Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

Within the caring science paradigm, variations of a method of interpretation inspired by the French philosopher Paul Ricoeur's theory of interpretation are used. This method consists of several levels of interpretation: a naïve reading, a structural analysis, and a critical analysis and discussion. Within this paradigm, the aim of this article is to present and discuss a means of creating distance in the interpretation and the text structure by using narration in a poetic language linked to the meaning of the (...) text. Ricoeur's ‘Hermeneutical function of distanciation’ will be introduced, and this concept of distanciation will be illustrated with reference to narrations from a study of patient's life experiences living with chronic illness and home mechanical ventilation in Denmark. Distanciation in the interpretation objectifies the text, and narration in a poetic language creates a particular kind of mediation in the interpretation. That narration represents an interpreted understanding of the whole, which facilitates an appropriate and evocative presentation of the interpreted data. This way of objectifying the text through narration can contribute yet another perspective to Ricoeur's rich and varied theory of interpretation. (shrink)

Altersarmut, Bildungsunterschiede, eine wachsende Kluft zwischen Arm und Reich - die deutsche Gesellschaft spaltet sich, und viele fordern mehr Soziale Gerechtigkeit. Die Autorin untersucht, wie sich das Verstandnis von Sozialer Gerechtigkeit in Philosophie und Politik gewandelt hat, und hinterfragt, inwieweit Politiker Soziale Gerechtigkeit als Akzeptanzmittel fur ihre Entscheidungen nutzen.

Pia Becker entwirft eine Konzeption von Patientenautonomie, die sich im Gegensatz zu in der Medizinethik bisher dominierenden Konzeptionen an der grundsätzlichen Fähigkeit des Patienten zur Autonomie orientiert. Ausgangspunkt bildet die Notwendigkeit der informierten Einwilligung, die neben der Patientenautonomie vor allem auch die körperliche Integrität des Patienten schützt. Als Adäquatheitsbedingungen dienen die beiden normativen Funktionen der Patientenautonomie als Barriere und Schlüssel einer medizinischen Behandlung. Diese Konzeption von Patientenautonomie hat den Vorteil, Patienten besser vor Überforderungen zu bewahren und deren Bedarf an Unterstützungsangeboten (...) zur Förderung der Patientenautonomie deutlicher hervorzuheben. (shrink)

Democracy is increasingly being challenged, by disengagement and by anti-pluralist movements (Levitsky and Ziblatt in How Democracies Die: What History Reveals About Our Future, Viking, New York, 2018; Wikforss in _Därför demokrati. Om kunskapen och folkstyret_ [Because of this, democracy. On knowledge and people’s rule] Fri Tanke, 2021; Svolik et al. in J Democr 34(1):5–20, 2023). This article draws upon a theoretical discussion about democracy, pluralism, and threats to democracy. Departing from Dewey, Laclau, Mouffe, Young and Allen, we address democracy (...) as an ideology that centers around pluralism, or an ever-increasing inclusion of voices from the margins as its goal. We argue that perceiving democracy pedagogically as a pluralistic ideology would support students’ democratic citizenship and equip them for a world where threats to democracy are being reported. Employing a case study on Finnish social studies textbooks, we analyze how democracy as well as threats to democracy are discursively portrayed. Our study shows that the textbooks present democracy as predominantly institutional and static. We also find that while disengagement is portrayed as a problem for democracy, anti-pluralist movements are generally not referred to as a threat. Additionally, we examine a discourse in the textbooks that connects freedom of speech with democracy in a way that favors a multitude of opinions, even antidemocratic ones, over creating space for marginalized voices. Drawing on the theoretical discussion and the results of the analysis, we argue that a focus on pluralism as the core of democracy makes the opposition between restricting hate speech and advocating for democracy redundant. (shrink)

This contribution is located in the field of Historical Theology. It gives an overview (post-World War II) of the philosophical-theological discourse on technology and humanity, articulated by academics who were members and ordained ministers of the Nederduitsch Hervormde Kerk van Afrika (NHKA). It serves to illustrate the close relationship between theology and philosophy within the theological tradition of the NHKA. The author concludes that there is a growing realisation that it is not primarily about technology anymore, but about humanity. In (...) theology, there is a fundamental concern for the well-being of humanity. Theologians would forsake their responsibility if they would stay quiet on something, which is not only transforming our world view and morality, but humanity itself.Contribution: The current discourse on technology tends to be dominated by economists, engineers, information technology specialists, jurists and medical specialists. As a result, technology takes the centre stage, emphasising the benefits of technological progress. Because of the radical impact of technology on humanity, disciplines such as history, philosophy, sociology, psychology and theology are becoming increasingly important discussion partners. (shrink)

This paper sets out to conduct an embodied and situated aural analysis of what silence in Northern Norway is about, with the aim of bringing forward the background noise. The paper brings together theories on construction of the rural, time-space relations, soundscape ecology, and on affect and power, and it merges academic traditions about how to communicate findings from non-visual biased studies. This interdisciplinary framework provides a novel structure for both analysing material and communicating findings from embodied studies of listening (...) out. The study found that silence in Northern Norway is about not listening to the economy of scale, to the commodification of the natural conditions and the suppression of lifestyles and territory. The paper illustrates how power is an inherent part of listening and how listening is a practice that is enacted to create emotions that are associated with a specific time-space relation. (shrink)

Background: The increasing number of elderly people in nursing homes with failing competence to give consent represents a great challenge to healthcare staff’s protection of patient autonomy in the issues of life-prolonging treatment, hydration, nutrition and hospitalisation. The lack of national guidelines and internal routines can threaten the protection of patient autonomy. Objectives: To place focus on protecting patient autonomy in the decision-making process by studying how relatives experience their role as substitute decision-makers. Design: A qualitative descriptive design with analysis (...) of the contents of transcribed in-depth interviews with relatives. Participants: Fifteen relatives of 20 patients in 10 nursing homes in Norway. Results and Interpretations: The main findings reveal deficient procedures for including relatives in decision-making processes. Relatives have poor knowledge about the end of life, and there is little discussion about their role as substitute decision-makers for patients who are not competent to give consent. Few relatives understand the concept of patient autonomy. In Norway the treating physician is responsible for patient treatment. When relatives are included in discussions on treatment, they perceive themselves as responsible for the decision, which is a burden for them afterwards. This qualitative study describes relatives’ experiences, thus providing important information on the improvement potential with the main objective of safeguarding patient autonomy and caring for relatives. Conclusion: The study reveals failing procedures and thus a great potential for improvement. Both ethical and legal aspects must be addressed when considering patient autonomy. (shrink)

The basics -- The dignity of the human person -- Autonomy, consent, refusing treatment and boundaries -- Ethics and non-autonomous patients -- Confidentiality, privacy, data protection, truth telling and trust -- Ethical issues at the beginning of life -- Ethical issues about babies, children and young adults -- Ethical issues at the end of life -- Dying and death: ethical issues -- Loss, grief and bereavement, burn-out and the wounded healer -- Conscientious objection and loyalties.

Traditional interpretations of Aristotle’s theory of perception mainly focus on uncovering the underlying mechanisms that are at stake when perceivers are affected by sensible qualities. Investigating the nature of sense perception is one of Aristotle’s main worries and one that he explicitly relates to the question of its causes (e. g.Sens. 436a16–17, 436b9) and its ends (e. g.de An. 434a30 ff.). Therefore I suggest that, in order to fully explain Aristotle’s view of perceptual phenomena, the possibilities, the constraints, and the (...) goals defined by the embodied and situated engagement of perceivers with the external world must be taken into account. Accordingly, in this paper, I provide an affective reading of Aristotle’s theory of perception. I shall ask what, in addition to functioning sense organs and appropriate response mechanisms, the perceiver contributes to perceptual content. Specifically, I propose to shed light on the significance of perceptual experience for the perceiver and I aim to show that, according to Aristotle, one’s biological and personal qualities are perceptually relevant, meaning that they underpin perception, rather than coming into play after perception has occurred and its objects have been discerned. The paper is divided into two parts, respectively dealing with sensory affections and more complex affective phenomena. As regards the domain of primal sense perception, I will focus on smell as a representative example: since Aristotle identifies it as the least developed of human sensory faculties, it will serve as a revealing illustration of how sense perception is informed and qualified by what, drawing on contemporary philosophical terminology, I will call ‘perceptual interests’, viz. the affective sense of what is at stake in the living being’s interaction with the environment. I will then proceed to consider the way more complex affective phenomena underpin perception by examining the case of emotions and that of virtues of character. By showing how perception is affectively inflected and how emotion is rooted in perception’s bodily nature, I aim to sketch out the general lines along which I believe that the Aristotelian theory of perception should be approached. (shrink)

Developing virtues requires attending to the affective and cognitive components of virtue. The former component implies cultivating apt emotional responses to specific situations. The cognitive part requires the (meta) virtue of phronesis. In dealing with “Phronesis in educating emotions,” this article attends to the nature of emotions and phronesis as its role in cultivating good action habits and virtuous emotional habits. It understands emotion regulation as one of the functions of phronesis. In the broader sense, phronesis includes elements other than (...) deliberation, such as dialectics and rhetoric, which can be helpful to induce a certain suspicion or to persuade somewhat since our affectivity is susceptible to persuasion (i.e. Aristotle’s political dominion of emotions). As a topic in the intersection of moral psychology and moral philosophy, we get valuable insights into a psychologist’s work, Magda Arnold’s (1903–2002) emotion theory. Her understanding of emotion elicitation elucidates the relation between phronesis and emotions. The article focuses on one of the central elements of emotion elicitation, the appraisal. This piece can make the education of emotions for virtue development more understandable. At first glance, our initial appraisal may be hasty and inaccurate, leading to emotional reactions. However, with careful reflection, we can correct and improve upon our initial appraisal and subsequent emotions. If our initial assessment was flawed, this second, more thoughtful evaluation can be enhanced through phronesis. Due to the appraisal’s spontaneity, cultivating educated emotions requires values’ teaching, learning, and thus, appraising good things. With the development of virtues, intuitive estimates become adequate, so emotional responses are more attuned to diverse situations. (shrink)

Die Arbeit zur regionalen Variation der Intonation bietet einen Forschungsüberblick über existierende Studien zum Thema und widmet sich dann der Analyse der Intonation der kölnischen Regionalvarietät auf der Basis von spontansprachlichen Daten. Die Analyse kombiniert Methoden des autosegmental-metrischen Ansatzes mit denen der Interaktionalen Linguistik. Da sich der autosegmental-metrische Ansatz in den letzten Jahren zum gängigen Beschreibungsansatz in der Intonationsforschung entwickelt hat, ist auf diese Weise eine Vergleichbarkeit der verschiedenen Untersuchungsergebnisse gewährleistet. Der Ansatz der Interaktionalen Linguistik erlaubt es darüber hinaus, die (...) tatsächliche Verwendungsweise der Intonationsverläufe durch die Interaktionsteilnehmer aufzuzeigen. Im Zentrum des Interesses stehen zwei steigend-fallende Konturen, die typisch für das Kölnische sind. Sie werden auf phonetischer, tonologischer und phonologischer (d.h. konversationell-funktionaler) Ebene analysiert. Die Arbeit verdeutlicht die große Bandbreite formaler Variation und zeigt, wie die Beteiligten Intonation als Ressource zur Gestaltung der Interaktion nutzen. (shrink)

It is often suggested that during development the brain barriers are immature. This argument stems from teleological interpretations and experimental observations of the high protein concentrations in fetal cerebrospinal fluid (CSF) and decreases in apparent permeability of passive markers during development. We argue that the developmental blood–CSF barrier restricts the passage of lipid‐insoluble molecules by the same mechanism as in the adult (tight junctions) rendering the paracellular pathway an unlikely route of entry. Instead, we suggest that both protein and passive (...) markers are transferred across the epithelium through a transcellular route. We propose that changes in volume of distribution can largely explain the decrease in apparent permeability for passive markers and that developmentally regulated cellular transfer explains changes in CSF protein concentrations. The blood–CSF tight junctions are functionally mature from very early in development, and it appears that transfer from blood into embryonic brain occurs predominately via CSF rather than the vasculature. BioEssays 30:237–248, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

The biological body has remained peripheral to much feminist theory which is the consequence of a legitimate critique of biologicaldeterminism. However, rejecting the biological body altogether runs the risk of treating the body as a sociopolitical effect. It is my argument that corporeal reality can be theorized without lapsing into the totalizing perspectives of essentialism or relativism. To do so Ipropose drawing upon Judith Butler’s analysis of the productive effect of power relations that materialize the body’s sex, and Margaret Lock’s (...) notion of local biology which introduces the notion that biological matter has dynamism of its own that is not reducible to discourse/power. Bringing together these two perspectives on the body holds the prospect of capturing the complex interrelationship between biology, culture, social structure, and power. (shrink)

The biological body has remained peripheral to much feminist theory which is the consequence of a legitimate critique of biologicaldeterminism. However, rejecting the biological body altogether runs the risk of treating the body as a sociopolitical effect. It is my argument that corporeal reality can be theorized without lapsing into the totalizing perspectives of essentialism or relativism. To do so Ipropose drawing upon Judith Butler’s analysis of the productive effect of power relations that materialize the body’s sex, and Margaret Lock’s (...) notion of local biology which introduces the notion that biological matter has dynamism of its own that is not reducible to discourse/power. Bringing together these two perspectives on the body holds the prospect of capturing the complex interrelationship between biology, culture, social structure, and power. (shrink)

Dreyer Kruger, now in his eighties, was asked to reflect on the years of his active professional experience, especially while at Rhodes University from 1974 to 1989. Considered by many to be the doyen of phenomenological psychology in South Africa, he introduced what, at that time, was a revolutionary view in the social sciences of understanding what it means to be human.During his tenure as an academic psychologist, a cohort of doctoral level phenomenologically-oriented psychologists emerged, many of whom emigrated (...) from South Africa during its apartheid era to take up high-raking positions elsewhere in the academic arena in the USA, UK, Australia and New Zealand, while those remaining in South Africa continued his legacy of promoting phenomenology as a field of interrogation in the social and human sciences. (shrink)

Academic bioethics does not appear to be interested in communication and its ethical concerns unless communication is to do with issues such as capacity, consent, truth telling and confidentiality. In contrast practitioners are interested in actually communicating with their patients and they are often particularly perplexed when it comes to people with profound disabilities where communication appears disrupted. Although some new and not so new communication strategies, and especially intensive interaction, are available, little has been written on either the ethical (...) concerns these may present or the deeper concepts that underpin them. This article explores the practical applications of some of these communication strategies. By engaging these strategies with theology, and specifically Pope John Paul’s Theology of the Body, this article identifies and addresses some significant ethical issues that may arise, notably the risk of dualism and of objectifying the human person. Moreover it provides communication strategies with a rationale that goes beyond practicalities to one based on respect for human dignity, justice and solidarity. (shrink)

En el ensayo se propone una reflexión crítica sobre los presupuestos lógicos de la categoría de igualdad y sus ambivalencias. A una premisa teórica, que enmarca los términos de lo que se configura como un problema conceptual, seguirá una breve reconstrucción histórico-filosófica, que tiene el objetivo de arrojar luz sobre cómo podemos, leyendo a un clásico, repensar críticamente las premisas teóricas de la igualdad normativa a través de una recuperación de la valorización aristotélica de la dimensión cognitiva y moral de (...) emociones como la cólera y la indignación. (shrink)

Conceptions of evil have changed dramatically over time, and though humans continue to commit acts of cruelty against one another, today we possess a clearer, more moral way of analyzing them. In _Narrating Evil_, María Pía Lara explores what has changed in our understanding of evil, why the transformation matters, and how we can learn from this specific historical development. Drawing on Immanuel Kant's and Hannah Arendt's ideas about reflective judgment, Lara argues that narrative plays a key role in helping (...) societies acknowledge their pasts. Particular stories haunt our consciousness and lead to a kind of examination and dialogue that shape notions of morality. A powerful description of a crime can act as a filter, helping us to draw conclusions about what constitutes a moral wrong, and public debates over these narratives allow us to construct a more accurate picture of historical truth, leading to a better understanding of why such actions are possible. In building her argument, Lara considers Greek tragedies, Shakespeare's depictions of evil, Joseph Conrad's literary metaphors, and movies that portray human cruelty. Turning to such philosophers and writers as Jürgen Habermas, Walter Benjamin, Primo Levi, Giorgio Agamben, and Ariel Dorfman, Lara defines a reflexive relationship between an event, the narrative of the event, and the public reception of the narrative, and she proves that the stories of perpetrators and sufferers are always intertwined. The process of disclosure, debate, and the public fashioning of collective judgment are vital methods through which we make sense not only of new forms of cruelty but of past crimes as well. _Narrating Evil_ describes the steps of this process and why they are a crucial part of our attempt to build a different, more just world. (shrink)

The boundary work approach has been established as one of the main ways to study controversies in science. However, it has been proposed that it does not meet the power dynamics of the scientific field sufficiently. This article concentrates on the intertwining of boundary work and power. It combines the boundary work approach developed by Thomas Gieryn and the analysis of power in the work of Pierre Bourdieu. Based on a literature review and an analysis of a controversy over therapeutic (...) touch, it finds four forms of boundary work: intradisciplinary, interdisciplinary, between science and society, and between science and other knowledge systems. The article shows how the different forms of boundary work reveal multiple power struggles, hierarchisations and tensions. The controversy appeared in Finnish nursing science when the Finnish Association of Sceptics gave its annual Humbug Award to a book on therapeutic touch. The book was based on a master’s thesis at the University of Tampere department of nursing science. The nursing scholars in the department reacted abruptly and banned certain books, which astonished the students, and a lively public debate followed. In the debate, nursing science was both defended and challenged. The framework of the study shows that the boundary work approach can be used to study different aspects of power. The article proposes that the framework could be used in other controversies as well to study the layers of power in boundary work. (shrink)

This article contributes to the current discussion on interdisciplinarity in the health research field. It focuses on the relationship between nursing research and gender research. Nursing research is a ‘health sciences’ field which draws from the social sciences, the humanities, and biomedicine. Previous research shows the difficulties that social scientists face in their efforts to integrate with biomedical scientists. The aim of this article is to analyse nursing researchers’ views about one potential collaboration partner in the social sciences and humanities: (...) gender research. The study draws its theoretical insights from research within the sociology of science. It uses ideas about the intertwining of power and knowledge, which is especially emphasised in the works of Pierre Bourdieu. The research material consists of 180 abstracts of nursing research articles that argue in some way about the relationship between nursing research and gender research. The Scopus database was selected because it covers nursing research in a broad sense. The scope of the study is long. The close reading of abstracts is inspired by rhetorical discourse analysis. We found three clearly different but also overlapping discourses that justified gender perspectives in nursing research: Gender research helps to highlight the socio-political context in nursing research; Gender research develops or reforms the nursing research tradition; and Gender research exists as a form of critique within nursing research. Most of the nursing research abstracts regard gender research positively for both external and internal reasons. The abstracts also demonstrate the tensions in the relationship and discuss the views and reasons that generate scepticism towards gender research in nursing research. (shrink)

In this volume, the world's foremost Scotus scholars collaborate to present the latest research on his work.

In responding to Mathias Beck's thought-provoking article, it seems helpful to begin with an outline and comments on Beck's case as I understand it. For me, this overview throws up three problematic areas that I explore further under the headings of 1. examining the New Testament evidence, 2. sin as disobedience, and 3. obedience, grace, and freedom. Clearly, the author's thoughts in all their nuances are not always adequately accessible in translation. Nevertheless, I hope that I have grasped the main (...) thread of his argument. If I am right in my interpretation then Beck still has work to do to clarify and make explicit what is not only barely implicit but what is obscured by his central theme: that obedience to God's will is the mainstay of our relationship to God. (shrink)

Emotion Review, Volume 13, Issue 4, Page 277-281, October 2021.

A recent report in the UK, Being Disabled in Britain: A Journey Less Equal, highlights the many inequalities, threats to dignity and discriminatory attitudes faced by disabled people. No doubt these are replicated in other countries. Using the evidenced-based findings from this report and the report’s invitation for those concerned to join the conversation on disability, this paper explores both the way in which the experiences of people with disabilities can sharpen up an understanding of Catholic social teaching and the (...) way in which that teaching contributes to a deeper theology of disability. Moreover, insights from this teaching demonstrate that people with disabilities contribute significantly and positively to society and to interpersonal relationships. (shrink)