This study reconsiders the purported benefits of community found in Community Supported Agriculture (CSA). Using an online survey of members who belong to CSAs in New York, between November and December 2010, we assess members’ reasons for joining a CSA, and their perceptions of community within their CSA and beyond. A total of 565 CSA members responded to the survey. Results show an overwhelming majority of members joined their CSA for fresh, local, organic produce, while few respondents joined their CSA (...) to build community, meet like-minded individuals or share financial risk with farmers. Members reported that they do not derive a strong sense of community from either their CSA or other forms of community, yet they volunteered at their CSA and appear to be engaged in activities within their communities, though the frequency of the latter is unknown. These data suggest New York CSAs are oriented toward the instrumental and functional models, which emphasize the economic aspects of farming rather than collaborative models, which foster community (Feagan and Henderson 2009). (shrink)

The Nuffield Council on Bioethics (NCOB) is delighted to pick up the mantel of the Ethics briefings. For readers less familiar with the NCOB’s work, we are a leading independent policy and research centre, and the foremost bioethics body in the UK. We identify, analyse and advise on ethical issues in biomedicine and health so that decisions in these areas benefit people and society.1 Established in 1991, the NCOB has tackled a wide range of bioethics and medical ethics issues over (...) its thirty-two years, including issues relating to the beginning and end of life, health and society, data and technology, and research ethics. Early reports in the 1990s included, for example, ‘Genetics screening: the ethical issues’ and ‘Animal-to-human transplants: the ethics of Xenotransplantation’. More recent projects include setting out an ethical framework in the report ‘The future of ageing: ethical considerations for research and innovation’2 and a current joint project with the Ada Lovelace Institute3 considering the potential ethical implications of the convergence of AI and genomics technologies.4 In recent years, NCOB has increasingly focused on horizon scanning. What current and future national and international developments are likely to raise ethical issues in the short, medium and long-term? Insights for 2023 will soon be available at www.nuffieldbioethics.org/what-we-do/horizon-scanning, with new developments likely to be included alongside ongoing areas of medical and scientific research that we are tracking progress in, for example, in vitro derived gametes, surrogacy, biosafety and novel neurotechnologies. Disagreements between parents and healthcare teams about …. (shrink)

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

The self is a common yet unclear theme in addiction studies. William James's model of self provides a framework to explore the experience of self. His model details the subjective and objective constituents, the sense of self‐continuity through time, and the ephemeral and plural nature of the changing self. This exploration yields insights into the self that can be usefully applied to subjective experiences with psychoactive drugs of addiction. Results of this application add depth to the common understanding of self (...) in addiction, acknowledge the importance of feelings and choice in the sense of self created in addiction experiences, and affirm the values salient to these interior experiences in addiction. These results suggest meaning derived from those values, and provide important background knowledge for the nurse interacting with these clients. (shrink)

Certified nursing assistants (CNAs) provide up to 80% of the direct care to older adults in long‐term care facilities. CNAs are perceived as being at the bottom of the hierarchy among healthcare professionals often negatively affecting their job satisfaction. However, many CNAs persevere in providing quality care and even reporting high levels of job satisfaction. The aim of the present investigation was to identify primary themes that may help CNAs make meaning of their chosen career; thus potentially partially explaining increases (...) in job satisfaction among this group. Focus groups were conducted with CNAs at three long‐term care facilities. Four themes emerged from the data: CNA work is good or special; CNA as relationship builder; CNA as expert; CNA as team member. These themes reflect the perceptions that these CNAs held in regard to themselves and their relationships to others in the work environment and, when present, can contribute to intrinsic job satisfaction. Our meaning‐making themes support the premise that CNAs do not passively accept the evaluations of others but instead actively frame identities that validate their importance to residents and the institution. (shrink)

This pilot study explores four nursing leaders' experiences with the ethical dimensions of leadership in education. Gathering and interpreting such data of experience fosters greater understanding of the nature of moral leadership as it is lived in nursing education. A phenomenological approach was used to collect and analyze the data. The results revealed four major themes: integrity, justice, wrestling with decisions in the light of consequences, and the power of information. These themes clarify the values that direct these leaders' actions (...) as they mediate community needs common to educational and health care institutions. (shrink)

The Second Edition of this celebrated book by two of the world's leading researchers in social work introduces readers to the main theories, theorists and perspectives that contribute to the debate on social work theory and social work ...

This study focused on the influence of American and Chinese cultures on consequentialism orientation in decision-making within the broader context of psychologists’ academic roles and responsibilities. In addition, this study hypothesized that educational level would affect culturally influenced ethical decision making in both cultures. Based on the American Psychological Association Ethics Code, 20 ethical scenarios in 5 domains in psychology were created and used to examine the influence of culturally ethical beliefs on psychologists’ decision making among 181 participants. The results (...) indicated that significant cultural differences in consequentialism orientation differentiated Chinese and American participants and influenced their resolution of ethical issues. (shrink)

In this paper we suggest an alternative approach to ethics in social work: virtue ethics. We argue that Habermas's theory of communicative action and discourse ethics needs to be supplemented with virtue ethics to provide an account useful to social work. In these times, sensitivity to others is needed for social work to succeed as a profession interested in combating the complacency, self-interest and lack of compassion evident in cutbacks to social welfare programmes and the resultant concerns with outcomes and (...) efficiencies that have all but obliterated care and compassion. We see in Habermas a furthering of Aristotelian and Thomist philosophy, most importantly with respect to his focus on emancipatory knowing?the critically reflective knower who knows self as the person doing the knowing. Habermas's distinction between values (objective), ethics (social) and morals (subjective) makes the province of emancipatory knowing (his epistemological theory) consistent with his moral theory?morality is personal. (shrink)

Older people enter the final phases of their lives with well‐established habits and rituals, some of which might be or become substance abuse. This inquiry focused on the relationship between habits, rituals, and the compulsive addictive behaviours evident in older persons' substance abuse. Habits and rituals, examined as adaptive and limiting functions in older persons, revealed changes in autonomy, social inclusion, and emotional responses to such changes as older persons experience declining energy reserves and physical debilities. Older persons' ebbing sense (...) of control and passionate responses to change illustrate the perennial struggle between the will and emotions when habits and rituals transform to compulsive addictive behaviours. Two concepts, germane to this struggle both in older persons' addictive behaviours and nurses' response, emerged from this inquiry: temperance, a balance between the will's freely chosen actions and passionate desire, and discipline, the means to achieve such balance. The focused attention demanded in discipline can be realized in spiritual exercises and daily care of the soul. Disciplined actions engage the older persons' imaginative capacities to manage and abandon the self in goals consistent with end‐of‐life issues: meaningful fulfillment of human potential and the need for daily joy and pleasure in living the final years. (shrink)