Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

Background: To place a dependent with severe dementia in a nursing home is a painful and difficult decision to make. In collectivistic oriented societies or families, children tend to be socialised to care for ageing parents and to experience guilt and shame if they violate this principle. Leaving the care to professional caregivers does not conform with the cultural expectations of many ethnic groups and becomes a sign of the family’s moral failure. Research design: Qualitative design with individual in-depth interviews (...) with nurses, family members and dementia care coordinators in Norway, Montenegro, Serbia and South Africa. Braun and Clarke’s six analytic phases were used. Ethical considerations: The project was approved by the Regional Committee for Research, South-Eastern Norway; the Norwegian Centre for Research Data; the Ethics Committee; University of Limpopo, MEDUNSA Campus, South Africa; and by the local heads of the respective nursing homes or home care services. Interviewees were informed orally and in writing and signed an informed consent form. Findings: Healthcare professionals tend to be contacted only when the situation becomes unmanageable. Interviewees talked about feelings of obligation, shame and stigma in their societies regarding dementia, particularly in connection with institutionalisation of family members. Many lacked support during the decision-making process and were in a squeeze between their own needs and the patients’ need of professional care, and the feeling of duty and worry about being stigmatised by their surroundings. This conflict may be a source of pre-decision regret. Conclusion: Family caregivers need help to understand the behaviours of persons with dementia and how to access the formal and informal services available. Thus, they may provide effective support to patients and family carers alike. Supportive interventions for caregivers need to be tailored to meet the individual needs of both the caregiver and the persons with dementia. (shrink)

Apresenta uma análise preliminar das manifestações dos autores das Ciências Sociais e Humanas dentro do campo da Biblioteconomia e da Ciência da Informação (B & C.I.), por meio do método bibliométrico e análise de citação. Com o objetivo de descortinar quais teóricos são convocados para a construção do conhecimento na produção científica dos campos supracitados, realizou-se uma pesquisa exploratória com vistas ao levantamento dos autores das Ciências Sociais e Humanas e, posteriormente, a verificação da ocorrência deles na produção indexada pela (...) Base de Dados em Ciência da Informação (BRAPCI). Foram identificados 180 autores, dos quais 91 apareceram pelo menos uma vez nas buscas empreendidas pelos nomes e sobrenomes desses autores das Ciências Sociais e Humanas. O resultado desta pesquisa demonstrou os dois autores mais citados, Michel Foucault e Pierre Bourdieu, bem como a presença de diversos autores das Ciências Sociais e Humanas na construção do conhecimento da Biblioteconomia e da Ciência da Informação, o que contribui para o fortalecimento e a consolidação de ambas. (shrink)

Prologue: the hooded friar -- A most solemn act of justice -- The Nolan philosopher -- "Napoli e tutto il mondo" -- "The world is fine as it is" -- "I have, in effect, harbored doubts" -- "I came into this world to light a fire" -- Footprints in the forest -- A thousand worlds -- Art and astronomy -- Trouble again -- Holy asininity -- The signs of the times -- A lonely sparrow -- Thirty -- The gifts of (...) the Magi -- The song of Circe -- "Go up to Oxford" -- Down risky streets -- The art of magic -- Canticles -- Squaring the circle -- Consolation and valediction -- Infinities -- Return to Italy -- The witness -- The adversary -- Gethsemane -- Hell's purgatory -- The sentence -- The field of flowers -- Epilogue: the four rivers. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

This article addresses the question whether a basic income will be a just social policy for women. The implementation of a basic income will have different effects for different groups of women, some of them clearly positive, some of them negative. The real issues that concern feminist critics of a basic income are the gender-related constraints on choices and the current gender division of labour, which are arguably both playing at the disadvantage of women. It is argued that those issues (...) are not adequately addressed by a basic income proposal alone, and therefore basic income has to be part of a larger packet of social policy measures if it wants to maximise real freedom for all. (shrink)

Human embryos produced in labs since the 1970s have generated layers of uncertainty for law and policy: ontological, moral, and administrative. Ontologically, these lab-made entities fall into a gray zone between life and not-yet-life. Should in vitro embryos be treated as inanimate matter, like abandoned postsurgical tissue, or as private property? Morally, should they exist largely outside of state control in the zone of free reproductive choice or should they be regarded as autonomous human lives and thus entitled to constitutional (...) protection like full-fledged citizens? Administratively, if they deserve protection, what institutional and policy mechanisms are best suited to carrying out the necessary oversight? Using a method termed comparative problematization, this article traces divergent answers to these questions produced in three countries—the United States, United Kingdom, and Germany—across the last twenty-five years. Comparison reveals distinct bioconstitutional foundations that give rise to systematically different understandings of each state’s responsibilities toward human life and hence its particular treatment of claims on behalf of embryonic lives. (shrink)

This study investigated attitudes toward the use of deception in negotiation, with particular attention to the distinction between deception regarding the informational elements of the interaction (e.g., lying about or misrepresenting needs or preferences) and deception about emotional elements (e.g., misrepresenting one's emotional state). We examined how individuals judge the relative ethical appropriateness of these alternative forms of deception, and how these judgments relate to negotiator performance and long-run reputation. Individuals viewed emotionally misleading tactics as more ethically appropriate to use (...) in negotiation than informational deception. Approval of deception predicted negotiator performance in a negotiation simulation and also general reputation as a negotiator, but the nature of these relationships depended on the kind of deception involved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Right HeartIngrid GouldI remarked to a friend, “We haven’t spoken since my arrest!” Alarm and confusion clouded his face, given my half-century of squeaky-clean living. “Cardiac arrest,” I clarified. “The fire department rebooted me.”An electrophysiologist diagnosed Arrhythmogenic Right Ventricular Dysplasia, prescribed medication, and implanted a defibrillator. For the next three-and-a-half years, he helped me live with a disease I didn’t know existed until he told me I had (...) it.The disease progressed—an ironic, disease-centric term since its advancement was to my detriment— prompting my cardiologist to recommend seeing someone who specialized in heart failure. I resisted the very idea of heart failure, a terrible term for a struggling organ, but took her advice and scheduled an appointment.The new cardiologist urged transplant testing, a lengthy process. I agreed, figuring that by the time I needed a new heart in 15–20 years, they’d be rolling off 3D printers.To record occasional transplant musings and inchoate fears and perhaps, over time, untangle them, I began journaling. I chronicled my passage through the echocardiogram, heart catheterization, 31 tubes of bloodwork, interviews with different clinical specialties, a pulmonary function test in a machine reminiscent of Star Trek’s Transporter, and more. Testing had barely begun when my medication stopped working—a Halloween shock.I began a harsher medication, underwent an ablation, and spent six weeks in a wearable defibrillator, a vest with abundant wires, and a purse-sized battery pack that made me resemble a character in [End Page 123] the Jetsons. This attire did not bring holiday comfort or joy to the TSA1 when I flew to visit my sister. As my R-waves faded to a whisper, I swapped the vest for a second implanted defibrillator, substantially more sensitive than the first.In early 2018, we learned I had qualified for transplant listing, though I wished to get as much mileage as possible from the original engine. My cardiologist warned, “There is no Plan B—no machine, device, or medication for the long-term. You will need a transplant.” He explained that since most cardiac patients have left-heart problems, companies develop products for the left side of the heart. My problem was on the right—a tiny market. He also cautioned that a patient needs to be sick enough to warrant transplant and well enough to remain a candidate, survive the surgery, and recover.Although clinically I was ready, I was not personally ready. I felt too good to trade an excellent quality of life for the promised miserable post-transplant year. The cardiologist wisely asked if I wanted to speak with another patient. When I requested someone beyond the dreaded first year, he put me in touch with two women who had received new hearts a few years earlier and befriended each other. They soon became my invaluable mentors and cherished friends. I will never forget seeing them stride into our first meeting and thinking, “They are beautiful! They look totally normal!”By May, climbing four flights of stairs took as much effort as five used to take. Tests confirmed further deterioration and suggested I had 7–13 months of declining health before my heart would give out completely. We chose a date for hospital admission, and I started telling people outside my immediate family. Most were flabbergasted, believing heart transplants were the last hope of the desperately ill. I did not look moribund, though, apparently, I was.The eight months after my first transplant appointment let me prepare psychologically to bid farewell to my heart—the metaphor for kindness, love, and bravery in our culture—and to welcome a new organ from a generous person less medically fortunate than I.In the hospital, I met others awaiting their hearts. A sudden intimacy arises when mortal choices catapult people into a medical realm suggestive of science fiction. Add the emotional intensity that accompanies knowing your extended life comes courtesy of a person who breathes no more on this earth and you wonder how an organ recipient integrates sorrow and gratitude.Two weeks after I was hospitalized, my cardiologist informed me the wait was over... (shrink)

This paper explores how individuals experiencing hostile affective states such as envy, jealousy, hate, contempt, and Ressentiment tend to deceive themselves about their own mental states. More precisely, it examines how the feeling of being diminished in worth experienced by the subject of these hostile affective states motivates a series of self-deceptive maneuvers that generate a fictitious upliftment of the subject’s sense of self. After introducing the topic (section 1), the paper explores the main arguments that explain why several hostile (...) affective states involve a feeling of diminution in the subject’s own value (section 2). Next, it offers an analysis of how the negative feeling of self-worth motivates self-deception. While in extrinsically motivated self-deception, the subject feels diminished in worth after negatively evaluating her own hostile affective states, in intrinsically motivated self-deception, the negative feelings of self-worth are constituent elements of the hostile affective state in question (section 3). Cases of intrinsically motivated self-deception are particularly intriguing because in them the motivation for self-deception is inherent to the hostile affective state, independently of external reasons. I coin the expression “self-deceptive style” to capture the distinctive form in which each hostile affective state intrinsically motivates changes in the architecture of the mind (e.g., perception, imagining, memory, judgment, attention, etc.) in order to generate an upliftment of the self (section 4). To show the descriptive and explanatory function of this concept, a comparative analysis of the self-deceptive styles of envy and hate is provided (section 5). The conclusion summarizes the main findings and explores directions for further research (section 6). (shrink)

Many older gay men experience diminished psychological well‐being (PWB) due to unique circumstances including discrimination, living with HIV, and aging through the HIV/AIDS crisis. However, there remains ambiguity as to how older gay men define and understand PWB. Our team interviewed and analyzed the accounts of 26 older (50+) self‐identifying English‐speaking men living in southwestern British Columbia, Canada. We drew on tenets of constructivist grounded theory and intersectionality to account for unique contextual considerations and power relations. Semi‐structured Zoom interviews were (...) conducted from August‐October 2022. Interview transcripts were compared to generate high‐order conceptual findings underpinned by processes understood as central to PWB. Three PWB temporal processes highlighted interlocking social and contextual circumstances intersecting with power and maturation: (1) being emotionally balanced, (2) living gratitude (3) and fully embracing self‐acceptance. Being emotionally balanced supported the affective and sustainable state of contentment, living gratitude drew from the wisdom of accrued experiences to cultivate a positive affective state inclusive to recognising social location privileges, whilst fully embracing self‐acceptance redressed the harms of anti‐gay discourses that men endured throughout their lives. The knowledge is relevant to service and resource development to deliver tailored PWB supports to older gay men. (shrink)

Two theme–setting quotations introduce this essay—that of Yeats's falcon, deaf to the falconer's call, adrift in space above the blood–dimmed tide, counterpoised to Pierre Teilhard de Chardin's call to abandon old nationalistic prejudices and build the earth. With primary references to the thought of Teilhard, along with, among others, to Ewert Cousins, Andrew M. Greeley, Karl Jaspers, Marshall McLuhan, Ilya Prigogine, Karl Rahner, Leonard Swidler, David Tracy, and Alfred North Whitehead, I argue that the most crucial intellectual paradigm shift of (...) the twenty–first century will challenge humanity to take the turn from uncritical attachment to rigid absolutism or atomistic fragmentation toward a sense of open–ended, off–centered centeredness and fluid connections—from a static to a dynamic model of reality. Central to my argument is the Teilhardian reinterpretation of the Christian metaphors of creation, fall, incarnation, salvation, and the eschaton in the evolutionary terms of the emergence of cosmic consciousness from the chrysalis of the world of the past—from chaos to order, from biosphere via noosphere to theosphere. Facilitated by the exponential growth of populations, collaborative research, science, technology, and global communication (most dramatically manifested by the Internet), this emergent understanding of what it means to be human can, first, foster the awareness that in humanity evolution has become conscious of itself, and then, gradually, precipitate the formation of “the global village” (the mystical body of Christ), as respectful dialogue replaces diatribe and the dualistic pugilism of Samuel Huntington's “Clash of Civilizations” is gradually transformed into a nonadversarial mentality that values shared humanity and a common purpose. Thus, eons hence, empowered by love–energy, the transmutation of the human into the ultra–human can take the ultimate quantum leap into a yet higher dimension where spirit/energy is no longer in need of flesh/mass, and Earth can be safely left behind. (shrink)

Abstract.Klaus Günther's (1988) book developed the distinction between two kinds of discourse, the foundation discourse and the application discourse. In an article (Günther 1989a) following the publication of the book, he used this basic distinction as the starting point for a criticism of the special case‐thesis as defended by Robert Alexy (1978, 32ff., 263ff.; Alexy 1989, 16ff., 213ff.). The aim of this article is to criticize this criticism in its turn and to show that the special case‐thesis does not need (...) the reformulation which Günther proposes. It should be clear from the outset that this concerns an internal discussion in the field of discourse theory; certain discourse‐theoretical premises are taken for granted. In order to understand Giinther's criticism I will first give a brief account of the distinction he has made. (shrink)

Michael T. Stuart (2021 and 2022) has proposed imagination as an intellectual dual‐process virtue, consisting of imagination1 (underwritten by cognitive Type 1 processing) and imagination2 (supported by Type 2 processing). This paper investigates the consequences of taking such an account seriously. It proposes that the dual‐process view of imagination allows us to incorporate recent insights from virtue epistemology, providing a fresh perspective on how imagination can be epistemically reliable. The argument centers on the distinction between General Reliability (GR) and Functional (...) System Reliability (FSR), for example in relation to Kengo Miyazono and Uko Tooming's (2023) argument for epistemic generativity. Furthermore, the paper claims that the dual‐process virtue account enables us to integrate a wide range of findings from the literature on epistemology and imagination. Moreover, it suggests a novel way to distinguish the virtues of creativity and imagination and presents a case for viewing imagination as a virtue rather than a skill. (shrink)

Background: Studies from Western countries show that doctors working in neonatal intensive care units find withdrawal of treatment to be their most difficult ethical dilemma. There is less knowledge of how this is experienced in other economic, cultural, religious and educational contexts.Objectives: To explore and describe how Indian doctors experience ethical dilemmas concerning the withdrawal of treatment among critically sick and/or premature neonates.Method: Qualitative data from interviews was analysed according to Giorgi's phenomenological approach. The subjects were 14 doctors with various (...) levels of neonatal experience, recruited from two state‐owned NICUs in India. Main outcome measures: description reflecting the nature of ethical dilemmas and how they are experienced.Results: All doctors reported situations where the question of withdrawal of treatment was experienced as the worst part of their job. They felt that they lacked training in how to handle such dilemmas, and some had never talked about ethics before. They were especially concerned about non‐medical considerations that do not feature in current treatment guidelines. In describing their personal experiences, the informants mentioned their sense of responsibility in situations where they were aware that their decisions would influence a family's economy and reputation, availability of food and education for siblings, other children's access to equipment in the unit, and the use of resources in an underprivileged population. Sometimes lack of resources, usually ventilators, forced them to make decisions about which babies should get the chance to live. Other reported dilemmas included difficulties co‐operating with uneducated and poor parents.Conclusion: While Western doctors seem to focus on the rights and problems of the individual child, Indian doctors tend to refer to consequences for other children, for parents and society. There is a need for further research in this field, and for the development of guidelines on how to cope with differences in resources, and how to handle different patient groups’ cultural and religious concerns. (shrink)

The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers’ integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility (...) of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people’s integrity relating to their corporal self were the least violated. On the other hand, their psycological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people’s social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions. (shrink)

In this paper, we show that non-well-founded sets can be defined constructively by formalizing Hallnäs' limit definition of these within Martin-Löf's theory of types. A system is a type W together with an assignment of ᾱ ∈ U and α̃ ∈ ᾱ → W to each α ∈ W. We show that for any system W we can define an equivalence relation = w such that α = w β ∈ U and = w is the maximal bisimulation. Aczel's proof (...) that CZF can be interpreted in the type V of iterative sets shows that if the system W satisfies an additional condition (*), then we can interpret CZF minus the set induction scheme in W. W is then extended to a complete system W * by taking limits of approximation chains. We show that in W * the antifoundation axiom AFA holds as well as the axioms of CFZ -. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

The Faust motif provides an opportunity to explore the spectrum of attitudes among Christians toward science and technology by placing them into a historic context. Depending on one's understanding of the relationship of God and the world, the accomplishments of a Leonardo, a Paracelsus, a Faust, an Oppenheimer, or some future scientist credited with the “production” of the first successfully cloned human being can be interpreted as divine or diabolic in origin. I use the example of Faust to demonstrate that (...) the Christian assessment of the scientific enterprise is closely correlated to the level of doctrinaire dualism informing the particular version of Christianity that inspires the assessment. I show that, contrary to what seems obvious, Faust's damnation originated not in medieval times but in early modern northern Europe, reflecting a dualistic obsession with human sinfulness more characteristic of Reformation Germany than of Renaissance Italy. Encouraged by hellfire‐and‐brimstone preachers, the common folk saw demons, devils, and witches in every dark corner, while humanist scholars sought to recapture the brilliant past of the Greeks and the Romans. Goethe's interpretation represents a return to earlier versions of the story, while some continue to accuse contemporary Faustians of Satanic connections for seeking forbidden knowledge and daring to play God by manipulating the stuff of life. (shrink)

Are global poverty and inequality on the rise or are they declining? And is the quality of life of the world's poorest people getting worse or better? These questions are often given conflicting answers by economists, the World Bank, and social activists. One reason for this is that assessments of quality of life can be made in terms of people's income, their resources, or their functionings and capabilities. This essay discusses the pros and cons of these evaluative approaches, and it (...) argues that all approaches have complementary strengths and should therefore in principle all be considered. Moreover, being aware that assessments of poverty and inequality can be made using these different frameworks helps us to understand the conflicting claims. (shrink)

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

Drawing on philosophy, theology, comparative religion, spirituality, Holocaust studies, physics, biology, psychology, and personal experience, I argue that continued human existence depends on our willingness to reject nihilism–not as an expedient “noble lie” but because faith in a meaningful cosmos and the power of love is at least as validly grounded in human experience as insistence on cosmic indifference and ultimate futility. I maintain that hope will free us to develop nonimperialistic methods of bridging cultural differences by forming a mutually (...) intelligible vocabulary that celebrates diversity, enters the worlds of others in respectful dialogue, and fosters a postmechanistic, organic, ecological, holistic, dynamic, interactive, open‐ended model of reality. I lay the foundation for a “hermeneutics of love” to complement Paul Ricoeur's “hermeneutics of suspicion” and invite speculation on the ways science, technology, and society would be transformed if those “glasses of friendship” were widely applied. (shrink)

In the second part of the study the Chiliastic Soul concept is discussed as the goal of unity. This is done by focusing on the Castalian "game" and the death of Joseph Knecht. In addition, evidence is presented for certain fundamental conceptual similarities in the thought of Hesse and Hegel and Hesse and Jung, respectively. The author argues not only for the relevance of dialectics as key to a full understanding of Hesse but for the proposition that Hegel, Jung, and (...) Hesse share a primary intuition of ultimate unity or non-duality which shows striking parallels to the metaphysical foundations of the I Ching, Lao-Tze's tao, and the Vedantic atman-brahman identity. Finally, the death of Joseph Knecht is interpreted as affirmation of transformation in the light of Jungian alchemical symbolism. (shrink)

This article explores a rarely acknowledged and all too often specifically denied possibility: the relevance of Hegel’s philosophy to the interpretation of the literary work of Hermann Hesse. Contemporary Hesse scholars critical of this position, such as Edmund Gnefkow, Martin Pfeifer, and Mark Boulby, tend to view Hegel primarily as a rigorously rationalist philosopher of history. Thus they perpetuate a myth which has long been abandoned by the mainstream of Hegelian scholarship and should have been permanently laid to rest by (...) Iwan Iljin in Die Philosophie Hegels als kontemplative Gotteslehre when he presented convincing evidence for considering Hegel as an “intuitively-rational clairvoyant”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Can't Say "No" to That!(A "Difficult Patient" Story)Ingrid BergAs a sequela of COVID-19, my rural Wisconsin hospital has been jam-packed for months with patients for whom we routinely provide care and many for whom we do not. An exodus of health care workers and other constraints have made the transfer of critically ill patients very difficult. In this disquieting "new-normal" of our work life, we routinely must (...) call bigger cities throughout our state to find beds for complex patients.So, it was not surprising when a young patient, an IV drug user in sepsis from a heart infection, was admitted to me in the middle of the night. In less disheartening times, before the pandemic, this patient would have been transferred promptly to the big-city hospital. Now, though, the possibility of finding an open bed is next to impossible. Resigned, I placed admission orders, continued antibiotics and fluids, and crossed my fingers. Then the unexpected happened: a bed opened up, and we could send her at once!The patient had a harsh heart murmur. It was likely that a "vegetation" was clinging to the valve, between the right upper and lower chambers of her heart. A vegetation is a clump of debris, such as platelets, clotting proteins, and bacteria that is a menace to the body. Her chest imaging looked like her infection had already spread to her lungs.A definitive diagnosis for endocarditis requires a special ultrasound with a probe that goes down through the esophagus, a procedure performed by cardiologists. It's a serious infection, one that requires weeks of IV antibiotics and is best monitored by infectious disease specialists. Sometimes, cardiothoracic surgeons are called upon to strip away the infection at the site, depending on how badly the valve has been slayed or the size of the vegetation. My only recommendation for a young, otherwise healthy patient in this scenario, is transfer.All of these reasons for transfer were lolling around in my tired head when the night-time [End Page 14] nursing supervisor approached me and said, "We have a problem." When the patient was updated about the transfer, she balked: "She says she is tired and refusing to go," the supervisor began. "She doesn't feel like getting into an ambulance in the middle of the night and she doesn't care if her condition is life-threatening. She knows we can't force her to go and she will only talk about it again in the morning."The cartoon version of myself at that moment had bugged-out eyes, a dropped jaw, fists tight and clenched at my sides, and steam coming out of my head. I can look past a patient's self-neglect, poor medication adherence, abysmal communication, alcohol and drug addiction, and other crimes. But saying no to a bed at a tertiary care facility? Unacceptable!I marched down the quiet hallway and into her room. She was lying on her side, facing the door, one IV in a thin arm. I was confident I could reason with her once I explained the scarcity of beds and the medical necessity of transfer. But she was having none of it. I was calm until I could no longer maintain my cool: "You can't give up this bed!""Maybe in the morning," she insisted, yawning. "But not now. I am tired and want to rest!""But there might not be a bed in the morning," I countered. "And your infection can be life-threatening." (This is true, but we both knew she wasn't dying at this very moment.)"I am not going anywhere!" She raised her voice and then closed her eyes.And she was right. I had no choice but to keep her. I could not kick her out of the hospital because she was making a poor choice, and I was frustrated for having to manage the fallout of that decision. Giving her antibiotics and fluid boluses to bolster her blood pressure was certainly within my scope of practice. And fretting. Fretting is always within my scope of practice; not that my scope of practice matters when all the big... (shrink)

It now seems technically feasible to culture human embryos beyond the “fourteen‐day limit,” which has the potential to increase scientific understanding of human development and perhaps improve infertility treatments. The fourteen‐day limit was adopted as a compromise but subsequently has been considered an ethical line. Does it remain relevant in light of technological advances permitting embryo maturation beyond it? Should it be changed and, if so, how and why? What justifications would be necessary to expand the limit, particularly given that (...) doing so would violate some people's moral commitments regarding human embryos? Robust stakeholder engagement preceded adoption of the fourteen‐day limit and should arguably be part of efforts to reassess it. Such engagement could also consider the need for enhanced oversight of human embryo research. In the meantime, developing and implementing reliable oversight systems should help foster high‐quality research and public confidence in it. (shrink)

This commentary focuses upon the ‘fetishism of persons’ in Marx which Balibar claims both mirrors and animates the better-known fetishism of things. Revisiting the chapter on exchange in which Balibar grounds his thesis, the essay attends to the theatrical metaphors by which Marx presents legal personhood as a pantomime of commodity fetishism. The essay demonstrates how the movable immobility of the commodity comes to life in its inverse, the mobile and immovable figure of the legal person; it then claims that (...) this inversion positions legal persons as animate props for property. But if legal persons, the essay asks, merely personify economic relations, by what means are they sufficiently distanced from commodities to be able to become their reflex and puppet? In other words, what vestibule keeps personal liberty’s analogy with economic relations from collapsing into identity? A significant historical answer, the essay asserts, is transatlantic chattel slavery—not only because this institution is both ideological foil to, and material basis for, liberal capital, but also because the slave herself, as animate property, undoes the distinction between persons and commodities. The essay concludes by insisting upon the significance of this neglected figure in philosophies of the transindividual, while also taking first steps toward a transindividual analysis of slavery. (shrink)

Communication about diagnosis and medical treatment for children suffering from life-threatening illnesses is complex. It is a primary step in involving underage patients and families in care and lays the foundation for obtaining parental permission and patient assent for treatment. In practice child participation in care is often difficult to obtain due to patients' different and sometimes fluctuating preferences, but also parents' protective strategies. Physicians may be susceptible to parental wishes to limit information and feel uncomfortable discussing issues related to (...) uncertainty of cure with patients. A qualitative study in Romanian paediatric oncology units was conducted to explore children's involvement from the perspectives of parents and oncologists. Interviews with participants discussed 18 patient cases. Data were transcribed and thematic analysis was used to interpret and mine patients' involvement during treatment. Different facets of patient participation were identified: restricting, widening and enhancing involvement. A fourth category, unintentional involvement, occurred for all patients due to children's observations during long-term hospitalisations and access to Internet. Uncertainty overarched parental attitudes regarding the extent to which children should be included. Physicians usually complied with parental wishes to limit involvement, but together with parents involved patients at least in a practical way. Adults' protective attitude may backfire, as adolescents' online searches often expose patients to worse-case scenarios. Further research should acknowledge the hazards of restricted diagnosis disclosure and develop clinician tools to support families in communicating with patients. This should be paralleled by physician efforts to elicit patients' needs regarding participation. (shrink)

Based on an empirical study regarding ethical challenges within intercultural health care, the focus of this article is upon autonomy and disclosure, discussed in light of philosophy and anthropology. What are the consequences for patients if the patients’ right to be autonomous and to participate in treatment and care decisions by health care workers is interpreted as an obligation to participate? To force a person to make independent choices who is socio-culturally unprepared to do so, may violate his/her integrity. This (...) may in turn jeopardise the respect, integrity and human worth the principle of autonomy was meant to ensure, and if so, may damage any relationship of trust that may exist between patient and health care worker. There is necessarily a link between autonomy and disclosure. Western disclosure practices may make the relationship between patients and health care workers difficult -- even distrustful. To confront a patient with a very serious diagnosis may be seen not only as a tactless action, but also an unforgivable one. Hence, among many ethnic groups it is a family member’s duty to shield patients from bad or disquieting news, e.g., a cancer diagnosis. If a family member is used to interpret in such situations, will the information given equal the information communicated by that interpreter? Even though respect for a person’s autonomy is part of the respect for a person, one’s respect for the person in question should not depend on his/her ability or aptitude to act autonomously. (shrink)

BackgroundNon-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate.AimTo learn what ethical issues operating room nurses perceive as important regarding non-technical skills.Research designQualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke’s six phases for thematic analysis.Participants and research contextEleven experienced perioperative/operating room nurses working in an operating unit at a Norwegian (...) university hospital.Ethical considerationsApproval was given by The Norwegian Social Science Data Service in care of the hospital’s Data Protection Officer.FindingsThree main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety.DiscussionDefending the patient’s dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other’s tasks and responsibilities and to talk to one another in a friendly manner.ConclusionBeing respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good ‘flow’ within the operating room team. (shrink)

Written more than a hundred years ago, Stein’s On the Problem of Empathy is, today more than ever, essential reading material for anyone interested in social cognition. In this book – which still inspires current research – Stein provides a systematic account of the empathic experience. Stein’s view of empathy as a process, and her understanding of its main forms and functions in presenting the other as a spiritual being, provide valuable insights on the intersubjective nature of the human being. (...) Yet, it is not only from the perspective of social cognition that Stein’s book is relevant today. In fact, the book approaches a wide range of issues, from the idea of personhood to social ontology and ethics, and it exemplifies the power of phenomenology to shed light on the basic structure of human consciousness (for an overview: Calcagno 2007; Lebech 2004; MacIntyre 2006; Moran 2004). In this chapter, my aim is to explore the relevance of Stein’s book on empathy for contemporary research by focusing on three main issues which, in my view, can enrich current scholarship. The first issue concerns Stein’s understanding of empathy as a three-step process through which we become conscious of the other’s experience. The second relates to her views of the intentional structure of the emotions as revelatory of the realm of value. The third is her idea that not only emotions but also moods might have correlates, e.g., the fact that the world appears to be bathed in black for the depressive person. These three issues are not exhaustive of the ways in which Stein’s early work can be an inspiration for today’s researchers, but they are illustrative of how her insights can advance three central debates of contemporary philosophy: on social cognition, on the relation between emotion and value, and on the intentionality of moods. (shrink)

According to Brentano and his followers, there is a genuine affective mode of intentional reference which consists in presenting the targeted objects imbued with value as being good or bad, and as inviting us to adopt a pro- or contra-attitude toward them. Let us call this view “the affective intentionality thesis”. In Brentano’s version of this thesis, not only do strictly affective phenomena such as feelings and emotions exhibit a sui generis affective intentionality, but so do conative ones, such as (...) wishes, desires, and acts of the will. However, in the version defended by the majority of his early phenomenological followers, this thesis applies only to affective phenomena in the narrow sense. This paper analyzes the reception of this later version of “the affective intentionality thesis” in Edith Stein’s early works, arguing that a further transformation of the thesis took place within her work. It argues that, for Stein, the intentionality exhibited by affective phenomena comes in different forms. According to this reading, the mode in which states that are affective in the strictest sense present their object as imbued with value admits variations. As I will demonstrate, a close analysis of her views on the stratification of the affective life and the different types of affective phenomena (general feelings, moods, emotions, and sentiments) suggests that at least three different forms of affective intentionality can be identified. I call them object intentionality, horizon intentionality, and personal intentionality. Since similar views can be found in other early phenomenologists, I suggest that Stein’s views can be taken as representative of a transformation that took place within this movement. -/- . (shrink)

In the past decade, scholars such as Samuel Freeman, Martin O’Neill, Alan Thomas and others have argued that no matter how widely Rawls’s theory of justice (TJ) was understood as a defence of the welfare state (WS), the socio-economic system Rawls defends and always defended is property-owing democracy (POD). In this article I present the argument that Rawls did not defend POD in TJ. However, while the claim that it was POD the socio-economic system implied by the principle of difference (...) generated heated reactions by defenders of the WS, the argument I raise differs from most of them. In the article I maintain that, for Rawls, principles of justice underdetermine the choice of social systems, and that although this is true of both principles, it is especially true of the difference principle, whose ability to arbitrate between different social and economic policies is limited. I show how the attempt to uniquely determine the set of social and economic policies authorized by the difference principle clashes with what Rawls explicitly states in TJ and contrasts with central aspects of his sociological and political conception of socio-economic decision-making. Although my aim is to show that the difference principle itself does not discriminate among socio-economic systems, this does not preclude that additional reasons can help in narrowing the range of socio-economic systems allowed. With reference to the ideal of social union that Rawls expounds in the third part of TJ, I argue that TJ does, in fact, offer additional reasons to appraise the WS as preferable to POD. I maintain that the centrality Rawls attributes to the social unity of a just society provides the basis for an understanding of Rawls’s position towards POD after TJ. (shrink)

On appearing in 1949, The Second Sex provoked violent controversy in the world of French literary reviews and in the popular press. It was attacked by the religious right wing for daring to speak frankly about female sexuality and by the Communists for taking women's emotional and sexual well‐being as seriously as their economic welfare. Reactions to Beauvoir's text indicate the depth of misogyny at the time of its publication and the ways in which class and educational prestige were used (...) to silence women's subjectivity. (shrink)

With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)