This paper considers the use of textual analysis of oral histories as a method for historians of nursing. Fifty‐three oral histories of retired nurses in midwestern USA were analyzed for the purpose of historical reconstruction of past education experiences in nursing. Textual analysis was used to determine how nurses made sense of their educational experiences, and it involved gathering data, analyzing the information, and using a different method of interpreting the data. Although the participants responded to specific questions, the oral (...) histories in this study are more than mere answers to the researchers’ queries. The participants’ memories are narratives that are the joint product of both the historian and the participant. As such, the oral history becomes a text to be stored along with other primary sources for future historians’ use. The research also suggests decentering oral histories from an exclusively academic agenda and focusing more on what the participants choose to remember and why they make those choices. (shrink)

Background:Collaboration between physicians and nurses is key to improving patient care. We know very little about collaboration and interdisciplinary practice in African healthcare settings.Research question/aim:The purpose of this study was to explore the ethical challenges of interdisciplinary collaboration in clinical practice and education in Botswana Participants and research context: This qualitative descriptive study was conducted with 39 participants (20 physicians and 19 nurses) who participated in semi-structured interviews at public hospitals purposely selected to represent the three levels of hospitals in (...) Botswana (referral, district, and primary).Ethical considerations:Following Institutional Review Board Approval at the University of Pennsylvania and the Ministry of Health in Botswana, participants’ written informed consent was obtained.Findings:Respondents’ ages ranged from 23 to 60 years, and their duration of work experience ranged from 0.5 to 32 years. Major qualitative themes that emerged from the data centered on the nature of the work environment, values regarding nurse–doctor collaboration, the nature of such collaboration, resources available for supporting collaboration and the smooth flow of work, and participants’ views about how their work experiences could be improved.Discussion:Participants expressed concerns that their work environment compromised their ability to provide high-quality and safe care to their patients. The physician staffing structure was described as consisting of a few specialists at the top, a vacuum in the middle that should be occupied by senior doctors, and junior doctors at the bottom—and not a sufficient number of nursing staff.Conclusion:Collaboration between physicians and nurses is critical to optimizing patients’ health outcomes. This is true not only in the United States but also in developing countries, such as Botswana, where health care professionals reported that their ethical challenges arose from resource shortages, differing professional attitudes, and a stressful work environment. (shrink)

This book analyses the moral theory of the seventh century Indian Mahayana master, Santideva. Santideva is the author of the well-known religious poem the Bodhicaryavatara (Entering the Path of Enlightenment) , as well as the significant, but relatively overlooked, Siksasamuccaya (Compendium of Teachings) . Both of these works describe the nature and path of the bodhisattva, the altruistic spiritual ideal especially exalted in Mahayana literature. With particular focus on the Siksasamuccaya , this work offers a response to three questions: What (...) is Santideva's moral theory? How does it compare to other analyses of Buddhist ethics? Can one moral theory adequately describe Buddhist moral thought? An exegetical account of the bodhisattva path as outlined in the Siksasamuccaya is provided by textual analysis and translations. The central moral concept of this Buddhist thinker and Santideva's ethical presuppositions and moral reasoning are brought to light by analysing the use of key moral terms and comparing them to other Buddhists' principles. It is also considered in relation to dominant Western ethical theories. By focusing on a neglected Buddhist Sanskrit text by a major Mahayana figure, Barbra Clayton helps to redress a significant imbalance in the scholarship on Buddhist ethics, which has up to now focused primarily on the ethics of the Pali literature and as interpreted in the Theravada tradition. (shrink)

This paper is a study of the place of luminosity in the films of Michael Mann and the way in which luminosity is not a tool of illumination but a radiance that signals the bodying forth of appearances. The event of luminosity in Mann's films is an attempt to re-imagine the conventional value structures that create a link between film and indexicality, as if his admiration for the photoreal effects of film belies an insistence that the advenience of (...) an appearance is what eventuates when objects ingress between reference and expression, between realism and dream. By using the most advanced high definition digital cameras to film his nightscapes - and his movies more generally - Mann defeats the illuminatory and transcriptual demands of a filmic iconography that rely on the power of light to tether a representation to a thing in the world. In doing so, however, he neither refuses nor rejects the power of representation as such. His picturing of luminous nightscapes in cities, for instance, transubstantiates the objecthood of urban spaces so that the iridescence of the lights makes the city feel at once vivid and unlike any object that might exist in the world. I conclude that Mann's commitment to filming luminosity presents a problem to the dominant methodologies for the analysis of aesthetics and politics that offer a moral theory of the image. Michael Mann's films, finally, offer an alternative to the moral theory of the image: a politics of appearances rooted in the experience of advenience. (shrink)

De natureza qualitativo-interpretativista, nosso estudo objetiva relacionar a educação linguística crítico-decolonial, bem como nossas experiências de vida e formação com as praxiologias freirianas. Redigimos narrativas autobiográficas a partir do questionamento: Como se deu seu primeiro encontro com a práxis freiriana? Produzimos, ainda, uma narrativa biográfica de Paulo, em bricolagem, com dados encontrados em cinco de suas obras. Como resultado de nossos esforços, acreditamos que este texto fortaleceu nosso sonho de vivenciar uma educação pública de qualidade, que encoraje mais sujeitos na (...) luta em defesa dos/as oprimidos/as pela raça, gênero e condição social. (shrink)

Having visited Ireland regularly during the 1930s, Ludwig Wittgenstein resigned his Cambridge philosophy professorship in 1947 and moved there, living in a fishing village on the Atlantic coast and hotels in Dublin and the Wicklow Mountains. Although Wittgenstein spent some time out of the country, Ireland was effectively his base for three very productive years during which he worked on what would become one of his key books, the posthumously published Philosophical Investigations. Wittgenstein in Ireland represents the first sustained account (...) of Wittgenstein's time in Ireland, placing it in its historical context. Wall pays a good deal of attention to the representation of the Irish landscape in which the Austrian philosopher found himself able to work; a large part of his writings were produced in the bleak landscapes of Ireland and Norway. (shrink)

Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.

Recent advances in medical and information technologies, the availability of new types of medical data, the requirement of increasing numbers of study participants, as well as difficulties in recruitment and retention, all present serious problems for traditional models of specific and informed consent to medical research. However, these advances also enable novel ways to securely share and analyse data. This paper introduces one of these advances—blockchain technologies—and argues that they can be used to share medical data in a secure and (...) auditable fashion. In addition, some aspects of consent and data collection, as well as data access management and analysis, can be automated using blockchain-based smart contracts. This paper demonstrates how blockchain technologies can be used to further all three of the bioethical principles underlying consent requirements: the autonomy of patients, by giving them much greater control over their data; beneficence, by greatly facilitating medical research efficiency and by reducing biases and opportunities for errors; and justice, by enabling patients with rare or under-researched conditions to pseudonymously aggregate their data for analysis. Finally, we coin and describe the novel concept of prosent, by which we mean the blockchain-enabled ability of all stakeholders in the research process to pseudonymously and proactively consent to data release or exchange under specific conditions, such as trial completion. (shrink)

Different ideas of the normative relevance of autonomy can give rise to profoundly different action-guiding principles in healthcare. If autonomy is seen as a value rather than as a right, it can be argued that patients’ decisions should sometimes be overruled in order to protect or promote their own autonomy. We refer to this as paternalism in the name of autonomy. In this paper, we discuss different elements of autonomy (decision-making capacity, efficiency, and authenticity) and arguments in favor of paternalism (...) for the sake of autonomy that have been proposed in the bioethical debate. We argue that if autonomy is valuable, then paternalism for the sake of autonomy may be justified. However, policies allowing paternalism in the name of autonomy may be self-defeating. (shrink)

There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly (...) rational grounds.We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views. (shrink)

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why it was justifiable (...) to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

In this paper I will revisit the debate over pornography by doing three things: (a) I will suggest a more sophisticated, two‐dimensional set of distinctions between positons in the debate; (b) I will then go on to attack both libertarians and the group I call “repressive feminists”; and (c) I will conclude by suggesting that by means of Hume's theory of sympathy we could support a limited form of censorship to bring women more fully into our moral and political community. (...) I turn first to the labors of definition. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Jerry L. Walls, the author of books on hell and heaven, completes his tour of the afterlife with a philosophical and theological exploration and defense of purgatory, the traditional teaching that most Christians require a period of postmortem cleansing and purging of their sinful dispositions and imperfections before they will be fully made ready for heaven. He examines Protestant objections to the doctrine and shows that the doctrine of purgatory has been construed in different ways, some of which are fully (...) compatible with Protestant theology. In particular, while purgatory has often been understood as matter of punishment in order to make satisfaction for sins that have not been fully remitted, it can also be seen as the completion of the sanctification process, an account of the doctrine that is fully consistent with the Protestant doctrine of justification by faith. Purgatory assumes not only continuity of personal identity but also gradual moral and spiritual growth between death and resurrection. Different theories of personal identity are examined and assessed in light of these assumptions. Walls also shows that the traditional doctrine of purgatory is not understood as a second chance for salvation, but goes on to argue that it should be modified to allow for postmortem repentance. He concludes with an examination of C.S. Lewis's writings on purgatory, and suggests that Lewis can be a model for evangelicals and other Protestants to engage the doctrine of purgatory in a way that is true to their theology. (shrink)

Three enduring models -- What constitutes human being? -- What is the ethical aim? -- What is owed each other? -- Human rights in light of childhood -- The generative family -- The art of ethical thinking.

Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month (...) or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed. (shrink)

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

Large language models (LLMs) such as ChatGPT or Google’s Bard have shown significant performance on a variety of text-based tasks, such as summarization, translation, and even the generation of new...

ABSTRACT As a classical philologist, Nietzsche was extremely familiar with the work of many ancient Greek writers. It is well known that Nietzsche made a practice of identifying with and praising ancient thinkers with whom he felt a kinship. It is worth investigating, then, whether Nietzsche's mention of Hippocrates in D signals a sustained interest in the so-called father of medicine. I argue that there is no evidence that Nietzsche paid special attention to Hippocrates or the Hippocratic corpus. Instead, Nietzsche's (...) curious allusion to Hippocrates is likely influenced in part by his reading of the Comtean positivist Émile Littré. Finally, I argue that if Nietzsche is consciously “Hippocratic” at all, he is so in virtue of the “medical posture” he adopts in D, where Nietzsche's remarks suggest his mission is to relieve humankind of the psychological suffering caused by morality. (shrink)

Down Girl is a broad, original, and far ranging analysis of what misogyny really is, how it works, its purpose, and how to fight it. The philosopher Kate Manne argues that modern society's failure to recognize women's full humanity and autonomy is not actually the problem. She argues instead that it is women's manifestations of human capacities -- autonomy, agency, political engagement -- is what engenders misogynist hostility.

For many of us, entry into motherhood involves an ambiguous visibility and intelligibility, where our acceptance into mainstream spaces as mothers entails a loss of lesbian difference. Mann explores this loss using the work of two philosophers of lesbian difference, Monique Wittig and Judith Butler. She argues that the figure of the lesbian mother is deployed on a broad cultural scale to reinvigorate and renaturaUze the myth of the happy, natural, heterosexual mother.

Plants from a handful of species provide the primary source of food for all people, yet this source is vulnerable to multiple stressors, such as disease, drought, and nutrient deficiency. With rapid population growth and climate uncertainty, the need to produce crops that can tolerate or resist plant stressors is more crucial than ever. Traditional plant breeding methods may not be sufficient to overcome this challenge, and methods such as highOthroughput sequencing and automated scoring of phenotypes can provide significant new (...) insights. Ontologies are essential tools for accessing and analysing the large quantities of data that come with these newer methods. As part of a larger project to develop ontologies that describe plant phenotypes and stresses, we are developing a plant disease extension of the Infectious Disease Ontology (IDOPlant). The IDOPlant is envisioned as a reference ontology designed to cover any plant infectious disease. In addition to novel terms for infectious diseases, IDOPlant includes terms imported from other ontologies that describe plants, pathogens, and vectors, the geographic location and ecology of diseases and hosts, and molecular functions and interactions of hosts and pathogens. To encompass this range of data, we are suggesting inOhouse ontology development complemented with reuse of terms from orthogonal ontologies developed as part of the Open Biomedical Ontologies (OBO) Foundry. The study of plant diseases provides an example of how an ontological framework can be used to model complex biological phenomena such as plant disease, and how plant infectious diseases differ from, and are similar to, infectious diseases in other organism. (shrink)

In The City of God , XI, 10, St Augustine claims that the divine nature is simple because ‘it is what it has’ . We may take this as a slogan for the Doctrine of Divine Simplicity , a doctrine which finds its way into orthodox medieval Christian theological speculation. Like the doctrine of God's timeless eternality, the DDS has seemed obvious and pious to many, and incoherent, misguided, and repugnant to others. Unlike the doctrine of God's timeless eternality, the (...) DDS has received very little critical attention. The DDS did not originate with Augustine, but I am not primarily concerned with its pedigree. Nor am I concerned to ask how the doctrine interacts with trinitarian speculation. I will have my hands full as it is. In Section I of this paper I shall provide a rough characterization of the DDS, indicate its complexity, and focus on a particular aspect of the doctrine which will exercise us in the remainder of the paper, namely, the thesis that the divine attributes are all identical with each other and with God. In section n I shall discuss Alvin Plantinga's recent objections to Aquinas' version of the DDS. I shall then offer a more detailed presentation of what I take to be Aquinas' version , and recast it in terms of a theory of attributes which is significantly different from Plantinga's . Although the recasting of the doctrine will enable me to rebut Plantinga's objections , it by no means solves all the problems of the DDS. In section vi I shall discuss the chief lingering problem facing a defender of the DDS. (shrink)

Are we responsible for our misdeeds in dreams? The obvious answer would seem to be ‘No’. Dreams catch us with our defences down: just those critical and discriminative abilities which are distinctive of our waking lives as responsible moral agents seem out of play when we dream; el sueño de la razón produce monstruos . Moreover, if we are responsible for our dreamt misdeeds, then parity of reasoning demands that we be praised for dreaming noble dreams. But that is absurd. (...) Moral credit should not come that easily, and so neither should moral blame. (shrink)

For some years, Matthew Meyer has labored at a comprehensive interpretation of Nietzsche’s oeuvre that understands his philosophical and literary output as a revival of a particularly Greek mode of thought. This volume represents the culmination of much, but not all, of this previous work, and it serves also as a promise of future work in the same vein. The title, Reading Nietzsche Through the Ancients, is therefore a trifle misleading: Meyer is not reading all of Nietzsche through all the (...) ancients, but only some of Nietzsche through some of them. That is all for the good, so far as I am concerned, since I am usually suspicious of ambitions to resolve Nietzsche’s debt to antiquity in a single... (shrink)

Hot spot policing is an established concept that is proven to reduce crime. It is mostly done through foot patrol or car patrols. In the present study it is tested whether helicopters can produce a deterrent policing effect to reduce the amount of vehicle arsons in Sweden on larger hot areas. Sweden tends to have elevated levels of vehicle arsons in August, with about 20% of police districts responsible for 50% of the cases. The risk narrative revolves around youth congregating (...) in public places in deprived neighborhoods to generate disturbances, and the disruption of the risk narrative tested here is based on providing deterrence through helicopter police presence. During 6 weeks in August and September of 2019 police helicopters patrolled four police districts in Sweden to attempt to prevent vehicle arsons. Our data comprise police reports of vehicle arson, and time stamped satellite data over the location for police helicopters. The evaluation considers whether there is an intention to treat effect from this project, in addition to whether there is an effect of actual helicopter presence. The study finds no significant effect of intention to treat, nor of actual dosage. (shrink)

The Durkheim Test. Remarks on Susan Leigh Star’s Boundary Objects. The article reconstructs Susan Leigh Star’s conceptual work on the notion of ‘boundary objects’. It traces the emergence of the concept, beginning with her PhD thesis and its publication as Regions of the Mind in 1989. ‘Boundary objects’ attempt to represent the distributed, multifold nature of scientific work and its mediations between different ‘social worlds’. Being addressed to several ‘communities of practice’, the term responded to questions from Distributed Artificial Intelligence (...) in Computer Science, Workplace Studies and Computer Supported Cooperative Work (CSCW), and microhistorical approaches inside the growing Science and Technology Studies. Yet the interdisciplinary character and interpretive flexibility of Star’s invention has rarely been noticed as a conceptual tool for media theory. I therefore propose to reconsider Star’s ‘Durkheim test’ for sociotechnical media practices. (shrink)