Background: Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in. Objective: To describe assistant nurses’ perspectives of providing care to older persons at the end of life in a nursing home. Research design: Data were collected (...) in semi-structured individual interviews and analyzed with inductive qualitative content analysis. Participants and research context: Seven assistant nurses from a nursing home in Sweden were randomly selected. Ethical consideration: The research was approved by the local ethics committee. Results: Three main categories emerged; “Death a natural part of life”; “The older person’s well-being”; and “Care in the moment of death”; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons’ dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions. Discussion: The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded. Conclusion: To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development. (shrink)

What kind of a science is psychoanalysis? What constitutes its domain? What truth claims does it maintain? In this unique and scholarly work concerning the nature of psychoanalysis, Gunnar Karlsson guides his arguments through phenomenological thinking which, he claims, can be seen as an alternative to the recent attempts to cite neuropsychoanalysis as the answer to the crisis of psychoanalysis. Karlsson criticizes this effort to ground psychoanalysis in biology and neurology and emphasizes instead the importance of defining the (...) psychoanalytic domain from the vantage point of the character of consciousness. His understanding of the unconscious, the libido and the death drive offer new insights into the nature of psychoanalysis, and he also illuminates and develops neglected dimensions such as consciousness and self-consciousness. Karlsson's approach to psychoanalysis is rigorous yet original, and this book fills an intellectual gap with implications for both the theoretical understanding and clinical issues of psychoanalysis. (shrink)

In this study the awake patient's intraoperative situation and experiences during regional anaesthetics and surgery are reflected upon by using the work of the French philosopher Maurice Merleau‐Ponty. Merleau‐Ponty's phenomenological idea of the body as being at the centre of the world highlights the patient's embodied position and bestows significance onto the body as a whole, as a lived body. A case, based on the findings from a previous interview study, is presented as a contextual starting point where a patient (...) goes from having a familiar body recognized as her own to having a partially anaesthetized body experienced as an unknown object. The intraoperative caring space is described in this context as the mutual ground where the awake patient and the nurse anaesthetist (NA) can interact to create meaning. The NA can act as the patient's bodily extension to bridge the gap between the patient's experiences and the situation. This calls for the NA's proximity and genuine presence in order to meet and understand the patient's awake experiences. Learning from the patient's situatedness gives information that is valuable for NAs to share with patients who are less experienced with this contextual situation. The challenge for the NA is not to perform routine‐based care, but to acknowledge every patient's lifeworld and uniqueness thus enabling the patient to move easily along the mind–body–world continuum. The core of intraoperative care is to provide support and promote well‐being of awake patients in the intraoperative environment. The use of a philosophical perspective is relevant for nurses who work in an intraoperative setting where patients undergo regional anaesthetics. This study shows how nursing research using phenomenological philosophy can help uncover new meanings known only to the patients living the experience. (shrink)

This study aims at discovering the essential constituents involved in the experiences of guilt and shame. Guilt concerns a subject’s action or omission of action and has a clear temporal unfolding entailing a moment in which the subject lives in a care-free way. Afterwards, this moment undergoes a reconstruction, in the moment of guilt, which constitutes the moment of negligence. The reconstruction is a comprehensive transformation of one’s attitude with respect to one’s ego; one’s action; the object of guilt and (...) the temporal-existential experience. The main constituents concerning shame are its anchorage in the situation to which it refers; its public side involving the experience of being perceptually objectified; the exclusion of social community; the bodily experience; the revelation of an undesired self; and the genesis of shame in terms of a history of frozen now-ness. The article ends with a comparison between guilt and shame. (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)

For us, narrative care is grounded in pragmatist philosophy and focused on experience. Narrative care is not merely about acknowledging or listening to people's experiences, but draws attention to practical consequences. We conceptualize care itself as an intrinsically narrative endeavour. In this article, we build on Lugones' understanding of playfulness, particularly to her call to remain attentive to a sense of uncertainty, and an openness to surprise. Playfulness cultivates a generative sense of curiosity that relies on a close attentiveness not (...) only to the other, but to who we each are within relational spaces. Generative curiosity is only possible if we remain playful as we engage and think with experiences and if we remain responsive to the other. Through playfulness, we resist dominant narratives and hold open relational spaces that create opportunities of retelling and reliving our experiences. Drawing on our work alongside older adults, as well as people who work in long‐term care, we show the possibilities of playfulness in the co‐composition of stories across time. By intentionally integrating playfulness, narrative care can be seen as an intervention, as well as a human activity, across diverse social contexts, places and times. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Epistemic Leaks and Epistemic Meltdowns: A Response to William Morris on Scepticism with Regard to Reason Mikael M. Karlsson I. In an excellent paper which appeared in the April, 1989 issue of this journal,2 William Morris attemptsto demonstrate thatthe arguments which make up Hume's notorious chapter, "Of scepticism with regard to reason, are, in the first place, coherent—both internally and with the overall strategy of the Treatise—and, in (...) the second place, successful. Morris' paper is an exercise in the noble art of what I style constructive exegesis, an enterprise to which many readers of Hume Studies, and myself as much as any, are committed. It is a guiding principle ofthis art that we donotunderstandaphilosophical textuntil we can interpret it in such a way as to render it both coherent and correct. From this point ofview, coherence and correctness are not as independent of one another as they may seem to be to others who are differently committed. Some texts, such as Hume's chapter, "Ofscepticism with regard to reason," are notoriously resistant to constructive exegesis, despite the formidable bag of tricks which scholars and interpreters have developed; so resistant, that in gloomier moments we may be brought to wonder about our interpretative enterprise itself. Constructive exegesis is indeed a strange, and peculiarly optimistic, enterprise. Someday, I imagine, in a leisurely moment, I will think more reflectively about the principles ofour art. But not now.6 As a fellow practitioner of constructive exegesis, I am in full sympathy with what Morris tries to do in his paper; and I think that he does contribute substantially to our understanding of what Hume is up to in the chapter, "Ofscepticism with regard to reason." The third section of Morris' paper is, in my judgement, particularly successful in showing how Hume's chapter fits into the larger framework of the Treatise: Hume is, we see, attacking both what Morris labels "intellectualist rationalism" and its counterpart, which we may call 'unmitigated scepticism', although the chapter's two main arguments go primarily to the former. I also think that Morris gives very helpful, Volume XVI Number 2 121 MIKAEL M. KARLSSON and to my mind accurate, accounts of these two arguments, which I dub, respectively, the epistemic leak argument, and the epistemic meltdown argument. However, I have personally never found either of these arguments remotely convincing; and I still do not, despite Morris' clarification and defense. In what follows, I shall indicate some ofthe reasons for my dissatisfaction.?. Theepistemicleakargumentpurportsto"prove"(in Hume's sense)that reason or demonstration cannot support knowledge. Morris rightlyreminds us that whatHume meansby knowledge is perfect assurance or conviction: Knowledge is, in short, subjective certainty. This has caused confusion, for this is not what we usually mean nowadays by knowledge; nor was it what people, philosophers included, generally meant prior to Descartes. In Hume itis the product ofthe attempttoresolve all epistemic statesintomental eventsorwhat he calls "perceptions." In any case, we must—as Morris rightly explains—be clear that the epistemic leak argument is aimed at showing that demonstration cannot supportperfect conviction. Inoutline, the argumentissimple: Itworks, asMorrismakes clear, by shifting attention away from the subject-matter or "objects" of demonstration, that is, relations of ideas, to the exercise of demonstrative reason by human agents. The necessity of relations of ideas may suggest to us that we can be certain about them. Against this, one may point out that people do err in the conclusions arrived at by demonstration; this presumably shows that our (rational) understandingis fallible. And once we recognize this, our confidence in any conclusion produced by exercising this facultyislessened—thus do we move from knowledge, or subjective certainty, toprobability: belief, or imperfect conviction. Arguments ofthis general type (we can call them, using Descartes' famous figure, Totten-apple arguments ) were around long before Hume, although they were more commonly directed against the senses than against reason. We find them in antiquity—in Plato and Sextus Empiricus, for instance —and in Descartes, in parallel passages in the Discourse on Method, the First Meditation and the Principles of Philosophy, wherein one can discern a version directed precisely against reason and demonstration.12 To find out what, if anything, Hume has... (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

What follows is a modest example of theorizing an existent theory (Karlsson and Bergman 2017; Swedberg 2014). The theory in question is Margaret S. Archer’s (1995, 2000a) Morphogenesis/Morphostasis...

This article examines how one of the most striking differences between the central doctrines of the Catholic Church and the secular context of Swedish society, attitudes to abortion, is managed by the Swedish church hierarchy and commentators in the official newsletter of the Catholic Church of Sweden. Using Foucauldian concepts of power, the article concludes that in its marginal position, the Catholic Church in Sweden mixes the traditional pastoral and sovereign power of the church with the way pastoral power is (...) exerted in modern society, in its efforts to continue asserting its influence over the possible courses of action for pregnant women. While traditionally abortion has been a woman’s crime, in the Swedish Catholic context it becomes rather the crime of the secular society. This means also that the image of woman as being responsible for her decisions and in need of forgiveness gives way to an image of woman as a victim in need of understanding. (shrink)

When Gödel developed his functional interpretation, also known as the Dialectica interpretation, his aim was to prove consistency of first order arithmetic by reducing it to a quantifier-free theory with finite types. Like other functional interpretations Gödel’s Dialectica interpretation gives rise to category theoretic constructions that serve both as new models for logic and semantics and as tools for analysing and understanding various aspects of the Dialectica interpretation itself. Gödel’s Dialectica interpretation gives rise to the Dialectica categories , in: Contemp. (...) Math., vol. 92, Amer. Math. Soc., Providence, RI, 1989, pp. 47–62] and J.M.E. Hyland in [J.M.E. Hyland, Proof theory in the abstract, Ann. Pure Appl. Logic 114 43–78, Commemorative Symposium Dedicated to Anne S. Troelstra ]). These categories are symmetric monoidal closed and have finite products and weak coproducts, but they are not Cartesian closed in general. We give an analysis of how to obtain weakly Cartesian closed and Cartesian closed Dialectica categories, and we also reflect on what the analysis might tell us about the Dialectica interpretation. (shrink)

The distinction between acting and suffering underlies any theory of agency. Among contemporary writers, Fred Dretske is one of the few who has attempted to explicate this distinction without restricting the notion of action to intentional action alone. Aristotle also developed a global account of agency, one which is deeper and more detailed than Dretske's, and it is to Aristotle's account (with some modifications) that the bulk of this paper is devoted. Dretske's sketchier theory faces at least two ground-level problems. (...) It is shown in the course of the paper how these can be handled by the Aristotelian account, in a way which is friendly to Dretske's approach. 1 An earlier, and fuller, version of this paper was presented at the international conference “Supervenience, Causality, Mind and Action”, Université de Provence (Aix-Marseille 1), Aix-en-Provence, 9-11 May 1999. I would like to thank Thorsteinn Gylfason, Logi Gunnarsson, Torfi Sigurdsson, Andri Björnsson and Lynne Rudder Baker for their helpful comments and criticisms. My research on causality and explanation, which forms the background for this paper, has been supported by the Icelandic Council of Science and the Research Fund of the University of Iceland. (shrink)

In nursing practice, awareness of ethical inner values and a common understanding of nursing and caring are needed. It is therefore important to highlight ideas of caring in nursing practice. The aim of this paper was to illuminate nursing, caring and ethical inner values in caring and caring in nursing practice. By being attentive, open, respectful and treating the patient as a person, nurses can enhance both their own and the patient's sense of personal meaning in the caring relationship. Nurses (...) can use self‐reflection to create an awareness of nursing, caring and ethical inner values in caring. (shrink)

The distinction between acting and suffering underlies any theory of agency. Among contemporary writers, Fred Dretske is one of the few who has attempted to explicate this distinction without restricting the notion of action to intentional action alone. Aristotle also developed a global account of agency, one which is deeper and more detailed than Dretske's, and it is to Aristotle's account (with some modifications) that the bulk of this paper is devoted. Dretske's sketchier theory faces at least two ground-level problems. (...) It is shown in the course of the paper how these can be handled by the Aristotelian account, in a way which is friendly to Dretske's approach. (shrink)

Mental accounting is a concept associated with the work of Richard Thaler. According to Thaler, people think of value in relative rather than absolute terms. They derive pleasure not just from an object’s value, but also the quality of the deal – its transaction utility (Thaler, 1985). In addition, humans often fail to fully consider opportunity costs (tradeoffs) and are susceptible to the sunk cost fallacy. Why are people willing to spend more when they pay with a credit card than (...) cash (Prelec & Simester, 2001)? Why would more individuals spend $10 on a theater ticket if they had just lost a $10 bill than if they had to replace a lost ticket worth $10 (Kahneman & Tversky, 1984)? Why are people more likely to spend a small inheritance and invest a large one (Thaler, 1985)? According to the theory of mental accounting, people treat money differently, depending on factors such as the money’s origin and intended use, rather than thinking of it in terms of the “bottom line” as in formal accounting (Thaler, 1999). An important term underlying the theory is fungibility, the fact that all money is interchangable and has no labels. In mental accounting, people treat assets as less fungible than they really are. Even seasoned investors are susceptible to this bias when they view recent gains as disposable “house money” (Thaler & Johnson, 1990) that can be used in high-risk investments. In doing so, they make decisions on each mental account separately, losing out the big picture of the portfolio. (See also partitioning and pain of paying for ideas related to mental accounting.) . (shrink)

Background Person-centred care is based on ethical principles, and it is regarded as high-quality care. Care of older persons should embrace person-centredness. During the pandemic, older persons were highlighted as a vulnerable group at risk of developing serious illness and/or suffering death from COVID-19. Several pandemic-related measures were introduced in residential care facilities (RCFs) to reduce this risk, which influenced the possibilities to lead and provide a person-centred care. Aim This study’s aim was to explore ethical challenges in relation to (...) person-centredness during the COVID-19 pandemic, from the perspective of leaders in RCFs. Research design The study had a qualitative descriptive design. Participants and research context Semi-structured interviews were conducted with 26 leaders working in RCFs in Sweden. Data were analysed using conventional content analysis. Ethical considerations The study was approved by the Swedish Ethical Review Authority. The participants received oral and written information about the study and gave written consent. The study was conducted in accordance with the Declaration of Helsinki. Findings The overarching ethical challenge was Having to disregard the individual needs of the person in order to protect the group and society. This included (a) Protecting the group versus promoting the older person’s autonomy; (b) Being forced to lead care based on uncertainty instead of evidence; (c) Striving to provide dignified care but lacking opportunities; and (d) Going far beyond ordinary duty and endangering one’s own and the staff’s health. Discussion The ethical challenges meant being torn between the person’s individual needs and protecting the group and society, with clashing ethical principles as a consequence. Conclusions The leaders faced ethical situations resulting in undignified and compromised person-centred care, which has implications for stakeholders and management who need to address the work conditions in RCFs. (shrink)

This phenomenological-psychological study aims at discovering the essential constituents involved in congenitally blind people's spatial experiences. Nine congenitally blind persons took part in this study. The data were made up of half structured (thorough) interviews. The analysis of the data yielded the following three comprehension forms of spatiality; (i) Comprehension in terms of image-experience; (ii) Comprehension in terms of notions; (iii) Comprehension in terms of knowledge.Comprehension in terms of image experience is the form which is most concretely and clearly experienced. (...) It is important to notice, that this kind of image experience is not synonymous with a visually based image experience — a fact which is discussed in the article. The following three features, which are to be understood as a description of what characterizes congenitally blind people's image experience, are presented; (i) Experience of the whole; (ii) Synthesizing/Harmonizing; (iii) Spontanous presentation of the whole. Furthermore, comprehension in terms of image experience is made up of the following four constituents, which aim at specifying the conditions for the possibility of having an image experience; (i) The image experience is based on tactile experiences; (ii) The inner horizon of the object has to be limited in order for the tactile sense to constitute an image experience; (iii) The person must have reached a certain degree of familiarity with the object; (iv) The importance of the emotional investment in the object. (shrink)

Lessons of history are often referred to in public discourse, but seldom in scholarly discussions. This book wants to change this by introducing an innovative scholarly, analytical model of historical lessons, starting from the basic three-fold perspective that you simultaneously are history, share history, and make history. Not any history is useful for extracting or using lessons. Here, what are denoted as borderline historical events, demonstrating both time-specific and time-transcending qualities, are suggested as useful materials. Scholarly works on the Holocaust (...) and Soviet terror, from Raul Hilberg's and Robert Conquest's classical works of the 1960s to more recent books by Jan Gross and Timothy Snyder, are analyzed to identify lessons of history, and their change during a full half-century. (shrink)

BackgroundVascular surgery offers a range of treatments to relieve pain and ulcerations, and to prevent sudden death by rupture of blood vessels. The surgical procedures involve risk of injury and harm, which increases with age and frailty leading to complex decision-making processes that raise ethical questions. However, how vascular surgeons negotiate these questions is scarcely studied. The aim was therefore to explore vascular surgeons’ moral reasoning of what ought to be done for the patient.MethodsQualitative, semi-structured interviews were conducted with 19 (...) vascular surgeons working at three Swedish university hospitals. Data were analysed according to systematic text condensation.ResultsThe surgeons’ moral reasoning about what ought to be done comprised a quest to relieve suffering and avoid harm by exploring what is reasonable to do for the patient. Exploring reasonableness included to shift one´s perspective from the vessels to the whole person, to balance patient’s conflicting needs and to place responsibility for right decision on one´s shoulders. The shift from blood vessels to the whole person implied gaining holistic knowledge in pondering of what is best, struggling with one´s authority for surgery through dialogue, and building relationship for mutual security. To balance patient’s conflicting needs implied weighing the patient’s independence and a sense of being whole against ease of suffering, respecting the patient’s will against protecting life and well-being, and weighing longer life against protecting the present well-being. Finally, to place responsibility on one´s shoulders was conveyed as an urge to remind oneself of the risk of complications, withholding one’s power of proficiency, and managing time during the illness course.ConclusionsThis study contributes to uncovering how moral reasoning is embodied in the vascular surgeons’ everyday clinical discourse as a tangible part of their patient care. The results underpin the significance of moral considerations in the assemblage of medical knowledge and technical skills to further understand vascular surgeons’ clinical practice. The clinical application of these results is the need of forums with sufficient possibilities for articulating these important moral considerations in everyday care. (shrink)

Aus dem Inhalt: Justice in General: E. Attwooll: Is the Idea of Justice Asymmetric? u C. L. Sheng: Injustice in Law Caused by Conflict between Equality and Equity u G. Barden: Approaches to Justice: The Economy and the State u C. Schmidt: The Concept of Justice in Economic Theory u M. Milde: Rawls, Pluralism and the Value of Contract Theory u J. Tasioulas: M. Walzer on Justice u L. Cedroni: An Ethological Approach to Law, Justice and the State uaR. Kevelson: (...) Justice as Artifice and Sign u A. Makolkin: Semiotics and Poeticity of Law and Justice u D. Ginev: Law and Morality from a Hermeneutic-Semiotic Perspective Rights in General: F. Viola: Personal Identity in the Human Rights Perspective u J.-R. Sieckmann: Justice and Rights u P. Comanducci: Justice and Rights u D. Wayand: Aboriginal Rights - Then and Now u M. Pavcnik: Argument der Grundrechte u D. B. Boersema: What's Wrong with Rights? u E. E. Dais: A Kantian Critique of Justice Holmes's Rights Theory Social and Environmental Rights: B. M. Baker: The Welfare State: Objectives, Subordinate Principles and Justifying Grounds u U. Penski: Zur Begruendung und Struktur sozialer Rechte u H. LaFolette: Two Forms of Paternalism u L. J. Mazor: Social Justice / Asocial Injustice u D. Wood: Constitutional Minimalism and the Discretionary Power of the Welfare State u u.a. (shrink)

When not acting in ways that are recognised as physical self-defence, women are often – in psychology and in other dominant discourses – generalised as inherently passive during subjection to sexualised coercion (rape and attempted rape). Likewise, in the aftermaths, their (in)actions are frequently pathologised as ‘maladaptive coping strategies’. We present theoretically and empirically based arguments for an agency-oriented approach to women’s perspectives on sexualised coercion. Agency is understood as intentional, situated and strategic. Sexualised coercion is not generalised as a (...) single “traumatic” event, but conceptualised as life events. Meanings of coercion are embedded in social activities connected to discourses on ‘rape’ and ‘trauma’. Thus personal meanings of subjection are understood as developed in and through participation in trajectories across diverse contexts. Adopted in our study, this approach points to the great diversity of personal meanings of sexualised coercion. Moreover, it reveals intimate connections between situated, personal and dominant discursive meanings of coercion, and women’s strategies of (in)actions during and in the aftermaths of the events. Our analysis of participants’ perspectives also indicates an imperative need for reinterpreting concepts such as ‘victim’ and ‘passivity’. In a reinterpretation women, although subjected to sexualised coercion, emerge as subjects both during subjection and in the aftermaths. Furthermore their seemingly pathological behaviour may be re-conceptualised as person ally sense-making strategies of action in reflected attempts at (re)formulating and (re)organising their life strategies. (shrink)

Background: SNOMED CT is a large terminology system designed to represent all aspects of healthcare. Its current form and content result from decades of bottom-up evolution. Due to SNOMED CT’s formal descriptions, it can be considered an ontology. The Basic Formal Ontology (BFO) is a foundational ontology that proposes a small set of disjoint, hierarchically ordered classes, supported by relations and axioms. In contrast, as a typical top-down endeavor, BFO was designed as a foundational framework for domain ontologies in the (...) natural sciences and related disciplines. Whereas it is mostly assumed that domain ontologies should be created as extensions of foundational ontologies, a post-hoc harmonization of consolidated domain ontologies in use, such as SNOMED CT, is known to be challenging. Methods: We explored the feasibility of harmonizing SNOMED CT with BFO, with a focus on the SNOMED CT Clinical Finding hierarchy. With more than 100,000 classes, it accounts for about one third of SNOMED CT’s content. In particular, we represented typical SNOMED CT finding/disorder concepts using description logics under BFO. Three representational patterns were created and the logical entailments analyzed. Results: Under a first scrutiny, the clinical intuition that diseases, disorders, signs and symptoms form a homogeneous ontological upper-level class appeared incompatible with BFO’s upper-level distinction into continuants and occurrents. The Clinical finding class seemed to be an umbrella for all kinds of entities of clinical interest, such as material entities, processes, states, dispositions, and qualities. This suggests the conclusion that Clinical finding would not be a suitable upper-level class from an BFO perspective. On closer inspection of the taxonomic links within this hierarchy and the implicit meaning derived thereof, it became clear that Clinical finding classes do not characterize the entity (e.g. a fracture, allergy, tumor, pain, hemorrhage, seizure, fever) in a literal sense but rather the condition of a patient having that fracture, allergy, pain etc. This gives sense to the current characteristic of the Clinical Finding hierarchy, in which complex classes are modeled as subclasses of their constituents. Most of these taxonomic links are inferred, as the consequence of the ‘role group’ design pattern, which is ubiquitous in SNOMED CT and has often been subject of controversy regarding its semantics. Conclusion: Our analyses resulted in the proposal of (i) equating SNOMED CT’s ‘role group’ property with the reflexive and transitive BFO relation ‘has occurrent part’; and (ii) reinterpreting Clinical Findings as Clinical Occurrents, i.e. temporally extended entities in an organism, having one or more occurrents as temporal parts that occur in continuants. This re-interpretation was corroborated by a manual analysis of classes under Clinical Finding, as well as the identification of similar modeling patterns in other ontologies. As a result, SNOMED CT does not require any content redesign to establish compatibility with BFO, apart from this re-interpretation, and a suggested re-labeling. Regarding the feasibility of harmonizing terminologies with principled foundational ontologies post-hoc, our results provide support to the assumption that this does not necessarily require major redesign efforts, but rather a careful analysis of the implicit assumptions of terminology curators and users. (shrink)

This article explores the issue of girls’ concerns about sexual activity in a liberal Nordic context. Drawing on ethnographic fieldwork among young people in Denmark, the article identifies three types of concerns girls can have about sexual activity: social expectations, relational expectations and dignity. Whilst contemporary research has tended to focus on the influence different sexual morality discourses have in shaping different expectations and concerns about these, little attention seems to be paid to girls’ normative concerns about sex related to (...) well-being. This article sheds light on how these normative concerns are related to girls’ sense of dignity based on Andrew Sayer’s work on dignity and moral sentiments. Finally, the article argues that tension between sexual morality discourses and moral sentiments may be the source of resistance that girls practise with a new ‘fuckboy’ discourse. (shrink)

Seeking to explain the emergence of anti-trafficking initiatives, scholars have explored two sets of ideas—national security and gender equality—thought to shape policy. In this study, we examine whether such ideational influence accounts for Sweden's evolving anti-trafficking policy over the past decade. As powerful domestic ideas about gender inequality informed the adoption of an abolitionist prostitution policy in the 1990s, one would expect similar ideas to influence domestic responses to the related issue of cross-border trafficking.However, our case study shows that the (...) policy area of trafficking has largely followed a different ideational path. Gendered ideas, periodically nested in a human rights discourse, have been salient in the public debate on trafficking in human beings, especially during the campaign to boycott the 2006 FIFA World Cup. However, they have exerted substantially less influence on Swedish legislative initiatives to combat trafficking, with security concerns still holding sway. (shrink)

Background Thirst and dry mouth are common symptoms in terminally ill patients. In their day-to-day practice, palliative care physicians regularly encounter ethical dilemmas, especially regarding artificial hydration. Few studies have focused on thirst and the ethical dilemmas palliative care physicians encounter in relation to this, leading to a knowledge gap in this area. Aim The aim of this study was to explore palliative care physicians’ experiences of ethical challenges in relation to thirst in terminally ill patients. Methods A qualitative interview (...) study with an inductive approach was conducted. Sixteen physicians working in four different specialised palliative care units and one geriatric care unit in different hospitals in Sweden were interviewed. The interviews were transcribed verbatim and analysed with a reflexive thematic analysis. Results When presented with an ethical challenge relating to thirst, physicians attempted to balance benefits and harms while emphasizing respect for the patient’s autonomy. The ethical challenges in this study were: Starting, continuing or discontinuing drips; lack of evidence and traditions create doubt; and lack of interest and time may result in patient suffering. Conclusions All physicians in this study reported that “Starting, continuing or discontinuing drips” was the main ethical challenge they encountered, where some were so accustomed to the decision that they had a standard answer ready to offer patients and families. Physicians reported that drips were a symbol of thirst quenching, life and survival but were not necessary in end-of-life care. Others questioned the traditions regarding thirst and emphasised drips in particular. (shrink)

Research study on management and social responsibility in prathama sukta of R̥gveda, Hindu canonical text.

The Indonesian Ulema Council (MUI) has issued an illegitimate fatwa against smoking in mosques because it endangers the health of worshippers and interferes with the comfort of worshippers. This study aims to investigate smoking behaviour in mosques and violations of fatwas from ulama and governor regulations. This study follows a cross-sectional design conducted by interviewing 531 Muslims who have prayed in the mosque for the last 14 days and observed the compliance of the mosque in implementing a smoke-free policy in (...) 315 mosques. Frequency distribution and cross-tabulation were carried out using JASP 16 software using cross-tabulation. The results of this study indicate that the implementation of the smoke-free policy for mosques in Medan has been violated many times (57.8%), especially the violation regarding smoking in mosques (32.1%); cigarette butts were still found in the yard of the mosque (44.1%). Violations of the policy of fatwa smoke-free areas occurred in public mosques (61%) and muhammadiyah mosques (46.5%). Smoking behaviour in mosques was seen in the last 2 weeks, namely smoking behaviour carried out by worshippers (57.6%), smoking behaviour carried out by mosque administrators (39.2%), smoking behaviour carried out by community leaders in mosques (19.4%) and smoking behaviour that ulemas carried out in mosques (14.3%). Worshippers must comply with the rules against smoking in mosques because it can endanger the health of other worshippers. Cigarette smoke in the mosque will make other worshippers uncomfortable to worship so that it can damage the solemnity of the congregation to worship in the mosque. Contribution: This study is expected to explain smoking behaviour in mosques, violations of smoking behaviour in mosques that violate the ulama’s fatwa regarding smoking behaviour in mosques and the governor’s regulation on smoking behaviour in mosques. (shrink)

Introduction Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? Method A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, treatment effect, cost effectiveness (...) and evidence for neonates born at 28 and 32 GAW. Results The ethical analysis sketches out two possibilities: (a) It is not ethically permissible to limit treatment to neonates below 32 GAW when assigning high weight to health maximisation and overall health equality. Neonates below 32 GAW score high on severity of disease and efficiency and cost-effectiveness of treatment if one gives full weight to early years of a newborn life. It is in the child's best interest to be treated. (b) It can be considered ethically permissible if high weight is assigned to reducing inequality of welfare and maximising overall welfare and/or not granting full weight to early years of newborns is considered acceptable. From an equity-motivated health and welfare perspective, we would not accept (b), as it relies on accepting the lack of proper welfare policies for the poor and disabled in India. Conclusion Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders. (shrink)

Bibliography of the works of Yaśovijaya, 1624-1688, Jaina philosopher.

Three classical work, with commentary on Jaina philosophy and doctrines.

Jild-i 1: Muntakhab-i ās̲ār-i: Sant Agūstīn, tarjumah-ʼi Muḥammad Taqī Bahrāmī Ḥarrān; Tūmās Akvīnās, tarjumah-ʼi Manūchihr Buzurgmihr; Bārūkh Ispīnūzā, tarjumah-ʼi Abū Ṭālib Ṣārimī; Bilz Pāskāl, tarjumah-ʼi Ḥusayn Kasmāʼī, va muntakhabātī az: Ūpānīshādhā, Dimāpādā, Sūrāngāmāsūtrā, Bhāgavat Gītāyā tarjumah-ʼi Riz̤ā Ṣaddūqī --.

On fundamentals of Nyaya philosophy with Nūtanāloka autocommentary and Ālokaprakāśa commentary by disciples.

Comparative study of Buddhist, Vedanta, and Kashmir Śaiva philosophies.

Aktualnejshaya problema segodnyashnego dnya - vyhod iz sistemy globalnyh krizisov, s kotorymi stolknulos naselenie Zemli, i perehod k "obschestvu razumnogo potrebleniya," obschestvu znaniya. Ogromnuyu rol v etom protsesse igraet obrazovanie - sotsialnyj institut, odnoj iz zadach kotorogo yavlyaetsya sohranenie i translyatsiya znaniya v sotsialnyh sistemah. A chto takoe informatsiya? Iznachalno ee teoriya voznikla dlya nuzhd tehniki. Iz-za etogo mnogie ee aspekty ostalis ne razvitymi, potomu chto oni prosto ne byli vazhnymi dlya tehnicheskih sistem. Primenenie teorii informatsii k biologicheskim sistemam uzhe (...) zastavilo zanyatsya voprosom vozniknoveniya novoj informatsii. A rabota s sotsialnymi sistemami vydvinula takie ponyatiya, kak tsennost, effektivnost, slozhnost informatsii i t. d. Bolee polnyj podhod k teorii informatsii, v svoyu ochered, pozvolyaet najti resheniya ryada problem v teorii sotsialnyh sistem, v chastnosti v obrazovanii, i pokazat puti optimizatsii etih protsessov. (shrink)

This paper is a survey of V.A. Smirnovs main results in modern logic.

Concept of Avidyā in the Vedānta philosophy of Śaṅkarācārya; a study.

jild-i 1. [Without special title] -- jild-i 2. Shāmil-i mustadrakāt va muṣṭalaḥāt va kullīyāt-i falsafah -- jild-i 3. Ilāhiyāt -- jildi 4. Ilāhiyāt bi-maʻnī-i akhaṣṣ -- jild-i 5. Dar Ilāhiyāt bi-maʻnī-i akhaṣṣ.

Religious life; Islam; Islam and social problems; Islamic ethics; security.