Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

The selectionsfrom the work of fourteen contemporary philosophers not only display the multiplicity of approachesbeing pursued since the breakup of any consensus on what philosophy is, but also help to clarifythis proliferation of views and ...

Craik published only one complete work of any length, this essay on The Nature of Explanation.

According to a venerable tradition in philosophy and linguistics, expressions have meaning through being subject to conventions or rules. This claim has become a central topic of contemporary philosophy of language and mind in the wake of Wittgenstein and Kripke, largely because the normativity of meaning is regarded as a serious challenge to naturalism. One reaction to this challenge is to deny that the normativity of meaning is genuine. While there are ‘semantic principles’ specifying conditions for the correct application of (...) expressions, these are either not genuinely normative or they are not in fact constitutive of meaning. But this dilemma can be defused if one distinguishes different dimensions of semantic normativity and pays attention to different types of mistakes that can afflict linguistic behavior. In particular, one needs to keep apart norms of truth and norms of meaning, regulative, and constitutive rules, and to appreciate the normative dimensions of the notion of correctness. The final section discusses the role of communally shared rules or conventions for language, in particular the age-old problem of circularity: how could such conventions be essential to language, given that the latter appears prerequisite for establishing and communicating conventions in the first place. (shrink)

The publication of a new ethics code for the American Psychological Association (1992), new guidelines (Committee on Ethical Guidelines for Forensic Psychologists, 1991), and two new versions of the Minnesota Multiphasic Personality Inventory (the MMPI-2, Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989; and the MMPI-A, Butcher et al., 1992) provide an opportunity to review ethical aspects of forensic assessment. Seven major issues-appropriate graduate training, competence in the use of standardized tests, using tests that fit the task, using tests that fit (...) the individual, administering tests correctly, using computers appropriately in forensic assessment, and assessing and reporting factors that may affect the meaning of test findings - are discussed. The revision of the MMPI is used to illustrate some of these issues. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

This paper explores the interpretation and use of polygenic risk scores (PRSs). We argue that PRSs generally do not directly embody causal information. Nonetheless, they can assist us in tracking other causal relationships concerning genetic effects. Although their purely predictive/correlational use is important, it is this tracking feature that contributes to their potential usefulness in other applications, such as genetic dissection, and their use as controls, which allow us, indirectly, to "see" more clearly the role of environmental variables.

Interpretation of theAgamemnonin general and of its first choral sequence in particular has tended to proceed on two assumptions: first, that Aeschylus could have given an answer to the question, ‘Was Agamemnon free to choose whether or not to sacrifice his daughter?’; and secondly, that he composed the play in such a way that if we try hard enough we can discover his answer. I submit in this paper an interpretation which replaces both these assumptions with an alternative trio of (...) hypotheses for which, I think, a case can be made: first, that Aeschylus was well aware that in real life we cannot know the extent to which an agent was able to choose whether or not to commit a particular act; secondly, that inAg.104–257 he has portrayed realistically the manner in which people respond to the commission of an extraordinary and disagreeable act by a respected agent; and thirdly, that the aspect of Agamemnon's predicament which made the most powerful impression on Aeschylus and his audience is an aspect to which modern interpreters of the play have seldom alluded even by implication. I would not be so rash as to assert that Aeschylus never concerned himself with the question of responsibility, nor that his concepts of justice and retribution are of small interest, but I am not satisfied that ‘with all the powers of his mind’, as Professor Lesky puts it, ‘he wrestled with the problem arising from the conflict between human existence and divine rule’, nor do I take the view that a dramatist passionately involved in metaphysics and theology is a wiser and greater man than one who devotes the powers of his mind to concrete problems of poetic and theatrical technique. The scale of values adopted by interpreters of early Greek tragedy has certainly been affected, and has perhaps been somewhat distorted, by the dominant position of philosophy in European culture and education. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 39.4 (2006) 333-339MuseSearchJournalsThis JournalContents[Access article in PDF]On Persuasion, Identification, and Dialectical SymmetryKenneth BurkeEdited with introduction by James ZappenNote: This untitled paper was found in two typed copies among the books and papers in Kenneth Burke's personal library in July 2006—one copy folded into a heavily used Loeb edition of Aristotle's Rhetoric, the other in a small file cabinet in the library.1 The two copies (...) are nearly identical carbon copies, probably typed by Burke's wife Libby; the original has not been found.2 The paper includes brief discussions of persuasion, identification, and dialectical symmetry (hence the current title), plus brief critiques of behaviorism and general semantics, with specific reference to Alfred Korzybski's notion of the structural differential. It was probably written in the mid-1940s, after the second edition of Korzybski's Science and Sanity and The Philosophy of Literary Form, both published in 1941; perhaps at roughly the same time as the more extended discussions of behaviorism and Korzybski in A Grammar of Motives, published in 1945; and before the full development of Burke's ideas about persuasion, identification, and dialectical symmetry in A Rhetoric of Motives, published in 1950. The paper might have been prepared for a public lecture or for circulation among Burke's literary friends, as a brief commentary on some of the key concepts in A Rhetoric of Motives, while he was completing A Grammar of Motives or perhaps shortly following its publication. If so, then it might have been written as late as 1947.3This paper suggests that Burke's concept of identification was in part a creative response to current issues in behaviorism and general semantics, formulated in sympathy with George Herbert Mead's observations on identification, communication, and community in Mind, Self, and Society and The Philosophy of the Act and in opposition to Korzybski's general semantics and his structural differential. Moreover, and more important, this paper suggests that the final section of A Rhetoric of Motives, titled simply "Order," is essential to a complete understanding of Burke's ideas about persuasion and identification since only in this last section does Burke show how competing points of view [End Page 333] might be reconciled in an ultimate identification via the dialectical symmetry that he traces through the long history of Platonic thought.4James P. Zappen Department of Language, Literature, and Communication Rensselaer Polytechnic Institute* * *What, in sum, would be the salient traits of Aristotle's Rhetoric?5 And what would be our attitude towards them?His "art" is constructed about his stress upon persuasion as the purpose of rhetoric. Hence he surveys the resources of rhetoric, to the end that one might use the best means available for a given situation. To narrow down the choice of means, he makes a division into kinds of oratory: deliberative (concerned with the expediency of steps still to be taken); forensic (concerned with the justice or injustice of past acts); and demonstrative or epideictic (concerned with praise and blame, primarily involving the present). But to be effective in any of these kinds, one must appeal to the opinions of one's audience—hence the lists of "topics" reviewing such opinions. First he considers the components of happiness, on the grounds that all men aim at happiness, hence this topic figures in all persuasion and dissuasion. For deliberative oratory specifically, he lists the topics naming men's opinions as to the good, the expedient, and their opposites (along with relevant observations on different forms of government). His topics for epideictic, dealing with praise and blame, comprise the things men consider virtuous and vicious. And his list of forensic topics has to do with the motives and effects of just and unjust acts. Also, there are such general topics as the possible and impossible, the more and the less, the likely and the unlikely.Enthymemes (deductions based on opinion) fit well with forensic, he says. Rhetorical induction (example) best suits the deliberative. And to epideictic, amplification (auxesis... (shrink)

Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

SummaryThe Gainj of highland Papua New Guinea do not use contraception but have a total fertility rate of only 4·3 live births per woman, one of the lowest ever recorded in a natural fertility setting. From an analysis of cross-sectional demographic and endocrinological data, the causes of low reproductive output have been identified in women of this population as: late menarche and marriage, a long interval between marriage and first birth, a high probability of widowhood at later reproductive ages, low (...) effective fecundability and prolonged lactational amenorrhoea. These are combined with near-universal marriage, a low prevalence of primary sterility and a pattern of onset of secondary sterility similar to that found in other populations. Of all the factors limiting fertility, by far the most important are those involved in birth spacing, especially lactational amenorrhoea. (shrink)

Report on Charles Sanders Peirce and his contributions to a newspaper, includes yearly breakdowns of his contributions, analysis of his writings, his contributions to philosophy, and more.

On the basis of interviews conducted in Bradford, Glasgow and Rotterdam, this article seeks to explore the issue of changing social values as they are affected by or affect the capacity (or incapacity) to participate in community and/or political life. The issue explored is in the context of globalisation and its impact on the communities in question. The aim is to offer some empirical basis for a theological reflection upon the nature and scope of value change and the opportunities and (...) challenges thus posed for publicly engaged Christians. (shrink)

SummaryThe effects of infant suckling patterns on the post-partum resumption of ovulation and on birth-spacing are investigated among the Gainj of highland New Guinea. Based on hormonal evidence, the median duration of lactational anovulation is 20·4 months, accounting for about 75% of the median interval between live birth and next successful conception. Throughout lactation, suckling episodes are short and frequent, the interval changing slowly over time, from 24 minutes in newborns to 80 minutes in 3-year olds. Maternal serum prolactin concentrations (...) decline in parallel with the changes in suckling patterns, approaching the level observed in non-nursing women by about 24 months post-partum. A path analysis indicates that the interval between suckling episodes is the principal determinant of maternal prolactin concentration, with time since parturition affecting prolactin secretion only in so far as it affects suckling frequency. The extremely prolonged contraceptive effect of breast-feeding in this population thus appears to be due to a slow decline in suckling frequency with time since parturition and absence of a decline over time in hypothalamic–pituitary responsiveness to the suckling stimulus. (shrink)

_Mirroring and Attunement_ offers a new approach to psychoanalysis, artistic creation and religion. Viewing these activities from a broadly relational perspective, Wright proposes that each provides a medium for creative dialogue: the artist discovers himself within his self-created forms, the religious person through an internal dialogue with ‘God’, and the analysand through the inter-subjective medium of the analysis. Building on the work of Winnicott, Stern and Langer, the author argues that each activity is rooted in the infant’s preverbal relationship (...) with the mother who ‘holds’ the emerging self in an ambience of mirroring forms, thereby providing a ‘place’ for the self to ‘be’. He suggests that the need for subjective reflection persists throughout the life cycle and that psychoanalysis, artistic creation and religion can be seen as cultural attempts to provide the self with resonant containment. They thus provide renewed opportunities for holding and emotional growth. _Mirroring and Attunement_ will provide essential reading for psychoanalysts, psychotherapists, and art therapists and be of interest to anyone working at the interface between psychoanalysis, art and religion. _ _. (shrink)

A book that pulls together the results of research by several scholars to provide a fresh look at the rich heritage of ideas that Wright contributed to the theory and practice of architecture, with special emphasis on the ordering of structuring of architectural experience. An attempt is made to convey an understanding of Wright's contributions through a direct analysis of his designs as they exist or existed in reality. The authors take a different look at Wright's work (...) in a search for clarity and understanding. (shrink)

News media helps shape the discourse around natural resource issues, especially rapidly emerging developments such as those taking place in the Arctic. Whilst the relationship between media and audience is complex, news media contributes towards setting the tone and expectations for the burgeoning number of stakeholders engaging with the Arctic, especially in the case of Greenland. This study undertakes a thematic analysis of English-language news media coverage surrounding natural resource development in Greenland to explore how the issue is framed. Five (...) media frames are identified: an emerging resource frontier; the warming Arctic; high-risk activity; geopolitical Greenland; and vulnerable traditional societies. An overarching frame is present within the coverage, one which depicts Greenland as 'a climate change frontier', facing 'uncertainties in the face of rapid change'. Media portrayals of a close-knit relationship between a warming climate and a rush for natural resources in Greenland could be problematic for several reasons, namely the disparity between actual resource development taking place and an overemphasis on increased economic development following increased warming. (shrink)