Background Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally. This is a review of the ethical considerations documented in the prehospital medical records (...) of patients in a Danish prehospital setting for whom the decision to resuscitate or not was made at the scene. Methods The study is based on discharge summaries of all patients subjected to crucial life-and-death decisions by the Mobile Emergency Care Unit in Odense in the years 2010 to 2014. The medical records with possible documentation of ethical issues were independently reviewed by two philosophers in order to identify explicit ethical or philosophical considerations pertaining to the decision to resuscitate or not. Results In total, 1275 patients were either declared dead at the scene without exhibiting layman’s reliable signs of death or admitted to hospital following resuscitation. In a total of 62 patients, 85 specific ethical issues related to resuscitation were documented. The expressions of the ethical considerations were generally vague or unclear and almost exclusively concerned the interests of the patient and not the relatives. In the vast majority of cases where an ethical content was identified, the ethical considerations led to a decision to terminate treatment. Conclusions A strengthened practice of documenting ethical considerations in prehospital life-and-death decision-making in the patient’s medical records is required. We suggest that a template be implemented in the prehospital medical records describing the basis for any ethical decisions. This template should contain information regarding the persons involved in the deliberations and notes on ethical considerations. The documentation should include considerations concerning the patient’s end-of-life wishes, the estimations of the quality of life before and after the incident, and a summary of other ethical concerns taken into account, such as the integrity of the patient and frame of mind of relatives. (shrink)

The "morning morality effect"-the alleged phenomenon that people are more likely to act in unethical ways in the afternoon when they are tired and have less self-control than in the morning-may well be expected to influence prehospital anaesthesiologist manning mobile emergency care units (MECUs). The working conditions of these units routinely entail fatigue, hunger, sleep deprivation and other physical or emotional conditions that might make prehospital units predisposed to exhibit the "morning morality effect". We investigated whether this is in fact (...) the case by looking at the distribution of patient transports to hospital with and without physician escort late at night at the end of the shift as a surrogate marker for changing thresholds in ethical behaviour. All missions over a period of 11 years in the MECU in Odense were reviewed. Physician-escorted transports to hospital were compared with non-physician-escorted transports during daytime, evening, and night-time (which correlates with time on the 24 h shifts). In total, 26,883 patients were transported to hospital following treatment by the MECU. Of these, 27.4% (26.9%-27.9%) were escorted to the hospital. The ratio of patient transports to hospital with and without physician escort during the three periods of the day did not differ (p = 1.00). We found no evidence of changes in admission patterns over the day. Thus, no evidence of the expected "morning morality effect" could be found in a prehospital physician-manned emergency care unit. (shrink)

BackgroundDecision-making in out-of-hospital cardiac arrest should ideally include clinical and ethical factors. Little is known about the extent of ethical considerations and their influence on prehospital resuscitation. We aimed to determine the transparency in medical records regarding decision-making in prehospital resuscitation with a specific focus on ethically relevant information and consideration in resuscitation providers’ documentation.MethodsThis was a Danish nationwide retrospective observational study of out-of-hospital cardiac arrests from 2016 through 2018. After an initial screening using broadly defined inclusion criteria, two experienced (...) philosophers performed a qualitative content analysis of the included medical records according to a preliminary codebook. We identified ethically relevant content in free-text fields and categorised the information according to Beauchamp and Childress’ four basic bioethical principles: autonomy, non-maleficence, beneficence, and justice. ResultsOf 16,495 medical records, we identified 759 (4.6%) with potentially relevant information; 710 records (4.3%) contained ethically relevant information, whereas 49 did not. In general, the documentation was vague and unclear. We identified four kinds of ethically relevant information: patients’ wishes and perspectives on life; relatives’ wishes and perspectives on patients’ life; healthcare professionals’ opinions and perspectives on resuscitation; and do-not-resuscitate orders. We identified some “best practice” examples that included all perspectives of decision-making. ConclusionsThere is sparse and unclear evidence on ethically relevant information in the medical records documenting resuscitation after out-of-hospital cardiac arrests. However, the “best practice” examples show that providing sufficient documentation of decision-making is, in fact, feasible. To ensure transparency surrounding prehospital decisions in cardiac arrests, we believe that it is necessary to ensure more systematic documentation of decision-making in prehospital resuscitation. (shrink)

Brogaard's non-indexical version of moral contextualism has two related problems. It is unable to account for the function of truth-governed assertoric moral discourse, since it leaves two (semantically clearheaded) disputants without any incentive to resolve seemingly contradictory moral claims. The moral contextualist could explain why people do feel such an incentive by ascribing false beliefs about the semantic workings of their own language. But, secondly, this leaves Brogaard's moral contextualism looking weaker than a Mackie-style invariantist error theory about morals. The (...) latter is equally non-objectivist, but less revisionist, since it takes the semantics of moral discourse at face value, and can also explain all of Brogaard's other linguistic evidence. (shrink)

Corporate social responsibility has become of great interest to both researchers and practitioners alike with much discussion on whether the costs outweigh the performance implications. CSR has become a firm strategic tool as firms recognize that the customer value proposition and CSR is integrated with the focus on how to differentiate the firm from the view of the customer. We utilized market orientation theory as our foundation for our research as it explains how organizations adapt to their customer environment to (...) develop competitive advantages. With the current customer focus on CSR, MO assists the field in identifying a possible firm differentiation. Our research found that firms that ranked high on CSR correlated positively to performance. We also found our theoretically developed constructs of firm customer orientation and firm market orientation correlated with the firm adopting CSR. The results also indicated that CSR positively mediates CO and MO to firm performance. As past research had mixed results over the direct relation of MO to performance, our research suggests that CSR may be the missing variable to explain the MO/performance relationship. (shrink)

Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

In this paper we explore the relation between health-care needs and patients’ desires within shared decision-making in a context of priority setting in health care. We begin by outlining some general characteristics of the concept of health-care need as well as the notions of SDM and desire. Secondly we will discuss how to distinguish between needs and desires for health care. Thirdly we present three cases which all aim to bring out and discuss a number of queries which seem to (...) arise due to the double focus on a patient’s need and what that patient desires. These queries regard the following themes: the objectivity and moral force of needs, the prediction about what kind of patients which will appear on a micro level, implications for ranking in priority setting, difficulties regarding assessing and comparing benefits, and implications for evidence-based medicine. (shrink)

Fronto-parietal activity has been frequently observed in fMRI and PET studies of attention, working memory, and episodic memory retrieval. Several recent fMRI studies have also reported fronto-parietal activity during conscious visual perception. A major goal of this review was to assess the degree of anatomical overlap among activation patterns associated with these four functions. A second goal was to shed light on the possible cognitive relationship of processes that relate to common brain activity across functions. For all reviewed functions we (...) observed a consistent and overlapping pattern of brain activity. The overlap was most pronounced for the bilateral parietal cortex , and dorsolateral prefrontal cortex . The common fronto-parietal activity will be discussed in terms of processes related to integration of distributed representations in the brain. (shrink)

Accounts of analogical inference are usually categorized into four broad groups: abductive, deductive, inductive and sui generis. The purpose of this paper is to defend a sui generis model of analogical inference. It focuses on the sui generis account, as developed by Juthe [2005, 2009, 2015, 2016] and Botting’s [2017] criticism of it. This paper uses the pragmadialectical theory of argumentation as the methodological framework for analyzing and reconstructing argumentation. The paper has two main points. First, that Juthe’s arguments against (...) a deductive interpretation of prima facie analogy argumentation remain unaffected by Botting’s criticism, which means that many of the reasons against deductive reformulation of analogy argumentation still stand. The additional argument, which Botting himself brings up, that a deductive interpretation cannot account for the cumulative effect of analogies, just provides further reason to reject deductivism. The second main point of this paper is that an inductive interpretation of analogical inference also fails. There are constitutional differences between inductive and analogical inference that cannot be bridged. The result is a firm defense of the sui generis view of analogical inference. (shrink)

Corporate sustainability is an important strategy and value orientation for marketing, but scarce research addresses the organizational drivers and barriers to including it in companies’ marketing strategies and processes. The purpose of this study is to determine levels of commitment to corporate sustainability in marketing, processes associated with sustainability marketing commitment, drivers of sustainability marketing at the functional level of marketing, and its organizational context. Using survey data from 269 managers in marketing, covering a broad range of industries in Sweden (...) and Denmark, we took a structural modelling approach to examine construct relationships, mediation, and moderation effects. Overall, the findings show that marketing capabilities associated with the innovation of new products, services, and business models constitute a strong driver to leverage sustainability marketing commitment. In conjunction with insights into processes related to the enactment of sustainability marketing, this result indicates that companies’ marketing departments have a propensity to drive corporate sustainability. The study provides substance to the idea of aligning substantive marketing capabilities closer to dynamic capabilities. Accordingly, the study reveals that reliance on market orientation alone does not lead to greater sustainability commitment. (shrink)

Religious coping and spiritual struggles were qualitatively analyzed in 15 semi-structured interviews with Norwegian Hodgkin’s disease survivors. We asked, How is religious coping expressed in 15 Norwegian Hodgkin’s disease survivors? The analyses were theory-driven, using religious coping and spiritual struggles theories as explorative tools. Especially we focused on coping processes, coping dynamics, coping styles, and coping activities. The analyses show that religiousness functioned as a positive factor in coping with cancer in 14 of the 15 participants, equally distributed as conservational (...) and transformational coping. The combination of the belief in a good, present God, eventually positive divine power, accessible through prayer, and religious support from people around the participants, were the most prominent activities in the religious coping processes. The religious coping had a character of being collaborative for almost all of the participants. Many participants had severe spiritual struggles. For many of the participants, it was difficult not only to be sick, but also to be a survivor. Theories on religious coping and spiritual struggles were useful and adaptable to a Norwegian sample regarding the main dynamics in the religious coping and spiritual struggles processes. The analyses detected a few different religious coping activities in this Norwegian sample compared to those identified in American samples, with the importance of meeting God in nature as the most significant difference. (shrink)

Der Ubergang von der Ideenwelt des Veda zu derjenigen der Upanisaden wird in der Regel als Beginn der indischen Philosophie angesehen. Lars Gohler zeigt in seiner Monographie zur fruhen Philosophie in Indien, dass es neben den Upanisaden hingegen noch eine weitere Traditionslinie in der Entstehung der indischen Philosophie gegeben hat: Sie fuhrt von der Opferritualistik des Veda zu der ihr nachfolgenden Ritualwissenschaft und Hermeneutik der Mimamsa. Ein Grossteil der Begriffe der indischen Philosophie, die ursprunglich aus dem Bereich der Opferritualistik (...) stammen, wurden in der Mimamsa von ihrem engeren rituellen Gebrauch gelost und erhielten eine philosophische Dimension. Ebenso haben die Diskurslogik, Sprachphilosophie und Hermeneutik der Mimamsa in methodischer Hinsicht wichtige Ausgangspunkte fur die klassische Philosophie Indiens dargestellt. Gohler beleuchtet in seiner Studie detailliert diese weitgehend unbekannte Traditionslinie und zeigt ihren entscheidenden Einfluss auf die Entwicklung der indischen Philosophie auf. (shrink)

We are living in a world which is severely crisis-ridden and faces some major challenges. The fact that we are currently facing a genuine global pandemic brings about even more uncertainty. The social and political institutions, which emerged and consolidated during the 20th century, and which created stability, have become fragile. The young generation born in the 1990s and onwards have experienced 9/11 and the ‘war against terrorism’, the financial crisis of 2008, changes to climate, environmental degradation, and most recently (...) the COVID-19 pandemic. The generation born between 1960 and 1990 have had the same experiences along with severe economic crises in the 1970s and 1980s and the Cold War. Some of these challenges are in different ways intertwined with capitalism and its crises, while others are linked to the rapid development of new technologies, in particular innovations within communication and information technologies. This introduction lists the most important grand challenges facing the world as they have emerged more recently. The five articles following this introduction address some of these challenges, with particular attention to the problems of capitalism and democracy and the relation between these two areas. Most authors agree that climate change and the destruction of the environment are the biggest and most pertinent problems to address, but it is their stance that we can only meet these challenges if democracy is functioning well. (shrink)

There is an emerging consensus that retrieval practice is a powerful way to enhance long-term retention and to reduce achievement gaps in school settings. Less is known whether retrieval practice benefits performance in individuals with low intrinsic motivation to spend time and effort on a given task, as measured by self-reported need for cognition. Here, we examined retrieval practice in relation to individual differences in NFC by combining behavioral and functional magnetic resonance imaging data. Using a within-subject design, upper-secondary school (...) students learned a language-based material, with half of the items by means of retrieval practice with feedback and half by study only. One week later, the students were tested on the word-pairs either in the classroom, or in a fMRI scanner. In both settings, a retrieval practice effect was observed across different levels of NFC. Relatedly, comparable fMRI effects were seen in both NFC subgroups. Taken together, our findings provide behavioral and brain-imaging evidence that retrieval practice is effective also for individuals with lower levels of NFC, which is of direct relevance for educational practice. (shrink)

This volume offers an original and innovative collection of fresh approaches to the investigation of the idea of taste. It is divided into three sections: the concept of taste; taste and culture; and gustatory taste. The papers in all three parts deal with the way that aesthetics interpenetrates discussions of food, political conflict, art appreciation, aesthetic judgement, and education. These are fresh, never-before published contributions from a range of scholars, using the most recent literature in their areas of expertise. There (...) is no other book available that collects the latest research in this field, and, as such, it represents a key contribution to recent aesthetic, and more broadly philosophical, interest in matters of taste. (shrink)

The authors offer a clear, succinct and basic introduction to set theory and formal logic for linguists.

ABSTRACTThe concept of need is often proposed as providing an additional or alternative criterion to cost‐effectiveness in making allocation decisions in health care. If it is to be of practical value it must be sufficiently precisely characterized to be useful to decision makers. This will require both an account of how degree of need for an intervention is to be determined and a prioritization rule that clarifies how degree of need and the cost of the intervention interact in determining the (...) relative priority of the intervention. Three common features of health care interventions must be accommodated in a comprehensive theory of need: the probabilistic nature of prognosis ; the time course of effects; and the fact that the most effective treatments often combine more than one intervention. These common features are problematic for the concept of need. We outline various approaches to prioritization on the basis of need and argue that some approaches are more promising than others. (shrink)

Journal of Philosophy of Education, EarlyView.

This volume offers one of the first systematic analyses of the rise of modern social science. Contrary to the standard accounts of various social science disciplines, the essays in this volume demonstrate that modern social science actually emerged during the critical period between 1750 and 1850. It is shown that the social sciences were a crucial element in the conceptual and epistemic revolution, which parallelled and partly underpinned the political and economic transformations of the modern world. From a consistently comparative (...) perspective, a group of internationally leading scholars takes up fundamental issues such as the role of the Enlightenment and the French Revolution in the shaping of the social sciences, the changing relationships between political theory and moral discourse, the profound transformation of philosophy, and the constitution of political economy and statistics. (shrink)