Background:Choice to live and die at home is supported by palliative care policy; however, health resources and access disparity impact on this choice in rural Australia. Rural end-of-life home care is provided by district nurses, but little is known about their role in advocacy for choice in care.Objectives:The study was conducted to review the scope of the empirical literature available to answer the research question: What circumstances influence district nurse advocacy for rural client choice to live and die at home?, (...) and identify gaps in the knowledge.Method:Interpretive scoping methodology was used to search online databases, identify suitable studies and select, chart, analyse and describe the findings.Results:34 international studies revealed themes of ‘the nursing relationship’, ‘environment’, ‘communication’, ‘support’ and ‘the holistic client centred district nursing role.Discussion:Under-resourcing, medicalisation and emotional relational burden could affect advocacy in rural areas.Conclusion:It is not known how district nurses overcome these circumstances to advocate for choice in end-of-life care. Research designed to increase understanding of how rural district nurses advocate successfully for client goals will enable improvements to be made in the quality of end-of-life care offered. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions in (...) connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

This article examines arguments concerning enhancement of human persons recently presented by Michael Sandel (2004). In the first section, I briefly describe some of his arguments. In section two, I consider whether, as Sandel claims, the desire for mastery motivates enhancement and whether such a desire could be grounds for its impermissibility. Section three considers how Sandel draws the distinction between treatment and enhancement, and the relation to nature that he thinks each expresses. The fourth section examines Sandel's views about (...) parent/child relations and also how enhancement would affect distributive justice and the duty to aid. In conclusion, I briefly offer an alternative suggestion as to why enhancement may be troubling and consider what we could safely enhance. (shrink)

In this article I am concerned with whether it could be morally significant to distinguish between doing something 'in order to bring about an effect' as opposed to 'doing something because we will bring about an effect'. For example, the Doctrine of Double Effect tells us that we should not act in order to bring about evil, but even if this is true is it perhaps permissible to act only because an evil will thus occur? I discuss these questions in (...) connection with a version of the so-called Trolley Problem known as the Loop Case. I also consider how these questions may bear on whether a rational agent must aim at an event which he believes is causally necessary to achieve an end he pursues. (shrink)

The Doctrine of Double Effect and the Principle of Do No Harm raise important theoretical and practical issues, some of which are discussed by Boyle, Donagan, and Quinn. I argue that neither principle is correct, and some revisionist, and probably nonabsolutist, analysis of constraints on action and omission is necessary. In making these points, I examine several approaches to deflection of threat cases, discuss an argument for the permissibility of voluntary euthanasia, and present arguments relevant to medical contexts which justify (...) intentionally hanning some to aid others, with and without the consent of those harmed. Keywords: consent, double effect, euthanasia, harming, organ transplantation, scarce resources, trolley problem CiteULike Connotea Del.icio.us What's this? (shrink)

Philosophers may play the role of insider, e.g., serving as advisor to government commissions, or of outsider, commenting on the work of such commissions. Each role may raise dilemmas. It is argued that as insider the philosopher's primary duties should be to clarify and inform, as well as philosophize with the commissioners, and help them stay on a course in which moral considerations are given their proper weight. Fulfilling these duties means that the philosopher will sometimes have to help produce (...) a weaker intellectual document than he would prefer, or lose a chance to directly promote the public good. The insider philosopher will also have to consider whether it is appropriate for a policy proposal from a commission to differ from much current government policy, and how morally appropriate compromise can be reached among commissioners. Given his understanding of how an insider philosopher should function and how commission reports are constructed, the outsider philosopher can comment both on how close a report comes to being perfect of its type, and how far short of an ideal philosophical analysis even a perfect government report is. It may be appropriate for him to give greater weight to the public good, if his comments are very likely to affect it, than the insider philosopher. Examples for discussion are drawn from government reports on organ transplantation, embryo research, terminating care, and compensation for research subjects. Keywords: embryo research, government commissions, moral conflict, moral compromise, organ transplants, philosophers and public policy CiteULike Connotea Del.icio.us What's this? (shrink)

Decreasing philanthropic funding from governments and foundations and increasing social needs are putting pressure on nonprofits to generate financial resources in more entrepreneurial ways. This type of social innovation within the nonprofit sector can be facilitated through collaborative alliances with universities, corporations and other public/private partnerships. This paper presents a case study of a university partnership between Institute of Social Innovation at Carnegie Mellon University and the Pittsburgh Social Innovation Accelerator.

In this article, I examine several distinctions that may be relevant to the morality (and conceptual characterization) of terrorism: (1) the state/nonstate agent distinction, (2) the combatant/noncombatant distinction, (3) the intention/foresight distinction, (4) the means/side-effect distinction, (5) the interrelated necessary/nonnecessary means and produce/sustain distinctions, (6) the mechanical/nonmechanical use distinction, (7) the military/political distinction, (8) the harm/terror distinction, and (9) the harm-for-terror/terror-for-goal distinction. I conclude that some of these factors (though not those most commonly cited) account for the prima facie wrongness (...) of terrorism and that the nondistinctive properties of terrorism (which it shares with some nonterrorist acts) are what make it most seriously wrong. I also provide a conceptual examination of terrorism as we commonly think of it and its relation to torture. In the course of discussing the distinctions and also in concluding the article, I consider why terrorism may sometimes be morally permissible. (shrink)

Book reviewed in this article: Greation and Abortion: A Study in Moral and Legal Philosophy. By Frances M. Kamm.

Most nurse leadership studies have concentrated on a classical, heroic, and hierarchical view of leadership. However, critical leadership studies have argued the need for more insight into leadership in daily nursing practices. Nurses must align their professional standards and opinions on quality of care with those of other professionals, management, and patients. They want to achieve better outcomes for their patients but also feel disciplined and controlled. To deal with this, nurses challenge the status quo by showing rebel nurse leadership. (...) In this paper, we describe 47 nurses’ experiences with rebel nurse leadership from a leadership‐as‐practice perspective. In eight focus groups, nurses from two hospitals and one long‐term care organization shared their experiences of rebel nurse leadership practices. They illustrated the differences between “bad” and “good” rebels. Knowledge, work experience, and patient‐driven motivation were considered necessary for “good” rebel leadership. The participants also explained that continuous social influencing is important while exploring and challenging the boundaries set by colleagues and management. Credibility, trust, autonomy, freedom, and preserving relationships determined whether rebel nurses acted visibly or invisibly. Ultimately, this study refines the concept of rebel nurse leadership, gives a better understanding of how this occurs in nursing practice, and give insights into the challenges faced when studying nursing leadership practices. (shrink)

Cramer et al. make a good case for reconceptualizing comorbid psychopathologies in terms of complex network theory. We suggest the need for an extension of their network model to include reference to latent causes. We also draw attention to a neglected approach to theory appraisal that might usefully be incorporated into the methodology of network theory.

The lateralized ERP N2pc component has been shown to be an effective marker of attentional object selection when elicited in a visual search task, specifically reflecting the selection of a target item among distractors. Moreover, when targets are known in advance, the visual search process is guided by representations of target features held in working memory at the time of search, thus guiding attention to objects with target-matching features. Previous studies have shown that manipulating working memory availability via concurrent tasks (...) or within task manipulations influences visual search performance and the N2pc. Other studies have indicated that visual vs. spatial working memory manipulations have differential contributions to visual search. To investigate this the current study assesses participants' visual and spatial working memory ability independent of the visual search task to determine whether such individual differences in working memory affect task performance and the N2pc. Participants completed a visual search task to elicit the N2pc and separate visual working memory and spatial working memory assessments. Greater SPWM, but not VWM, ability is correlated with and predicts higher visual search accuracy and greater N2pc amplitudes. Neither VWM nor SPWM was related to N2pc latency. These results provide additional support to prior behavioral and neural visual search findings that spatial WM availability, whether as an ability of the participant's processing system or based on task demands, plays an important role in efficient visual search. (shrink)

There is growing political pressure for farmers to use more sustainable agricultural practices to protect people and the planet. The farming press could encourage farmers to adopt sustainable practices through its ability to manipulate discourse and spread awareness by changing the salience of issues or framing topics in specific ways. We sought to understand how the UK farming press framed sustainable agricultural practices and how the salience of these practices changed over time. We combined a media content analysis of the (...) farming press alongside 60 qualitative interviews with farmers and agricultural advisors to understand whether the farming press influenced farmers to try more sustainable practices. Salience of sustainable agricultural practices grew between 2009 and 2020. Many of the practices studied were framed by the press around economic and agronomic aspects, and farmer respondents said the most common reasons for trying sustainable agricultural practices were for economic and agronomic reasons. The farming press tended to use more positive rather than negative tones when covering sustainable agricultural practices. Respondents used the farming press as a source of information, though many did not fully trust these outlets as they believed the farming press were mouthpieces for agribusinesses. Whilst a minority of farmers stated they were motivated to try a new sustainable agricultural practice after learning about it in the farming press, this was rare. Instead, the farming press was used by respondents to raise their awareness about wider agricultural topics. We reflect on the role and power given to agribusinesses by the farming press and what this means for agricultural sustainability. (shrink)