In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (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)

It is well known that close relatives of terminally ill patients endure great emotional stress. Many factors, such as existential concerns, contribute to the distress of these relatives. In this study, interviews were conducted to explore experiences concerning life restrictions, emotional distress, and limited support, in a group of close relatives of patients with amyotrophic lateral sclerosis (ALS). The purpose was to identify, illuminate and clarify ethical problems related to these experiences. The results indicate that close relatives of patients with (...) ALS need someone to talk to, as well as more information about the disease and its process. Furthermore, the study illustrates how ethical problems are related to choices and conflicts, and that a process including shared decision making is often an ideal when trying to find a solution to ethical problems. (shrink)

The aim of this article is to analyse and discuss the ethically problematic conflict raised by patients with stroke who refuse nutritional treatment. In analysing this conflict, the focus is on four different aspects: (1) Is nutritional treatment biologically necessary? (2) If necessary, is the reason for refusal a functional disability, lack of appetite or motivation, misunderstanding of the situation or a genuine conflict of values? (3) If the latter, what values are involved in the conflict? (4) How should we (...) deal with the different kinds of refusal of nutritional treatment? We argue that patients' autonomy should be respected as far as possible, while also considering that those who have suffered a stroke might re-evaluate their life as a result of a beneficial prognosis. However, if patients persist with their refusal, health care professionals should force nutritional treatment only when it is clear that the patients will re-evaluate their future life. (shrink)

Background: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the (...) views of frail older persons and their significant others concerning existential loneliness are in concordance. Objective: To contrast frail older persons’ experiences with their significant others’ perceptions of existential loneliness. Methods: A case study design was chosen for this study. Individual interviews with frail older persons and interviews with their significant others, as well as field notes, served as a basis for the study. A thematic analysis was used to interpret data. Ethical considerations: This study was conducted in accordance with the principles of research ethics. Findings: The findings showed three themes: Meaningless waiting in contrast to lack of activities, Longing for a deeper connectedness in contrast to not participating in a social environment and Restricted freedom in contrast to given up on life. Discussion: Knowledge about the tensions between older persons’ and their significant others’ views of existential loneliness could be of use as a basis for ethical reflections on the care of older people and in the encounter with their significant others. Conclusion: It is of importance that health care professionals listen to both the frail older person and their significant other and be aware of whose voice that the care given is based on, in order to provide care that is beneficial and not to the detriment of the older person. (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

Social-emotional competences are critical for positive development and significantly predict educational and occupational attainment, health, and well-being. There is however a lack of consensus about the number of core competences, and how these are defined and operationalized. This divergence in approach challenges future research as well as the scientific usefulness of the construct. In an effort to create an integrative framework, this focused review evaluates different approaches of conceptualizing and assessing social-emotional competences. Building on shared conceptions, an integrative taxonomy “DOMASEC” (...) is introduced, specifying core domains and manifestations of social-emotional competences that bridge across frameworks focusing on social and emotional learning, personality traits and self-determination theory. Core domains include intrapersonal, interpersonal and task-oriented competencies, differentiating between affective, cognitive, and behavioral manifestations of competences across these domains. It is argued that the integrative taxonomy facilitates the conceptual specification of key constructs, that it helps to better organize the multitude of terms and definitions used, and to guide the conceptualization and operationalization of social-emotional competences and their various facets. (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 is the sixth edition of a textbook that has been instrumental in introducing a generation of students to the history of economic thought. It charts the development of economics from its establishment as an analytical discipline in the eighteenth century through to the late twentieth century. The book discusses the work of, amongst others: Ricardo, Malthus, Marx, Walras, Marshall and Keynes as well as the institutionalists, the Chicago School and the emergence of econometrics. This edition has been fully revised (...) and updated and includes: * chronologies of the key dates in the development of economics * extracts from original texts * an examination of how the study of the history of economic thought impinges upon modern thinking. (shrink)

Wie erlangt man ethische Urteilskompetenz?

The transition from university to working life appears a critical period impacting human service workers’ long-term health. More research is needed on how psychological factors affect the risk. We aimed to investigate how subgroups, based on self-efficacy, psychological flexibility, and basic psychological needs satisfaction ratings, differed on self-rated health, wellbeing, and intention to leave. A postal survey was sent to 1,077 recently graduated psychologists in Sweden, response rate 57.5%, and final sample 532. A hierarchical cluster analysis resulted in a satisfactory (...) eight-cluster solution. We identified two at-risk subgroups, displaying the lowest scores on health and wellbeing, and one potential low-risk subgroup with the highest ratings on said variables. The “Low risk?” group rated high on all three psychological constructs, a positive transition to working life, a work environment where resources balanced relatively high emotional demands, good health, and wellbeing. Almost the complete opposite ratings characterized the potential risk groups. “Quitting?” scored significantly higher than “Getting sick?” on self-efficacy and psychological flexibility as well as actively seeking new employment and reporting daily thoughts on leaving the profession. We suggest that a combination of low self-efficacy and psychological flexibility could increase the risk of individuals staying despite suboptimal working conditions. With combined higher self-efficacy and psychological flexibility, individuals in similar circumstances appear more inclined to quit. We conclude that the ways recently graduated psychologists rate their self-efficacy, psychological flexibility, and basic needs satisfaction appear to be reflected in their self-rated health and wellbeing. (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)

A IMPORTÂNCIA DE TRATAMENTO DE ÁGUAS RESIDUAIS ATRAVÉS DA BIORREMEDIAÇÃO: UMA ANÁLISE PRINCIPIOLÓGICA.

The paper at hand analyzes the economic implications of service robots as expected important future technology. The considerations are embedded into global trends, focusing on the interdependencies between services and industry not only in the context of the provision of services but already starting at the level of the innovation process. It is argued that due to the various interdependencies combined with heterogenous application fields, the resulting implications need to be contextualized. Concerning the net labor market effects, it is reasonable (...) to assume that the field of service robotics will generate overall job creation that goes along with increasing skill requirements demanded from involved employees. It is analyzed which challenges arise in evaluating and further developing the new technology field and some policy recommendations are given. (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (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)

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)

Utilizes Heidegger in rethinking common environmental paradigms.

Eine Grundmotivation, sich mit fiktionaler Literatur zu beschäftigen, liegt in ihrer Fähigkeit, uns Lebenswahrheiten zu vermitteln, die Welt aus einer anderen Perspektive zu zeigen und unseren Erfahrungshorizont zu erweitern. In all diesen Fällen handelt es sich um Metaphern, die auf die kognitive Relevanz unserer Auseinandersetzung mit literarischen Werken hinweisen. Die Erklärung dieser Metaphern kann nicht nur unsere Beschäftigung mit fiktionaler Literatur, sondern auch den Begriff der Erkenntnis und seine Vielfalt erhellen. In diesem Buch wird eine akkurate Analyse des kognitiven Werts (...) fiktionaler Literatur unternommen. Neben der Vermittlung von Wahrheiten und propositionalem Wissen steht im Mittelpunkt des Buches die Untersuchung von Erkenntnisformen, welchen bislang eher wenig Aufmerksamkeit zuteil wurde. Vor diesem Hintergrund werden perspektivische, phänomenale, empathische und ethische Erkenntnisse in Betracht gezogen. Es sind insbesondere die letztgenannten Erkenntnisformen diejenigen, die für die Literatur kennzeichnend sind und die es uns ermöglichen, über uns selbst hinauszuschauen und unsere Existenz in verschiedener Form zu bereichern. (shrink)

How can we understand God's work in a world permeated with evil? Narrating her own wrestling with evil as well as engaging in biblical and philosophical analysis, biblical scholar Ingrid Faro explores the many dimensions to evil in a way that is soberly honest, biblically engaged, and theologically nuanced.

Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (shrink)

When in 1801, after the assassination of Paul I., the more liberal Alexander I. became Czar, he began to reorganize the educational system in Russia. He founded a Ministry for People’s Englightenment , re-opened the University of Dorpat (in 1802), planned to restore the University of Wilna and made preparations for the foundation of new universities in Kazan, Charkov, St. Petersburg, Kiev, Tobol’sk, and Ustiug-Velikii. One of the mediating personalities involved in the negotiations about German professors for Russia was Johann (...) Wolfgang von Goethe. Proposed by Goethe, the chemist Ludwig Schnaubert and the philosopher Johann Baptist Schad were appointed professors at the University of Charkov in 1804. Based on documents from the Goethe-Schiller-archives in Weimar, Goethe’s efforts concerning German academic personnal for Russia are described. (shrink)

ABSTRACT:Increasing research attention to the ways that firms seek to influence the emotions of employees, consumers, and other stakeholders has not been accompanied by systematic attention to the ethical dimensions of emotion management. In this article we review and discuss research that informs the morality of influencing and regulating the emotions of others. What are the moral limits of the use of emotion as a management tool for shaping workplace behavior and influencing the thoughts and actions of consumers? Do the (...) ethics of emotional labor and emotional appeals (e.g., in consumer advertising) depart from moral rules that apply in “non-emotional” contexts? To explore these questions we examine research on the means by which individuals’ emotions are shaped and on the organizationally relevant consequences of individual emotional experience. We then discuss a number of potential ethical issues that are implicit or explicit in the organizationally sanctioned use of emotion management, incorporating existing literature in management and business ethics that has addressed the moral obligations of organizations in this context, and highlighting areas where there is yet work to be done. We conclude by discussing the implications of our analysis. (shrink)