both individuals and the organization. CECs, perhaps particularly in transitional countries, must counter the charge of “alibi ethics”. CECs must define their contribution to in-house quality management in their respective health care organization, clarifying how ethical reflection on various levels serves the hospital and patient care in general. This last challenge is made more difficult by lack of consensus about appropriate quality outcomes for CECs internationally. These are daunting challenges, but the fact that CECs continue to develop suggests that we should make the effort to overcome them. We believe there is a need for further research that specifically addresses some of the institutional challenges facing CECs. (shrink)

The interdisciplinary Hannover Qualification Programme on ethics consultation has trained hospital staff to operate clinical ethics services in their respective hospitals since 2003. To evaluate Hannover Qualification Programme, all former participants were contacted using an online questionnaire including four domains: status quo before attending Hannover Qualification Programme, present status, impact of Hannover Qualification Programme, future challenges. Research objectives were the long-term satisfaction with Hannover Qualification Programme and its impact on clinical ethics services. The response rate was 45%. Hannover Qualification Programme (...) was evaluated as helpful and the responders were capable of applying their acquired skills. Most participants could contribute to the implementation of clinical ethics services. They were satisfied with Hannover Qualification Programme and with the degree of changes in their hospitals. In conclusion, clinical ethics education had long-term effects on trainees and on their respective hospitals. Problems were mentioned rather in the field of utilisation than with implementation or quality of clinical ethics services. (shrink)

The Hannover qualifying programme ‘ethics consultation in hospitals’, conducted by a four-institution cooperation partnership, is an interdisciplinary, scientifically based programme for healthcare professionals interested in ethics consultation services and is widely acknowledged by hospital managements and healthcare professionals. It is unique concerning its content, scope and teaching format. With its basic and advanced modules it has provided training and education for 367 healthcare professionals with 570 participations since 2003 (until February 2010). One characteristic feature is its attractiveness for health professionals (...) from different backgrounds. Internationally, the Hannover programme is one of the few schedules with both academics and non-academics as target groups and a high participation rate of physicians. The concept of the Hannover programme is in great demand, and its schedule is continuously optimised through evaluation. The goals of enabling healthcare professionals from different professional backgrounds to define and reflect ethical problems, to facilitate and support the process of decision-making and to work out structures for their own institutions seem to have been achieved. However, in order to obtain effective and sustainable results, participation in the programme should be supplemented regularly by in-house training sessions or individual expert consultations. Future challenges include new thematic courses and providing a network for former participants, especially when they come from non-academic hospitals. The network is a reasonable platform to discuss participants' experiences, successes and pitfalls. A further task will be research on how the programme's concept can support the sustainability of ethics structures in the various institutions. (shrink)

Science generates an image of nature as devoid of meaning or value. and this image makes moral limits on the human manipulation of nature appear irrational. In part. this results from the particular kind of abstraction that constitutes scientific activity. For both epistemological and practical reasons. this abstract ion should not be taken as the only reality of nature. Such mis-taking becomes increasingly Iikely-and dangerous-as science and technology are used in the construction of the world within which we experience nature (...) and ourselves. Three alternative images of nature are discussed to indicate other possibilities. Imaging nature as an interconnected network. a view rooted in both ecology and Buddhism. is a more comprehensive and adcquate foundation for conceptualizing the practical and ethical dimensions of humanity’s relation with nature. (shrink)

This article offers an introduction to the four philosophical perspectives on school inspection that are presented in the articles which follow. Several aspects of practical contexts relating to school inspection are outlined (with particular reference to England) and major points made in the articles are outlined.

Elizabeth Fricker’s writings on testimonial justification include some contrary ideas. In this paper, we propose Fricker’s theory of justification coherently and explain why she speaks of different ideas and which idea is more compatible with her general theory of knowledge. Fricker proposes three conditions for justification of testimonial beliefs for adults by appealing to commonsense world-picture and defining a paradigm case of testimony: justified belief of using speech act of telling, justified belief of the sincere of testifier and the competence (...) of testifier. The speech act of telling itself requires that for example, testifier at least apparently speaks from his knowledge and thinks that hearer is ignorant of the testimony. We argue that various parts of Fricker’s theory face problems. For example, double standard about children and adults in testimonial justification is against unity of conception of knowledge. چون تعداد کلمات کمتر از 150 کلمه بود این عبارت در اینجا قرار گرفت تا اجازه عبور از این مرحله داده شود. (shrink)