Understanding between care providers and patients with stroke and aphasia: a phenomenological hermeneutic inquiry The present study illuminates the understanding in communication between formal care providers and patients with stroke and aphasia. Five care providers and three such patients participated in the study. Video recordings were made during conversations about pictures (n = 15), and the care providers were also interviewed (n = 15) after the video‐recorded conversations. A phenomenological hermeneutic method of interpretation of the interview text was used. The (...) findings showed that a range of conditions for ‘understanding and being understood’ in the communication on the part of the care providers exists. These different conditions are: lacking both knowledge and understanding; having knowledge but not necessarily accompanied by understanding; and being in understanding. Within the condition ‘being in understanding’, the care providers create a feeling of at‐homeness in a relaxed atmosphere and thus have the opportunity to be in ‘understanding and being understood’ together with the patient. The condition ‘being in understanding’ appears in connection with the care providers’ creating of a ‘calm liturgy of caring’ by mediating humility and calm vitality affects to the patients, and further, when needed, being present on the level of mystery, i.e. caring communion. (shrink)

BÄCKSTRÖM B, ASPLUND K and SUNDIN K.Nursing Inquiry2010;17: 257–268 The meaning of middle‐aged female spouses’ lived experience of the relationship with a partner who has suffered a stroke, during the first year postdischargeStroke consequences present a great long‐term challenge to the spouses of the stroke sufferer. A longitudinal study with a phenomenological hermeneutic approach was used to illuminate the meanings of middle‐aged female spouses’ lived experience of their relationship with a partner who has suffered a stroke, during the first (...) year postdischarge. Four middle‐aged female spouses of stroke sufferers participated in the study. Narrative interviews were conducted 1, 6 and 12 month postdischarge (total of 12 interviews), audio‐taped and transcribed verbatim to a text and interpreted by a phenomenological hermeneutic method inspired by Ricoeur. The findings showed a process over time during which spouses come to know, recognize and acknowledge the residual changes in their partners’ cognitive and emotional conditions and the impact on their relationship. Spouses showed grief due to the loss of the marital relationship they once had and anxiety that they would not be able to continue in an undesired relationship in the future. Even if the partner is still alive, there is a loss to grieve and to be understood, an important meaning of the transition process in the relationship during the first year after the partner's discharge. (shrink)

The meaning of being a middle‐aged close relative of a person who has suffered a stroke, 1 month after discharge from a rehabilitation clinicThe sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle‐aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged (...) over 18 and under 65. A phenomenological‐hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: ‘being called to mission’, ‘feeling lost and set adrift’ and ‘struggling to keep going’. The middle‐aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained. (shrink)

Every day situations arising in health care contain ethical issues influencing care providers' conscience. How and to what extent conscience is influenced may differ according to how conscience is perceived. This study aimed to explore the relationship between perceptions of conscience and stress of conscience among care providers working in municipal housing for elderly people. A total of 166 care providers were approached, of which 146 (50 registered nurses and 96 nurses' aides/enrolled nurses) completed a questionnaire containing the Perceptions of (...) Conscience Questionnaire and the Stress of Conscience Questionnaire. A multivariate canonical correlation analysis was conducted. The first two functions emerging from the analysis themselves explained a noteworthy amount of the shared variance (25.6% and 17.8%). These two dimensions of the relationship were interpreted either as having to deaden one's conscience relating to external demands in order to be able to collaborate with coworkers, or as having to deaden one's conscience relating to internal demands in order to uphold one's identity as a `good' health care professional. (shrink)

How does science create knowledge? Epistemic cultures, shaped by affinity, necessity, and historical coincidence, determine how we know what we know. In this book, Karin Knorr Cetina compares two of the most important and intriguing epistemic cultures of our day, those in high energy physics and molecular biology. The first ethnographic study to systematically compare two different scientific laboratory cultures, this book sharpens our focus on epistemic cultures as the basis of the knowledge society.

Die Rassentheorie, die Geschichtsphilosophie, die Ästhetik und die Naturteleologie haben eine Gemeinsamkeit: In all diesen Themengebieten entwickelte Immanuel Kant ein Denken der Zweckmässigkeit. Die Fokussierung auf diesen Strang macht eine Verbindung sichtbar, die von seinen frühen Schriften zu den unterschiedlichen »Rassen« der Menschen hin zur Kritik der Urteilskraft und damit zu seiner Selbstreflexion über die kritische Philosophie reicht. Karin Hostettler arbeitet das mit diesem Denken verbundene Othering und die damit einhergehende Selbstaffirmation heraus und zeigt so die Selbstverortung der kritischen (...) Philosophie in einer kolonialen Episteme auf. (shrink)

Some philosophers claim that young children cannot do philosophy. This paper examines some of those claims, and puts forward arguments against them. Our beliefs that children cannot do philosophy are based on philosophical assumptions about children, their thinking and about philosophy. Many of those assumptions remain unquestioned by critics of Philosophy with Children. My conclusion is that the idea that very young children can do philosophy has not only significant consequences for how we should educate young children, but also for (...) how adults should do philosophy; and that further research is urgently needed. (shrink)

This paper suggests that the practice of anamnesis—the taking of a patient history in preparation for making a diagnosis, as well as the related form of investigation, historia—offers a way to understand the role of medical collections in generating medical knowledge. Anamnesis derives from ancient Greek “recollecting” or “opening of memory,” and “taking a history” from historia, an ancient and early modern epistemic practice of gathering empirical observations from the past and present. Doctors and medical researchers perform, this paper argues, (...) a form of anamnesis when they access collections—of pathological organs, experimental animals, diagnostic slides, samples, and data—and the collections may in turn be seen as constituting institutional and disciplinary memories. It moreover shows that doctors and medical researchers in their work with collections negotiate two ways of organizing observations that are also present in an anamnesis. One way clusters and classifies observations, while the other traces developments and requires significant past observations to understand the present. This double nature plays out in different ways in different historical collections. Last, the paper itself may also be seen as performing an anamnesis: looking for patterns and tracing a development in medical history. It “opens the memory” of medical collection practices, and shows that medicine is past-heavy and that the past plays a central role in modern biomedicine. Anamnesis is thus used as a historiographical stance that seeks to understand present practices of generating knowledge about diseases through an inquiry into the past. (shrink)

One theme of this special issue is an incitement to reconsider the relationship between pragmatism and critical realism. While their advocates sometimes come into conflict, there are also clearly b...

Classical conceptual distinctions in philosophy of education assume an individualistic subjectivity and hide the learning that can take place in the space between child and adult. Grounded in two examples from experience I develop the argument that adults often put metaphorical sticks in their ears in their educational encounters with children. Hearers’ prejudices cause them to miss out on knowledge offered by the child, but not heard by the adult. This has to do with how adults view education, knowledge, as (...) much as child, and is even more extreme when child is also black. The idea is what Miranda Fricker calls ‘epistemic injustice’ which occurs when someone is wronged specifically in their capacity as a knower. Although her work concerns gender and race, I extrapolate her radical ideas to child. Awareness of the epistemic injustice that is done to children and my proposal for increased epistemic modesty and epistemic equality could help transform pedagogical spaces to include child subjects as educators. A way forward is suggested that involves ‘cracking’ the concept of child and a different non-individualised conception of education. (shrink)

BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in the (...) United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

The U.S. National Institute of Allergies and Infectious Diseases and the National Institute of Mental Health have a new research priority: inclusion of terminally ill persons living with HIV in HIV cure-related research. For example, the Last Gift is a clinical research study at the University of California San Diego for PLWHIV who have a terminal illness, with a prognosis of less than 6 months. As end-of-life HIV cure research is relatively new, the scientific community has a timely opportunity to (...) examine the related ethical challenges. Following an extensive review of the EOL and HIV cure research ethics literature, combined with deliberation from various stakeholders and our experience with the Last Gift study to date, we outline considerations to ensure that such research with terminally ill PLWHIV remains ethical, focusing on five topics: 1) protecting autonomy through informed consent, 2) avoiding exploitation and fostering altruism, 3) maintaining a favorable benefits/risks balance, 4) safeguarding against vulnerability through patient-participant centeredness, and 5) ensuring the acceptance of next-of-kin/loved ones and community stakeholders. EOL HIV cure-related research can be performed ethically and effectively by anticipating key issues that may arise. While not unique to the fields of EOL or HIV cure-related research, the considerations highlighted can help us support a new research approach. We must honor the lives of PLWHIV whose involvement in research can provide the knowledge needed to achieve the dream of making HIV infection curable. (shrink)

The Posthuman Child combats institutionalised ageist practices in primary, early childhood and teacher education. Grounded in a critical posthumanist perspective on the purpose of education, it provides a genealogy of psychology, sociology and philosophy of childhood in which dominant figurations of child and childhood are exposed as positioning child as epistemically and ontologically inferior. Entangled throughout this book are practical and theorised examples of philosophical work with student teachers, teachers, other practitioners and children (aged 3-11) from South Africa and Britain. (...) These engage arguments about how children are routinely marginalised, discriminated against and denied, especially when the child is also female, black, lives in poverty and whose home language is not English. The book makes a distinctive contribution to the decolonisation of childhood discourses. Underpinned by good quality picturebooks and other striking images, the book's radical proposal for transformation is to reconfigure the child as rich, resourceful and resilient through relationships with (non) human others, and explores the implications for literary and literacy education, teacher education, curriculum construction, implementation and assessment. It is essential reading for all who research, work and live with children. (shrink)

Philosophy with children (P4C) 1 presents significant positive challenges for educators. Its 'community of enquiry' pedagogy assumes not only an epistemological shift in the role of the educator, but also a different ontology of 'child' and balance of power between educator and learner. After a brief historical sketch and an outline of the diversity among P4C practitioners, epistemological uncertainty in teaching P4C is crystallised in a succinct overview of theoretical and practical tensions that are a direct result of the implementation (...) of P4C in mainstream education. These recurring pedagogical tensions in my practice as P4C teacher, teacher educator and mentor of teacher educators cause disequilibrium that opens up rich opportunities for philosophy of education in supporting novice P4Cers. Disequilibrium is a positive force that opens up a space in which educators need to reflect upon their values, their beliefs about learning and teaching, and ultimately encourages educators to rethink their own role. Plato's metaphor of the stingray highlights the role of the P4C teacher educator as model of the P4C teacher in any setting: 'to numb and to be numbed'. The P4C community and its institutions need to address the questions arising from these pedagogical tensions; and this needs to be done with integrity, that is, in communities of enquiry that include children. If not, in the long term, a more instrumental version of P4C may prevail. (shrink)

In order to discover an effective treatment for dementia it is necessary to include dementia patients in clinical research trials. Dementia patients face an increased risk to lose the capacity to consent to research participation, and research possibilities with incompetent participants are legally strictly limited. One solution is for patients to consent to research through an advance research directive whilst still competent. In order to explore whether such a directive would be useful and valuable in practice we conducted a qualitative (...) study. We explored the opinions and arguments of researchers in the field of dementia, aiming to map the possibilities and constraints of ARDs. It was argued that a positive ARD could be valuable to discuss research participation with proxies, and patients with a negative ARD will be excluded from research trials. However, it is argued that an ARD cannot replace the informed consent procedure, and in practice proxy dissent will overrule written consent. The practical use of these directives is thus limited, as most researchers will not comply with positive directives. (shrink)

Relational, selfless, caring, polite, nice, and kind are not how we imagine a woman giving birth in U.S. culture. Rather, we picture her as screaming, yelling, self-centered, and demanding drugs or occasionally as numbed and passive from pain-killing medication. Using in-depth interviews with women about their labor and childbirth, the author presents data to suggest that white, middle-class, heterosexual women often worry about being nice, polite, kind, and selfless in their interactions during labor and childbirth. This finding is important not (...) only because it contradicts the dominant cultural image of the birthing woman but because it reveals that an internalized sense of gender plays a role in disciplining women and their bodies during childbirth. The feminist sociological literatures on birth are concerned with how women and their bodies are controlled, yet they have overlooked this other dimension of control that is not institutional but is a product of how gender is internalized. (shrink)

In feminist media studies, the growing body of research on media production has indicated that journalism remains divided along gender lines. The purpose of this study is to address the lack of relevant multi-method research on gender inequality in journalism. To assess the structural position of women in the journalistic workforce, the authors conducted a large-scale survey of journalists in Belgium. The survey results were explored in more depth by conducting qualitative interviews with 19 female journalists. The analysis confirms the (...) existence of all traditional barriers that women journalists experience. The added value of this study is that it enumerates several additional difficulties, and offers insight into the strategies that the respondents use to deal with gender-related career obstacles. These strategies were associated with the degree of flexibility in the newsroom for journalists with children, the choice to work part-time or freelance, and the use of new communication technologies. (shrink)

Volume 19, Issue 4, August 2020, Page 309-313.

Some philosophers claim that young children cannot do philosophy. This paper examines some of those claims, and puts forward arguments against them. Our beliefs that children cannot do philosophy are based on philosophical assumptions about children, their thinking and about philosophy. Many of those assumptions remain unquestioned by critics of Philosophy with Children. My conclusion is that the idea that very young children can do philosophy has not only significant consequences for how we should educate young children, but also for (...) how adults should do philosophy; and that further research is urgently needed. (shrink)

The philosophy for children curriculum was specially written by Matthew Lipman and colleagues for the teaching of philosophy by non-philosophically educated teachers from foundation phase to further education colleges. In this article I argue that such a curriculum is neither a necessary, not a sufficient condition for the teaching of philosophical thinking. The philosophical knowledge and pedagogical tact of the teacher remains salient, in that the open-ended and unpredictable nature of philosophical enquiry demands of teachers to think in the moment (...) and draw on their own knowledge and experience of academic philosophy. Providing specialist training or induction in the P4C curriculum cannot and should not replace undergraduate and postgraduate degrees in academic philosophy at universities. However, although for academic philosophers the use of the P4C curriculum could be beneficial, I will argue that its use poses the risk of wanting to form children into the ideal ‘abnormal’ child, the thinking child—the adult philosopher’s child positioned as such by the Lipman novels. The notion of narrativity is central in my argument. With the help of two picturebooks—The Three Pigs by David Weisner and Voices in the Park by Anthony Browne—I illustrate my claim that philosophy as ‘side-shadowing’ or meta-thinking can only be generated in the space ‘in between’ text, child and educator, thereby foregrounding a ‘pedagogy of exposure’ rather than ‘teacher proof’ texts. (shrink)

The use of black box algorithms in medicine has raised scholarly concerns due to their opaqueness and lack of trustworthiness. Concerns about potential bias, accountability and responsibility, patient autonomy and compromised trust transpire with black box algorithms. These worries connect epistemic concerns with normative issues. In this paper, we outline that black box algorithms are less problematic for epistemic reasons than many scholars seem to believe. By outlining that more transparency in algorithms is not always necessary, and by explaining that (...) computational processes are indeed methodologically opaque to humans, we argue that the reliability of algorithms provides reasons for trusting the outcomes of medical artificial intelligence. To this end, we explain how computational reliabilism, which does not require transparency and supports the reliability of algorithms, justifies the belief that results of medical AI are to be trusted. We also argue that several ethical concerns remain with black box algorithms, even when the results are trustworthy. Having justified knowledge from reliable indicators is, therefore, necessary but not sufficient for normatively justifying physicians to act. This means that deliberation about the results of reliable algorithms is required to find out what is a desirable action. Thus understood, we argue that such challenges should not dismiss the use of black box algorithms altogether but should inform the way in which these algorithms are designed and implemented. When physicians are trained to acquire the necessary skills and expertise, and collaborate with medical informatics and data scientists, black box algorithms can contribute to improving medical care. (shrink)

Recension av boken _Gravstenar berättar. Judiskt liv i Stockholm 1775-1875 _.

This article analyses the relationship between the concept of single aspect similarity and proposed measures of similarity. More precisely, it compares eleven measures of similarity in terms of how well they satisfy a list of desiderata, chosen to capture common intuitions concerning the properties of similarity and the relations between similarity and dissimilarity. Three types of measures are discussed: similarity as commonality, similarity as a function of dissimilarity, and similarity as a joint function of commonality and difference. Relative to the (...) desiderata, it is found that a measure of the second type fares the best. However, rather than recommend this measure alone as a measure of similarity, it is suggested that there are at least three separate concepts of single aspect similarity, corresponding to the three types of measures. In light of this proposal, three of the eleven measures (and variants of these) are deemed acceptable. (shrink)

Hegel is most famous for his view that conflicts between contrary positions are necessarily resolved. Whereas this optimism, inherent in modernity as such, has been challenged from Kierkegaard onward, many critics have misconstrued Hegel's own intentions. Focusing on the Science of Logic, this transformative reading of Hegel on the one hand exposes the immense force of Hegel's conception of tragedy, logic, nature, history, time, language, spirit, politics, and philosophy itself. Drawing out the implications of Hegel's insight into tragic conflicts, on (...) the other hand, De Boer brings into play a form of negativity that allows us to understand why the entanglement of complementary positions always tends to turn into their conflict, but not necessarily into its resolution. (shrink)

How do scientists generate knowledge in groups, and how have they done so in the past? How do epistemically motivated social interactions influence or even drive this process? These questions speak to core interests of both history and philosophy of science. Idealised models and formal arguments have been suggested to illuminate the social epistemology of science, but their conclusions are not directly applicable to scientific practice. This paper uses one of these models as a lens and historiographical tool in the (...) examination of actual scientific collectives. It centres on the analysis of two episodes from the history of photosynthesis research of the late nineteenth- to mid-twentieth centuries, which display a wide and coordinated intellectual diversity similar to Kitcher’s “division of cognitive labour”. The concept, I argue, captures important aspects of the photosynthesis research communities, but the underlying process unfolded in ways that differ from the model’s assumption in interesting ways. The paper unravels how the self-organised interplay of cooperation and competition, and the dynamics of individual and collective goals within scientific communities were influential factors in the generation of knowledge. From there, some thoughts are developed on how historical and philosophical approaches in the analysis of science can productively interact. (shrink)

In the first decades of the twentieth century, the process of photosynthesis was still a mystery: Plant scientists were able to measure what entered and left a plant, but little was known about the intermediate biochemical and biophysical processes that took place. This state of affairs started to change between the two world wars, when a number of young scientists in Europe and the United States, all of whom identified with the methods and goals of physicochemical biology, selected photosynthesis as (...) a topic of research. The protagonists had much in common: They had studied physics and chemistry (although not necessarily plant physiology) to a high level; they used physicochemical methods to study the basic processes of life; they believed these processes were the same, or very similar, in all life forms; and they were affiliated with institutions that fostered this kind of study. This set of cognitive, methodological, and material resources enabled these protagonists to transfer their knowledge of the concepts and techniques from microbiology and human biochemistry, for example, to the study of plant metabolism. These transfers of knowledge had a great influence on the way in which the biochemistry and biophysics of photosynthesis would be studied over the following decades. Through the use of four historical cases, this paper analyzes these knowledge transfers, as well as the investigative pathways that made them possible. (shrink)

Recently, Weisbecker and Goswami presented the first comprehensive comparative analysis of brain size, metabolic rate, and development periods in marsupial mammals. In this paper, a strictly energetic perspective is applied to identify general mammalian correlates of brain size evolution. In both marsupials and placentals, the duration or intensity of maternal investment is a key correlate of relative brain size, but here I show that allomaternal energy subsidies may also play a role. In marsupials, an energetic constraint on brain size in (...) adults is only revealed if we consider both metabolic and reproductive rates simultaneously, because a strong trade‐off between encephalization and offspring production masks the positive correlation between basal metabolic rate and brain size in a bivariate comparison. In conclusion, starting from an energetic perspective is warranted to elucidate relations between ecology, social systems, life history, and brain size in all mammals. (shrink)

In 2015, the world's first self-defined feminist government was formed in Sweden with the explicit ambition of pursuing a feminist foreign policy. This essay seeks to unpack and highlight some of the substance and plausible future directions of a feminist foreign policy. The overarching ambition is three-fold: to probe the normative contents of feminist foreign policy in theory and in practice; to identify a number of potential challenges and ethical dilemmas that are detrimental to gender-sensitive global politics; and to advance (...) a research agenda that can deepen the normative and ethical notions of a feminist foreign policy. Sweden's feminist foreign policy is still in the making. Its conduct is mostly incremental and focused on international agenda setting and normative entrepreneurship, which is guided by an ethically informed framework of cosmopolitanism and human rights. Yet, this essay argues that this reorientation is distinct for two reasons: First, by adopting the “F-word” it elevates politics from a broadly consensual orientation of gender mainstreaming towards more controversial politics, which explicitly seeks to renegotiate and challenge power hierarchies and gendered institutions that hitherto defined global institutions and foreign and security policies. Second, it contains a normative reorientation of foreign policy, which is guided by an ethically informed framework based on broad cosmopolitan norms of global justice and peace. The article concludes by advancing a research agenda that draws upon feminist IR theory and enhances the ethical and transformative contents of the English School by making it more gender-sensitive and appropriate for the study of feminist foreign policy. (shrink)

The amount of realist positions put forward by philosophers of religion and theologians is impressive. one can certainly doubt whether there is a need for yet another alternative. However, most realist positions employed in studies on religion fall prey to Hilary Putnam’s criticism against metaphysical realism. This gives rise to a dilemma that I aim at solving by introducing yet another realist position, namely non-metaphysical realism.

In her book Epistemic Injustice: Power and the Ethics of Knowing , Miranda Fricker introduces the helpful notion of “identity prejudice” as “a label for prejudices against people qua social type” . She focuses on race, class and gender, and Michael Hand in his article What Do Kids Know? A response to Karin Murris is indeed correct when he states that I have applied her arguments to age as a category of epistemic exclusion.I argue that among the usual contenders (...) of epistemic prejudices, we also need to be cognisant of adults’ implicit and explicit assumptions and prejudices about child and childhood. However, Hand incorrectly uses Fricker’s ideas to reject my proposal to include child as being on the receiving end of epistemic injustice. A close reading of some passages about stereotyping will show why this is the case and why his own claim that “children typically are immature, ill-informed and endearing” will turn out to .. (shrink)