Patients in nursing homes sometimes give accounts of episodes in which they feel their autonomy and/or self-respect are violated as a result of the care they receive from nursing staff. In these ethically difficult care situations nurses use strategies such as negotiation, explanation and, in some cases, restraint. This study investigates how nurses apply these strategies to resolve ethical dilemmas in such a way that patients experience respect rather than violation. Critical issues that will be discussed include the definition of (...) ethically difficult care situations in nursing homes and the identification of strategies for resolving such situations. Examples of the use of three strategies are presented. The use of negotiation, restraint and explanation are discussed in order to ensure respect for patients’ autonomy and thus to optimize health care outcomes. (shrink)

Background: Providing care for a home-dwelling person with dementia who resists care is an ethical and practical complex and challenging task. Faced with a growing number of persons with dementia, the healthcare professional’s understanding of how to best care for and prevent unnecessary use of coercion with persons with dementia is of key importance. Research aim: The aim of this study was to explore the use of trust-building interventions in home-dwelling persons with dementia resisting care, as described by health professionals (...) in documents of decisions of forced treatment and care. Research design: A qualitative thematic document analysis inspired by critical realism was conducted. Participants and research context: Descriptions of trust-building interventions were extracted from 88 documents of forced treatment and care for home-dwelling persons with dementia, receiving home healthcare, in 2015 and 2016. Ethical considerations: Approved by the Regional Committee for Medical and Health Research Ethics, reference number 2017/788, and controlled by the Norwegian Centre for Research Data, reference number 54897. The study adhered to the guidelines of the Declaration of Helsinki. Findings: We found that “balancing safe care with the person’s integrity” was an overarching theme that permeated the descriptions of trust-building interventions in the study. Three main themes were identified when the data were analyzed: safeguarding care, protecting integrity, and optimizing the environment. Discussion and conclusion: Health professionals balanced on a thin line between care and integrity when met with resistance from person with dementia. However, the trust-building interventions used in the most challenging situations did not differ from the interventions used in general in dementia care. Two knowledge gaps were identified: how to perform appropriate assessments of situations of home-dwelling persons with dementia when met with resistance to care, and whether environmental initiatives may also benefit home-dwelling persons with dementia who are not easily cared for. (shrink)

Theoretical models for patient-physician communication in clinical practice are frequently described in the literature. Respecting patient autonomy is an ethical problem the physician faces in a medical emergency situation. No theoretical physician-patient model seems to be ideal for solving the communication problem in clinical practice. Theoretical models can at best give guidance to behavior and judgement in emergency situations. In this article the premises of autonomous treatment decisions are discussed. Based on a case-report we discuss different genuine efforts the physician (...) can do to uncover treatment refusal and respect patient autonomy in an emergency situation. Autonomy requires competence and in emergency medicine time does not allow intimate exploration of patient competence and reasons for treatment refusal. We find that the physician must base her decision on a firm theoretical base combined with a practical and realistic view of the patient's situation on a case to case basis. (shrink)

Ethical problems regularly arise during daily care in nursing homes. These include violation of patients' right to autonomy and to be treated with respect. The aim of this study was to investigate how caregivers emphasize daily dialogue and mutual reflection to reach moral alternatives in daily care. The data were collected by participant observation and interviews with seven caregivers in a Norwegian nursing home. A number of ethical problems linked to 10 patients were disclosed. Moral problems were revealed as the (...) caregivers acted in ways that they knew were against patients' interest. We used a theoretical interpretation according to Habermas' discourse ethics on the importance of dialogue when deciding moral courses of action for patients. This theory has four basic requirements: communicative competence, equality, self-determination, and openness about motives. (shrink)

Ecologically responsible policies are concerned only in part with pollution and resource depletion. There are deeper concerns which touch upon principles of diversity, complexity, autonomy, decentralization, symbiosis, egalitarianism, and classlessness.

Introduction: Expressions of dignity as a clinical phenomenon in nursing homes as expressed by caregivers were investigated. A coherence could be detected between the concepts and phenomena of existence and dignity in relationships and caring culture as a context. A caring culture is interpreted by caregivers as the meaning-making of what is accepted or not in the ward culture. Background: The rationale for the connection between existence and dignity in relationships and caring culture is that suffering is a part of (...) existence, as well as compassion in relieving suffering, and ontological interdependency. Aim: To describe different expressions of dignity in relationships and existence in context of caring cultures from the perspective of the caregivers. Research design: The methodology and method are hermeneutic. The method used was to merge the theoretical preunderstanding as one horizon of understanding with empirical data. Participants and research context: Focus group interviews with caregivers in nursing homes. Ethical considerations: The principles of the Helsinki Declaration have been followed to, for example, preserve self-determination, integrity, dignity, confidentiality and privacy of the research persons. Findings: Data interpretation resulted in four themes: Encountering existential needs that promote dignity in a caring culture; To amplify dignity in relationships by the creative art of caring in a caring culture; Violation of dignity by ignorance or neglect in a non-caring culture and The ethic of words and appropriated ground values in a caring culture. Discussion: Dignity-promoting acts of caring, or dignity-depriving acts of non-caring are adequate to see from the perspective of dignity in relationships and existence and the caring culture. Conclusions: Dignity in relationships seems to touch the innermost existential life, as the existential life is dependent on confirmation from others. (shrink)

The language comprehension system preferentially assumes that agents come first during incremental processing. While this might reflect a biologically fixed bias, shared with other domains and other species, the evidence is limited to languages that place agents first, and so the bias could also be learned from usage frequency. Here, we probe the bias with electroencephalography (EEG) in Äiwoo, a language that by default places patients first, but where sentence-initial nouns are still locally ambiguous between patient or agent roles. Comprehenders (...) transiently interpreted nonhuman nouns as patients, eliciting a negativity when disambiguation was toward the less common agent-initial order. By contrast and against frequencies, human nouns were transiently interpreted as agents, eliciting an N400-like negativity when the disambiguation was toward patient-initial order. Consistent with the notion of a fixed property, the agent bias is robust against usage frequency for human referents. However, this bias can be reversed by frequency experience for nonhuman referents. (shrink)

In a Norwegian study on how children aged 7-12 years cope during a period of serious illness within the family and on their quality of life at this time, several ethical questions became apparent. These were mainly concerned with the vulnerability of children during research, with their ability to make autonomous decisions, and with considerations regarding how to respect their right to confidentiality during the research process. In this article we approach these questions using our experience from this previous study, (...) discussing them within the framework of theories of ethics and relevant research ethical guidelines. Finally, we discuss our experience in the light of the overall purpose of this article: how to deal with the ethical dilemmas that may appear during research involving young children. (shrink)

There is an international deep ecology social movement with key terms, slogans, and rhetorical use of language comparable to what we find in other activist “alternative” movements today. Some supporters of the movement partake in academic philosophy and have developed or at least suggested philosophies, “ecosophies,” inspired by the movement. R. A. Watson does not distinguish sufficiently between the movement and the philosophical expressions with academic pretensions. As a result, he falsely concludes that deep ecology implies setting man apart from (...) nature-a kind of “anthropocentrism” in his terminology: humans and only humans have no right to interfere with natural processes. What the deep ecology movement insists on is rather that life on Earth has intrinsic value and that human behavior should and must change drastically-and soon. (shrink)

This work is for scholars, researchers and students in history and philosophy of science focusing on Logical Empiricism and analytic philosophy (of science). It provides historical and systematic research and deals with the influence and impact of the Vienna Circle/Logical Empiricism on today's philosophy of science. It also explores the intellectual context of this scientific philosophy and focuses on main figures and peripheral adherents.

Journal Name: Cognitive Linguistics Issue: Ahead of print.

There is an international deep ecology social movement with key terms, slogans, and rhetorical use of language comparable to what we find in other activist “alternative” movements today. Some supporters of the movement partake in academic philosophy and have developed or at least suggested philosophies, “ecosophies,” inspired by the movement. R. A. Watson does not distinguish sufficiently between the movement and the philosophical expressions with academic pretensions. As a result, he falsely concludes that deep ecology implies setting man apart from (...) nature-a kind of “anthropocentrism” in his terminology: humans and only humans have no right to interfere with natural processes. What the deep ecology movement insists on is rather that life on Earth has intrinsic value and that human behavior should and must change drastically-and soon. (shrink)

Originally published in 1968. Scepticism is generally regarded as a position which, if correct, would be disastrous for our everyday and scientific beliefs. According to this view, a sceptical argument is one that leads to the intuitively false conclusion that we cannot know anything. But there is another, much neglected and more radical form of scepticism, Pyrrhonism, which neither denies nor accepts the possibility of knowledge and is to be regarded not as a philosophical position so much as the expression (...) of a philosophical way of life. Professor Naess argues that, given a sympathetic interpretation, Sextus Empiricus’s outline of Pyrrhonian scepticism provides the essentials of a genuine and rational sceptical point of view. He begins with a brief account of Pyrrhonism, then goes on to argue for the psychological possibility of this kind of scepticism, defending it against common objections, and examining some of its implications. The last two chapters provide detailed support for the rationality of Pyrrhonism, drawing mainly on certain methodological distinctions in semantics which both justify the Pyrrhonist’s failure to make assertions and restrict the scope of recent epistemological arguments against scepticism in such a way as to modify severely the conclusions based on them. (shrink)

The volume documents, and makes an original contribution to, an astonishing period in twentieth-century philosophy—the progress of Arne Naess's ecophilosophy from its inception to the present. It includes Naess's most crucial polemics with leading thinkers, drawn from sources as diverse as scholarly articles, correspondence, TV interviews and unpublished exchanges. The book testifies to the skeptical and self-correcting aspects of Naess's vision, which has deepened and broadened to include third world and feminist perspectives. Philosophical Dialogues is an essential addition to the (...) literature on environmental philosophy. (shrink)

An attempt is made to find a coherent verbal expression of the intuition that reality is a manifold of more or less comprehensive wholes (gestalts), all discernible in terms of qualities. Quantitative natural science is thought to describe abstract structures of reality, not contents. The qualities are neither subjective nor objective, they belong to concrete contents with structures comprising at least three abstract relata: object, subject, and medium. Their status is that of entia rationis, not content of reality. Recent developments (...) in physics suggest that we shall look in vain for physical ?things? of which reality is composed. Adequate expressions of concrete contents form designations rather than declarative sentences. They may obviously contain value terms. The attempt to formulate an ontology along the suggested lines seems to be closely related to phenomenology of a Heideggerian rather than Cartesian kind. It serves the endeavour to change the conception of the man?nature relationship. (shrink)

Interdisciplinarity has been a key term in the ecological debate ever since its advent in the early 1960s. The paper addresses these historical links and how the two terms ‘interdisciplinary’ and ‘ecology’ have influenced each other. The later concept ‘sustainable development’ is also truly interdisciplinary, including physical, biological, socio-economic and cultural, as well as normative, mechanisms, contexts and effects operating at scales ranging from the microscopic to the macroscopic. Policies to promote sustainable development need to be based on the type (...) of interdisciplinary thinking that has been advocated for several decades within the ecological debate. This applies not least to research into the sustainability aspects of urban development, the case discussed in this paper. Despite longstanding requests for interdisciplinarity, the development within the academic world has proceeded in the opposite direction. Many of the most influential metatheoretical perspectives virtually prohibit, or at best strongly discourage, the inclusion of insights about certain parts of reality. Here, critical realism could play a very important role as an underlabourer of interdisciplinarity. (shrink)

Based on metatheoretical considerations, this article discusses what kinds of traffic forecasts are possible and what kinds are impossible to make with any reasonable degree of accuracy. It will be argued on ontological and epistemological grounds that it is inherently impossible to make exact predictions about the magnitude of the ‘general’ traffic growth 20–30 years ahead, since many of the influencing factors depend on inherently unpredictable geopolitical trajectories as well as contested political decision-making. Due to the context-dependency of each particular (...) planning situation, it is also hardly possible to make exact, quantitative predictions about the impact of implementing a specific infrastructure project, compared to ‘doing nothing’. Instead of relying on traffic model simulations as the general forecasting and assessment tool in transport planning, we propose to separate the so-called strategic, tactical and operational levels of traffic forecasting into three distinct methodological approaches reflecting the different degrees of openness/closure of the systems at hand: scenario analyses at the strategic level; theory-informed, mainly qualitative analyses supplemented with simple calculations at the tactical level; while more traditional micro-simulations should be applied only at a detailed operational level. (shrink)

In what follows I shall speak about many phenomena, but what I wish to convey more than anything else is a combination of positive aspects of the rightly famous seminar headed by Moritz Schlick the years before he was shot on the stairs of the University of Vienna in 1936. These aspects make the seminar unique. I have taken part in a wealth of good seminars before and after 1936, but my experience as a participant of that seminar makes it, (...) for me, stand out as unsurpassed. (shrink)

The paper assumes as a general abstract norm that the specific potentialities of living beings be fulfilled. No being has a priority in principle in the realizing of its possibilities, but norms of increasing diversity or richness of potentialities put limits on the development of destructive life-styles. Application is made to the mixed Norwegian communities of certain mammals and humans. A kind of modus vivendi is established which is firmly based on cultural tradition. It is fairly unimportant whether the term (...) 'rights (of animals)' is or is not used in the fight for human peaceful coexistence with a rich fauna. (shrink)

The distinction made by Kant between 'moral' and 'beautiful' actions is relevant to efforts to counteract the current ecological crisis. Actions proceeding from inclination may be politically more effective than those depending on a sense of duty. Education could help by fostering love and respect for life.

Originally published in 1968. Scepticism is generally regarded as a position which, if correct, would be disastrous for our everyday and scientific beliefs. According to this view, a sceptical argument is one that leads to the intuitively false conclusion that we cannot know anything. But there is another, much neglected and more radical form of scepticism, Pyrrhonism, which neither denies nor accepts the possibility of knowledge and is to be regarded not as a philosophical position so much as the expression (...) of a philosophical way of life. Professor Naess argues that, given a sympathetic interpretation, Sextus Empiricus’s outline of Pyrrhonian scepticism provides the essentials of a genuine and rational sceptical point of view. He begins with a brief account of Pyrrhonism, then goes on to argue for the psychological possibility of this kind of scepticism, defending it against common objections, and examining some of its implications. The last two chapters provide detailed support for the rationality of Pyrrhonism, drawing mainly on certain methodological distinctions in semantics which both justify the Pyrrhonist’s failure to make assertions and restrict the scope of recent epistemological arguments against scepticism in such a way as to modify severely the conclusions based on them. (shrink)

Originally published in 1968. Scepticism is generally regarded as a position which, if correct, would be disastrous for our everyday and scientific beliefs. According to this view, a sceptical argument is one that leads to the intuitively false conclusion that we cannot know anything. But there is another, much neglected and more radical form of scepticism, Pyrrhonism, which neither denies nor accepts the possibility of knowledge and is to be regarded not as a philosophical position so much as the expression (...) of a philosophical way of life. Professor Naess argues that, given a sympathetic interpretation, Sextus Empiricus’s outline of Pyrrhonian scepticism provides the essentials of a genuine and rational sceptical point of view. He begins with a brief account of Pyrrhonism, then goes on to argue for the psychological possibility of this kind of scepticism, defending it against common objections, and examining some of its implications. The last two chapters provide detailed support for the rationality of Pyrrhonism, drawing mainly on certain methodological distinctions in semantics which both justify the Pyrrhonist’s failure to make assertions and restrict the scope of recent epistemological arguments against scepticism in such a way as to modify severely the conclusions based on them. (shrink)

In this article, an attempt is made to analyse important implications of the hermeneutic approach in qualitative studies. The article discusses the hermeneutic circle with regard to reasoning contexts, on which the researcher's interpretation is based. Problems in connection with achievement of ‘proper’ understanding in an interpretative process are discussed in light of Gadamer's hermeneutic philosophy. Some features of qualitative studies are addressed. This is concerned with arguments in the presentation of findings in qualitative studies using the hermeneutic approach. The (...) essence of the article is there are grounds for reasonable understanding, even though it cannot be absolute in the hermeneutic. (shrink)

The aim of this article is to show the importance of moral sensitivity when including persons with dementia in research. The article presents and discusses ethical challenges encountered when a total of 15 persons with dementia from two nursing homes and seven proxies were included in a qualitative study. The examples show that the ethical challenges may be unpredictable. As researchers, you participate with the informants in their daily life and in the interviews, and it is not possible to plan (...) all that may happen during the research. A procedural proposal to an ethical committee at the beginning of a research project based on traditional research ethical principles may serve as a guideline, but it cannot solve all the ethical problems one faces during the research process. Our main argument in this article is, therefore, that moral sensitivity is required in addition to the traditional research ethical principles throughout the whole process of observing and interviewing the respondents. (shrink)