Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The aim of this Swedish study was to develop the concept of moral sensitivity in health care practice. This process began with an overview of relevant theories and perspectives on ethics with a focus on moral sensitivity and related concepts, in order to generate a theoretical framework. The second step was to construct a questionnaire based on this framework by generating a list of items from the theoretical framework. Nine items were finally selected as most appropriate and consistent with the (...) research team’s understanding of the concept of moral sensitivity. The items were worded as assumptions related to patient care. The questionnaire was distributed to two groups of health care personnel on two separate occasions and a total of 278 completed questionnaires were returned. A factor analysis identified three factors: sense of moral burden, moral strength and moral responsibility. These seem to be conceptually interrelated yet indicate that moral sensitivity may involve more dimensions than simply a cognitive capacity, particularly, feelings, sentiments, moral knowledge and skills. (shrink)

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

t. 1. Dialog s V. V. Davydovym -- t. 2. Nereshennye problemy razvivai︠u︡shchego obrazovanii︠a︡.

Standard models of adolescent risk taking posit that the cognitive abilities of adolescents and adults are equivalent, and that increases in risk taking that occur during adolescence are the result of socio emotional differences in impulsivity, sensation seeking, and lack of self-control. Fuzzy-trace theory incorporates these socio emotional differences. However, it predicts that there are also cognitive differences between adolescents and adults, specifically that there are developmental increases in gist-based intuition that reflects understanding. Gist understanding, as opposed to verbatim-based analysis, (...) generally has been hypothesized to have a protective effect on risk taking in adolescence. Gist understanding is also an essential element of informed consent regarding risks in medical decision- making. Evidence thus supports the argument that adolescents’ status as mature minors should be treated as an exception rather than a presumption, because accuracy in verbatim analysis is not mature gist understanding. Use of the exception should be accompanied by medical experts’ input on the bottom-line gist of risks involved in treatment. (shrink)

BackgroundThis study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care.MethodA phenomenological (...) hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology.ResultsThe analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made.ConclusionThe meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good. (shrink)

The purpose. Critical social philosophy of education strives to provide a radical critique of existing models of education in the so-called Western models of democracy, creating progressive alternative models. In this context, the proposed integrative metatheory, which is based on classical and modern sources, concepts, aims for a comprehensive understanding and reconstruction of the phenomenon of education. One of the main tasks in the sphere of education’s democratization today, therefore, is to bring to education the results of restructuring and democratization (...) of the society, to reflect changes in conditions of life and thinking, experience and transformation of subjectivity in the context of the technological revolution and globalization. Methodology. The critical social theory, which developed in the framework of contemporary neo-Marxism, indicates the need for a thorough analysis of society, however, unlike other theoretical concepts and research programs in order to analyze not a fixation and a statement of the existing social givens. On the contrary, critical analysis of society involves the identification of existing antagonistic, alienating factors that distort public communication.The subject of social analysis is the whole sphere of human and non-human nature, which interacts a person depend on it, the whole system of relations between society and nature, society and man, which is covered by the historical practice of conscious – "praxis". The representative of "pure science" isn't the learning, research subject. He is a public a person, which is the totality of all social definitions included in society and its constituent individuals. For such a "total subject" Object of interest is not something external; on the contrary, the latter appears as a product of his own activity. The scientific novelty examines trends in educational institutions and models of globalizing society in the context of our particular relationship of education and society, man and the state, and processes. The research and systematic analysis of neoliberal reforms at the level of society in general and education in particular are conducted. It examines substantive, structural and functional characteristics of the concept of «critical social philosophy of education» in the context of institutional tendencies of social life, as well as forms and possibilities of its methodological application. It consider a model of «critical social philosophy of education», as embodied in the programs of social development and learning, which are primarily designed to teach people how to lead an independent and original research themselves, society and knowledge systems. However, it is proved that the models and programs should not be cut off from any individual and the collective system of moral and social values, theoretical and applied training, nor from further use of the acquired values, norms and skills in everyday life, science, or in production, sphere of all social institutions. Conclusions. Critical philosophical, educational, pedagogical-psychological surprisingly theory, its models and concepts seek to redefine public and private and the public mind. Based on these grounds, in the future, it allows philosophy of education to develop a more inclusive philosophical vision of education, to apply directly to the problems of democratization and changes in social relations in the direction of equality and social justice in the field of education. The point of view of socio-philosophical and philosophical-еducational, pedagogical-psychological, normative understanding and social critics also requires the use of active efforts in the reconstruuction of education and society, the social vision of what education and human life can be and what their specific limitations in existing societies. (shrink)

The purpose. Critical social philosophy of education strives to provide a radical critique of existing models of education in the so-called Western models of democracy, creating progressive alternative models. In this context, the proposed integrative metatheory, which is based on classical and modern sources, concepts, aims for a comprehensive understanding and reconstruction of the phenomenon of education. One of the main tasks in the sphere of education’s democratization today, therefore, is to bring to education the results of restructuring and democratization (...) of the society, to reflect changes in conditions of life and thinking, experience and transformation of subjectivity in the context of the technological revolution and globalization. Methodology. The critical social theory, which developed in the framework of contemporary neo-Marxism, indicates the need for a thorough analysis of society, however, unlike other theoretical concepts and research programs in order to analyze not a fixation and a statement of the existing social givens. On the contrary, critical analysis of society involves the identification of existing antagonistic, alienating factors that distort public communication.The subject of social analysis is the whole sphere of human and non-human nature, which interacts a person depend on it, the whole system of relations between society and nature, society and man, which is covered by the historical practice of conscious – "praxis". The representative of "pure science" isn't the learning, research subject. He is a public a person, which is the totality of all social definitions included in society and its constituent individuals. For such a "total subject" Object of interest is not something external; on the contrary, the latter appears as a product of his own activity. The scientific novelty examines trends in educational institutions and models of globalizing society in the context of our particular relationship of education and society, man and the state, and processes. The research and systematic analysis of neoliberal reforms at the level of society in general and education in particular are conducted. It examines substantive, structural and functional characteristics of the concept of «critical social philosophy of education» in the context of institutional tendencies of social life, as well as forms and possibilities of its methodological application. It consider a model of «critical social philosophy of education», as embodied in the programs of social development and learning, which are primarily designed to teach people how to lead an independent and original research themselves, society and knowledge systems. However, it is proved that the models and programs should not be cut off from any individual and the collective system of moral and social values, theoretical and applied training, nor from further use of the acquired values, norms and skills in everyday life, science, or in production, sphere of all social institutions. Conclusions. Critical philosophical, educational, pedagogical-psychological surprisingly theory, its models and concepts seek to redefine public and private and the public mind. Based on these grounds, in the future, it allows philosophy of education to develop a more inclusive philosophical vision of education, to apply directly to the problems of democratization and changes in social relations in the direction of equality and social justice in the field of education. The point of view of socio-philosophical and philosophical-еducational, pedagogical-psychological, normative understanding and social critics also requires the use of active efforts in the reconstruuction of education and society, the social vision of what education and human life can be and what their specific limitations in existing societies. (shrink)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

"This book is an augmented and updated translation by the author of Theorie des Subjekts: Subjectiviteat und Identiteat zwischen Moderne und Postmoderne, Teubingen, Francke-UTB, 2010 (3rd ed.)"--Title page verso.

Moral philosophers have often felt the need of a concept which would cover all those cases where we are prevented from achieving our ends through no fault of our own: a criterion for saying when failure is not blameworthy. The deontologists thought we were not to blame for actions done in genuine ignorance of the facts. Kant declared in a famous passage that we were not morally responsible for failures due to the “niggardliness of stepmother nature.” In this article I (...) want to introduce into moral philosophy a new concept for clarifying the failures for which we are not to blame: the notion of scarcity, taken from economic theory. (shrink)

The importance of communities in strengthening the ethics of international collaborative research is increasingly highlighted, but there has been much debate about the meaning of the term ‘community’ and its specific normative contribution. We argue that ‘community’ is a contingent concept that plays an important normative role in research through the existence of morally significant interplay between notions of community and individuality. We draw on experience of community engagement in rural Kenya to illustrate two aspects of this interplay: (i) that (...) taking individual informed consent seriously involves understanding and addressing the influence of communities in which individuals’ lives are embedded; (ii) that individual participation can generate risks and benefits for communities as part of the wider implications of research. We further argue that the contingent nature of a community means that defining boundaries is generally a normative process itself, with ethical implications. Community engagement supports the enactment of normative roles; building mutual understanding and trust between researchers and community members have been important goals in Kilifi, requiring a broad range of approaches. Ethical dilemmas are continuously generated as part of these engagement activities, including the risks of perverse outcomes related to existing social relations in communities and conditions of ‘half knowing’ intrinsic to processes of developing new understandings. (shrink)

George V. Walsh examines the differences and similarities between Immanuel Kant and Ayn Rand in the area of metaphysics. He presents Kant's premises and conclusions on the major issues and provides a detailed discussion of Rand's criticisms of Kant. Walsh argues that Rand has seriously misread Kant on several points. Her interpretation—that Kant saw our sensory grasp of the world as "delusion," rather than knowledge—resembles that of Arthur Schopenhauer, except that the latter declares Kant's doctrine worthy of praise instead of (...) condemnation. (shrink)

We introduce proof nets and sequent calculus for the multiplicative fragment of non-commutative logic, which is an extension of both linear logic and cyclic linear logic. The two main technical novelties are a third switching position for the non-commutative disjunction, and the structure of order variety.