Background The fourth section of the 1967 Abortion Act states that individuals (including health care practitioners) do not have to participate in an abortion if they have a conscientious objection. A conscientious objection is a refusal to participate in abortion on the grounds of conscience. This may be informed by religious, moral, philosophical, ethical, or personal beliefs. Currently, there is very little investigation into the impact of conscientious objection on service users in Britain. The perspectives of service users are (...) imperative in understanding the real-world consequences and potential impact of conscientious objection and should be considered when creating and reviewing policies and guidelines. This research provided a platform for women and those who can become pregnant to share their experiences and opinions at a time when these voices are largely excluded in the great tradition of Western political philosophy and law-making processes. Method Five service users were interviewed using a narrative interview approach to uncover their abortion journeys and experiences of conscientious objection. Findings The findings were presented as found poems and uncovered that doctors are not always: informing service users that they have a conscientious objection to abortion, giving service users enough information to access abortion (indirect referral), treating them non-judgmentally, and providing medically correct information. Service users did not experience burdens such as long waiting times and were still able to access legal abortion. However, service users did experience negative emotional effects, as they were often left feeling scared, angry, and hopeless when they were not referred and/or were mistreated. Conclusions Findings indicate that conscientious objection could work in practice. However, it is currently failing some individuals on an emotional level, as not all doctors are adhering to guidelines. Conscientious objection in Britain needs to be addressed, to ensure service users receive fair, impartial, non-judgmental care. (shrink)

Our goal was to explore self‐care practices among men who have sex with men in the context of Mpox in Brazil. This study used qualitative research methods, including interviews and thematic analysis, to collect and analyze data from male participants across the Brazilian territory. The narratives unveil men's perspectives on self‐care, risk reduction, and health beliefs during the Mpox pandemic. Our findings highlight a multifaceted approach to self‐care among men, encompassing hygiene, physical contact (...) management, mask usage, skin lesion vigilance, and adherence to official guidelines. Men's attitudes toward sexual behaviors emphasize the importance of reducing sexual partners, practicing safe sex, and combating misinformation through accurate information dissemination. The development of these behaviors and self‐care practices can be facilitated by nurses guided by Dorothea Orem's Self‐Care Theory, supported by patient‐centered care, with strategies to address and confront the stigma associated with the disease and provide emotional support. Thus, the study underscores the pivotal role of self‐care in mitigating infection risks, especially in the context of emerging infectious diseases. It acknowledges the impact of socio‐cultural factors and healthcare policies on men's preventive measures. However, it also recognizes limitations, such as potential bias due to stigma concerns and a nonrepresentative sample. Ultimately, the research advocates for tailored education, promotion of gender equity, and healthcare empowerment to effectively manage health risks in such contexts. (shrink)

Although Nietzsche scholars have paid close attention to his aphoristic and rhetorical style, few have focused on his practice of writing prefaces. In this paper, I engage in a close reading of Nietzsche’s prefaces and identify five themes present in his earlier and later prefaces: (1) he speaks directly to his readers, (2) he stresses the necessity of slow and careful reading, (3) he encourages readers to trust themselves, (4) he refers to himself as a herald, and (5) he uses (...) combative and polemical language to describe his work. Given these themes, I conclude that Nietzsche’s preface writing project constitutes a practice of self-care as described by Foucault in “Technologies of the Self” and “The Ethics of the Concern for Self as a Practice of Freedom.”. (shrink)

The paper studies two fundamentally different forms in which the concept of care makes its comeback in twentieth-century thought. We make use of a distinction made by Peter Sloterdijk, who argues that the ancient and medieval ‘ascetic’ ideal of self-enhancement through practice has re-emerged in the nineteenth and twentieth centuries, particularly in the form of a rehabilitation of the Hellenistic notion of self-care (epimeleia heautou) in Michel Foucault’s late ethics. Sloterdijk contrasts this return of self- (...) class='Hi'>care with Martin Heidegger’s concept of being-in-the-world as ‘total care’ (Sorge), an utterly ‘secularized’ understanding of the human being as irreducibly world-embedded that rejects the classical ascetic ideal of world-secession. We examine further the historical roots and emergence of these contrasting contemporary reappropriations of care in the Western tradition of thought and show them to be rooted in two different ontologies and ethics of the self as either world-secluded or world-immersed, autonomous or constitutively relational. The historical point of divergence of these two approaches to care, we argue, can be found in the Christian transformation of Hellenistic ethics. (shrink)

IntroductionPalliative care is an emotionally and spiritually high-demanding setting of care. The literature reports on the main issues in order to implement self-care, but there are no models for the organization of the training course. We described the structure of training on self-care and its effects for a Hospital Palliative Care Unit.MethodWe used action-research training experience based mostly on qualitative data. Thematic analysis of data on open-ended questions, researcher’s field notes, oral and written (...) feedback from the trainer and the participants on training outcomes and satisfaction questionnaires were used.ResultsFour major themes emerged: “Professional role and personal feelings”; “Inside and outside the team”; “Do I listen to my emotions in the care relationship?”; “Death: theirs vs. mine.” According to participants’ point of view and researchers’ observations, the training course resulted in ameliorative adjustments of the program; improved skills in self-awareness of own’s emotions and sharing of perceived emotional burden; practicing “compassionate presence” with patients; shared language to address previously uncharted aspects of coping; allowing for continuity of the skills learned; translation of the language learned into daily clinical practices through specific facilitation; a structured staff’s support system for emotional experiences.DiscussionSelf-care is an important enabler for the care of others. The core of our intervention was to encourage a meta-perspective in which the trainees developed greater perspicacity pertaining to their professional role in the working alliance and also recognizing the contribution of their personal emotions to impasse experienced with patients. (shrink)

Patient-centered care is now recognized as a clinical method and ideal model for patient – health professional relationships, and many definitions have influenced its evolution. Overall the patient-centered care literature has provided relatively little to define patient-centered care at the level of the patient-professional relationship. Additionally, patient-centered care lacks grounding in ethical theory. This thesis asserts that theoretical concepts from the ethics of care can provide a stronger conceptual basis for patient-centered care.This thesis begins (...) with a critical interpretive review of the patient-centered care literature, yielding 12 articles that previously introduced new theoretical and definitional work on patient-centered care and patient-centered communication. Six common themes and ideas were discovered, and include Engaging the Patient as a Whole Person, Recognizing and Responding to Emotions, Fostering a Therapeutic Alliance, Promoting an Exchange of Information, Sharing Decision Making, and Enabling Self-Management and Patient Navigation. These elements were then compared to key elements of the ethics of care. This thesis argues that feminists have good reason to consider care as a type of moral duty, and it describes how this duty functions. This thesis also argues that a duty to care is triggered when caregivers are presented with particular substantive forms of vulnerability. Specifically, this thesis argues that vulnerable subjects whose constitutive needs are at risk require particular moral obligations. The links between the ethics of care and patient-centered care are discussed, including how an ethics of care response ought to function in the health care context. Finally, the cases of J.J. and Makayla Sault, two aboriginal girls who refused chemotherapy in favour of traditional aboriginal healing practices, are analyzed. This thesis offers a short scoping review of the bioethics discourse surrounding these cases. A review of this discourse revealed several common themes, which included the peripheral importance of culture and history, the equating of best interests with survival, the supremacy of science-based medicine, and the impartial application of ethical principles. This thesis recommends that health care professionals apply an ethics of care approach to similar ethical dilemmas in the future, which involves shifting one's ethical focus to the central relationships of the case, understanding the unique perspective of the patient's narrative, and promoting a care-based rather than a justice-based approach to problem-solving. (shrink)

Recent feminist accounts of autonomy have focused both on autonomous agents’ relationships to others and on their self-regarding attitudes or self-relations. This chapter focuses on the attitude of practical self-care, arguing that autonomous agents must care about themselves in a sense that amounts to caring about their practical reasons. While self-care is primarily a self-relation, it also implies a form of interpersonal relationality. Caring about one’s reasons requires caring about intersubjective assessments thereof, (...) and the relation of self-care thus implies openness to the reasons of others and a disposition to hold oneself answerable for one’s identity-constituting concerns. (shrink)

I wish to take up the subject ... in relation to a set of practices in late antiquity. Among the Greeks, these practices took the form of a precept: epimeleisthai sautou, "to take care of yourself," to take "care of the self," "to be concerned, to take care of yourself."The precept of the "care of the self" [souci de soi] was, for the Greeks, one of the main principles of cities, one of (...) the main rules for social and personal conduct and for the art of life. For us now, this notion is rather obscure and faded. (Foucault, TS, 19). (shrink)

Internet companies place a high priority on the safety of their services and on their corporate social responsibility towards protection of all users, especially younger ones. However, such efforts are undermined by the large numbers of children who circumvent age restrictions and lie about their age to gain access to such platforms. This paper deals with the ethical issues that arise in this not-so-hypothetical situation. Who, for instance, bears responsibility for children’s welfare in this context? Are parents/carers ethically culpable in (...) failing to be sufficiently vigilant or even facilitating their children’s social media use? Do industry providers do enough to enforce their own regulations and remove those users they know to be underage? How far does a duty of care extend? Regulation of age restrictions has, it is argued, created unintended consequences that heighten online dangers for young people. While children are inevitably drawn to new online spaces for entertainment and fun, should their rights to participate in the social world around them be curtailed to ensure their best interests and those of the wider community? Such questions now pose significant practical and ethical dilemmas for policy makers and other stakeholders involved in internet governance. It especially highlights the question of responsibility for protection of minors online and calls into question whether the current model of shared responsibility is working. (shrink)

At the heart of soul care is self-care. Being able to love God and love others is rooted in how we love ourselves. Each person’s understanding of self-care is informed by their personal belief system and their implementation practices. This article will provide a multi-phasic model that describes the self-care journey and focuses on how to implement self-care practices. A key distinction of this model is that it is used (...) in an ongoing fashion. To avoid confusion between beliefs and practice, attention will be given to the decision-making process for self-care implementation. Specific activities that address the physical, mental, emotional, spiritual, and relational parts of people will be discussed. The article will also consider the nuances of assessing self-care and why it is important to value self-care, which is in keeping with the greatest commandments provided by Jesus in Mark 12:28–30. (shrink)

Psychologists, as well as other mental health professionals, face unique demands in the workplace that create increased risk for burnout. This article discusses burnout prevalence and detection, including issues of complexity regarding diagnosis and assessment. An ethical lens is utilized to explore problems that may arise due to burnout, and the ethical responsibility of practicing self-care. Recommendations for graduate clinical training programs as well as practicing professionals are suggested, including strategies for monitoring self and others for warning (...) signs of burnout and implementing self-care. (shrink)

Introduction -- Healing justice and whole self-care -- Oppression, trauma, and healing justice -- Stress and the self-care revolution -- The whole self -- A skillful path of healing justice -- Holistic self-care practices and skills -- Connecting to the body -- Befriending the mind-heart -- Rediscovering spirit -- In the fabric of community -- Cultivating connections between person and planet -- Where the rubber meets the road -- The healing justice organization (...) -- Healing justice on the frontlines -- Widening the circle and coming home -- Notes -- Index. (shrink)

Clinical ethics consultants are inevitably called to participate in and bear witness to emotionally challenging cases. With the move toward the professionalization of ethics consultants, the responsibility to respond to and address difficult ethical dilemmas is likely to fall to a small set of people or a single clinical ethicist. Combined with time constraints, the urgent nature of these cases, and the moral distress of clinicians and staff encountered during consultation, like other healthcare professionals such as physicians and nurses, clinical (...) ethics consultants could risk burnout. If it is true that clinical ethicists are at risk for burnout, an important strategy to avoid burnout is to develop sound self-care practices. This article reviews the goals and skills of ethics consultation and the role-specific reasons that clinical ethicists may be at risk for burnout, and argues that clinical ethicists may need to engage in self-care practices. Strategies to address burnout are reviewed and opportunities for future research are identified. (shrink)

This paper will explore both the ways in which the practices of self-care, specifically related to mental health, have emerged as responses to the increasingly precarious status of life after the economic shocks of the Global Financial Crisis, whilst also looking to the work of Silvia Federici and Kathi Weeks to propose models for immanent critique of these practices. Although it cannot be taken as a pure origin, post-GFC mental health discourse has increasingly seen mental health (...) discussed as a form of resilience to precarity. Furthermore, practices of self-care, and psychological forms of treatment such as cognitive behavioural therapy have become vehicles for the intensification of personal resilience in the face of systemic crisis. If self-care involves an inward looking and depoliticised subject, surely political emancipation lies elsewhere. The possibility of some alternative to our present state of affairs, where self-care increasingly appears as a form of ‘voluntary servitude,’ that is to say, a form of self-subjugation with serious political risks, must surely be taken as a continual project for those engaged in critical inquiry. Then again, to suggest that those engaging in self-care are simply reproducing neoliberal subjectivity would surely miss the ways in which such forms of self-preservation might appear as unavoidable for the individuals in question. Through an engagement with their work—and one that draws parallels between their strategic critiques of reproductive labour broadly speaking, and the more specific area of mental illness and neoliberal governmentality—the question of the “necessity” of self-care will be brought into alignment with the possibilities of its practicality. (shrink)

Burnout among health professionals is at epidemic proportions. In response, many health institutions have emphasised the importance of self-care, relying particularly on the idea that doctors who are burned out provide worse care for their patients. Although not made explicit, this suggests that doctors might have a responsibility to their patients (and perhaps others) to practice self-care. This chapter explores the potential grounds for such an obligation. We suggest that while there is potential for a (...) limited obligation of self-care, institutional emphasis on this risks instrumentalising doctors' well-being, minimising institutional responsibilities and workers' rights, and being excessively demanding for individuals. (shrink)

This collection of essays examines urban communities and societies in Asia and the West to shed much-needed light on issues that have emerged as the world experiences its new urban turn. An urbanized world should be an improving place, one that is better to live in, one where humans can flourish. This book examines contemporary practices of care of the self in cities in Asia and the West, including challenges to citizenship and even the right to the (...) city itself. Written by a range of academics from different backgrounds (from architecture and urbanism, anthropology, social science, psychology, gender studies, history, and philosophy) their trans- and multidisciplinary approaches shed valuable light on what are sometimes quite old problems, leading to fresh perspectives and news ways of dealing with them. One thing that unites all of these papers is their people-centred approach, because, after all, a city is its people. (shrink)

This text through the direct use to Foucault’s work and using the concepts of ‘care of the self’ and biopolitics is questioning and analyzing resistance and practices of freedom. Mainly, from the Foucault’s courses at the College de France and the methodological tools found there, here I present a discussion about Gilles Deleuze’s contributions to Foucault’s thought and I develop a dialog where I try to explain the concepts of domination, power, ethics, esthetics and the relationship of (...) the self with himself. (shrink)

: This essay appropriates the understanding of ethics developed by Michel Foucault in his courses at the Collège de France from 1980 until his death in 1984, with the aim of formulating a progressive environmental politics. As such, it attempts to navigate some of the long–standing divides between the movement for animal rights and environmental ethics proper, finding in the practice of vegetarianism a form of self-relation that is conducive to critical forms of speech and politics. The final phase (...) of Foucault's work is replete with insights into how the care of the self can serve as a resistance to forms of power and political stasis. This paper presents these unpublished materials, allowing for a glimpse of the unknown Foucault, and reinterprets vegetarianism as a form of self-practice that is linked with truth and critical speech. (shrink)

Interviews with Community Supported Agriculture (CSA) growers in Iowa, a majority of whom are women, shed light on the relationship between gender and CSA as a system of resource management. Growers, male and female alike, are differentiated by care and caring-practices. Care-practices, historically associated with women, place priority on local context and relationships. The concern of these growers for community, nature, land, water, soil, and other resources is manifest in care-motives and care-practices. Their (...) specific mix of motives differs: providing safe and nutritious food, educating self and others, and building relationships with other growers, shareholder-members, and the land. Care-practices include reducing or eliminating chemical usage, encouraging or accepting beneficial insects and wildlife, building soil, and creating resource management partnerships with shareholder members. CSA, viewed through a lens of care, may offer a means of transcending gender stereotypes. (shrink)

BackgroundSocial support plays an important role for health outcomes. Support for those living with chronic conditions may be particularly important for their health, and even for their survival. The role of support for the survival of cancer patients after receiving an allogeneic hematopoietic cell transplant is understudied. To better understand the link between survival and support, as well as different sources and functions of support, we conducted two studies in alloHCT patients. First, we examined whether social support is related to (...) survival. Second, we examined who provides which support and which specific support-related functions and tasks are fulfilled by lay caregivers and healthcare professionals.MethodsIn Study 1, we conducted a retrospective chart review of alloHCT patients and registered availability of a dedicated lay caregiver and survival. In Study 2, we prospectively followed patients after alloHCT from the same hospital, partly overlapping from Study 1, who shared their experiences of support from lay caregivers and healthcare providers in semi-structured in-depth interviews 3 to 6 months after their first hospital discharge.ResultsPatients with a dedicated caregiver had a higher probability of surviving to 100 days than patients without a caregiver, OR = 2.84, p = 0.042. Study 2 demonstrated the importance of post-transplant support due to patients’ emotional needs and complex self-care regimen. The role of lay caregivers extended to many areas of patients’ daily lives, including support for attending doctor’s appointments, managing medications and financial tasks, physical distancing, and maintaining strict dietary requirements. Healthcare providers mainly fulfilled medical needs and provided informational support, while lay caregivers were the main source of emotional and practical support.ConclusionThe findings highlight the importance of studying support from lay caregivers as well as healthcare providers, to better understand how they work together to support patients’ adherence to recommended self-care and survival. (shrink)

The likelihood of nurse reflection is examined from the theoretical perspectives of Habermas' Theory of Communicative Action and Moral Action and Sumner's Moral Construct of Caring in Nursing as Communicative Action, through a critical social theory lens. The argument is made that until the nurse reaches the developmental level of post-conventional moral maturity and/or Benner's Stage 5: expert, he or she is not capable of being inwardly directed reflective on self. The three developmental levels of moral maturity and Benner's (...) stages are presented with discussion on whether or not there can be self-reflection because of an innate vulnerability that leads to self-protective behaviours. It is only when the confidence from mastery of practice has been achieved can the nurse be comfortable with reflection that enables him or her to become enlightened, emancipated, and empowered. The influences and constraints of the knowledge power between nurse and patient are acknowledged. The power hierarchy of the institution is recognized as constraining. (shrink)

Many teacher candidates get their first taste of life as a full-time teacher in their practicums, during which they confront a host of challenges, pedagogical and ethical. Because ethics is fundamental to the connection between teachers and students, teacher candidates are often required to negotiate dilemmas in ways that keep with the ethical ideals espoused both by the professional body and the community at large. Presenting the case of a teacher candidate who finds herself emotionally depleted in her devotion to (...) students, we look to the ethics of care and virtue for clarifying insights. Care ethics extols intersubjectivity and reciprocity, while virtue ethics enjoins commitment to a noble ideal for its own sake; both perspectives offer useful insights for our case. We argue that the perspectives and practices of contemplative traditions can facilitate the integration of care and virtue ethics, mitigating the risk of disruption in caring relations while minimizing the possibility of a personal p... (shrink)

In this paper, I discuss nurses' ongoing difficulty in engaging with politics and address the persistent belief that political positioning is antithetical to quality nursing care. I suggest that nurses are not faced with choosing either caring for their patients or engaging with politics. I base my discussion on the assumption that such dichotomy is meaningless and that engaging with issues of relationships firmly grounds nursing in the realm of politics. I argue that the ethical merit of nursing (...) class='Hi'>care relies instead on positioning nurses squarely at the centre of care activities, experiences, and functions. Such positioning makes possible what Foucault called ‘practices of self‐formation’, that is, micro‐level processes that balance out the ubiquitous economic, cultural, legal, and scientific technologies that steadily constitute subjects in this era of modernity. Nurses, then, become not a group that needs to be controlled and governed, but individuals who must care for their self before they may care for anyone else. (shrink)

BackgroundUndocumented migrants experience multiple institutional and legal barriers when trying to access healthcare services. Due to such limitations, healthcare workers often experience ethical dilemmas when caring for undocumented migrants. This article aims to understand how individual healthcare workers who regularly take care of undocumented migrants deal with these dilemmas in practice. So far, the role of healthcare workers in this context has mainly been theorized through the lens of biopolitics, conceiving of healthcare workers as merely obedient instruments of humanitarian (...) government or gatekeeping.MethodsBased on semi-structured, in-depth interviews and ethnographic observations with healthcare workers in Belgium, we explore how they ascribe meaning, reflect upon and give shape to care practices in relation to undocumented migrants. We use Foucault’s later work on care of the self to interpret the accounts given by the healthcare workers.ResultsHealthcare workers in clinical roles exercise a certain degree of freedom in relation to the existing limitations to healthcare access of undocumented migrants. They developed techniques such as purposefully being inattentive to the undocumented status of the migrants. They also try to master their affective responses and transform their bodily attitude towards undocumented patients. They perform practical mental exercises to remind themselves of their role or position in the wider healthcare system and about their commitment to treat all patients equally. These techniques and exercises are inspired by colleagues who function as role models, inspiring them to relate in an ethical way to limitations in healthcare access. The developed care practices sometimes reproduce, sometimes transform the legal and institutional limitations to care for undocumented migrants.ConclusionsThe findings nuance the biopolitical analysis regarding the role of healthcare workers in healthcare delivery to undocumented migrants that has been dominant so far. Theoretically this article provides a reconceptualization of healthcare ethics as care of the self, an ethical practice that is somewhat independent of the traditional professional ethics.Trial Registration Medical ethics committee UZ Jette, Brussels, Belgium – Registration date: 18/05/2016 – Registration number: B.U.N. 143201628279. (shrink)

It is a popular view thatpractical deliberation excludes foreknowledge of one's choice. Wolfgang Spohn and Isaac Levi have argued that not even a purely probabilistic self-predictionis available to thedeliberator, if one takes subjective probabilities to be conceptually linked to betting rates. It makes no sense to have a betting rate for an option, for one's willingness to bet on the option depends on the net gain from the bet, in combination with the option's antecedent utility, rather than on the (...) offered odds. And even apart from this consideration, assigning probabilities to the options among which one is choosing is futile since such probabilities could be of no possible use in choice. The paper subjects these arguments to critical examination and suggests that, appearances notwithstanding, practical deliberation need not crowd outself-prediction. (shrink)

ObjectiveThis study aims to investigate the lived experience in patients with obstructive sleep apnea syndrome and comorbid obesity following after continuous positive airway pressure therapy made with the disease the device, and to identify barriers and facilitators to the use of CPAP to improve rehabilitation provision and aid in disease self-management.MethodsQualitative research was conducted using three focus groups with a representative sample of 32 inpatients undergoing a 1-month pulmonary rehabilitation program at the IRCSS Istituto Auxologico Italiano San Giuseppe Hospital, (...) Verbania, Italy. The focus groups were recorded on tape, and contemporaneous notes were made. The tapes were transcribed verbatim, and Interpretative Phenomenological Analysis was used to develop themes.ResultsSix main themes were extracted: Living the diagnosis as a shock; You should not sleep on it: the importance of prevention; The adjustment to CPAP; Barriers and facilitators to the use of CPAP; Three in a bed; and The relationship with the healthcare system.ConclusionResults of this study suggest potential avenues for interventions to increase adherence to CPAP, including the provision of information and continued support. Individual counseling providing strategies aimed at helping the person to cope with the emotional problem and relational difficulties associated with the use of CPAP, and at strengthening self-efficacy and self-management skills are also encouraged for optimal care during the rehabilitation program. (shrink)

Purpose – Contemporary technology has been implicated in the rise of perfectionism, a personality trait that is associated with depression, suicide and other ills. is paper explores how technology can be developed to promote an alternative to perfectionism, which is a self- constructionist ethic. Design/methodology/approach – is paper takes the form of a philosophical discussion. A conceptual framework is developed by connecting the literature on perfectionism and personal meaning with discussions in information ethics on the self, the ontic (...) trust and technologies of the self. To illustrate these themes, the example of selfies and self-portraits is discussed. Findings – e self today must be understood as both individualistic and relational, i.e., hybrid; the trouble is balance. To realize balance, the self should be recognized as part of the ontic trust to which all information organisms and objects belong. us technologically-mediated self-care takes on a deeper urgency. e selfie is one example of a technology for self-care that has gone astray (i.e., lost some of its care-conducive aspects), but this can be remedied if selfie-making technology incorporates relevant aspects of self-portraiture. is example provides a path for developing self- constructionist and meaningful technologies more generally. Practical implications – Technology development should proceed with self-care and meaning in mind. e comparison of selfies and self-portraits, situated historically and theoretically, provides some guidance in this regard. Some specific avenues for development are presented. Originality/value – e question of the self has not been much discussed in information ethics. is paper links the self to the ontic trust: the self can be fruitfully understood as an agent within the ontic trust to which we all belong. (shrink)

The American Meditation Institute founder Leonard Perlmutter shares his extraordinary knowledge of the world's oldest and most practical mind/body medicine. As one of the West's foremost guides to understanding the nature of consciousness, Leonard gently leads you to a realization of the profound wisdom and power that you already possess. As modern medicine rediscovers and systematically documents the physical, mental and emotional benefits of Yoga, millions of Americans from all walks of life are incorporating the timeless practices of this (...) ancient science into their lives. Whether you are a beginner or a long-time student, Leonard provides loving support and valuable insights to advance your understanding and nurture your Selftransformation. Yoga Science promises that through the process of personal experimentation you too can access an inner reservoir of creativity to make every relationship rewarding - no matter what. The Heart and Science of Yoga. (shrink)

SARGENT A. Nursing Inquiry 2012; 19: 134–143 [Epub ahead of print]Reframing caring as discursive practice: a critical review of conceptual analyses of caring in nursingThis study critically examines the way in which the concept of caring is presented in the nursing literature through conceptual analytic approaches. A critical reflection on the potential consequences of representing a concept of caring as vague and ambiguous, yet central to ontology and epistemology in professional nursing is presented drawing on comparisons between the conceptual analyses (...) of caring, and of structuralist perspectives of language, and how this potentially limits scholarship in this area. A search of the literature revealed nine conceptual papers. These papers highlight the self‐referential characteristics of the concept of caring, and of analytical methods in general. It is proposed that this is the result of a systematic adherence to a rigid, structuralist view of language, whereby stable relationships between words and their meanings are assumed. An alternative perspective is offered by viewing caring as a discursive practice rather than a fixed conceptual entity, calling into question the role that the concept plays in nursing practice. A poststructuralist perspective requires caring to be perceived as a discourse of nursing that is fluid and contingent, rather than a central and guiding concept, opening up a new orientation for nursing scholarship in caring research. (shrink)

According to the ethics of care, practices of care are sources of moral knowledge that take human relatedness into account. However, caregivers may also find themselves in situations that demand sacrifices, even to the point where their own self is at stake. This may not only be cause for concern about the risks of caregivers, the result of an unequal distribution of power, but it may as well be a chance for affirmation of one’s identity, of (...) self-attestation. As Ricoeur argues, giving of the self or even giving one’s life may be the ultimate expression of one’s belonging, in friendship, devotion or loyalty. Ricoeur also considers the meaning of giving a gift, which to him does not lie in any return gift, but rather in the gift as offering, as generosity. Giving is first of all a risk, a sacrifice, with only the hope that it will be received. In this article I aim to extend his argument to the realm of caregiving, thereby supporting my claim that some sort of self-sacrifice is implied in the very act of caring for others. (shrink)

This book focuses on two important, interlinked themes in psychiatry, i.e., the relation between self (or: person), context and psychopathology; and the intrinsic value-ladenness of psychiatry as a practice. -/- Written against the background of scientistic tendencies in today’s psychiatry, it is argued in Part I that psychiatry needs a clinical conception of psychopathology alongside more traditional scientific conceptions; that this clinical conception of psychopathology must be based on a fundamental rethinking of the interaction between illness manifestations, contextual influences (...) and the patient as person, such that psychopathology is conceived as the product of this interaction rather than as the outward manifestation of a broken mechanism within the patient. -/- In Part II, it is shown that self- and context-related factors have a large impact on who one is as a professional. I argue that an analysis is needed of the normative aspects of the relations that sustain and frame professional role-fulfilment. This analysis culminates into a so-called normative practice model (NPM) which distinguishes between qualifying, conditioning and foundational principles (or: rules, norms). The normative practice model helps to locate and resist scientistic defenses of the legitimacy of psychiatry and to replace them by a positive account that provides clinicians (and scientists) the conceptual tools they need to justify what they do in broader contexts. The main thrust of the argument is to show that psychiatry needs a value-sensitive account of its legitimacy, in which other normative dimensions are recognized than those that sustain the expert role. Psychiatrists should in other words not defend the legitimacy of their profession by referring to the expert role solely but provide a broader account in which justice is done to the broader social, legal, and economic contexts of professional activity. The analysis of this inherent normativity begins within clinical practice, it extends to the concept of disease as well as to wider domains of psychiatric care and the sociology of professions, and, finally, amounts into an analysis of the value-ladenness of interactions between healthcare institutions, the government, professional organizations and patient groups. (shrink)

This paper explores a novel philosophy of ethical care in the face of burgeoning biomedical technologies. I respond to a serious challenge facing traditional bioethics with its roots in analytic philosophy. The hallmarks of these traditional approaches are reason and autonomy, founded on a belief in the liberal humanist subject. In recent years, however, there have been mounting challenges to this view of human subjectivity, emerging from poststructuralist critiques, such as Michel Foucault's, but increasingly also as a result of (...) advances in biotechnology itself. In the face of these developments, I argue that the theoretical relevance and practical application of mainstream bioethics is increasingly under strain. Traditionalists will undoubtedly resist. Together, professional philosopher-bioethicists, public health policymakers, and the global commercial healthcare industry tend to respond conservatively by shoring up the liberal humanist subject as the foundation for medical ethics and consumer decision-making, appealing to the familiar tropes of reason, autonomy, and freedom. (shrink)

It has often been argued that Foucault’s turn to antique and early Christian care of the self, spiritual self-.practices and truth-telling (parrhesia) results from inquiries into the confession practices and pastoral power structures in the context of a genealogy of the desiring subject. This line of reasoning is in itself not incorrect, but – this article claims – needs to be complemented with an account of Foucault’s philosophical quest for freedom and for conditions, possibilities and (...) modes of thinking and acting differently vis-à-vis the normalizing regimes of power in science and, hence, in philosophy as an academic discipline. In this context a first turn to antique philosophy seen as a ‘way of life’ constructed through ascetic practices can be detected already writings from the late 1960s and early 1970s. Although indeed the project of the history of sexuality moved in a direction than Foucault had foreseen in the first volume published in 1976, earlier reflections on the need for free and critical philosophical thought relative to scientific ‘disciplines’ already prelude the later inquiries into care of the self, self-practices and parrhesia as productive for a critical philosophical attitude. (shrink)

High moral standards and adherence to a moral code have long been strong tenets of the profession of medicine, even though there have been occasional lapses that have led to renewed calls for a revitalization of moral integrity in medicine. Certainly, a moral component has generally been held to be an important aspect of the concept of a physician.

Reasoning and judgement in health care entail complex responses to problems whose demands typically derive from several areas of specialism at once. We argue that current evidence- or value-based models of health care reasoning, despite their virtues, are insufficient to account for responses to such problems exhaustively. At the same time, we offer reasons for contending that health professionals in fact engage in forms of reasoning of a kind described for millennia under the concept of wisdom. Wisdom traditions (...) refer to forms of deliberation which combine knowledge, reflection and life experience with social, emotional and ethical capacities. Wisdom is key in dealing with problems which are vital to human affairs but lack prescribed solutions. Uncertainty and fluidity must be tolerated in seeking to resolve them. We illustrate the application of wisdom using cases in psychiatry, where non-technical aspects of problems are often prominent and require more systematic analysis than conventional approaches offer, but we argue that our thesis applies throughout the health care field. We argue for the relevance of a threefold model of reasoning to modern health care situations in which multifaceted teamwork and complex settings demand wise judgement. A model based on practical wisdom highlights a triadic process with features activating capacities of the self, other and aspects of the problem itself. Such a framework could be used to develop current approaches to health care based on case review and experiential learning. (shrink)

In this paper the authors argue that the exploration of the nature of needs and rights should begin with the actually existing organization of care and of justice in society. The authors raise two key concerns with this organization: 1) the invisibility of care to some, and 2) the inaccessibility of rights to others. Recent work by care scholars has called attention to the ways the current organization of care work perpetuates the myth of self-sufficiency (...) for some, while reducing others to mere dependents. Law and Society scholars have demonstrated the problems of uneven access to legal remedies within the current organization of the legal system. Addressing these concerns simultaneously reveals both the problems of the current organization of needs and rights as well as illuminating alternative possibilities. The authors argue, first, that a justice perspective, based on rights is inadequate because its presumed universality is belied by the reality of the inaccessibility of rights to many. Second, the authors argue that a care perspective, currently formulated upon the assumption that only some people have needs, is also flawed because its presumed particularity distorts the human experience and subsequent policies. Instead, the authors need to conceive of care in a public way that permits both rights and needs to be understood as applicable to all. The authors propose some initial thoughts about how to create such a public concept of care. (shrink)

Monique Lanoix | : Over three decades ago, Carol Gilligan’s seminal book In a Different Voice provided feminist theorists with a powerful new approach to address the shortcomings of traditional moral theories. With a focus on concrete situations, an ethics of care can attend to the specifics of moral dilemmas that might otherwise be glossed over. As feminist reflection on moral and political philosophizing has progressed, another challenge has emerged. Recent feminist scholarship proposes non-ideal theories as preferable action-guiding theories. (...) In this paper, I examine Kittay’s call for a version of care ethics as a naturalized ethics that comes from lived experience, in order to draw out the salient characteristics of the caring agent. This allows me to show how Kittay’s key assertion that “we are all some mother’s child” resonates with Ricoeur’s framing of self-esteem, which is, in turn, anchored on a notion of solicitude. Secondly, I make the case that care ethics can benefit from Ricoeur’s little ethics as it helps buttress the goal of good caring practices. Finally, care ethics, with its emphasis on the universality of care needs, helps to strengthen the central role of solicitude for the political sphere. | : Il y a plus de trente ans, le livre fondateur de Carol Gilligan, In a Different Voice, fournissait aux théoriciennes féministes une nouvelle approche permettant d’affiner la critique des théories morales traditionnelles, particulièrement en ce qui concerne leur universalisme. Focalisant sur les situations concrètes, l’éthique du care chez Gilligan permet de recentrer l’attention sur les spécificités d’un dilemme moral qui, autrement, risquent de rester dans l’ombre. La réflexion féministe en philosophie morale et politique a progressé depuis, s’attelant à de nouveaux défis. La recherche récente suggère qu’une théorie morale non idéale est préférable aux théories dites idéalistes. Dans cet article, j’examine l’éthique du care selon Eva Feder Kittay, soit à titre d’éthique naturalisée, afin de mettre en relief les caractéristiques saillantes de l’agent.e caring. Cela me permettra ensuite de montrer comment l’affirmation clé de Kittay selon laquelle « nous sommes tou.te.s l’enfant d’une mère » fait écho à la pensée ricoeurienne de l’estime de soi qui est, en retour, ancrée dans la notion de sollicitude. Deuxièmement, je soutiens que la « petite éthique » ricoeurienne peut enrichir les éthiques du care, précisément en ce qui a trait au telos du care. Ce faisant, les éthiques du care, qui placent l’accent sur l’universalité des besoins en cette matière, pourront mieux ancrer la sollicitude dans la sphère politique. (shrink)

Objectives The use of empathy during clinical practice is paramount to delivering quality patient care and is important for understanding patient concerns at both the cognitive and affective levels. This study sought to determine how and when physicians self-report the use of empathy when interacting with their patients. Methods A cross-sectional survey of 76 physicians working in a large urban hospital was conducted in August of 2017. Physicians were asked a series of questions with Likert scale responses as (...) well as asked to respond to open-ended questions. Results All physicians self-report that they always (69%) or usually (29.3%) use empathic statements when engaging with patients. 93.1% of physicians believe that their colleagues always (20.7%) or usually (69%) use empathic statements when communicating with patients. Nearly one-third of physicians (33%) indicated that using the words “I understand” denotes an empathic statement. Although 36% of physicians reported that they would like to receive more training or assistance about how and when to use empathy during clinical practice. Significance of Results Despite the self-reported prevalent use of empathic statements, one-third of physicians indicate a desire for more training in what empathy means and when it should be used in a clinical setting. Additionally, nearly one-third of physicians in this study reported using responses that patients may not perceive as being empathic, even when intended to be empathic. This suggests that many physicians feel uncertain about a clinical skill they believe should be used in most, if not all, encounters. (shrink)

Introduction. In the context of the COVID-19 pandemic, which spread around the world in early 2020, special attention is paid to external transformations in human life: forced staying at home, using personal protective equipment in public places, social distance, etc. Nevetheless, the inner world of a man is susceptible to serious transformations. Another necessary element that structures the world of self (J. Deleuze’s point of view) is turning into a potential carrier of the virus. Therefore, the problem of human (...) reflection with the goal of taking care of oneself in a crisis situation is of particular relevance. The aim of the study is to substantiate the effectiveness of spiritual practices of the period of Antiquity and the early Middle Ages as forms of caring of the internal in a person in the pandemic. Methods. The author uses general scientific methods: analysis and synthesis, induction, deduction, abstraction. In addition, a comparative historical method, an interpretation method and a systematic approach are applied. With the help of the dialectical approach, the connection between the external and the internal in a person was designated. Scientific novelty of the study. Three scenarios of human responses to self-isolation in the context of an event (external) – meaning (internal) are outlined: orientation to an external event; creating an external event; appeal to the self. Results. In the context of self-isolation, staying alone with himself, a person faced a problem, a crisis of identity (empirical evidence for this problem was provided by psychologists and psychotherapists in Chelyabinsk and the Chelyabinsk region). This problem is due to the fact that the pandemic has reduced many of the person’s connections with the outside world (work, study, relationships with friends and relatives) and / or transferred them to a remote format. Therefore, consciously or optionally, at the level of an unreasonable request, a person has a need to rethink his self. Rethinking is a reflexive procedure when a person re-learns to communicate with his self. M. Foucault analyzed and systematized examples of spiritual work with I, looking into the practices of care of the self in ancient thinkers’ and early Christians’ studies. Conclusion. The COVID-19 virus has made significant adjustments to human life. No less adjustments were made to the events (F. Girenok) that fill the life of a person. A man’s replies to changes in his being can be laid between two poles: event and meaning. Even while at home, many continue to focus on the external, creating something of their own (for example, audiovisual production) or consuming the results of others. At the same time, orientation to meaning involves focusing on oneself. Philosophers and theologians who practiced self-care about two millennia ago, proposed different forms of reflection, pursuing one goal, to learn to talk with oneself. (shrink)