Person‐centred care is founded on ethics as a basis for organizing care. In spite of healthcare systems claiming that they have implemented person‐centred care, patients report less satisfaction with care. These contrasting results require clarification of how to practice person‐centred ethics using Paul Ricoeur's ‘Little ethics’, summarized as: ‘aiming for the good life, with and for others in just institutions’. In this ethic Kantian morality is at once subordinate and complementary to Aristotelian ethics because the ethical goal needs to be (...) critically assessed and passed through the examination of the norm in each care situation. This paper presents examples that describes a person‐centred care practice that balance a critical review of care activities based on a conviction of aiming for patients' wellbeing. In contrast to patients' experiences of person‐centred care in real life, research projects have shown that if the clinical performers comprehend and apply the practice of person‐centred ethics, patients report positive outcomes. The implementation of person‐centred care therefore demands that stakeholders and managers enables and requires that healthcare staff study ethics in the same way as studying for example pharmacology is required when handling patients' medicines. (shrink)

This study explored patients' experiences of participation and non-participation in their health care. A questionnaire-based survey method was used. Content analysis showed that conditions for patient participation occurred when information was provided not by using standard procedures but based on individual needs and accompanied by explanations, when the patient was regarded as an individual, when the patient's knowledge was recognized by staff, and when the patient made decisions based on knowledge and needs, or performed self-care. Thus, to provide conditions for (...) true patient participation, professionals need to recognize each patient's unique knowledge and respect the individual's description of his or her situation rather than just inviting the person to participate in decision making. (shrink)

In recent years the formerly quite strong interest in patient compliance has been questioned for being too paternalistic and oriented towards overly narrow biomedical goals as the basis for treatment recommendations. In line with this there has been a shift towards using the notion of adherence to signal an increased weight for patients’ preferences and autonomy in decision making around treatments. This ‘adherence-paradigm’ thus encompasses shared decision-making as an ideal and patient perspective and autonomy as guiding goals of care. What (...) this implies in terms of the importance that we have reason to attach to (non-)adherence and how has, however, not been explained. In this article, we explore the relationship between different forms of shared decision-making, patient autonomy and adherence. Distinguishing between dynamically and statically framed adherence we show how the version of shared decision-making advocated will have consequences for whether one should be interested in a dynamically or statically framed adherence and in what way patient adherence should be assessed. In contrast to the former compliance paradigm (where non-compliance was necessarily seen as a problem), using observations about (non-)adherence to assess the success of health care decision making and professional-patient interaction turns out to be a much less straightforward matter. (shrink)

As contemporary socio-ecological challenges such as climate change and biodiversity preservation have become more important, the three pillars concept has increasingly been used in planning and policy circles as a framework for analysis and action. However, the issue of how culture influences sustainability is still an underexplored theme. Understanding how culture can act as a resource to promote sustainability, rather than a barrier, is the key to the development of cultural sustainability. This book explores the interfaces between nature and culture (...) through the perspective of cultural sustainability. A cultural perspective on environmental sustainability enables a renewal of sustainability discourse and practices across rural and urban landscapes, natural and cultural systems, stressing heterogeneity and complexity. The book focuses on the nature-culture interface conceptualised as a place where experiences, practices, policies, ideas and knowledge meet, are negotiated, discussed and resolved. Rather than looking for lost unities, or an imaginary view of harmonious relationships between humans and nature based in the past, it explores cases of interfaces that are context-sensitive and which consciously convey the problems of scale and time. While calling attention to a cultural or 'culturalised' view of the sustainability debate, this book questions the radical nature-culture dualism dominating positive modern thinking as well as its underlying view of nature as pre-given and independent from human life. (shrink)

BackgroundResearch proactively and deliberately aims to bring about specific changes to how societies function and individual lives fare. However, in the ever-expanding field of ethical regulations and guidance for researchers, one ethical consideration seems to have passed under the radar: How should researchers act when pursuing actual, societal changes based on their academic work?Main textWhen researchers engage in the process of bringing about societal impact to tackle local or global challenges important concerns arise: cultural, social and political values and institutions (...) can be put at risk, transformed or even hampered if researchers lack awareness of how their ‘acting to impact’ influences the social world. With today’s strong focus on research impacts, addressing such ethical challenges has become urgent within in all fields of research involved in finding solutions to the challenges societies are facing. Due to the overall goal of doing something good that is often inherent in ethical approaches, boundaries to researchers’ impact of something good is neither obvious, nor easy to detect. We suggest that it is time for the field of bioethics to explore normative boundaries for researchers’ pursuit of impact and to consider, in detail, the ethical obligations that ought to shape this process, and we provide a four-step framework of fair conditions for such an approach. Our suggested approach within this field can be useful for other fields of research as well.ConclusionWith this paper, we draw attention to how the transition from pursuing impact within the Academy to trying to initiate and achieve impact beyond the Academy ought to be configured, and the ethical challenges inherent in this transition. We suggest a stepwise strategy to identify, discuss and constitute consensus-based boundaries to this academic activity. This strategy calls for efforts from a multi-disciplinary team of researchers, advisors from the humanities and social sciences, as well as discussants from funding institutions, ethical committees, politics and the society in general. Such efforts should be able to offer new and useful assistance to researchers, as well as research funding agencies, in choosing ethically acceptable, impact-pursuing projects. (shrink)

The United Nation’s (UN) 3rd Annual Multi-stakeholder Forum on ‘Science, Technology and Innovation for the Sustainable Development Goals (STI Forum) - Transformation Towards Sustainable and Resilient Societies’ was held at the UN Headquarters in New York on 5th and 6th of June, 2018. This STI Forum set out to discuss a suit of the sustainable development goals, namely sustainable management of water and sanitation for all (SDG 6), sustainable consumption and production patterns (SDG 12), and sustainable terrestrial ecosystems (SDG 15). (...) It also discussed how to ensure access to affordable, reliable, sustainable and modern energy for all (SDG 7) and how to make cities and human settlements inclusive, safe, resilient and sustainable (SDG 11). I participated in the panel debate on ‘Science, Technology and Innovation for Sustainable Terrestrial Ecosystems (SDG 15)’ – emphasizing the importance of food systems in the context of SDG 15. My statement is summarized below. The panel debate aimed at helping to identify good practices and policy recommendations, as well as challenges and needs, especially as they relate to international cooperation, innovation and capacity-building, with a view to facilitate the development, scaling up adoption and dissemination of relevant technologies for SDG 15. A food system can be described as a system that embraces all the elements (environment, people, inputs, processes, institutions, infrastructure, markets and trade) and activities that relate to the production, processing, distribution and marketing, preparation and consumption of food and the outputs of these activities, including socio-economic and environmental outcomes. A sustainable food system delivers food and nutrition security for all in such a way that the economic, social and environmental bases to generate food security and nutrition for future generations are not compromised. (shrink)

This article is a contribution to the existing debate about the marketization of higher education and offers a detailed study of the way the practices of marketization manifest themselves at the level of discourse in higher education. Taking its point of departure in Critical Discourse Analysis and using a text-driven procedure for genre analysis, the article describes and analyses the international student prospectus as an instance of a highly promotional genre which clearly reflects the values and forces of the free (...) market. The article contains two analyses. The first analysis compares four instances of the international student prospectus genre from Finland, Scotland, Australia and Japan and tries to establish genre membership and genre characteristics by considering the overall text structure, and by looking for similarities in content and `rhetorical moves'. The second analysis is an in-depth analysis of the language use in the international student prospectus from the University of Stirling, Scotland. This analysis pays particular attention to the way the rhetorical moves and visual and lexico-grammatical features in the text are used to represent the two main participants in the text: the university and its students. Both analyses show that the student prospectus is trying to construct an image of the University of Stirling and its students which goes hand in hand with the new trend in higher education — namely that of offering innovative products to `demanding' clients on the look-out for the best possible `university experience'. (shrink)

The theory of formal spaces is developed in terms of presentations, in order to study effectivity.

Emotions are viewed as having evolved through their adaptive value in dealing with fundamental life-tasks. Each emotion has unique features: signal, physiology, and antecedent events. Each emotion also has characteristics in common with other emotions: rapid onset, short duration, unbidden occurrence, automatic appraisal, and coherence among responses. These shared and unique characteristics are the product of our evolution, and distinguish emotions from other affective phenomena.

The right of access to documents is constitutionally based in Sweden and has a long history. The right of access is considered crucial to Swedish democracy. On entering the EU in 1995, Sweden declared that public access to official records forms part of Sweden’s constitutional, political and cultural heritage. The members of the EU for their part declared that they took it for granted that Sweden would fully comply with Community, now Union, law with respect to openness and transparency. Sweden (...) continues to push for transparency when EU legislation potentially containing secrecy clauses is negotiated in the EU. It turns out, however, that the EU membership does pose challenges to the strong Swedish right of access to documents. The protection of personal data is controversial in Sweden to the extent that the stricter EU legislation clashes with the traditionally weak protection of privacy in Swedish law; the right of access to information has largely overridden the right to privacy. Large amounts of publicly available personal data, amassed in data bases by private actors, for commercial reasons but under the protection of the Swedish constitution, is causing problems especially since the Swedish constitutional law is considered, by Sweden, to precede EU legislation in the field. Sweden will somehow have to solve the dilemmas caused by the differing traditions of transparency between itself and other members of the EU and of other international organizations. Many answers – perhaps converging - will be provided in 2016 by Swedish official inquiries and the EU Regulation.Article first published online: 22 MARCH 2016. (shrink)

This contribution explores Grotian Moments in the practice of the UN Security Council in three different but closely related subject areas. The three areas are, in turn, the way the Security Council interprets the concept of ‘threat to the peace’ or more generally ‘international peace and security’, the law-making by the Security Council, and the subjects – in the sense of legal or natural persons – that the Security Council chooses to address. It turns out that the interpretation by the (...) Security Council of the UN Charter has been remarkably flexible, expanding the scope of action of the Council considerably. Whether its interpretation of the UN Charter also deserves to be labelled ‘Grotian’, however, is rather a matter of rhetoric than law. (shrink)

The purpose of this overview of published articles on decision making in paediatric care was to identify important aspects of its possible use in clinical practice and to obtain a base for future research. A literature review was undertaken utilizing snowball sampling to identify articles because of the diversity present within the area of decision making in paediatric care. The databases PubMed and CINAHL were used. The search was limited to articles published in English during the period 1994-2004. The analysis (...) entailed a series of comparisons across articles, focusing on major areas of enquiry and patterns of results. Various levels of decision making are described because these seem to form a basis for how decisions are made. Concepts found to be of importance for decision making are described under the following headings: competence, the child’s best interests, knowledge, values and attitudes, roles and partnership, power, and economy. Further research is suggested. (shrink)

When a child is hospitalized, the parents find themselves in an unfamiliar environment and their parental role changes. They are in a stressful and often anxiety-filled situation and it may be difficult for them to participate in decisions. The purpose of this study was to examine the extent to which parents participate in decisions during the course of events when their child is hospitalized. Thirty-five parents of 24 children (aged 5 months to 18 years) were followed by mobile observation during (...) their child’s hospitalization in a paediatric department in Sweden. Three researchers analysed field notes in three steps, using manifest and latent coding. In step 1, 119 situations that included a decision process were identified. In step 2, the situations were assessed according to a five-level scale concerning how the parents’ wishes, desires or values had been respected. In step 3, each situation was scrutinized with respect to factors influencing the extent of the parents’ participation. The results showed that parents have varying ability to be involved in decision making. Professionals need to communicate more openly with them in order to identify and satisfy their needs because some parents are unwilling or incapable of expressing them. (shrink)

Patients are supposed to be given care according to their needs. This concept is, however, difficult to define and patients and caregivers may have different opinions about a patient’s needs. Twenty patients were interviewed and asked to give a definition of need, describe their needs while hospitalized and depict what they do to make sure their needs are fulfilled. Ten groups of needs were identified: communication, basic care, contact with other people, behaviour of staff, empathy, competent caregivers, continuity, integrity, participation (...) in decision making, and pain relief. The descriptions patients gave of how they ensured their needs were met could be divided into two groups: openly seeking attention; or not wanting to disturb the staff. Interviews with patients emphasized the importance of recognizing that they have individual needs and varying abilities to see that their needs are fulfilled. (shrink)

Emotions are discrete, automatic responses to universally shared, culture-specific and individual-specific events. The emotion terms, such as anger, fear, etcetera, denote a family of related states sharing at least 12 characteristics, which distinguish one emotion family from another, as well as from other affective states. These affective responses are preprogrammed and involuntary, but are also shaped by life experiences.

The editors of this unique volume have brought together 24 leading emotion theorists with a wide variety of perspectives to address 12 fundamental questions about the subject.