The aim of this article is twofold. First, it is a theoretical and empirically based contribution to the branch of research that studies enabling conditions of human sense-making. It demonstrates the value of a coherent ecological framework, based on dialogism and interactivity for the study of sense-making, problem-solving and task performance in naturalistic contexts. Second, it presents a promising method for the analysis of cognitive activities, Cognitive Event Analysis, with which we investigate real-life medical interactions, especially the emergence of insights (...) in procedural task performance in emergency medicine. We show how sense-making and insights are accomplished by medical teams when they integrate cultural expertise, professional skills, inter-bodily dynamics, material constraints and affordances within the environment, i.e. when local co-action is embedded in socio-cultural patterns of behaviour. (shrink)

These are not easy times for extending liberal religious traditions. I am struck by how much has changed in the past two decades, how differently I now imagine the challenges and possibilities of constructive religious thought. What's happened? What are the salient features of our current moment, and the constraints and opportunities for religious reflection that it affords? These are, of course, large and complex questions. But my charge to reflect upon future directions in liberal religious thought must inevitably begin (...) here.1To provide a sketch of our particular historical juncture I will focus my remarks on the shifting American religious landscape and more broadly on what I am calling a "late secular" age.2 I .. (shrink)

ObjectiveThere have been increased efforts to implement medical ethics curricula at the student and resident levels; however, practising physicians are often left unconsidered. Therefore, we sought to pilot an ethics and professionalism curriculum for faculty in obstetrics and gynaecology to remedy gaps in the formal, informal and hidden curriculum in medical education.MethodsAn ethics curriculum was developed for faculty within the Department of Obstetrics and Gynaecology at a tertiary care, academic hospital. During the one-time, 4-hour, mandatory in-person session, the participants voluntarily (...) completed the Oldenburg Burnout Inventory, Handoff Clinical Evaluation Exercise, University of Missouri-Kansas City School of Medicine and overall course evaluation. Patient satisfaction survey scores in both the hospital and ambulatory settings were compared before and after the curriculum.ResultsTwenty-eight faculty members attended the curriculum. Overall, respondents reported less burnout and performed at the same level or better in terms of patient handoff than the original studies validating the instruments. Faculty rated the professionalism behaviours as well as teaching of professionalism much lower at our institution than the validation study. There was no change in patient satisfaction after the curriculum. However, overall, the course was well received as meeting its objectives, being beneficial and providing new tools to assess professionalism.ConclusionThis pilot study suggests that an ethics curriculum can be developed for practising physicians that is mindful of pragmatic concerns while still meeting its objectives. Further study is needed regarding long term and objective improvements in ethics knowledge, impact on the education of trainees and improvement in the care of patients as a result of a formal curriculum for faculty. (shrink)

It is often claimed both that forgiveness is elective and that forgiveness is something that we do for reasons. However, there is a tension between these two central claims about the nature of forgiveness. If forgiving is something one does for reasons, then, at least sometimes, those reasons may generate a requirement to forgive or withhold forgiveness. While not strictly inconsistent with electivity, the idea of required forgiveness strikes some as antithetical to the spirit of the concept. They argue that (...) forgiveness is essentially elective. In this paper, I dispute these arguments. I argue that the intuitive plausibility of the position diminishes upon reflection and that the best arguments fail to explain why reasons to forgive, unlike most other reasons for action, cannot generate requirements. (shrink)

Abolitionism is the view that if no one is responsible, then we ought to abandon the reactive attitudes. Proponents suggest that reactive attitudes can be replaced in our emotional repertoire by non-reactive analogues. In this paper, I dispute and reject a common challenge to abolitionism according to which the reactive attitudes are necessary for protesting unfairness and maintaining social harmony. While other abolitionists dispute the empirical basis of this objection, I focus on its implications. I argue that even if non-reactive (...) analogues cannot perform the interpersonal and social functions of reactive attitudes, it does not follow that the losses of abandoning them outweigh the gains of retaining them. The force of the challenge rests on a mistake, identified by John Stuart Mill among others, that is common when evaluating entrenched social practices. (shrink)

When we forgive, we do so for reasons. One challenge for forgiveness theorists is to explain which reasons are reasons to forgive and which are not. This paper argues that we forgive in response to a perceived change of heart on the part of the offender. The argument proceeds in four steps. First, I show that we forgive for reasons. Second, I argue that forgiveness requires the right kind of reason. Third, I show that these two points explain a common (...) distinction between forgiving and letting go and, in doing so, solve a problem facing many accounts of forgiveness. Finally, I consider candidate reasons to forgive and argue that all of them are either the wrong kind of reason or are instances of a more general reason of the right kind, namely, a perceived change of heart. (shrink)

Wrongdoing is inescapable. We all do wrong and are wronged; and in response we often blame one another. But if blame is a defining feature of our social lives, so is ceasing to blame. We might excuse, justify, or forgive an offender; or simply let the offence go. Each mode of ceasing to blame is a social practice and each has characteristic norms that influence when and how we do it, as well as how it’s received. We argue that how (...) we relinquish blame, and how effective we are, depends on many circumstances only partially within our control. Like any norm-governed practice, one can do it well or poorly, appropriately or inappropriately, successfully or unsuccessfully. To successfully participate in a practice, one’s action must be done for the right reasons and secure uptake. We argue that social and material circumstances can compromise one’s ability to effectively cease to blame in the manner one prefers. But if one can fail, then one can lack access to particular ceasing to blame practices if one is regularly prevented from effectively relinquishing blame. However, uncooperative social and material circumstances do not only arise by chance. Our central argument is that circumstances of oppression can systematically compromise one’s ability and opportunities to effectively perform a variety of ceasing to blame practices. This deprivation is an insidious facet of oppression that is neglected both in theories of oppression and of forgiveness but which has significant implications for how we understand the power and purpose of forgiveness. (shrink)

In this article, we defend two claims about the precautionary principle. The first is that there is no ‘core’ precautionary principle that unifies all its different versions. It is more plausible to think of the different versions as being related to each other by way of family resemblances. So although precautionary principle x may have much in common with precautionary principle y, and y with z, there is no set of necessary and sufficient conditions that unify all versions of the (...) principle. Our second claim is that it is sometimes appropriate to think of the precautionary principle as a midlevel principle in the sense proposed by Beauchamp and Childress in their Principles of Biomedical Ethics, i.e. as a non-rigid moral principle. We argue that if the precautionary principle is conceived as a non-rigid principle that needs to be balanced against other principles before a moral verdict can be reached, then this enables us to address some standard objections to the principle. (shrink)

The article entails a critical discussion of the book Capitalism, Alienation and Critique by Asger Sørensen. Like Sørensen’s book, it stresses the importance of the first generation of critical theory – especially Horkheimer and Adorno – although Sørensen is at the same time critized for neglecting the insights of Horkheimer and Adornos work from the mid-1940s and onwards. In arguing for the actuality of especially the late Horkheimer, the article emphasizes the following topics: The problems of education and ‘Bildung’, The (...) historical transformation of the critique of Capitalism after the Second World War and The drawbacks of classical humanism when it comes to grasping the current political and ecological crisis. (shrink)

Abolitionism is the view that if no one is responsible, we ought to abandon the reactive attitudes. This paper defends abolitionism against the claim, made by P.F. Strawson and others, that abandoning these attitudes precludes the formation and maintenance of valuable personal relationships. These anti-abolitionists claim that one who abandons the reactive attitudes is unable to take personally others’ attitudes and actions regarding her, and that taking personally is necessary for certain valuable relationships. I dispute both claims and argue that (...) this objection exaggerates the role of the reactive attitudes and underestimates the importance of non-reactive moral emotions. (shrink)

Philosophy & Social Criticism, Volume 48, Issue 2, Page 164-173, February 2022. The article entails a critical discussion of the book Capitalism, Alienation and Critique by Asger Sørensen. Like Sørensen’s book, it stresses the importance of the first generation of critical theory – especially Horkheimer and Adorno – although Sørensen is at the same time critized for neglecting the insights of Horkheimer and Adornos work from the mid-1940s and onwards. In arguing for the actuality of especially the late Horkheimer, the (...) article emphasizes the following topics: The problems of education and ‘Bildung’, The historical transformation of the critique of Capitalism after the Second World War and The drawbacks of classical humanism when it comes to grasping the current political and ecological crisis. (shrink)

Once relegated to the margins of the responsibility debate, moral influence theories have recently been rehabilitated. This paper offers a moral influence theory with two parts: a theory of responsibility as influenceability and an act-consequentialist justification of blame. I defend this account against six concerns commonly raised both by opponents and by advocates of similar views. Some concerns target act consequentialism, claiming that it 1) permits blaming innocents; 2) permits coercion, manipulation, and other objectionable forms of influence; and 3) fails (...) to capture intuitions about desert. Other concerns target responsibility as influenceability, claiming that influenceability accounts are 4) unsophisticated, 5) make ascriptions of responsibility dependent on assessments of permissible blame, and 6) have various counterintuitive implications. (shrink)

ABSTRACTIn Critical Discourse Studies and in other linguistics oriented scholarly journals we now see more research which draws upon multimodality as part of carrying out analyses of how text...

This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on (...) the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care. (shrink)

The studies of mind and language have traditionally been linked to one another. Indeed, theories of reference have over time brought more and more mind into meaning. Here I argue that the links must be made far stronger still if we are to understand either. I offer some criticism of the causal-functionalist theories of reference on this ground, and present some ideas for improvements. The upshot will be that intentionality is largely internal and very real indeed, that it provides a (...) genuine distinction between systems that have it and ones that do not, and that it hinges on internal complexities of a specifiable sort, ones that are tied to the detection of error. What is meaning, what is it good for, and what is a naturalist account of how it works? In this paper. I will argue that first two of these questions should be answered primarily in terms of processes inside the mind/brain, contrary to most recent thinking on this. In the sequel paper, I will argue that a key aspect of this is the physical body of the meaning agent, and propose a way in which this might work and how an external notion of reference can be recaptured from internal processes. (shrink)

This paper examines the existential context of physical and mental health. Hans Georg Gadamer and The World Health Organization’s conceptualizations are discussed, and current medicalized and idealized views on health are critically examined. The existential dimension of health is explored in the light of theories of selfhood consisting of different parts, Irvin Yalom’s approach to “ultimate concerns” and Martin Heidegger’s conceptualization of “existentials.” We often become aware of health as an existential concern during times of illness, and health and illness (...) can co-exist. The paper discusses how existential suffering in Western culture is described, to an increasing degree, as disorders or psychological deficits, and perfectionistic health goals easily can become a problem. We seek to avoid suffering rather than relate to it, with all the tension that may create. The paper argues that suffering is an unavoidable aspect of people’s experience of their lives, and actively relating to suffering must be regarded as a fundamental aspect of health. The need and usefulness of a concept of “existential health” is discussed. (shrink)

This paper argues that there is a dimension of human consciousness which allows for a pre-intentional and non-cognitive intuition of sensibility. A sensibility which allows for the vulnerability of the human other is by nature characterized by passivity and receptivity. Moreover, sensibility invokes the significance of relating to the human other in an affective way of being touched by his or her pain and suffering. This capacity of being distressed by the distress of another person opens up for ethical responsibility (...) and even in a fundamental sense is a presupposition for full-fledged clinical knowledge in medical care and health care. (shrink)

Anthropocentrism—the idea that humans are the most important beings there are—comes in many guises. One version of anthropocentrism states that only humans have full moral status. Those who argue for such a position usually refer to some trait that confers moral status and that only humans have. Suggestions include linguistic ability, self-awareness or rationality. However, regardless of what trait one picks it will not track the line between Homo sapiens and other species. You will always be able to find some (...) non-human animal that possesses the trait to a greater degree than some human does— even potentially. Koplin and Wilkinson1 adopt a broadly sentientist position: moral status is conferred by some mental or cognitive function. They discuss two sources of moral uncertainty related to this. In cases of moral uncertainty of the first type, it is uncertain whether Property X confers moral status. In cases of uncertainty of the second type, we assume it to be true that moral status is conferred by X, but it is uncertain whether a particular entity possesses the property. There are reasons to believe …. (shrink)

The concept of ‘empowerment’ is used frequently in a number of professional areas, from psychotherapy to social work. But even if the same term is used, it is not always clear if the concept denotes the same goals or the same practice in these various fields. The purpose of this paper is to clarify the discussion and to find a plausible and useful definition of the concept that is suitable for work in various professions. Several suggestions are discussed in the (...) paper, for example control over life or health, autonomy, ability, self-efficacy, self-esteem, and freedom, and it is concluded that there are two plausible complementary uses, one as a goal and one as a process or approach. Empowerment as a goal is to have control over the determinants of one’s quality of life, and empowerment as a process is to create a professional relation where the client or community takes control over the change process, determining both the goals of this process and the means to use. (shrink)

This article considers the foundation of nursing as a moral practice. Its basic claim is that all nursing knowledge and action reside on a moral foundation. The clinical gaze meets vulnerability in the patient’s human condition. To see a patient’s wound is to see his or her hurt and discomfort; it is a concerned observation. To see the factual and pathophysiological is at the same time to see the ethical: the moral realities of suffering, pain and discomfort. A nurse’s emotional (...) sensitivities are central to understanding a patient’s experiences of illness. Emotions reveal value and ascribe moral importance to certain situations; they are addressed centrally by vulnerability and the moral realities of illness. Hence, the essence of nursing knowledge and nursing performance cannot be understood merely as ontology (i.e. as being-with-the-other). Nursing is basically being-for-the-other; it is responsibility; it is ethics. (shrink)