La investigación responde al propósito de conocer cómo la comunicación masiva influye en los procesos de participación ciudadana. El problema se asume desde la óptica de la construcción de ciudadanía en Maracaibo. Se aplica una perspectiva epistémica cualitativa y recursos correspondientes a la inve..

The wilderness is one of the most widely recognized sources of transcendent emotion. Various recent studies have demonstrated nature’s power to induce intense emotions. The study at hand will generate conceptual and operational definitions of sublime emotion toward nature. Taking into consideration the recent research on feelings of awe, an instrument is devised to measure sublime emotion toward nature. The proposed scale’s reliability and validity is tested in a sample of 280 participants from the general population of Madrid. Results show (...) that sublime emotion was defined by two conceptual components: awe, and inspiring energy, both obtained using the computer program FACTOR. After reliability and validity analysis, the Sublime Emotion toward Nature (SEN) scale included 18 items, distributed into awe (6 items, α =.881) and inspiring energy (12 items, α=.933). Awe was defined by feelings of fear, threat, vulnerability, fragility, and respect for nature, which is perceived as vast, powerful, and mysterious. Inspiring energy was defined by feelings of vitality, joy, energy, oneness, freedom, eternity, and harmony with the universe. The SEN is an adequate instrument to measure transcendent emotions provoked by direct wilderness exposure or memory thereof. (shrink)

The aim of this hermeneutic study was to gain a broader understanding of nurses’ workload and what characterizes a nurse’s experience in terms of the various levels of intensity of nursing care. Twenty-nine nurses participated in seven focus groups. The interpretation process took place in six different phases and the three laws of dialectics were used as interpretation rules. An optimal nursing care intensity level can be understood as a situation characterized by the balance between the intensity of care needed (...) by patients and the external and internal factors of the current nursing care situation. The nurses’ work situation can be understood as a dialectic struggle between ‘being’ and ‘not being’ a good nurse; this can be said to be the underlying root metaphor. Nursing care can be understood as consisting of ‘complex and meaningful caring situations’. Dialectics can be used as a fruitful method of revealing the complexity of clinical reality. (shrink)

Modern medical ethics in the English-speaking world is commonly thought to derive from the medical philosophy of the Scotsman John Gregory (1725-1773) and his younger associates, the English Dissenter Thomas Percival (1740-1804) and the American Benjamin Rush (1745-1813). This book is the first extensive study of this suggestion. Dr Haakonssen shows how the three thinkers combined Francis Bacon's and the Scottish Enlightenment's ideas of the science of morals and the morals of science. She demonstrates how their medical ethics was a (...) successful adaptation of traditional moral ideas to the dramatically changing medical world especially the voluntary hospital. In accounting for the dynamics of this process, she rejects the anachronism that modern medical ethics was a new paradigm. (shrink)

It does not seem terribly unfair to say that studies of both rhetoric and dialogue have tended, by and large, to pass over listening in favor of speaking. In scholarly as well as quotidian parlance, it would appear that both rhetoric and dialogue are principally concerned with speech, banishing listening to the silent subservience of rhetoric's other. Whichever way it is glossed—as rhetoric, dialogue, language, or argumentation—the Western conception of logos emphasizes speaking at the expense of listening. And the problem (...) with conceiving of logos in terms of speech and speaking is not only that it ignores the importance of listening but also that it obscures how listening makes the ethical response possible. Drawing on the philosophy of Emmanuel Levinas, this article examines the ethical exigency of the face and its relation to primordial discourse in order to disclose the otherwise hidden ethical significance of listening and its vocation as a form of co-constitutive communicative action that can “listen persons to speech.”. (shrink)

This article examines clinical wisdom, which has emerged from a broader study about nurse managers' influence on proficient registered nurse turnover and retention. The purpose of the study was to increase understanding of proficient nurses' experience and clinical practice by giving voice to the nurses themselves, and to look for differences in their practice. This was a qualitative study based on semistructured interviews followed by analysis founded on Gadamerian hermeneutics. The article describes how proficient nurses experience their practice. Proficient practice (...) constitutes clinical wisdom based on responsibility, thinking and ethical discernment, and a drive for action. The study showed that poor working conditions cause proficient nurses to regress to non-proficient performance. Further studies are recommended to allow deeper searching into the area of working conditions and their relationship to lack of nurse proficiency. (shrink)

In this paper, I explore the concept conduct of everyday life, namely routines and real life, as they are confronted with empirical observations. The observations are from a study of changes in the conduct of everyday life for individuals who attended a patient education course. The course was a part of their treatment after a hospitalisation with depression in a psychiatric ward. I use analysis of the main individual, Steven’s, conduct of everyday life and illustrate my points with models of (...) conduct of everyday life made using beads. The conceptualisation of conduct of everyday life is expanded through three points. Firstly, cyclic routines can matter and fulfill life, which can support the ongoing discussion about the concept conduct of everyday life. Secondly, I show that, from a first person perspective, what matters in conduct of everyday life is more complex than what is possible to grasp analytically through a dualistic opposition between cyclic everyday conduct and the particular meaningful conduct of everyday life. Thirdly, I expand on the notion of timeouts/breaks as solely something that lifts us out of mundane everyday life. I conclude that it makes a more comprehensive analysis to perceive all conduct of everyday life as having profound personal meaning and to analyse the individuals' concerns in relation to their social self-understanding and localisation at a certain time. (shrink)

Based on a historical and a contemporary fieldwork at a Danish hospital, this article offers a genealogical and philosophical exploration of the development of nurses’ doing and focus within a hospital setting from the 1800 s to the present day. This exploration finds that nurses’ doing has changed during history, which is reflected in their focus. Thus, nurses’ focus has developed from, what the Danish philosopher Uffe Juul Jensen refers to as a situation‐oriented, to a disease‐oriented practice, and while new (...) values are established, the conception of care as a core value in nursing seems to have receded. This article also argues that today's nurses are doing what doctors did in the 19th century. The French philosopher Michel Foucault discusses how things repeat themselves in new ways and new contexts. The nursing profession has become ‘a career open to the talents’ where nurses with the appropriate skills and talents are able to build a career, within which they provide status, position and legitimacy. The conclusion of the article discusses the significance of this development for patients and the nursing profession. (shrink)

Healthcare apps er blevet en omfattende industri. Vi kan ganske gratis downloade tusindvis af apps, som sætter os i stand til at monitorere alt fra vores fysiske form til vores mentale velbefindende, og vi kan gennem denne monitorering, producere endeløse datamængder og viden om os selv og vores liv – altså skabe et «monitoreret mig». Men hvordan forholder vi os til denne mulighed? I nærværende artikel tages udgangspunkt i foreløbige resultater fra et igangværende ph.d. projekt, hvor brugen af apps og (...) biofeedback anvendes i praksis, til at belyse en stigende stressproblematik blandt lærere i den danske folkeskole. Artiklens ærinde er, at tematisere de normer og fortolkningsrammer, som kommer til syne, når aktørerne selv italesætter sit «monitorerede mig» og hernæst diskutere, i hvilken position, disse normer og tolkninger af teknologien i anvendelse, bringer aktøren. Er «det monitorerede mig» en mulighed for frisættende autonomi – en empowerment? Eller bidrager monitoreringen i stedet til individualisering eller patologisering, hvor vi gennem ejerskabet af vores egen fortælling, producerer et overansvar for eksempelvis hvilken behandling vi skal modtage, eller hvordan vores arbejdsmiljø bør være?Nøgleord: Etik, humanistisk sundhedsforskning, selvmonitorering, Ecological Momentary StorytellingEnglish summary: The Monitored Me - empowerment or pathologization?Healthcare apps have become a major industry. We can freely download thousands of apps, that enable us to monitor everything, from our physical condition to our mental well-being, and we can through the monitoring produce endless amounts of data and knowledge about our inner selves and our lives - creating a “monitored me”. But how is this technological possibility dealt with, in practice? The present article presents and discusses results from a case study in which apps and biofeedback were used to illuminate an increasing stress problem among teachers in the Danish preliminary school system. The focus of the article is to analyze the self-interpretation framework that appears when the users of the technology articulate the "monitored me” and hereafter discuss how these self-interpretations position the user. Is “the monitored me” an opportunity for liberating autonomy – for empowerment? Or does it contribute to individualization or pathologization? (shrink)

Two related aspects of the present ‘knowledge capitalism’ stage of globalisation are discussed in this article: the transformation of education to make it more directly supportive of educational growth and competition, and the growing demands on educational research to provide scientific evidence for education policy and practice, using narrowly defined methods and techniques. It is argued that both developments have profound consequences for the construction and use of educational theory, and the vital need for critical discussion and communication in this (...) respect is emphasised. (shrink)

Questions on what it means to live and die well are raised and discussed in the hospice movement. A phenomenological lifeworld perspective may help professionals to be aware of meaningful and important dimensions in the lives of persons close to death. Lifeworld is not an abstract philosophical term, but rather the opposite. Lifeworld is about everyday, common life in all its aspects. In the writings of Cicely Saunders, known as the founder of the modern hospice movement, facets of lifeworld are (...) presented as important elements in caring for dying patients. Palliative care and palliative medicine today are, in many ways, replacing hospices. This represents not only a change in name, but also in the main focus. Hospice care was originally very much about providing support and comfort for, and interactions with the patients. Improved medical knowledge today means improved symptomatic palliation, but also time and resources spent in other ways than before. Observations from a Nordic hospice ward indicate that seriously ill and dying persons spend much time on their own. Different aspects of lifeworld and intersubjectivity in the dying persons’ room is presented and discussed. (shrink)

This article presents a discourse model of polling that investigates what poll discourse is, how it is structured and how it functions. In contrast to most polling research, which presupposes polling to be primarily a psychological measurement tool, this article explores how it is primarily a discursive form of social interaction. Using the tools of discourse analysis, the model reveals that far from reflecting the beliefs and preferences of citizens, poll questions can instead tacitly evoke and sustain conservative and status (...) quo ideologies. Hence polls can play a significant role in constructing what is admissible and legitimate in political discourse. (shrink)

BackgroundAs part of the research project “End-of-life Communication in Nursing Homes. Patient Preferences and Participation”, we have studied how Advance Care Planning is carried out in eight Norwegian nursing homes. The concept of ACP is a process for improving patient autonomy and communication in the context of progressive illness, anticipated deterioration and end-of-life care. While an individualistic autonomy based attitude is at the fore in most studies on ACP, there is a lack of empirical studies on how family members’ participation (...) and involvement in ACP- conversations may promote nursing home patients’ participation in decisions on future treatment and end-of-life care. Based on empirical data and family ethics perspectives, the purpose of this study is to add insights to the complexity of ACP-conversations and illuminate how a family ethics perspective may improve the quality of the ACP and promote nursing home patients’ participation in advance care planning.MethodsParticipant observations of ACP-conversations in eight nursing homes. The observations were followed by interviews with patients and relatives together on how they experienced being part of the conversation, and expressing their views on future medical treatment, hospitalization and end-of-life issues.ResultsWe found that the way nursing home patients and relatives are connected and related to each other, constitutes an intertwined unit. Further, we found that relatives’ involvement and participation in ACP- conversations is significant to uncover, and give the nursing home staff insight into, what is important in the nursing home patient’s life at the time. The third analytical theme is patients’ and relatives’ shared experiences of the dying and death of others. Drawing on past experiences can be a way of introducing or talking about death.ConclusionsAn individual autonomy approach in advance care planning should be complemented with a family ethics approach. To be open to family ethics when planning for the patient’s future in the nursing home is to be open to diversity and nuances and to the significance of the patient’s former life and experiences. (shrink)

This chapter outlines how biotechnology can be seen as a challenge to our notion of nature, and how the complexity of the concept of nature in itself is a challenge in the debate on enhancement of capacities in humans, animals and plants by means of biotechnology. It then explores how the same concept contributes to the ethical arguments both for and against enhancement of human capacities, focusing on two central aspects of the enhancement debate namely: (i) the debate that focuses (...) on enhancement as an overreaching form of therapy; and (ii) the debate that focus on enhancement as the goal in itself. Finally, the chapter summarizes the contribution of the concept of nature in terms of the challenges that its inherent complexity poses to the ethical and philosophical debate on enhancement technologies, also briefly discussing how “nature” and “naturalness” can be said to have moral relevance in the enhancement debate. (shrink)

Explores listening as a fundamental human endowment connected with language and thought, and its potential for social, personal, and political action. Incorporates historical, literary, intercultural, scientific, musical, and philosophical perspectives"--Provided by publisher.

In mammals, a network of cellular circadian clocks organizes physiology and behavior along the 24‐h day cycle. The traditional hierarchical model of circadian clock organization with a central pacemaker and peripheral slave oscillators has recently been challenged by studies combining tissue‐specific mouse mutants with transcriptome analyses. First, a surprisingly small number of tissue rhythms are lost when only local clocks are ablated and, second, transcriptional circadian rhythms appear to be regulated by a complex mix of local and systemic factors. As (...) reviewed here, these findings suggest a more integrated model of clock network interaction with the central pacemaker as the main source of behavioral and systemic–physiological rhythms and peripheral clocks controlling some local rhythms while at the same time acting as gatekeepers that temporally adjust cellular responses to external stimuli. (shrink)

In the present Western cultural and political context, the concept of nature plays a central role in the debate about new technologies. However, the concept of nature is complex and reflects more than one frame of reference stemming from a long historical tradition. ‘Nature’ is referred to: a) as the object (phenomenon) toward which the debate is directed, and b) as the normative frame of reference that either justifies or rejects the technological method in specific situations. This paper argues, that (...) this double character of ‘nature’ is not particular for the debate on ethical concern for the non-human nature, rather it constitutes the complexity of the concept itself. This, in turn, leads to a more fundamental question, namely: What is ‘nature’?—Or rather: Is ‘nature’ to be defined? (shrink)

An amendment to this paper has been published and can be accessed via the original article.

Background Health ministries in Europe are investing increasingly in innovative digital technologies. Older adults, who have not grown up with digital innovation, are expected to keep up with technological shifts as much as other age groups. This is ethically challenging, as it may threaten a sense of dignity and well-being in older adults. Research objective To clarify the phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within the context of digitally led (...) healthcare in Norway. Research design A Reflective Lifeworld Research design was chosen, and purposive, in-depth interviews were conducted. Participants and research context The participants were 13 adults 75 years and older from Northern Norway, living at home and not receiving consistent assistance. Ethical considerations Followed the principles of the Helsinki Declaration. This study was approved by the Social Science Data Services in Norway (project number 916119). Interviews were conducted carefully within a safe environment chosen by the participants. Findings Older adults experience that using new digital systems in healthcare makes them become dependent with experiences of helplessness. They feel an increased sense of dependency on other people, and that recognition can assail their experience of personal dignity. Older adults not only expect digitally led healthcare to give them a feeling of safety but also experience feeling insecure concerning privacy and loss of possibilities for dialogue with healthcare providers. They are met by demands from society, which they often struggle to achieve. Conclusion The phenomenon of sense of dignity experienced in older adults, concerning how their expectations and needs are met within digitally led healthcare, indicates a sense of feeling lost in the digital world. Further, innovative healthcare lacks focus on ethical performance. This impacts their perception of dignity, as loss of dignity is noticed especially in its rupture. (shrink)

The increasing need for innovative research driven by rapid global changes gives doctoral supervisors of early-stage researchers a significant role in facilitating the ethical conduct of qualitative research. In the context of European Commission funding, the demands of research ethics and integrity place a tremendous responsibility on the supervisors of early-stage researchers involved in cross-national projects. This document study seeks to illuminate the role of the supervisors in facilitating research ethics in these projects. Specifically, we describe and discuss the supervisor (...) role associated with five approaches to doctoral supervision of qualitative research, namely those described as ‘Functional’, ‘Enculturation’, ‘Critical thinking’, ‘Emancipation’ and ‘Developing a quality relationship’. The main challenges for supervisors of cross-national research projects are the cultural and linguistic mobilisation of ethical principles in qualitative research processes and the management of the future use of open data. The results from this study have implications for planning and conducting cross-national studies within research involving human participants. These results can guide supervisors in the codification and mobilisation of ethical qualitative research in practice. (shrink)

Dignity is a central value in care for aged adults, and it must be protected and respected. With demographic changes leading to an aging population, health ministries are increasingly investing in digitalization. However, using unfamiliar digital technology can be challenging and thus impact aged adults' dignity and well‐being. The INNOVATEDIGNITY project aims to research new, dignified ways of engaging with aged adults to shape digital developments in care delivery. This qualitative study aimed to explore how innovative digitally‐led healthcare have influenced (...) aged adults' well‐being and dignity through three studies conducted as part of the INNOVATEDIGNITY project: a scoping review, an empirical study and a policy analysis. The three documents were analysed to uncover meanings relevant to the research problem revealing four main themes: the advantages of new technologies in facilitating aged adults' well‐being, the rupture of dignity due to bewilderment in the digital world, aged adults' dignity is affected by their worries about human face of care being replaced by technology and preserving aged adults' dignity in digitally‐led healthcare. Digitalization in healthcare impacts aged adults' well‐being as providing new opportunities for care, but preserving aged adults' dignity when working with unfamiliar digital innovations is challenging. Aged adults need to be informed about the use of technology in their care and supported to develop the necessary digital skills to better adapt to digitally‐led healthcare. The circumstances, conditions and needs of individuals should remain central when implementing new technologies in healthcare settings in a dignified way. (shrink)

Deuteronomy-Kings as Emerging Authoritative Books: A Conversation. Edited by Diana V. Edelman. Ancient Near East Monographs, vol. 6. Atlanta: Society of Biblical Literature, 2014. Pp. xi + 289. $33.95.

Daughters of Hecate: Women & Magic in the Ancient World. Edited by Kimberly B. Stratton and Dayna S. Kalleres. New York: Oxford University Press, 2014. Pp. xv + 533. $39.95.

Hasmonean Realities behind Ezra, Nehemiah, and Chronicles: Archaeological and Historical Perspectives. By Israel Finkelstein. Ancient Israel and Its Literature, vol. 34. Atlanta: SBL Press, 2018. Pp. xi + 208. $32.95.

Women in Antiquity: Real Women across the Ancient World. Edited by Stephanie Lynn Budin and Jean Macintosh Turfa. Rewriting Antiquity. London: Routledge, 2016. Pp. xxxvi + 1074, illus. $240.

An argument is developed that supports a simulationist account about the foundations of infants' and young children's understanding that other people have mental states. This argument relies on evidence that infants come to the world with capacities to send and receive affective cues and to appreciate the emotional states of others – capacities well suited to a social environment initially made up of frequent and extended emotional interactions with their caregivers. The central premise of the argument is that the foundation (...) of infants' understanding of other minds is built upon an early-developing capacity to share others' emotion experiences. The emotion experiences elicited in interactions between caregivers and infants enable the elaboration of this primitive understanding into a more fully developed understanding of psychological subjects. The evidence presented in support of these claims derives from a wide range of studies of the phenomena of emotional contagion, affective communication, and emotion regulation involving infants, young children, and adults. (shrink)

The complex health and social circumstances of living-at-risk, frequent users of emergency departments (aREDFUs) in the health jurisdictions of high-income countries, and the related, significant challenges posed for emergency departments and the health care providers working within them, are identified and explored in the paper. Ethical analyses of a set of relevant domains are performed, i.e., individual and relational autonomy considerations, relevant social construction and personal responsibility conceptions, patient welfare principles (beneficence, nonmaleficence, continuity of care), harm reduction methodologies and their (...) applications, health equity, and justice considerations of the distributive, formal and social types. The outcomes of these analyses demonstrate that there are ethically compelling reasons for emergency departments to adopt an ethics-informed, policy-based approach to the longitudinal care and management of living-at-risk, frequent users of emergency departments. From a formal justice perspective, the development and uses of such an approach are justified by a demonstrable relevant difference between living-at-risk, frequent users of emergency departments and other persons and groups of patients who visit emergency departments. We propose an example of such a policy-based approach. Examples of possible, pragmatic applications of this approach, which help ensure that aREDFUs who present to the ED are managed in a fair and optimally consistent manner, are provided for the consideration of an urban emergency department’s policymaking working group. (shrink)

Nowadays, special attention is given to the hazards associated with genetic engineering and new inventions in biotechnology, and in fear of severe consequences, researchers, institutions and governments are required to act responsibly. The term “responsibility” may be defined in numerous ways. The definition considered in this paper, is one we believe is in common use: “Generally speaking, a person has a special responsibility for a particular outcome if they knowingly brought it about and it would not exist if not for (...) what they did”. This concept of moral responsibility rests on what we term the three ‘I's’: individual, intentional and informed. Responsibility is individual in the sense that it must be directed towards someone. A second requirement of moral responsibility presupposes the ability to do otherwise, i.e. it presupposes each human being as an intentional actor, capable of acting according to his/her own free will. In order for someone to be responsible for their actions, the choice between alternatives must be informed. The article focus' on these three aspects of responsibility in order to reveal how difficult it is to apply and make sense of this definition with regard to new inventions in science. (shrink)

The use of robotic technology in healthcare is increasing. The aim was to explore attitudes toward the use of humanoid robots in healthcare among patients, relatives, care professionals, school actors and other relevant actors in healthcare and to analyze the associations between participants’ background variables and attitudes. The data were collected through a cross-sectional survey (N = 264) in 2018 where participants met a humanoid robot. The survey was comprised of background variables and items from a modified Robot Attitude Scale. (...) Multiple linear regression analysis and Spearman’s Rho correlation were used to analyze associations between variables. Most of the participants were positive toward the use of humanoid robots in healthcare and only a few were negative. Attitudes toward the use of humanoid robots were more positive among other relevant actors, such as service personnel and politicians in healthcare, participants with a higher educational level and older adults. More research is needed on the reasons underlying negative attitudes because these might affect the introduction of humanoid robots in healthcare. A careful evaluation of appropriate first target groups as well as which tasks are appropriate for humanoid robots to perform in healthcare are needed. (shrink)

Israel in the Persian Period: The Fifth and Fourth Centuries B.C.E. By Erhard S. Gerstenberger, translated by Siegfried S. Schatzmann. Biblical Encyclopedia, vol. 8. Atlanta: Society of Biblical Literature, 2011. Pp. xviii + 575. $65.95.

Becoming Diaspora Jews: Behind the Story of Elephantine. By Karel van der Toorn. The Anchor Yale Bible Reference Library. New Haven: Yale University Press, 2019. Pp. xi + 270. $65.

The Posen Library of Jewish Culture and Civilization. Vol. 1: Ancient Israel, from Its Beginnings through 332 BCE. Edited by Jeffrey H. Tigay and Adele Berlin. Lucerne: The Posen Foundation, and New Haven: Yale University Press, 2021. Pp. lvii + 538, illus. $200.

Would primary care services benefit from the aid of a clinical ethics committee (CEC)? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation (...) and disagreement with next of kin; and priority setting, resource use and quality. Nursing homes and home care were the primary care services most often involved. Next of kin were present in 10 case deliberations, whereas patients were never present. The investigation indicates that it might be feasible for new CECs to attain a high level of activity including case deliberations within the time frame. It also confirms that significant, characteristic and complex moral problems arise in primary care services. (shrink)

BackgroundHow should clinical ethics support services such as clinical ethics committees (CECs) be implemented and evaluated? We argue that both the CEC itself and theimplementationof the CEC should be considered as ‘complex interventions’.Main textWe present a research project involving the implementation of CECs in community care in four Norwegian municipalities. We show that when both the CEC and its implementation are considered as complex interventions, important consequences follow – both for implementation and the study thereof. Emphasizing four such sets of (...) consequences, we argue, first, that the complexity of the intervention necessitates small-scale testing before larger-scale implementation and testing is attempted; second, that it is necessary to theorize the intervention in sufficient depth; third, that the identification of casual connections charted in so-called logic models allows the identification of factors that are vital for the intervention to succeed and which must therefore be studied; fourth, that an important part of a feasibility study must be to identify and chart as many as possible of the causally important contextual factors.ConclusionThe conceptualization of the implementation of a CEC as a complex intervention shapes the intervention and the way evaluation research should be performed, in several significant ways. We recommend that researchers consider whether a complex intervention approach is called for when studying CESS implementation and impact. (shrink)