Nursing policy and healthcare reform are focusing on two, interconnected areas: person‐centred care and fundamental care. Each initiative emphasises a positive nurse–patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse–patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called (...) holistic interpretive synthesis (HIS), for interpreting empirical research findings to create practice‐relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse–patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse–patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person‐centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. (shrink)

The Fundamentals of Care Framework is an evidence‐based, theory‐informed framework that conceptualises high‐quality fundamental care. The Framework places the nurse–patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse–patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse–patient relationship instruments (...) by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty‐seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring ‘focus’, ‘anticipate’ and ‘evaluate’. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse–patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework. (shrink)

This article examines how third-party complaints were responded to by counsellors on a men’s relationship-counselling helpline. Much prior conversation analytic research has shown that third-party complaints in institutional settings are embedded in other activities and treated as secondary to the main interactional business. As such, complaints are routinely responded to with a shift to a new, institutionally relevant activity. In the context examined here, however, the third-party complaints constituted callers’ reasons for call. We show that, as in many other institutional (...) contexts, counsellors do not, commonly, affiliate with callers’ complaints in the sense of displaying a similar stance towards a described third party. However, unlike in other settings that have been examined, counsellors’ responses did not result in an immediate shift away from callers’ complaints. This was primarily because, following counsellors’ non-affiliative responses, callers regularly engaged in work to pursue affiliation. (shrink)

In his latest paper, Loland1 tackles the question of whether athletes with differences of sexual development may compete in the women’s division. The topic is one of the most complex in sport and, as such, is fraught with debate. On one hand, the higher testosterone levels of athletes with DSD means they have an unfair performance advantage over their female competitors. On the other hand, it is argued that women with DSD should be able to compete in the gender division (...) with which they identify, especially as many will have been raised with a clear gender identity. Loland uses the Rawlsian notion of ‘fair equality of opportunity’ in which individuals with similar talents and ambitions should have roughly equivalent prospects for competitive success. For example, in most situations in society, one’s age, biological sex, ethnic and religious background, colour of skin, or sexual orientation are irrelevant to whether an individual should be given a job or is eligible for social welfare. In addition to being irrelevant, these factors are also stable—they are inequalities that ‘individuals cannot control or impact in any significant way’.1 However, Loland recognises that some stable inequalities, such as biological sex and body size, are relevant to FEO in sport. For example, a featherweight boxer may have similar talents and …. (shrink)

The metaphysical question presupposes the ontological one: are there forms of social unit that can be recognized as real groups and, if so, what are they? The ontological answer can be affirmative only if we are able to identify real collective entities, that is, social wholes that are not reducible to the mere sum of their individual parts. Through an ontological comparison between different types of social interaction, this paper shows the ontological properties of a real collective subject. It is (...) such, only if relations between its constituent parts generate an intrinsic normative structure, which gives existence to a higher order of social units. In this order members are bound to each other and are collectively bound to their group. They are bearers of collective intentionality. Their actions contribute to collective agency. Their responsibility is more complex and stratified than that of an independent individual. Moreover, all types of real wholes depend on ontological constitution processes, which give them the following: an intrinsic structural unit, a typological identity and emerging properties. The latter can be both new characteristics and new causal powers, which constituent parts do not have. Therefore, a right understanding of these ontological constitution processes is capable of overcoming reductionist isomorphism. It also offers the fundamental criterion for proposing a metaphysical theory that, being rooted in a rigorous ontology, is not an arbitrary exercise of imagination. (shrink)

"Patient advocates can help make research more ethical, but advocacy raises ethical issues of its own.

: Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers' raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's (...) account of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Traditionally, social entities (i.e., social properties, facts, kinds, groups, institutions, and structures) have not fallen within the purview of mainstream metaphysics. In this chapter, we consider whether the exclusion of social entities from mainstream metaphysics is philosophically warranted or if it instead rests on historical accident or bias. We examine three ways one might attempt to justify excluding social metaphysics from the domain of metaphysical inquiry and argue that each fails. Thus, we conclude that social entities are not justifiably excluded (...) from metaphysical inquiry. Finally, we ask how focusing on social entities could change the character of metaphysical inquiry. We suggest that starting from examples of social entities might lead metaphysicians to rethink the assumption that describing reality in terms of intrinsic, independent, and individualistic features is preferable to describing it in terms of relational, dependent, and non-individualistic features. (shrink)

Proofs are central, and unique, to mathematics. They establish the truth of theorems and provide us with the most secure knowledge we can possess. It is thus perhaps unsurprising that philosophers once thought that the only value proofs have lies in establishing the truth of theorems. However, such a view is inconsistent with mathematical practice. If a proof’s only value is to show a theorem is true, then mathematicians would have no reason to reprove the same theorem in different ways, (...) yet this is a practice they frequently engage in. This suggests that proofs can have a wide variety of values. My purpose in this chapter is to provide a survey of some of them. I will discuss how proofs can have practical value, for example, by helping mathematicians to make new discoveries or learn new mathematical tools, and how they can have abstract value, for example, by being beautiful or explanatory. I will also explore the relationships between different proof values. (shrink)

The 'Gamer's Dilemma' is the problem of why some actions occurring in video game contexts seem to have similar, albeit attenuated, kinds of moral significance to their real-world equivalents, while others do not. In this paper, I argue that much of the confusion in the literature on this problem is not ethical but metaphysical. The Gamer's Dilemma depends on a particular theory of the virtual, which I call 'inflationary', according to which virtual worlds are a metaphysical novelty generated almost exclusively (...) by video games. Actions performed in virtual worlds really belong to the kinds of action they appear to—'virtual murder' is a kind of murder. Inflationary theories are contrasted with 'deflationary' theories which, in effect, consider video games purely as systems for generating images, and thus the gamer as a consumer of media images. Inflationary theories struggle to explain why video games produce this unique metaphysical novelty; deflationary theories fail to do justice to the intuition that there is some significant difference between the gamer and the consumer of other media forms. In place of either, I sketch a theory of the gamer as performer, primarily by analogy with stage and cinema actors, which I suggest captures more of the moral complexity of the gamer's action. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Aanerud's project is to develop an account of white antiracist mothering, using a model of maternal duty to raise antiracist white children. The author sets this project in the context of historic constructions of white mothering in the twentieth century and then contrasts the need for an exploration of white mothers raising white children against the literature of white mothers’ raising children of color and mothers of color raising their own children, Once this distinction is made, Aanerud uses Collins's account (...) of racial ethnic mothering as a springboard into her discussion of antiracist white mothering of white children. (shrink)

Emerging from the internationally recognised Theorising Normalcy and the Mundane conference series, the chapters in this book offer wide-ranging critiques of that most pervasive of ideas, 'normal'. In particular, they explore the precarious positions we are presented with and, more often than not, forced into by 'normal', and its operating system, 'normalcy' (Davis, 2010). They are written by activists, students, practitioners and academics and offer related but diverse approaches. Importantly, however, the chapters also ask, what if increasingly precarious encounters with, (...) and positions of, marginality and non-normativity offers us a chance (perhaps the chance) to critically explore the possibilities of 'imagining otherwise'? The book questions the privileged position of 'non-normativity'; in youth and unpacks the expectation of the 'normal' student in both higher and primary education. It uses the position of transable people to push the boundaries of 'disability', interrogates the psycho-emotional disablism of box-ticking bureaucracy and spotlights the 'urge to know' impairment. It draws on cross-movement and cross-disciplinary work around disability to explore topics as diverse as drug use, The Bible and relational autonomy. Finally, and perhaps most controversially, it explores the benefits of (re)instating 'normal'. By paying attention to the opportunities presented amongst the fissures of critique and defiance, this book offers new applications and perspectives for thinking through the most ordinary of ideas, 'normal'. (shrink)

In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...) of moral responsibility should be avoided. This indicates that some approaches to health promotion ought not to be employed. We suggest, however, that another form of responsibility might be more appropriately identified. This is based on the claim that agents have prudential reasons to maintain their health, in order to pursue those things which make their lives go well—i.e. that maintenance of a certain level of health is rational for many agents, given their pleasures and plans. On this basis, we propose that agents have a self-regarding prudential responsibility to maintain their health. We outline the implications of a prudential responsibility approach to health promotion. (shrink)

Former NAACP chapter head Rachel Dolezal's attempted transition from the white to the black race occasioned heated controversy. Her story gained notoriety at the same time that Caitlyn Jenner graced the cover of Vanity Fair, signaling a growing acceptance of transgender identity. Yet criticisms of Dolezal for misrepresenting her birth race indicate a widespread social perception that it is neither possible nor acceptable to change one's race in the way it might be to change one's sex. Considerations that support transgenderism (...) seem to apply equally to transracialism. Although Dolezal herself may or may not represent a genuine case of a transracial person, her story and the public reaction to it serve helpful illustrative purposes. (shrink)

Human Rights Education (HRE) has traditionally been articulated in terms of cultivating better citizens or world citizens. The main preoccupation in this strand of HRE has been that of bridging a gap between universal notions of a human rights subject and the actual locality and particular narratives in which students are enmeshed. This preoccupation has focused on ‘learning about the other’ in order to improve relations between plural ‘others’ and ‘us’ and reflects educational aims of national identity politics in citizenship (...) education. The article explores the learning of human rights through narratives in relations, drawing on Hannah Arendt and Sharon Todd. For this re-thinking of relations in learning human rights, the article argues that HRE needs to address both competing historical narratives on the drafting of the Universal Declaration on Human Rights (UDHR) as well as unique life narratives of learners. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

Biological ontologies are used to organize, curate, and interpret the vast quantities of data arising from biological experiments. While this works well when using a single ontology, integrating multiple ontologies can be problematic, as they are developed independently, which can lead to incompatibilities. The Open Biological and Biomedical Ontologies Foundry was created to address this by facilitating the development, harmonization, application, and sharing of ontologies, guided by a set of overarching principles. One challenge in reaching these goals was that the (...) OBO principles were not originally encoded in a precise fashion, and interpretation was subjective. Here we show how we have addressed this by formally encoding the OBO principles as operational rules and implementing a suite of automated validation checks and a dashboard for objectively evaluating each ontology’s compliance with each principle. This entailed a substantial effort to curate metadata across all ontologies and to coordinate with individual stakeholders. We have applied these checks across the full OBO suite of ontologies, revealing areas where individual ontologies require changes to conform to our principles. Our work demonstrates how a sizable federated community can be organized and evaluated on objective criteria that help improve overall quality and interoperability, which is vital for the sustenance of the OBO project and towards the overall goals of making data FAIR. Competing Interest StatementThe authors have declared no competing interest. (shrink)

This paper argues that there exists a collective epistemic state of ‘Broad Medical Uncertainty’ regarding the effectiveness of many medical interventions. We outline the features of BMU, and describe some of the main contributing factors. These include flaws in medical research methodologies, bias in publication practices, financial and other conflicts of interest, and features of how evidence is translated into practice. These result in a significant degree of uncertainty regarding the effectiveness of many medical treatments and unduly optimistic beliefs about (...) the benefit/harm profiles of such treatments. We argue for an ethical presumption in favour of openness regarding BMU as part of a ‘Corrective Response’. We then consider some objections to this position, including concerns that public honesty about flaws in medical research could undermine trust in healthcare institutions. We suggest that, as it stands, the Anti-Corrective Response is unconvincing. (shrink)

Recent theoretical models suggest that the difference between human and nonhuman primate life-history patterns may be due to a reliance on complex foraging strategies requiring extensive learning. These models predict that children should reach adult levels of efficiency faster when foraging is cognitively simple. We test this prediction with data on Meriam fishing, spearfishing, and shellfishing efficiency. For fishing and spearfishing, which are cognitively difficult, we can find no significant amount of variability in return rates because of experiential factors correlated (...) with age. However, for shellfish collecting, which is relatively easy to learn, there are strong age-related effects on efficiency. Children reach adult efficiency more quickly in fishing as compared to shellfish collecting, probably owing to the size and strength constraints of the latter. (shrink)

El presente artículo propone un análisis sobre el derecho a la libertad de expresión de jueces y magistrados desde la perspectiva de los estándares de derechos huma­nos en el ámbito regional e internacional, a través de la normativa y la práctica jurisprudencial al respecto. El trabajo pretende arrojar luz sobre las posibles res­tricciones a las que se podrían ver sometidos en este ámbito los miembros de la ju­dicatura con motivo del especial contenido de las funciones que desarrollan. Esta investigación hace (...) especial hincapié en el impacto que las redes sociales pueden tener sobre el disfrute de este derecho por parte de jueces y magistrados. (shrink)

In medias res: the life of Claude de Seyssel -- The scholar diplomat -- The translator of histories -- Seyssel in Italy : a scholar looks at war -- The scholar and the state -- Seyssel, the church, and the ideal prelate.

The postmodern criticism of music analysis remains unwittingly preoccupied with a false image of ‘the Whole’, or with the construction of unity precisely through privileging its opposite. At the centre of this discourse there often emerges a split between two things—analysis/aesthetics, part/whole, subject/object—where the question then becomes one of reconciliation: how can the analytical methods be subsumed into aesthetic discussions of subjectivity to better represent the ‘thing itself’? This problem is now a cross-disciplinary one, with criticism favouring the application of (...) ‘external’ disciplines to complement the ‘internal’ act of music analysis. This article takes Žizek’s comments on the difference between modernism and postmodernism as alienation and separation as its starting point in order to reconsider the effects of the supposedly postmodern concept of interdisciplinarity for music analysis. Through a critique of existing musico-psychoanalytic literature, it demonstrates the ways in which the interdisciplinary relation currently seems to occupy the space of an objet petit a in scholarship that is therefore marked by a failure restricted to the principles of alienation. If read alongside Žižek’s phenomenology of the subject however, rather than become a fetishized unity, this relation could be seen to construct the space for a self-reflexive musical subject, able to avoid false reconciliation through critical self- awareness, and could also therefore hold greater significance for an interdisciplinary musicology. (shrink)

Ch. G. Bardili (1761-1808) ist der Begrunder des rationalen Realismus mit dem Ziel eines von der Materialitat ausgehenden Gottesbeweises. Heute nur noch als von den Zeitgenossen fast einhellig abgelehnter Denker bekannt, bietet sein Schaffen in der enormen Spannbreite von Wissenschaftsreflexionen, Ethik, Philosophiegeschichte und Logik doch ein interessantes, facettenreiches und in seiner Radikalitat anregendes Gesamtkonzept. Dieses Werk erstmals in vollem Umfang zu erschliessen, das ganze System Bardilis in seiner Entwicklung und seinen Inhalten nachzuzeichnen sowie in seinen Grundzugen, die fur die Debatten (...) der Zeit, etwa mit Fichte, Schelling und Reinhold, bedeutsam sind, aufzuweisen, ist die Absicht des vorliegenden Bandes.'Bislang liegt uber Bardili keine nennenswerte Literatur vor. [.] Diese Lucke schliesst nun die vorgelegte Monographie, [.] um so ein Werk vorzustellen, das zwar heute weitgehend in den Hintergrund geruckt oder oft schlicht vergessen ist, das es gleichwohl - wie die Vf. uberzeugend zu zeigen vermag - verdient hat, wieder starkere Beachtung zu finden, weil es zu zentralen Fragestellungen, wie sie im Bereich der klassischen deutschen Philosophie wichtig und bestimmend geworden sind, eine haufig zweifellos eigenwillige, aber trotzdem wegen seines hohen Grades an Originalitat und seiner radikalen, wenn auch bisweilen exzentrisch anmutenden, Alternativstellung bedenkenswerte Anstosse bietet. [.] Insgesamt leistet die Vf. mit ihrer Monographie Hervorragendes und Vorbildliches: Sie zeichnet den Denkweg und das System Bardilis in ihrer Entwicklung und ihren Inhalten nach. Die wesentlichen Grundzuge, die sich fur die Debatten, Streitgesprache und [.] philosophischen Konstellationen der Zeit als so bedeutsam erwiesen, werden pragnant aufgewiesen und mit denkerisch hochster Souveranitat durchdrungen.' Dirk Cursgen, Philosophische Rundschau. (shrink)

In Showing Perseverance, beginning readers will learn about all the ways they can be strong in spite of difficulty. Vibrant, full-color photos and carefully leveled text engage young readers as they discover how they can build character by showing perseverance.

van der Pijl et al 1 argue that if ‘stakes are high’ and there is ‘clear conviction by the care provider’ that it is ‘necessary’, episiotomy may be given after ‘opt-out consent’. Here I caution against the applicability of their approach to vaginal examination (VE): another routine intervention in birth to which they suggest their discussion may apply. I highlight three concerns: first, the subjective and unjustified nature of assessments of ‘necessity’; second, the inadequacy of current consent practices in relation (...) to VE; and third, the significant risk of perpetuating under-recognised harms associated with unwanted or unconsented VE. I argue that opt-out consent cannot be ethically justified for VE. Its use would result in further weakening of consent practices, circumvention of individuals’ autonomy, and greater harm for women and birthing people. At the outset, it is important to recognise that the authors do not claim that their approach should be applied to VE, merely that their discussion may have relevance to consent for other interventions beyond episiotomy ‘where consent is also frequently lacking, and which are under-researched’, including VE.1 Nonetheless, it is easy to assume that episiotomy and VE are sufficiently similar that their analysis might be transferred wholesale. I disagree. There are similarities: both interventions are performed on ‘the most intimate and socially sensitive body parts’1; …. (shrink)

My particular focus in this article is on getting clearer about what Nietzsche’s experimentalism entails. Some immediate resistance may form in response to this proposal, based on my use of the term experimentalism. As Walter Kaufmann has pointed out in a discussion of experimentalism, Nietzsche himself does not discuss his work using this concept; in the original German, Nietzsche uses the terms “Experiment” and “Versuch.”1 In light of this, two main concerns may be raised about my proposal that experimentalism is (...) worth some of our time and attention: whether it is necessary or helpful to focus discussion on yet another “ism” within Nietzsche scholarship and given that experimentalism is not Nietzsche’s.. (shrink)

The claim that we have a moral obligation, where a choice can be made, to bring to birth the 'best' child possible, has been highly controversial for a number of decades. More recently Savulescu has labelled this claim the Principle of Procreative Beneficence. It has been argued that this Principle is problematic in both its reasoning and its implications, most notably in that it places lower moral value on the disabled. Relentless criticism of this proposed moral obligation, however, has been (...) unable, thus far, to discredit this Principle convincingly and as a result its influence shows no sign of abating. I will argue that while criticisms of the implications and detail of the reasoning behind it are well founded, they are unlikely to produce an argument that will ultimately discredit the obligation that the Principle of Procreative Beneficence represents. I believe that what is needed finally and convincingly to reveal the fallacy of this Principle is a critique of its ultimate theoretical foundation, the notion of impersonal harm. In this paper I argue that while the notion of impersonal harm is intuitively very appealing, its plausibility is based entirely on this intuitive appeal and not on sound moral reasoning. I show that there is another plausible explanation for our intuitive response and I believe that this, in conjunction with the other theoretical criticisms that I and others have levelled at this Principle, shows that the Principle of Procreative Beneficence should be rejected. (shrink)

Questions of what a self-driving car ought to do if it encounters a situation analogous to the ‘trolley problem’ have dominated recent discussion of the ethics of self-driving cars. This paper argues that this interest is misplaced. If a trolley-style dilemma situation actually occurs, given the limits on what information will be available to the car, the dynamics of braking and tyre traction determine that, irrespective of outcome, it is always least risky for the car to brake in a straight (...) line rather than swerve. (shrink)

Mathematicians judge proofs to possess, or lack, a variety of different qualities, including, for example, explanatory power, depth, purity, beauty and fit. Philosophers of mathematical practice have begun to investigate the nature of such qualities. However, mathematicians frequently draw attention to another desirable proof quality: being motivated. Intuitively, motivated proofs contain no "puzzling" steps, but they have received little further analysis. In this paper, I begin a philosophical investigation into motivated proofs. I suggest that a proof is motivated if and (...) only if mathematicians can identify (i) the tasks each step is intended to perform; and (ii) where each step could have reasonably come from. I argue that motivated proofs promote understanding, convey new mathematical resources and stimulate new discoveries. They thus have significant epistemic benefits and directly contribute to the efficient dissemination and advancement of mathematical knowledge. Given their benefits, I also discuss the more practical matter of how we can produce motivated proofs. Finally I consider the relationship between motivated proofs and proofs which are explanatory, beautiful and fitting. (shrink)

In 1837, Dirichlet proved that there are infinitely many primes in any arithmetic progression in which the terms do not all share a common factor. Modern presentations of the proof are explicitly higher-order, in that they involve quantifying over and summing over Dirichlet characters, which are certain types of functions. The notion of a character is only implicit in Dirichlet’s original proof, and the subsequent history shows a very gradual transition to the modern mode of presentation. In this essay, we (...) describe an approach to the philosophy of mathematics in which it is an important task to understand the roles of our ontological posits and assess the extent to which they enable us to achieve our mathematical goals. We use the history of Dirichlet’s theorem to understand some of the reasons that functions are treated as ordinary objects in contemporary mathematics, as well as some of the reasons one might want to resist such treatment. We also use these considerations to illuminate the formal treatment of functions and objects in Frege’s logical foundation, and we argue that his philosophical and logical decisions were influenced by many of the same factors. (shrink)

The oblivion of the interval -- Being in place -- The aporia between envelope and things -- Dualism in Bergson -- Interval, sexual difference -- Beyond man: rethinking life and matter -- Conclusion: interval as relation, interval as becoming.