Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The aim of this Swedish study was to develop the concept of moral sensitivity in health care practice. This process began with an overview of relevant theories and perspectives on ethics with a focus on moral sensitivity and related concepts, in order to generate a theoretical framework. The second step was to construct a questionnaire based on this framework by generating a list of items from the theoretical framework. Nine items were finally selected as most appropriate and consistent with the (...) research team’s understanding of the concept of moral sensitivity. The items were worded as assumptions related to patient care. The questionnaire was distributed to two groups of health care personnel on two separate occasions and a total of 278 completed questionnaires were returned. A factor analysis identified three factors: sense of moral burden, moral strength and moral responsibility. These seem to be conceptually interrelated yet indicate that moral sensitivity may involve more dimensions than simply a cognitive capacity, particularly, feelings, sentiments, moral knowledge and skills. (shrink)

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

BackgroundThis study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection.The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care.MethodA phenomenological (...) hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology.ResultsThe analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made.ConclusionThe meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a guide - in situations where no way of solving the problem seems to be good. (shrink)

Ocherk 1. Voprosy ontologii -- Ocherk 2. Voprosy ėtiki i ėstetiki -- Ocherk 3. Voprosy gnoseologii i aksiologii.

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Because the techno-economic paradigm of contemporary conceptualizations of innovation is often taken for granted in the literature, this chapter opens up this self-evident notion. First, the chapter consults the work of Joseph Schumpeter, who can be seen as the founding father of the current conceptualization of innovation as technological and commercial. Second, we open up the concept by reflecting on two aspects of Schumpeter’s conceptualization of innovation, namely its destructive and its constructive aspect, based on findings in the history of (...) innovation. Finally, we synthesize our findings and propose an ontic-ontological conceptualization of innovation as ontogenetic process and outcome with six dimensions—newness, political dimension, economic dimension, temporal dimension, human dimension and risk—that moves beyond its technological and commercial orientation. (shrink)

Research on brain or cognitive/affective processes, culture, social interaction, and structural analysis are overlapping but often independent ways humans have attempted to understand the origins of their evolution, historical, and contemporary development. Each level seeks to employ its own theoretical concepts and methods for depicting human nature and categorizing objects and events in the world, and often relies on different sources of evidence to support theoretical claims. Each level makes reference to different temporal bandwidths (milliseconds, seconds, minutes, hours, days, months, (...) years, decades, and centuries) and focuses on different spatio-temporal activities and controlled and non-controlled stimulus conditions. Biological mechanisms and environmental pressures for survival simultaneously created a gradual intersection and enhancement of cognitive/affective skills, cultural practices, and changes in collaborative social interaction and communicative skills. The evolution of a given level of analysis is assumed to have been incremental and overlapping. These innovative and independent ways humans have learned to characterize their brain or cognitive/affective and social/economic/political life often depend on unexamined, representational re-descriptions or cognitive/affective and socio-cultural devices and forms of communication that facilitate the depiction of practices and beliefs we attribute to respondents or subjects and research colleagues. (shrink)

Selected Logic Papers, long out of print and now reissued with eight additional essays, includes much of the author's important work on mathematical logic and ...

В книге очерки Владимира Брагинского в жанре ироничного эссе о любви.

The article is devoted to the memory of Vyacheslav Semenovich Stepin and Nikita Nikolaevich Moiseev, whose multifaceted work was integrally focused on philosophical, interdisciplinary and transdisciplinary research of the key ideas and principles of universal human-dimensional evolutionism. Other remarkable Russian scientists V.I. Vernadsky, S.P. Kurdyumov, S.P. Kapitsa, D.S. Chernavsky worked in the same tradition of universal evolutionism. While V.I. Vernadsky and N.N. Moiseev had been the originators of that scientific approach, V.S. Stepin provided philosophical foundations for the ideas of those (...) remarkable scientists and thinkers. The scientific legacy of V.S. Stepin and N.N. Moiseev maintained the formation of a new quality of research into the philosophy of science and technology as well as into the philosophy of culture. This new quality is multidimensional and it is difficult to define unambiguously, but we presume the formation of those areas of philosophical knowledge as constructively oriented languages of interdisciplinary and transdisciplinary co-participation of philosophy in the convergent-evolutionary development of scientific knowledge in general. In this regard, attention is paid to V.S. Stepin’s affirmations about non-classical nature of modern social and humanitarian knowledge. Quantum mechanics teaches us that the reality revealed through it is a hybrid construct, or symbiosis, of both mean and object of cognition. Therefore, the very act of cognitive observation constructs quantum reality. Thus, it is very close to the process of cognition in modern sociology and psychology. V.S. Stepin insisted that these principles are applicable to all complex selfdeveloping systems, and such are all “human-dimensional” objects of modern humanities. In all the phases of homeostasis changes, or crises, there is necessarily a share of chaos, instability, uncertainty in the selection process of future development scenarios, which is ineliminably affected by our observation. Therefore, a cognitive observer in the humanities should be considered as a concept of post-non-classical rationality, that is as an observer of complexity. (shrink)

t. 1. Filosofii︠a︡ ; Izbrannye predislovii︠a︡ ; I︠A︡zykoznanie -- t. 2. Filologii︠a︡ ; Vospominanii︠a︡ i nabli︠u︡denii︠a︡ ; Pami︠a︡ti uchiteleĭ i kolleg ; Prilozhenie : A.N. Kolmogorov, semioticheskie poslanii︠a︡.

Formulation of a general model of evolution is presented which is based upon the recognition of the ?biosocial? entity, that is the biosphere and human society, as a component?system. It can be demonstrated that the interactions of the components (moleculas, cells, organisms, ecosystems in the biological realms and people, artifacts and ideas in the societies) have replicative organization. We suggest an explanation for the spontaneous emergence of replicative function and organization, a process called autogenesis. During autogenesis, hierarchical levels of replicative (...) organization emerge and compartmentalization and convergence of replicative information occurs. Questions of the origin and evolution of life are discussed. The replicative paradigm can also be applied to the processes of cultural evolution, in which complex replicative networks of people, ideas, and man?made artifacts show all stages and phenomena of autogenesis. Finally, the present state of evolution of the whole global biosocial system is discussed. (shrink)