Discussion about a dignified death has almost exclusively been applied to palliative care and people dying of cancer. As populations are getting older in the western world and living with chronic illnesses affecting their everyday lives, it is relevant to broaden the definition of palliative care to include other groups of people. The aim of the study was to explore the views on dignity at the end of life of 12 elderly people living in two nursing homes in Sweden. A (...) hermeneutic approach was used to interpret the material, which was gathered during semi-structured interviews. A total of 39 interviews were transcribed. The analysis revealed three themes: (1) the unrecognizable body; (2) fragility and dependency; and (3) inner strength and a sense of coherence. (shrink)

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection (...) from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient’s dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient’s wishes and needs are the starting point. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

The aim of the present study was to describe variations in patient participation in decisions about care planning during the final phase of life for a group of gravely ill patients, and how the different actors’ manner of acting promotes or impedes patient participation. Thirty-seven qualitative research interviews were conducted with relatives of the patients. The patients’ participation in the decisions could be categorized into four variations: self-determination, co-determination, delegation and nonparticipation. The manner in which patients, relatives and caregivers acted (...) differed in the respective variations; this seemed either to promote or to impede the patients’ opportunities of participating in the decision making. The possibility for participation seems to be context dependent and affected by many factors such as the dying patient’s personality, the social network, the availability of different forms of care, cultural values, and the extent to which nurses and other caregivers of the different forms of care can and want to support the wishes of the patients and relatives in the decision-making process. (shrink)

This article provides a deeper understanding of how meaning can be created in everyday life at a nursing home. It is based on a primary study concerning dignity involving 12 older people living in two nursing homes in Sweden. A secondary analysis was carried out on data obtained from three of the primary participants interviewed over a period of time (18—24 months), with a total of 12 interviews carried out using an inductive hermeneutic approach. The study reveals that sources of (...) meaning were created by having a sense of: physical capability, cognitive capability, being needed, and belonging. Meaning was created through inner dialogue, communication and relationships with others. A second finding is that the experience of meaning can sometimes be hard to realize. (shrink)

The patient’s home is a common setting for palliative care. This means that we need to understand current palliative care philosophy and how its goals can be realized in home‐care nursing encounters (HCNEs) between the nurse, patient and patient’s relatives. The existing research on this topic describes both a negative and a positive perspective. There has, however, been a reliance on interview and descriptive methods in this context. The aim of this study was to explore planned HCNEs in palliative care. (...) The design was a multiple case study based on observations. The analysis includes a descriptive and an explanation building phase. The results show that planned palliative HCNEs can be described as a process of co‐creating possibilities for the patient to reach vital goals through shared knowledge in a warm and caring atmosphere, based on good caring relations. However, in some HCNEs, co‐creation did not occur: Wishes and needs were discouraged or made impossible and vital goals were not reached for the patients or their relatives. Further research is needed to understand why. The co‐creative process presented in this article can be seen as a concretization of the palliative care ideal of working with a person‐centered approach. (shrink)

Background On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature. Research aim The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ theory of (...) communicative actions, after 6 months from the perspective of an inter-professional team. Research design A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis. Participants The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions. Ethical considerations The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration. Findings Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations. Discussion Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts. Conclusion The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’. (shrink)

The main objective of this study is to eliminate the obstacles that the stylistic, structural, and methodological aspects of the text place in the way of reading and understanding Ludwig Wittgenstein's later work. The characteristic features of these elements are developed and discussed in the context of a close reading of the short section on reading in the Philosophical Investigations. Wittgenstein's aim in this section is the negative one of completely undermining explanatory accounts of the meaning of reading in terms (...) of mental states, experiences, or neurophysiological functions of the brain. In this respect the section on reading forms a clearing ground and a propaedeutic to Wittgenstein's conception of understanding as a rule-following activity. ;The signature of Wittgenstein's style is characterized by a dialogic terseness, an economy of expressions manifest in the brevity of numbered remarks, and a number of strategically indirect rhetorical devices. The structure of the text is shown to be discontinuous and multidirectional. The textual organization forms an overlapping and complex network that mirrors the complexity and multifaceted structure of language. The discontinuity easily inhibits following Wittgenstein's thought, and results in a judgment and dismissal of the text as being fragmented, frayed, and thus lacking structure. ;Wittgenstein's method is contrasted to the application of the scientific method to solving philosophical problems and to the phenomenological method of examining experiences. The argument for the existence of a method at all consists in focussing on and developing three methodological principles: recalling the course of philosophical nonsense; reminding ourselves of what we already know; and arranging and rearranging what already lies open to view. ;Bringing philosophical problems to an end by exposing them as pseudo-problems that often are caused by the forms of our expressions, is reached by an Ubersicht, an overview, of the multiple facets of language. Such an overview is gained by an application of Wittingenstein's method. An analysis of the section on reading in terms of its philosophical purpose and point illuminates the complex interplay of the methodological aspects, the unconventional structure of the text, and the profile of Wittgenstein's unique philosophical style. (shrink)

Today, societal decisions in areas of complexity are often dominated by one of three alternative ways: (a) by scientists, nowadays often in combination with commercial interest; (b) by politicians alone; and (c) by simply “laissez-faire,” or “the tyranny of small steps.” None of these three ways of decision making is fully democratic because they do not create enough awareness among the politicians and the general public. One reason is that the decision making basis becomes too narrowly framed and fragmented. Biotechnology (...) will continue to feed society with new democratic challenges for many years, perhaps decades, to come. The initially promising ideas of participative and deliberative democracy do not seem to solve the awareness problem. Instead, the authors propose an approach with more structured efforts for awareness building with transparency and participation taking place within the framework of representative democracy. (shrink)

Aus dem Inhalt: Views from the North: Hans Petter Graver: Law, Justice and the State: Nordic Perspectives u Jacob Dahl Rendtorff: The Danish Welfare State: Philosophical Ideals and Systemic Reality u Sigri!Dur *orgeirsdottir: Feminist Ethics and Feminist Politics u Kuellike Lengi: The Situation of Human Rights in Estonia u Einar Palsson: Pythagoras and Early Icelandic Law u Law, Discourse and Rationality: Mats Flodin: Internal and External Rationality of Legal Systems u Logi Gunnarsson: A Discourse About Discourse u Hjordi!s Hakonardottir: Legal (...) Language: A Tool of Justice u Ghita Holmstrom-Hintikka: On the Use of Expert Witness in Legal Reasoning and Inquiry u Law, State and Nation: Agust H. Ing*orsson: Democracy, Bureaucracy and Marginalization of the State u Aleksander Peczenik: Law-State, Legal Certainty and Legitimacy of Law u Ove K. Pedersen/Sverre Raffnsoe: Reorganizing Society u Juha Raikka: Mill on National Sentiment u Pall Skulason: Concepts of the State and Classes of Value u Problems of Law and Rights: Britt-Mari Blegvad: How to Cope With Uncertainty: Trust and Law u Jon Wetlesen: Animal Rights or Human Duties?. (shrink)

Les enfants peuvent apprendre à penser et " conceptualiser"s'ils sont mis dès leur plus jeune âge en situation de réfléchir et discuter des questions philosophiques. Matthew Lipman a développé une méthodologie, la " philosophie pour enfants ", qui a fait ses preuves dans le monde entier. Cet ouvrage, qui s'ouvre par un texte de Matthew Lipman, a pour objectif de confronter le modèle lipmanien à d'autres points de vue pour en dégager les points forts, tout en l'enrichissant de la recherche (...) actuelle en pédagogie menée par des auteurs aussi différents que Marie-France Daniel, Jacques Lévine, Michel Tozzi et Britt-Mari Barth, etc. Cet ouvrage s'adresse aux enseignants et étudiants des IUFM et Hautes Ecoles. Il intéressera également les chercheurs et étudiants en Sciences de l'éducation, de même que les étudiants en Philosophie. Il est destiné, plus largement, à toute personne amenée à travailler avec des enfants et à expérimenter de nouvelles formes d'apprentissage et à stimuler l'esprit critique et la réflexion. (shrink)

The central aim of this article is to specify the ontological nature of constitutive mechanistic phenomena. After identifying three criteria of adequacy that any plausible approach to constitutive mechanistic phenomena must satisfy, we present four different suggestions, found in the mechanistic literature, of what mechanistic phenomena might be. We argue that none of these suggestions meets the criteria of adequacy. According to our analysis, constitutive mechanistic phenomena are best understood as what we will call ‘object-involving occurrents’. Furthermore, on the basis (...) of this notion, we will clarify what distinguishes constitutive mechanistic explanations from etiological ones. 1 Introduction 2 Criteria of Adequacy 2.1 Descriptive adequacy 2.2 Constitutive–etiological distinction 2.3 Constitution 3 The Ontological Nature of Constitutive Mechanistic Phenomena 3.1 Phenomena as input–output relations 3.2 Phenomena as end states 3.3 Phenomena as dispositions 3.4 Phenomena as behaviours 4 Phenomena as Object-Involving Occurrents 4.1 What object-involving occurrents are and why we need them 4.2 The object in the phenomenon 4.3 The adequacy of option 5 Conclusion. (shrink)

This dissertation aims to construct a non-dogmatic defence of common sense. It tries to show why the absence of justification for the judgements of common sense, which the sceptic reveals, does not invalidate them.

Leuridan (2011) questions whether mechanisms can really replace laws at the heart of our thinking about science. In doing so, he enters a long-standing discussion about the relationship between the mech-anistic structures evident in the theories of contemporary biology and the laws of nature privileged especially in traditional empiricist traditions of the philosophy of science (see e.g. Wimsatt 1974; Bechtel and Abrahamsen 2005; Bogen 2005; Darden 2006; Glennan 1996; MDC 2000; Schaffner 1993; Tabery 2003; Weber 2005). In our view, Leuridan (...) misconstrues this discussion. His weak positive claim that mechanistic sciences appeal to generalizations is true but uninteresting. His stronger claim, that all causal claims require laws, is unsupported by his arguments. Though we proceed by criticizing Leuridan’s arguments, our greater purpose is to embellish his arguments in order to show how thinking about mechanisms enriches and transforms old philosophical debates about laws in biology and provides new insights into how generalizations afford prediction, explanation and control. (shrink)

Mechanisms are said to consist of two kinds of components, entities and activities. In the first half of this chapter, I examine what entities and activities are, how they relate to well-known ontological categories, such as processes or dispositions, and how entities and activities relate to each other (e.g., can one be reduced to the other or are they mutually dependent?). The second part of this chapter analyzes different criteria for individuating the components of mechanisms and discusses how real the (...) boundaries of mechanisms are. (shrink)

Individuals of many animal species are said to have a personality. It has been shown that some individuals are bolder than other individuals of the same species, or more sociable or more aggressive. In this paper, we analyse what it means to say that an animal has a personality. We clarify what an animal personality is, that is, its ontology, and how different personality concepts relate to each other, and we examine how personality traits are identified in biological practice. Our (...) analysis shows that biologists often study specific personality traits, such as boldness, sociability or aggressiveness, rather than personalities in general. We claim that personality traits are best understood as dispositions and that they are operationally defined in terms of certain sets of behaviours, which are studied in specific experimental set-ups. Furthermore, we develop an integrative philosophical account that specifies and formalises three criteria for identifying personality traits, which are used in biological practice. For an individual animal to have a personality trait it must, first, behave differently than others. Second, these behavioural differences must be stable over a certain time, and third, they must be consistent in different contexts. (shrink)

What are the conditions under which one biological object is a part of another biological object? This paper answers this question by developing a general, systematic account of biological parthood. I specify two criteria for biological parthood. Substantial Spatial Inclusionrequires biological parts to be spatially located inside or in the region that the natural boundary of t he biological whole occupies. Compositional Relevance captures the fact that a biological part engages in a biological process that must make a necessary contribution (...) to a condition that is minimally sufficient to one or more of the characteristic behaviors of the biological whole. Instead of emphasizing the diversity of part-whole relations in the biological world, this paper asks what biological part-whole relations have in common and what constrains their existence, in general. After presenting the two criteria for biological parthood I discuss in how far my account can cope with hard cases (e.g., redundant parts) and I reveal the merits and limits of monism. (shrink)

In the contemporary life sciences more and more researchers emphasize the “limits of reductionism” (e.g. Ahn et al. 2006a, 709; Mazzocchi 2008, 10) or they call for a move “beyond reductionism” (Gallagher/Appenzeller 1999, 79). However, it is far from clear what exactly they argue for and what the envisioned limits of reductionism are. In this paper I claim that the current discussions about reductionism in the life sciences, which focus on methodological and explanatory issues, leave the concepts of a reductive (...) method and a reductive explanation too unspecified. In order to fill this gap and to clarify what the limits of reductionism are I identify three reductive methods that are crucial in the current practice of the life sciences: decomposition, focusing on internal factors, and studying parts in isolation. Furthermore, I argue that reductive explanations in the life sciences exhibit three characteristics: first, they refer only to factors at a lower level than the phenomenon at issue, second, they focus on internal factors and thus ignore or simplify the environment of a system, and, third, they cite only the parts of a system in isolation. (shrink)

This paper looks at statements I am in a position to make ‘straight off’: observational judgements, perceptual and memory statements, statements about my posture, my intentions, and so on. These kinds of statement pose a problem: what is the nature of my entitlement to them? I focus on observational judgements and on two contrasting approaches to them. The first, which I reject, provides an account of my warrant for them; the second, which I defend, disconnects my entitlement from possession of (...) a justification. I consider what light the second approach sheds on the other kinds of statements I am in a position to make straight off. (shrink)

The positive psychology landscape is changing, and its initial identity is being challenged. Moving beyond the “third wave of PP,” two roads for future research and practice in well-being studies are discerned: The first is the state of the art PP trajectory that will continue as a scientific discipline in/next to psychology. The second trajectory links to pointers described as part of the so-called third wave of PP, which will be argued as actually being the beginning of a new domain (...) of inter- or transdisciplinary well-being studies in its own right. It has a broader scope than the state of the art in PP, but is more delineated than in planetary well-being studies. It is in particular suitable to understand the complex nature of bio-psycho-social-ecological well-being, and to promote health and wellness in times of enormous challenges and changes. A unique cohering focus for this post-disciplinary well-being research domain is proposed. In both trajectories, future research will have to increase cognizance of metatheoretical assumptions, develop more encompassing theories to bridge the conceptual fragmentation in the field, and implement methodological reforms, while keeping context and the interwovenness of the various levels of the scientific text in mind. Opportunities are indicated to contribute to the discourse on the identity and development of scientific knowledge in mainstream positive psychology and the evolving post-disciplinary domain of well-being studies. (shrink)

The topic of this special issue of Synthese is hyperintensionality. This introduction offers a brief survey of the very notion of hyperintensionality followed by a summary of each of the papers in this collection. The papers are foundational studies of hyperintensionality accompanied by ample philosophical applications.Hyperintensionality concerns the individuation of non-extensional entities such as propositions and properties, relations-in-intension and individual roles, as well as, for instance, proofs and judgments and computational procedures, in case these do not reduce to any of (...) the former. Hyperintensional individuation is frequently also referred to as ‘fine-grained’ or sometimes simply ‘intensional’ individuation, when ‘intensional’ is not understood in the specific sense of possible-world semantics or in the pejorative sense of flouting various logical rules of extensional logic. A principle of individuation qualifies as hyperintensional as soon as it is finer than necessary .. (shrink)

In recent years there has been an expansion of scientific work on consciousness. However, there is an increasing necessity to integrate evolutionary and interdisciplinary perspectives and to bring affective feelings more centrally into the overall discussion. Pursuant especially to the theorizing of Endel Tulving , Panksepp and Vandekerckhove we will look at the phenomena starting with primary-process consciousness, namely the rudimentary state of autonomic awareness or unknowing consciousness, with a fundamental form of first-person ‘self-experience’ which relies on affective experiential states (...) and raw sensory and perceptual mental existences, to higher forms of knowing and self-aware consciousness. Since current scientific approaches are most concerned with the understanding of higher declarative states of consciousness, we will focus on these vastly underestimated primary forms of consciousness which may be foundational for all forms of higher ‘knowing consciousness’. (shrink)

In this paper I develop a new account of the philosophical motivations for Descartes’s theory of judgment. The theory needs explanation because the idea that judgment, or belief, is an operation of the will seems problematic at best, and Descartes does not make clear why he adopted what, at the time, was a novel view. I argue that attending to Descartes’s conception of the will as the active, free faculty of mind reveals that a general concern with responsibility motivates his (...) theory of judgment. My account avoids some unappealing features of the standard interpretation, renders the theory more plausible than many have suggested, and explains why his theory does not fall neatly into any current-day position on the issue of the control we have over belief. (shrink)

AI systems that demonstrate significant bias or lower than claimed accuracy, and resulting in individual and societal harms, continue to be reported. Such reports beg the question as to why such systems continue to be funded, developed and deployed despite the many published ethical AI principles. This paper focusses on the funding processes for AI research grants which we have identified as a gap in the current range of ethical AI solutions such as AI procurement guidelines, AI impact assessments and (...) AI audit frameworks. We highlight the responsibilities of funding bodies to ensure investment is channelled towards trustworthy and safe AI systems and provides case studies as to how other ethical funding principles are managed. We offer a first sight of two proposals for funding bodies to consider regarding procedures they can employ. The first proposal is for the inclusion of a Trustworthy AI Statement’ section in the grant application form and offers an example of the associated guidance. The second proposal outlines the wider management requirements of a funding body for the ethical review and monitoring of funded projects to ensure adherence to the proposed ethical strategies in the applicants Trustworthy AI Statement. The anticipated outcome for such proposals being employed would be to create a ‘stop and think’ section during the project planning and application procedure requiring applicants to implement the methods for the ethically aligned design of AI. In essence it asks funders to send the message “if you want the money, then build trustworthy AI!”. (shrink)

In this paper I argue that it is finally time to move beyond the Nagelian framework and to break new ground in thinking about epistemic reduction in biology. I will do so, not by simply repeating all the old objections that have been raised against Ernest Nagel’s classical model of theory reduction. Rather, I grant that a proponent of Nagel’s approach can handle several of these problems but that, nevertheless, Nagel’s general way of thinking about epistemic reduction in terms of (...) theories and their logical relations is entirely inadequate with respect to what is going on in actual biological research practice. (shrink)

The visual attention (VA) span is defined as the amount of distinct visual elements which can be processed in parallel in a multi-element array. Both recent empirical data and theoretical accounts suggest that a VA span deficit might contribute to developmental dyslexia, independently of a phonological disorder. In this study, this hypothesis was assessed in two large samples of French and British dyslexic children whose performance was compared to that of chronological-age matched control children. Results of the French study show (...) that the VA span capacities account for a substantial amount of unique variance in reading, as do phonological skills. The British study replicates this finding and further reveals that the contribution of the VA span to reading performance remains even after controlling IQ, verbal fluency, vocabulary and single letter identification skills, in addition to phoneme awareness. In both studies, most dyslexic children exhibit a selective phonological or VA span disorder. Overall, these findings support a multi-factorial view of developmental dyslexia. In many cases, developmental reading disorders do not seem to be due to phonological disorders. We propose that a VA span deficit is a likely alternative underlying cognitive deficit in dyslexia. (shrink)

In [12], P. Scowcroft and L. van den Dries proved a cell decomposition theorem for p-adically closed fields. We work here with the notion of P-minimal fields defined by D. Haskell and D. Macpherson in [6]. We prove that a P-minimal field K admits cell decomposition if and only if K has definable selection. A preprint version in French of this result appeared as a prepublication [8].