In the United States, disease screening is offered to the public as a consumer service. It has been proposed that the act of “consumption” is a manifestation of agency and that the decision to consume is an exercise of autonomy. The enthusiasm of the American public for disease screening and the expansion in the demand for all sorts of disease screening in recent years can be viewed as an expression of such autonomy. Here, we argue that the enthusiasm for disease (...) screening witnessed in the American public today may be more a reflection of the constraint on autonomy than its facilitation. It is our opinion that the articulation of socio-historical processes has contributed to a moral imperative which is reflected in the decision making of individuals around disease screening. We suggest medical and health professionals have a responsibility to facilitate the exercise of individual autonomy in health care decision making as an integral component of professional obligation. These professionals need to problematise healthcare activities that constrain individual autonomy. (shrink)

This book represents the most comprehensive attempt to date to explore and test Derrida's contribution and influence on the study of theology, biblical studies, and the philosophy of religion. Over the course of the last decade, the writings of Derrida and the key concepts that emerge from his work such as the gift, apocalypse, hospitality, and messianism have wrought far-reaching and irresistible changes in the way that scholars approach biblical texts, comparative religious studies, and religious violence, for instance, as well (...) as the way they understand basic religious themes as myth, creation, forgiveness, one-ness, and multiplicity. In addition to original contributions from over twenty highly-regarded scholars including John Caputo, Daniel Boyarin, Edith Wyschogrod, Tim Beal, and Gil Anidjar, the volume opens with a lengthy interview with Derrida. (shrink)

We discuss cases where subjects seem to enjoy conscious experience when the relevant first-order perceptual representations are either missing or too weak to account for the experience. Though these cases are originally considered to be theoretical possibilities that may be problematical for the higher-order view of consciousness, careful considerations of actual empirical examples suggest that this strategy may backfire; these cases may cause more trouble for first-order theories instead. Specifically, these cases suggest that (I) recurrent feedback loops to V1 are (...) most likely not the neural correlate of first-order representations for conscious experience, (II) first-order views seem to have a problem accounting for the phenomenology in these cases, and either (III) a version of the ambitious higher-order approach is superior in that it is the simplest theory that can account for all results at face value, or (IV) a view where phenomenology is jointly determined by both first-order and higher-order states. In our view (III) and (IV) are both live options and the decision between them may ultimately be an empirical question that cannot yet be decided. (shrink)

The question of whether grammaticality is a binary categorical or a gradient property has been the subject of ongoing debate in linguistics and psychology for many years. Linguists have tended to use constructed examples to test speakers’ judgements on specific sorts of constraint violation. We applied machine translation to randomly selected subsets of the British National Corpus (BNC) to generate a large test set which contains well-formed English source sentences, and sentences that exhibit a wide variety of grammatical infelicities. We (...) tested a large number of speakers through (filtered) crowd sourcing, with three distinct modes of classification, one binary and two ordered scales. We found a high degree of correlation in mean judgements for sentences across the three classification tasks. We also did two visual image classification tasks to obtain benchmarks for binary and gradient judgement patterns, respectively. Finally, we did a second crowd source experiment on 100 randomly selected linguistic textbook example sentences. The sentence judgement distributions for individual speakers strongly resemble the gradience benchmark pattern. This evidence suggests that speakers represent grammatical well-formedness as a gradient property. (shrink)

Background:Within nursing, the concepts of home and homelike have been used indiscriminately to describe characteristics of healthcare settings that resemble a home more than an institution.Objectives:The aim of this study was to investigate the concept of home. The main questions were as follows: What does the concept of home entail etymologically and semantically? Of what significance is the meaning of the concept to caring science and nursing?Design and methods:This study had a qualitative design with a hermeneutical approach guided by Gadamer. (...) Eriksson’s model of concept determination was partly used to determine the etymology and semantics, the essence and epistemic category of the concept of home. In this study, etymological dictionaries and 17 Swedish language dictionaries published between 1850 and 2001 were investigated.Ethical consideration:In all parts of this study, ethical guidelines have been followed concerning both gathering data from dictionaries and other sources and during the interpretation of these sources.Findings:The home, framed as the ethos of caring, can be drawn as a three-dimensional picture where the three dimensions have a common core, enclosed and inviolable. Symbolically, the picture of home can be seen as the ethos of the human being’s innermost room, the human being’s manner of being and the tone expressed in the external or abstract room where the human being lives and interacts with others.Conclusion:Based on the findings in this study, we conclude that home as ethos is an inner ethical dimension within the human being. Human beings who are in contact with their ethos, the self, feel at home and dare to follow the voice of their heart. Nurses who experience at-homeness have an ability to invite the patient into a caring relationship. The home and the feeling of being at home have significant meaning in terms of human beings’ health and well-being. (shrink)

This study focuses on the cultural context of ethical decision making by considering the relationship between power distance and ethical judgment. Specifically, we propose that this relationship exists because of the influence of peers on ethical judgment and perceptions of justice. Considering the importance of peers in stage three of Kohlberg's model of moral development, we argue that peers are the basis for social comparisons, social cues and social identification and, hence, are critical to an individual's beliefs about justice. Using (...) scenarios developed by Reidenbach and Robin, data were collected from German and Italian graduate business students. Germany and Italy differ substantially in power distance, but not in the three other cultural dimensions of Hofstede. Results show that the ethical assessment of the respondents from the two countries differs when justice criteria are used. Theoretical and practical implications of the results are discussed. (shrink)

In this paper, we explore the concept of virtue in nursing care. We particularly examine the description of ‘virtue’ offered by Aristotle, who considers it the mental constitution that forms the basis for laudable social behaviour. We then turn to Katie Eriksson's work on caritative caring ethics and draw parallels between the Aristotelian concept of virtue and being a good nurse. Eriksson suggests that embracing an ethos, a set of basic values, affects nurses’ attitudes as well as the way they (...) speak and take on their responsibility for the patient. We discuss these ideas in relation to a tentative ideal model of the movement from ethos to action to understand and address nurses’ ethical thinking and acting. Here, we focus on the catalytic role of virtue as a means for realizing a deliberate, intentional acting with the best of the patient in mind. As an outcome of our analysis, we suggest that the movement of virtue from ethos to action is most usefully conceptualized as knowledge about facts, habits of the heart, deeds of the hand and the power of words. Implications for nursing leadership are suggested, including incorporating organizational values through the means of ethical conversations. (shrink)

This study focuses on the cultural context of ethical decision making by considering the relationship between power distance and ethical judgment. Specifically, we propose that this relationship exists because of the influence of peers on ethical judgment and perceptions of justice. Considering the importance of peers in stage three of Kohlberg's model of moral development, we argue that peers are the basis for social comparisons, social cues and social identification and, hence, are critical to an individual's beliefs about justice. Using (...) scenarios developed by Reidenbach and Robin, data were collected from German and Italian graduate business students. Germany and Italy differ substantially in power distance, but not in the three other cultural dimensions of Hofstede. Results show that the ethical assessment of the respondents from the two countries differs when justice criteria are used. Theoretical and practical implications of the results are discussed. (shrink)

Although there has been significant work on aesthetic snobbery and its ethical implications, much less work has been done on the aesthetic normie (normie for short). The normie is someone who primarily engages with popular aesthetic items. I argue that the normie is motivated by a drive towards sociality to connect with others and to rely on them given limited resources and time. I argue that the normie who is motivated by this drive will limit their aesthetic range and depth. (...) This makes it harder for them to access new aesthetic experiences, distorts their ability to accurately appraise others, and makes it harder for them to connect with others. Nonetheless, I argue that we can achieve the goods of sociality by being aesthetically open. Expanding our willingness to engage with new aesthetic items and to develop and share more informed aesthetic judgments allows us to access more aesthetic values, appraise each other more accurately, and form valuable aesthetic communities. (shrink)

Hong Kong is a territory of only 400 square miles in size, but with a large population of six million people. We have excellent medical facilities in both the public and private sector and the general health indices of the population are good, with low infant mortality rates and long life expectancies.

Yet, he also says that it is philosophically indeterminate which criterion for what exists is correct. Nominalism is the view that certain objects ( i.e ., abstract objects) do not exist, and not the view that it is philosophically indeterminate whether or not they do. I resolve the dilemma that Azzouni's claims pose: Azzouni is a non-factualist about what exists, but he is a factualist about which criterion for what exists our community of speakers has adopted. It is in the (...) latter sense only that Azzouni can call himself a nominalist. My thanks to Jody Azzouni and to an anonymous referee for helpful suggestions. CiteULike Connotea Del.icio.us What's this? (shrink)

This book is about the basic principles that underlie critical thinking and creativity. The majority of the content is on critical thinking since more topics are naturally involved and since they can be discussed readily and systematically. The last few chapters are devoted to creativity and research methodology, not typical the book's plethora of competition. Each chapter introduces a specific topic, usually by introducing the relevant theories in conjunction with realistic examples that show how the theories can be applied. Each (...) chapter concludes with a set of exercises whose solutions are detailed at the rear of the book. While the writing style is purposefully informal, the presentation is complete, at least with respect to the intended introductory level. (shrink)

Women generally initiate, lead, and constitute the rank and file of environmental justice activism. However, there is little research on why there are comparatively so few men involved in these movements. Using the environmental justice movement in the Central Appalachian coalfields as a case study, we examine the ways that environmental justice activism is gendered, with a focus on how women’s and men’s identities both shape and constrain their involvement in gendered ways. The analysis relies on 20 interviews with women (...) and men grassroots activists working for environmental justice in the coalfields of Appalachia. We find that women draw on their identities as “mothers” and “Appalachians” to justify their activism, while the hegemonic masculinity of the region, which is tied to the coal industry, has the opposite effect on men, deterring their movement involvement. We explore the implications of these findings for understanding the relationship of gender to environmental justice activism. (shrink)

How should we measure metacognitive sensitivity, i.e. the efficacy with which observers’ confidence ratings discriminate between their own correct and incorrect stimulus classifications? We argue that currently available methods are inadequate because they are influenced by factors such as response bias and type 1 sensitivity . Extending the signal detection theory approach of Galvin, Podd, Drga, and Whitmore , we propose a method of measuring type 2 sensitivity that is free from these confounds. We call our measure meta-d′, which reflects (...) how much information, in signal-to-noise units, is available for metacognition. Applying this novel method in a 2-interval forced choice visual task, we found that subjects’ metacognitive sensitivity was close to, but significantly below, optimality. We discuss the theoretical implications of these findings, as well as related computational issues of the method. We also provide free Matlab code for implementing the analysis. (shrink)

In 2009, with the enactment of the Lisbon Treaty, the Charter of Fundamental Rights of the European Union entered into force. Under Article 8 of the Charter, for the first time, a stand-alone fundamental right to data protection was declared. The creation of this right, standing as a distinct right to the right to privacy, is undoubtedly significant, and it is unique to the European legal order, being absent from other international human rights instruments. This commentary examines the parameters of (...) this new right to data protection, asking what are the principles underpinning the right. It argues that the right reflects some key values inherent in the European legal order, namely: privacy, transparency, autonomy and nondiscrimination. It also analyses some of the challenges in implementing this right in an era of ubiquitous veillance practices and Big Data. (shrink)

Spätestens am Beginn der 80er Jahre dieses Jahrhunderts entstand in den Geistes-und Sozialwissenschaften eine Renaissance des Ästhetischen, die bis heute andauert. Der Ästhetik wird, besonders unter dem Eindruck von Sinn­ verlust und Orientierungslosigkeit, eine besondere Leistungsfähigkeit zuge­ schrieben. Sie wird, beginnend bei speziellen Kunst-und Musiktherapien bis hin zur "Ästhetisierung des Alltags" als Mittel gegen gesellschaftliche und individuelle Probleme, seien es Jungendgewalt, Naturzerstörung, kulturelle Integration, Beziehungsschwierigkeiten oder Neurosen angeboten. Diese Beispiele stehen für ein Phänomen, welches in diesem Buch mit der Wen­ (...) dung "Versprechungen des Ästhetischen" gekennzeichnet wird. Diese Ver­ sprechungen werden heute in vielen gesellschaftlichen Bereichen als Innova­ tion offeriert und gefeiert, so daß der Eindruck vermittelt wird, daß das Medium des Ästhetischen zu keinem früheren historischen Zeitpunkt für sol­ che ethischen Absichten zur Verfügung gestanden habe. Dieser Eindruck ist indessen völlig falsch. Um zu zeigen, daß diese "Versprechungen des Ästhetischen" viel älter sind, ja daß diese Verspre­ chungen einen Toposcharakter haben, der besonders in gesellschaftlichen Krisenlagen eingesetzt wird, rekonstruiert Yvonne Ehrenspeck die Geschich­ te dieser Versprechungen seit dem Beginn ihrer modernen Version am Ende des 18. Jahrhunderts. Dieser Beginn lag in der Transzendentalphilosophischen Grundlegung des Ästhetischen bei Kant, eine Konzeption, die keineswegs, wie besonders in der "postmodernen" Ästhetikrezeption gern behauptet, als gesellschaftli­ ches Versprechen intendiert war, sondern als systematisches Schlußstück für die Transzendentalphilosophie Kants. Das Buch zeigt, wie dieses systemati­ sche Interesse Kants durch Schillers Ästhetik gewissermaßen zweckentfrem­ det wird. (shrink)

Wenn Bildung die Aneignung von Welt bedeutet, dann schienen lange Zeit insbesondere die hohen Freiheitsgrade dieser Aneignung entscheidend: "Erziehung ist eine Zumutung, Bildung ein Angebot".

In this article, I discuss the contribution of theoretical resources to the transformation in my thinking about professional development and accountability, within an action research self-study of practice as a civil servant, in the context of participation on the Doctor in Education programme at Dublin City University in the period 2008-2012. It is at the intersection of these subject positions, between theory and practice, that professional development was explored through the ‘leadership problem’ of encouraging trainer colleagues to investigate the educational (...) potential of information and communications technologies for the development of their practice. Ultimately, this constituted a critical space for sustained dialogue between the self and the social in exploring professional subjectivity. The resources discussed supported the interrogation of social, cultural and historical conditions influencing self-understanding and narrative reasoning and movement from strategic to communicative reasoning. It is claimed that this has significance for the development of a more educational training practice, which expresses a concern for subjectivity and agency in the face of a growing ‘performativity’ in professional life. (shrink)

After a regime-changing war, a state often engages in lustration—condemnation and punishment of dangerous, corrupt, or culpable remnants of the previous system—e.g., de-Nazification or the more recent de-Ba’athification in Iraq. This common practice poses an important moral dilemma for liberals because even thoughtful and nuanced lustration involves condemning groups of people, instead of treating each case individually. It also raises important questions about collective agency, group treatment, and rectifying historical injustices. Liberals often oppose lustration because it denies moral individualism and (...) ignores rule of law, and their only justifications for lustration are consequentialist ones. This article suggests that lustration may not necessarily be a problem for liberals. While group treatment might be justified on grounds of convenience and pragmatism in times of transitional justice, there are also valid moral arguments consistent with moral individualism and due process for wholesale group punishment after a war. This article offers four overlapping moral justifications, in a robust defense of the core concept of lustration that is covered by each argument. (shrink)

The social media industry lacks developed principles of professional ethics that it would need in order to better navigate the ethics of conforming to local media laws in authoritarian countries that lack meaningful protections for privacy, personal and political expression, and intellectual property. This chapter analyzes this question through three frameworks of professional ethics—journalism ethics, technology ethics, and business ethics—and the ways that social media resembles and crucially differs from these three industries.

Contemporary international law separates the international justice of war from the domestic justice of society, but empirically, there is a correlation between democratic governance and military effectiveness, which could have a number of causes. A contemporary reconstruction from _The Seven Military Classics_ of Chinese military philosophy offers potential lessons for how domestic virtues may yield military and geopolitical victory. This chapter reconstructs arguments from the seven treatises into a collective an amalgamated conception of “good governance” that weaves together military strategy (...) and virtue ethics and maintains that good governance at home actually wins wars abroad. A reconstructed classical Chinese conception of “good governance” presents theoretical and ethical challenges, but also offers viable justicial content for contemporary jus ad bellum considerations beyond sovereign self-defense or human rights. It presents a way of instantiating the sprawling conception of human rights that falls short in contemporary discourse. (shrink)

The Finnish nursing theorist Katie Eriksson's (1943–2019) theory of caritative caring represents a non‐medical paradigm concerning the phenomena of nursing. The aim of this article was to present an oversight of the development of Eriksson's theory of caritative caring from a human science point of view. The historical development of the theory is outlined, combined with a brief overview of its philosophical connections, its impact on contemporary caring science research and its implications for nursing care. Caring science is considered a (...) human science in the Nordic tradition, as it is deeply rooted in basic issues of human life and existence. The key ideas of Eriksson's theory of caritative caring are linked to the metaparadigm concepts of human being, health and suffering, caring and environment. All of these are permeated with the ethos of caritative caring, that is, the caritas thought of human love and mercy, and the honouring of the absolute dignity of human beings. Epistemologically, Gadamer is the most influential philosopher when it comes to the theory of caritative caring. Eriksson's theory is used in, for example, intercultural caring, caring for patients suffering from addiction, the importance of aesthetic surroundings, providing ethically good care for older people and mothers as patients in psychiatric care. In these fields of research, Eriksson's ideas of ethics, caring and suffering are highlighted in various clinical contexts. Beyond the areas of nursing care in which Eriksson's work has been cited and developed, there are at least two areas that have been actively enhanced by her works: the field of leadership and education for nursing teachers. According to Eriksson, it is momentous to ponder scientific results as not limited to empirically strengthened, randomized outcomes. Part of making the results of scientific work evident is up to the individual nurses and their being in the world. (shrink)

Does a human right to healthcare imply individual obligations to healthy behavior? Or put another way: Is a self-induced condition a relevant criterion for some sort of restriction of this right—like withholding or modifying treatment in circumstances where choices have to be made? For instance, should a drunk driver bear the costs of medical care that he needs after a car accident he has caused? Should there be a difference in healthcare entitlements between the smoker with a heart attack who (...) is seriously overweight and the 60-year old man who has always taken excellent care of himself and is suddenly stricken by leukemia? And how should we think about the risk-taking behavior of all the persons going on a skiing holiday or an exotic hiking trip? a. (shrink)

Critics have often misunderstood the higher-order theory (HOT) of consciousness. Here we clarify its position on several issues, and distinguish it from other views such as the global The higher-order theory (HOT) of consciousness has often been misunderstood by critics. Here we clarify its position on several issues, and distinguish it from other views such as the global workspace theory (GWT) and early sensory models (e.g. first-order local recurrency theories). For example, HOT has been criticized for over-intellectualizing consciousness. We show (...) that while higher-order states are cognitively assembled, the requirements are actually considerably less than often presumed. In this sense HOT may be viewed as an intermediate position between GWT and early sensory views. Also, we clarify that most proponents of HOT do not stipulate consciousness as equivalent to metacognition or confidence. Further, compared to other existing theories, HOT can arguably account better for complex everyday experiences, such as of emotions and episodic memories. This makes HOT particularly useful as a framework for conceptualizing pathological mental states. (shrink)

Objectives: Initially, we analyzed relations between the challenging working conditions of flight attendants with symptoms of depression, anxiety and stress. As the COVID-19 pandemic plunged airlines into an unprecedented crisis, its impact on the mental health of flying cabin crews became the focus of a second survey.Methods: Flight attendants were surveyed online with DASS-21 in May 2019 and April 2020, complemented with questions about working conditions and existential fears and fear of job loss.Results: Sample 1 revealed that symptoms of depression, (...) anxiety and stress highly correlated with the subjective assessment of working conditions, but not with objectifiable parameters. Sample 2 showed significant positive correlations between existential fears and fear of job loss with depression, anxiety and stress. Crew members, grounded in April 2020, showed significantly higher scores in depression and stress, while still flying individuals had more clinically relevant symptoms of anxiety. Mean value comparisons between sample 1 and 2 in DASS-21 revealed a significant increase in symptoms at the time of crisis with effect sizes of d = 0.63 for depression, d = 0.26 for anxiety, and d = 0.52 for stress. The incidence of clinically relevant symptoms among the respondents increased from 8 to 23%, from 6 to 14%, and from 8 to 24%.Conclusion: The COVID-19 pandemic and associated work restrictions coincide with severe impairment of mental health of flying cabin crews, consistent with a mental health protecting function of labor. (shrink)

2020 Center for Biblical Studies Book Award (New Testament) Our culture often views shame in a negative light. However, Paul's use of shame, when properly understood and applied, has much to teach the contemporary church. Filling a lacuna in Pauline scholarship, this book shows how Paul uses shame to admonish and to transform the minds of his readers into the mind of Christ. The author examines Paul's use of shame for moral formation within his Jewish and Greco-Roman context, compares and (...) contrasts Paul's use of shame with other cultural voices, and offers a corrective understanding for today's church. Foreword by Luke Timothy Johnson. (shrink)

*North American Society for Social Philosophy (NASSP) Book Award 2019.* -/- *International Studies Association (ISA) - International Ethics Section Book Award 2021.* -/- Although military mores have relied primarily on just war theory, the ethic of cooperation in warfare (ECW)—between enemies even as they are trying to kill each other—is as central to the practice of warfare and to conceptualization of its morality. Neither game theory nor unilateral moral duties (God-given or otherwise) can explain the explicit language of cooperation in (...) developing and enforcing principles of military ethics and the law of armed conflict. -/- The ethic of cooperation is borne of various motivations: reciprocity, self-preservation, and efficiency, to be sure, but also a sense of warrior honor and concern with human rights. This shared morality can persist despite making it more difficult for one side or the other to win and, unfortunately, its well-meaning motivations often lead to unintended tragic consequences. -/- This book explores three manifestations of this significant yet overlooked ethic of cooperation in warfare: (1) for a “fair fight,” (2) to protect classes of individuals (e.g., non-combatants or prisoners of war), and (3) to end the war quickly. Such cooperation can take unexpected forms, from ad hoc decisions on the battlefield to institutionalization in international law, and is the source of some critical tensions in one of the most significant developments in warfare in recent years: namely, how to handle terrorism or other forms of warfare that lie outside the purview of international law. -/- Each type of ECW raises questions internal to that ethic, such as inconsistencies in the concept of “parity” across different weapons bans, contradictions within the warrior ethic that heavily influence—and therefore confuse—notions of the “fair fight,” the disconnect between what protections a person receives and his responsibility for the war (e.g., political leaders), or the limited decisiveness of outcomes generated by very short wars. -/- Their simultaneous application also generates significant tensions and raises questions about the proper relationship of ECW to the immediate goal of war itself, which is to win, and thus yield either a political settlement or a justicial decision. For example, the ECWs for a “fair fight” and to protect classes of individuals can make it harder to win the war, but even more concerning is that they can also kill more people, which in the latter case contravenes its very purpose. -/- Human history is in some ways the story of trying to concurrently wage and tame war, and the architecture of warfare itself is informed by the ECW, in particular: (a) the political nature of war, (b) the abdication from jus ad bellum judgments in order to concentrate on justice within war (jus in bello), and (c) the ways in which modern nation-states collude to define “legitimacy” in war. -/- The combination of these three features leave questions of justicial right and responsibility for war disturbingly unresolved, it also generates new challenges in a geopolitical context in which cooperative and non-cooperative (e.g. contemporary terrorism) forms of warfare clash. (shrink)

The American Journal of Bioethics, Volume 12, Issue 10, Page 12-14, October 2012.

This study investigates whether and to what extent publicly listed corporations voluntarily comply with and disclose recommended good corporate governance practices, and distinctively examines whether the observed cross-sectional differences in such CG disclosures can be explained by ownership and board mechanisms with specific focus on Saudi Arabia. The study’s results suggest that corporations with larger boards, a Big 4 auditor, higher government ownership, a CG committee, and higher institutional ownership disclose considerably more than those that are not. By contrast, the (...) study finds that an increase in block ownership significantly reduces CG disclosure. The study’s results are generally robust to a number of econometric models that control for different types of disclosure indices, firm-specific characteristics, and firm-level fixed effects. The study’s results have important implications for policy makers, practitioners, and regulatory authorities, especially those in developing countries across the globe. (shrink)

Within contemporary health care, many of the decisions affecting the health and well-being of patients are not being made by the clinicians or health professionals, but by those involved in health care management. Existing literature on organizational ethics provides insight into the various structures, processes and strategies - such as mission statement, ethics committees, ethical rounds … - that exist to create an organizational climate, which fosters ethical practices and decision-making It does not, however, show how health care managers experience (...) their job as being intrinsically ethical in itself. In the present article, we investigate the way in which ethical values are present in the lived experiences and daily practice of health care management. What does it imply to take up a managing position within a health care institution and to try to do this in an ethically inspired way? We carried out a qualitative study (Grounded Theory Approach) to explore the essence of values-based leadership in health care. We interviewed 15 people with extensive experience in health care management in the fields of elderly care, hospital care and mental health care in the various regions of Flanders, Belgium. Six predominant themes, presented as metaphors, illustrate the essence of values-based leadership in health care management. These are: (1) values-based health care management as managing a large garden, (2) as learning and using a foreign language, (3) going on a trekking with an ethical compass, (4) embodying integrity and authenticity in a credible encounter with everyone, (5) being a present and trustworthy leader during sun and storm, and (6) contributing to human flourishing by giving people wings to fly. Notwithstanding the importance of organizing a good ethics infrastructure, values-based leadership in health care entails much more than that. It is about the co-creation of an integrated and comprehensive ethical climate of which community-model thinking and authentic leadership are essential components. As a never-ending process, the six metaphors can help leaders to take substantive proactive steps to shape a fruitful ethical climate within their organization. (shrink)