In this groundbreaking new study, Lowell Nissen explores the use of teleological language in the study of subjects such as behaviorism, negative feedback, and natural selection. He argues that all existing analyses fail to explain how teleological language can be used legitimately, and provides his own analysis in terms of intentionality.

Larry Wright's analysis of teleological description of goal-directed behavior, though ingenious and insightful, errs in the following ways: it incorrectly claims that intentional human action exhibits consequence-etiology, making it impossible, contrary to his claim, for reference to consequence-etiology to be metaphorically transmitted to teleological descriptions of nonhuman behavior; it does not remove the threat of reverse causation for nonhuman behavior; it assumes in the face of contrary evidence that reference to purpose drops out in metaphorical extension; and it cannot account (...) for unrequired behavior directed toward impossible goals. (shrink)

The claim that there are nonpurposive functional statements is critically examined by looking at nine translation schemata, several of which are drawn from recent literature. All but one or two fail, suggesting that all functional statements (a) are causal (and not about probabilities or necessary conditions), and (b) have implicit reference to goals. If so, then the possibility of nonpurposive functional statements rests squarely on the possibility of nonpurposive goals.

Woodfield's analysis of teleology, though it has many virtues, nevertheless exhibits defects that are by no means peripheral. The acknowledged unity of teleological statements is removed because of the unnoticed difference between something being good and something appearing good. It is removed again because "good" does not have one meaning throughout but means desired in purposive and artifact-function TDs and beneficial in behavioral function and biological function TDs. In addition, the analyses of purposive and artifact-function TDs incorrectly claim that all (...) goals are desired. Further, if "desired" is substituted for "good," those same analyses become incoherent. Finally, the interpretation of "belief" assigned to "S believes B is good" makes unintelligible "S believes B causally contributes to G.". (shrink)

The purpose of this study was to explore situations experienced by 12 health-care providers working in two nursing homes. Individual interviews, using a narrative approach, were conducted. A phenomenological–hermeneutical method, developed for researching life experiences, was applied in the analysis. The findings showed that good care situations are experienced when the time culture is flexible, the carers act in a sovereign time rhythm, not mentioning clock time or time as a stress factor. The results are discussed in terms of anthropological (...) and sociological theory: time as event and action and flexible time cultures. Care settings for persons with dementia represent many challenges, such as a heavy workload and time strain. Time ethics is a construction, understanding time used in caring for persons suffering from dementia, which involves a mature, responsible and flexible nursing approach to these patients. (shrink)

This article is the first in a series that looks at the technological transformation of Des Moines Public Schools (DMPS). It concentrates on the costs, some financial but mostly human and organizational, that are emerging as the district begins to implement its plans for dramatically increasing computer technology use. The conclusion reached here is that not only ave the costs been greatly underestimated, they may even force a gradual shift of control over the learning environment.

Taking as a starting point the assertion of an ambiguity in the Lutheran tradition's assessment of reason, the essay argues that the Kantian unreserved confidence in reason is criticised in Bonhoeffer. Based upon a Christological understanding of reason, Bonhoeffer endorses a view of reason which is specifically Christian and yet maintains a universality. With a focus on Bonhoeffer's Ethik as the hermeneutical key to his theology, Bonhoeffer's notion is also discussed in light of contemporary Christian ethics. In this part it (...) is particularly the role of reason within a public discourse which is treated in the essay. Here it is argued that Bonhoeffer may be appropriated in attempting to outline a Christological ontology of reason holding essential implications for the sources and conditions of public discourse. (shrink)

We examine the influence of word choices on mathematical practice, i.e. in developing definitions, theorems, and proofs. As a case study, we consider Euclid’s and Euler’s word choices in their influential developments of geometry and, in particular, their use of the term ‘polyhedron’. Then, jumping to the twentieth century, we look at word choices surrounding the use of the term ‘polyhedron’ in the work of Coxeter and of Grünbaum. We also consider a recent and explicit conflict of approach between Grünbaum (...) and Shephard on the one hand and that of Hilton and Pedersen on the other, elucidating that the conflict was engendered by disagreement over the proper conceptualization, and so also the appropriate word choices, in the study of polyhedra. (shrink)

Background:The nursing community in the Nordic countries has become multicultural because of migration from European, Asian and African countries. In Norway, minority health care providers are recruited in to nursing homes which have become multicultural workplaces. They overcome challenges such as language and strangeness but as a group they are vulnerable and exposed to many challenges.Purpose:The aim is to explore minority healthcare providers, trained nurses and nurses’ assistants, and their experiences of challenges when working in a multicultural team in a (...) Norwegian context.Research method:The study has a qualitative design, using narrative interviews, and a phenomenological–hermeneutic analysis method to explore the experiences of challenges in dementia care.Ethical considerations:The study was approved by The Norwegian Regional Ethics Committee, and the Norwegian Social Science Data Services.Participation and research context:Five informants from different African, Asian and European countries participated in the study. The study was conducted in a Norwegian nursing home, in a dementia care unit.Findings:The results show that minority health care providers experience and find meaning in being a member of a team, they overcome challenges, characterized by the interdependency in the team, appreciating new cultural experiences and striving to belong. They must overcome challenges such as language problems and the feeling of strangeness.Discussion:The findings are discussed considering Løgstrup’s ethic of proximity, the ethical demand of trust, and interdependency. The ethical demand is an answer to a common, transparent, unspoken agreement to be met, seen, and understood.Conclusion:The study shows that cooperation in a multi-professional and multi-ethnic team is important, and secures the quality of care to persons with dementia. Further research is necessary to examine the relation between a multi-ethnic staff and the patients experiencing dementia. Further research is necessary to examine ethnicity, the relation between a multi-ethnic staff, the patients experiencing dementia and next of kin. (shrink)

The degree of success in creating quality care for people suffering from dementia is limited despite extensive research. This article describes Healthcare providers’ experience with the ethical challenges and possibilities in the relationship with patients suffering from dementia and its impact on quality care. The material is based on qualitative, in-depth individual narrative interviews with 12 professional Healthcare providers from two different nursing homes. The transcribed interview texts were subjected to a phenomenological–hermeneutical interpretation. To provide quality care to patients with (...) dementia, the Healthcare providers emphasized the importance of sensing and understanding the patients’ emotional and bodily expressions through sentient attentiveness and recognition of the patient as a person. They also described reciprocity of expressions in the relationship where the patient recognized them both as persons and Healthcare providers. The analyses of the findings are, inter alia, discussed in light of Løgstrup’s relational philosophy of ethics. (shrink)

There are compelling medical, ethical, and legal arguments that support mandating use of a central institutional review board for the review of clinical trials performed at multiple institutional sites. Progress against serious diseases depends on this.

Is there truth to the widespread belief that the ig8os saw a redistribution of income upward, from the poor and the middle class to the rich? While the eighties witnessed an abundance of new and high‐paying jobs and a sharp redistribution of taxes upward, income inequality did increase. But this was not because the poor lost ground but because the rich gained more ground than the poor. In reality, then, the eighties were not only good for the rich and the (...) middle class but met Rawlsian standards of “justice as fairness.”. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task of ensuring that the right sorts of information gets to the right sorts of people remains. We argue that the many efforts underway to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations. This in turn requires that the management of information and knowledge within healthcare (...) organizations be combined with models of resources and processes of patient care that are based on a general ontology of social interaction. The Health Level 7 (HL7) is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. HL7 has advanced a widely used messaging standard that enables healthcare applications to exchange clinical and administrative data in digital form. HL7 focuses on the interface requirements of the entire healthcare system and not exclusively on the requirements of one area of healthcare such as pharmacy, medical devices, imaging or insurance transactions. This has inspired the development of a powerful abstract model of patient care called the Reference Information Model (RIM). The present paper begins with an overview of the core classes of the HL7 (Version 3) RIM and a brief discussion of its “actcentered” view of healthcare. Central to this account is what is called the life cycle of events. A clinical action may progress from defined, through planned and ordered, to executed. These modalities of an action are represented as the mood of the act. We then outline the basis of an ontology of organizations, starting from the theory of speech Acts, and apply this ontology to the HL7 RIM. Special attention is given to the sorts of preconditions that must be satisfied for the successful performance of a speech act and to the sorts of entities to which speech acts give rise (e.g. obligations, claims, commitments, etc.). Finally we draw conclusions for the efficient communication and management of medical information and knowledge within and between healthcare organizations, paying special attention to the role that medical documents play in such organizations. (shrink)

Background:Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves.Purpose:The aim of this study is to illuminate multi-ethnic healthcare providers’ lived experiences of their own working relationship, and its importance to quality care for people with dementia.Research design:The study is part of a greater (...) participatory action research project: ‘Hospice values in the care for persons with dementia’. The data material consists of extensive notes from seminars, project meetings and dialogue-based teaching. The text material was subjected to phenomenological-hermeneutical interpretation.Participants and research context:Participants in the project were healthcare providers working in a nursing home unit. The participants came from 15 different countries, had different formal qualifications, varied backgrounds and ethnic origins.Ethical considerations:The study is approved by the Norwegian Regional Ethics Committee and the Norwegian Social Science Data Services.Findings:The results show that good working relationships, characterized by understanding each other’s vulnerability and willingness to learn from each other through shared experiences, are prerequisites for quality care. The healthcare providers further described ethical challenges as uncertainty and different understandings.Discussion:The results are discussed in the light of Lögstrup’s relational philosophy of ethics and the concepts of vulnerability, ethic responsibility, trust and openness of speech.Conclusion:The prerequisite for quality care for persons with dementia in a multicultural working environment is to create arenas for open discussions between the healthcare providers. Leadership is of great importance. (shrink)

Despite the recent advances in information and communication technology that have increased our ability to store and circulate information, the task remains of ensuring that the right sorts of information reach the right sorts of people. In what follows we defend the thesis that efforts to develop efficient means for sharing information across healthcare systems and organizations would benefit from a careful analysis of human action in healthcare organizations, and that the communication of healthcare information and knowledge needs to rest (...) on a sound ontology of social interaction. We illustrate this thesis in relation to the HL7 RIM, which is one centrally important tool for communication in the healthcare domain. (shrink)