This paper examines how different forms of performance evaluation relate to aspects of the creative climate in a major pharmaceutical company. The study was based on a large employee-attitude survey that was distributed to all company employees. The study analyses survey results from 5,333 employees at five R&D sites. The results indicate that management’s evaluation of employees (either dialogue-based or control-based) relates to the type of motivation (intrinsic or extrinsic) that drives employees, to their style of thinking (value-focused thinking) and (...) on their attitudes to organizational creativity. The paper then discusses implications of these findings for HRM. (shrink)

Berg, J. Buñuels dagdröm.--Bergström, L. Pessimismens konsekvenser.--Furberg, M. Möjliga teser hos Johannes Climacus.--Halldén, S. Teckenrelationen och språkreglernas juridik.--Hedenius, I. Ett argument mot den rättsfilosofiska domstolsrealismen.--Mates, B. Om Platons argument "den tredje människan."--Marc-Wogau, K. Kant om lögnen.--Næss, A. Om filosofiske projekter som forener empirisk semantikk og metafysisk spekulasjon.--Ofstad, H. Får nazister lettere magesår enn humanister?--Prawitz, D. Om moraliska och logiska satsers sanning.--Stenius, E. Om Descartes' psykofysiska modell.--Tranøy, K. E. Filosofenes etiske ansvar.--Wright, G. H. von. En filosof ser på filosofien.

miembro del Future of Humanity Institute de la Universidad de Oxford y experto en mejoramiento humano y transhumanismo, sobre cuestiones centrales de su labor investigadora.PALABRAS CLAVETRANSHUMANISMO, MEJORAMIENTO HUMANO, ANDERS SANDBERG, BIOTECNOLOGÍAABSTRACTInterview with Anders Sandberg, member of the Future of Humanity Institute at Oxford University and expert in human enhancement and transhumanism, about central topics in his works.KEYWORDSTRANSHUMANISM, HUMAN ENHANCEMENT, ANDERS SANDBERG,BIOTECHNOLOGY.

v. 1. Antiquity and the Middle Ages -- v. 2. The modern age to Romanticism -- v. 3. From Bolzano to Wittgenstein.

A wide range of gene knockout experiments shows that functional stability is an important feature of biological systems. On this backdrop, we present an argument for higher‐level causation based on counterfactual dependence. Furthermore, we sketch a metaphysical picture providing resources to explain the metaphysical nature of functional stability, higher‐level causation, and the relevant notion of levels. Our account aims to clarify the role empirical results and philosophical assumptions should play in debates about reductionism and higher‐level causation. It thereby contributes to (...) the development of a philosophical foundation for systems biology. †To contact the authors, please write to: CSMN/IFIKK, University of Oslo, Box 1020 Blindern, N‐0315, Oslo, Norway; e‐mail: anders[email protected] , [email protected]. (shrink)

Understanding how individual agency and group agency relate is of great importance for a range of philosophical and practical concerns, including responsibility ascription and institutional design. This article discusses the relation between corporate and individual responsibility in agency—in particular, the relation between corporate and individual control of actions. First, I criticize Christian List and Philip Pettit’s causal account of combined corporate and individual control. Second, I develop an alternative account in terms of structural control, and I show how this gives (...) a better grasp of the issue. Third, I argue for an act-dualism that complements my account of control and sheds further light on the relation between corporate and individual agency and responsibility. (shrink)

In _Plato on Democracy and Political technē_ Anders Dahl Sørensen offers an in-depth investigation of Plato’s discussions of democracy’s ‘epistemic potential’, arguing that this question is far more central to his political thought than is usually assumed.

The overarching topic of this dissertation is the semantics and pragmatics of definite descriptions. It focuses on the question whether sentences such as ‘the king of France is bald’ literally assert the existence of a unique king or simply presuppose the existence of such a king. One immediate obstacle to resolving this question is that immediate truth value judgments about such sentences are particularly unstable; some elicit a clear intuition of falsity whereas others simply seem awkward or strange. Because of (...) these variations, truth value judgments are generally considered unreliable. In the first chapter of the dissertation, an explanation of this phenomenon is developed. It is observed that when these types of sentences are considered in the context of a discourse, a systematic pattern in judgments emerges. This pattern, it is argued, should be explained in terms of certain pragmatic factors, e.g. whether a speaker’s utterance is interpreted as cooperative. A detailed and general explanation of the phenomenon is then presented which draws importantly on recent research in the semantics and pragmatics of questions and focus. It is shown that the behavior of these judgments can be systematically explained, that truth value judgments are not as unreliable as standardly assumed, and that the proposed explanation best supports the conclusion that definite descriptions presuppose rather than assert existence. In the second chapter, the following problem is investigated. If definite descriptions are assumed to literally assert existence, a sentence such as ‘Hans wants the ghost in his attic to be quiet’ is incorrectly predicted to be true only if Hans wants there to be a ghost in his attic. This prediction is often considered evidence against Russell’s quantificational analysis and evidence in favor of the referential analysis of Frege and Strawson. Against this claim, it is demonstrated that this problem is a general problem about the existence commitments of natural language determiners, i.e. not an argument in favor of a referential analysis. It is shown that in order to avoid these undesirable predictions, quite radical changes to the semantic framework are required. For example, it must be assumed that a sentence of the form ‘The F is G’ has the open sentence ‘x is G’ as its asserted content. A uniform quantificational and presuppositional analysis of definites and indefinites is outlined which by exploiting certain features of so-called dynamic semantics unproblematically assumes that the asserted contents indeed are open sentences. In view of the proposed quantificational/presuppositional analysis, the dissertation is concluded by a rejection of the argument put forward by Reimer and Devitt that definite descriptions are ambiguous between attributive and referential uses. Reimer and Devitt’s argument is based primarily on the assumption that definite descriptions are conventionally used to communicate singular thoughts and that the conventional meaning of a definite description therefore must be fundamentally indexical/directly referential. I argue that this argument relies crucially on tacit assumptions about semantic processing for which no empirical evidence is provided. I also argue that the argument is too general; if sound, it would be an argument for an indexical treatment of most, if not all, other determiners. I then conclude by demonstrating that the view does not explain any new data and thus has no clear motivation. In short, this dissertation provides a detailed pragmatic explanation of a long-standing puzzle about truth value judgments and then outlines a novel dynamic semantic analysis of definites and indefinites. This analysis solves a significant problem about existence commitments — a problem that neither Russell’s nor the Frege/Strawson analysis are equipped to handle. This analysis is then defended against the claim that definite descriptions are ambiguous. (shrink)

Wonder is commonly perceived as akin to curiosity, as stimulating inquiry, and as something that enhances pleasure in learning, but there are many experiences of wonder that have a less obvious place in education. In Wonder and Education, Anders Schinkel theorises a kind of wonder which he calls 'contemplative wonder'. Contemplative wonder opens up space for the consideration of (radical) alternatives wherever it occurs, and in many cases is linked with deep experiences of value; therefore, it is not just (...) important for education in general, but also, more specifically, for moral and political education. (shrink)

This article offers a discussion of the connection between technology and values and, specifically, I take a closer look at ethically sound design. In order to bring the discussion into a concrete context, the theory of Value Sensitive Design (VSD) will be the focus point. To illustrate my argument concerning design ethics, the discussion involves a case study of an augmented window, designed by the VSD Research Lab, which has turned out to be a potentially surveillance-enabling technology. I call attention (...) to a “positivist problem” that has to do with the connection between the design context and the use context, which VSD seems to presuppose, and I argue that it is necessary to clearly distinguish between the two, since the designers’ intentions do not always correspond with the users’ practice; in fact, the relation between design and use is very complex and principally unpredictable. Thus, a design theory must accept that foresight is limited to anticipation rather than prediction. To overcome the positivist problem, I suggest a phenomenological approach to technology inspired by Don Ihde’s concept of multistability. This argument, which is general in nature and thus applies to any theory of design ethics, is intended as a constructive criticism, which can hopefully contribute to the further development of design ethics. (shrink)

Causal selection and priority are at the heart of discussions of the causal parity thesis, which says that all causes of a given effect are on a par, and that any justified priority assigned to a given cause results from causal explanatory interests. In theories of causation that provide necessary and sufficient conditions for the truth of causal claims, status as cause is an either/or issue: either a given cause satisfies the conditions or it does not. Consequently, assessments of causal (...) parity and priority require more resources, which can either be additional or part of the causal analysis itself. While adding resources in terms of a theory of causal explanation has been standard, here we develop a unified conceptual analysis that includes a range of different precise causal concepts that allows for assessments of causal priority in terms of different kinds of causal relevance. (shrink)

Anders, Rudi They dance in view, they dance in secret. And yet they dance together...

Anders Pettersson presents a comprehensive account of the foundations of literature, grounded in an original analysis of the interactions between author and reader. Drawing on post-Gricean pragmatics and Nicholas Wolterstorff's notion of presentationality, Pettersson develops the idea of the verbal text and conveys an integrated and nuanced understanding of literary experience, its conditions, and the values it affords. In the second part of Verbal Art he systematically examines the cognitive, affective, and formal aspects of the literary work and explores (...) their interrelations.Pettersson demonstrates the implications and applications of the theory through a series of detailed studies of literary works, taking care to show that his theory is compatible with a broad variety of perspectives. Combining an intimate knowledge of modern literary theory and the aesthetics of literature with innovative applications of linguistics and cognitive psychology to the literary work, he provides a thorough treatment of fundamental problems in the area, including the concept of a text or work, the concept of form, and the distinctiveness of the literary use of language. (shrink)

This book provides an overview of different ethical views on animal experimentation. Special attention is given to the production and experimental use of genetically modified animals. It proposes a middle course between those positions that are very critical and those very positive. This middle course implies that animal experiments originating in vital human research interests are commonly justified, provided that animal welfare is taken seriously. Some animal experiments are not acceptable, since the expected human benefit is too low and the (...) animal suffering too severe. This position is supported by an argument from species care according to which we have special obligations to our children and other humans due to special relations. The book tries to bridge the gap between animal ethics and animal welfare science by discussing various conceptions of animal welfare: function-centered, feeling-based, and those focusing on natural living. The theoretical starting-point is “imaginative casuistry.” This approach stresses the role of moral imagination and metaphor in ethical deliberation, accepts a plurality of values, and recognizes the importance of case-by-case balancing. In the discussion of genetically modified animals, both intrinsic ethical concerns and animal welfare concerns are addressed. (shrink)

Interview with Anders Sandberg, member of the Future of Humanity Institute at Oxford University and expert in human enhancement and transhumanism, about central topics in his works.

In many biological experiments, due to gene-redundancy or distributed backup mechanisms, there are no visible effects on the functionality of the organism when a gene is knocked out or down. In such cases there is apparently no counterfactual dependence between the gene and the phenotype in question, although intuitively the gene is causally relevant. Due to relativity of causal relations to causal models, we suggest that such cases can be handled by changing the resolution of the causal model that represents (...) the system. By decreasing the resolution of our causal model, counterfactual dependencies can be established at a higher level of abstraction. By increasing the resolution, stepwise causal dependencies of the right kind can serve as a sufficient condition for causal relevance. Finally, we discuss how introducing a temporal dimension in causal models can account for causation in cases of non-modular systems dynamics. (shrink)

BackgroundEthical problems in everyday healthcare work emerge for many reasons and constitute threats to ethical values. If these threats are not managed appropriately, there is a risk that the patient may be inflicted with moral harm or injury, while healthcare professionals are at risk of feeling moral distress. Therefore, it is essential to support the learning and development of ethical competencies among healthcare professionals and students. The aim of this study was to explore the available literature regarding ethics education that (...) promotes ethical competence learning for healthcare professionals and students undergoing training in healthcare professions.MethodsIn this integrative systematic review, literature was searched within the PubMed, CINAHL, and PsycInfo databases using the search terms ‘health personnel’, ‘students’, ‘ethics’, ‘moral’, ‘simulation’, and ‘teaching’. In total, 40 articles were selected for review. These articles included professionals from various healthcare professions and students who trained in these professions as subjects. The articles described participation in various forms of ethics education. Data were extracted and synthesised using thematic analysis.ResultsThe review identified the need for support to make ethical competence learning possible, which in the long run was considered to promote the ability to manage ethical problems. Ethical competence learning was found to be helpful to healthcare professionals and students in drawing attention to ethical problems that they were not previously aware of. Dealing with ethical problems is primarily about reasoning about what is right and in the patient’s best interests, along with making decisions about what needs to be done in a specific situation.ConclusionsThe review identified different designs and course content for ethics education to support ethical competence learning. The findings could be used to develop healthcare professionals’ and students’ readiness and capabilities to recognise as well as to respond appropriately to ethically problematic work situations. (shrink)

Inference has long been a concern in epistemology, as an essential means by which we extend our knowledge and test our beliefs. Inference is also a key notion in influential psychological or philosophical accounts of mental capacities, from perception via utterance comprehension to problem-solving. Consciousness, on the other hand, has arguably been the defining interest of philosophy of mind over recent decades. Comparatively little attention, however, has been devoted to the significance of consciousness for the proper understanding of the nature (...) and role of inference. It is commonly suggested that inference may be either conscious or unconscious. Yet how unified are these various supposed instances of inference? Does either enjoy explanatory priority in relation to the other? In what ways or senses, can an inference be conscious, or fail to be conscious, and how does this matter? This book brings together original essays from established scholars and emerging theorists that illustrate how several current debates in epistemology, philosophy of psychology, and philosophy of mind can benefit from reflections on these and related questions about the significance of consciousness for inference. Contributors include: Kirk Ludwig and Wade Munroe; Michael Rescorla; Federico Bongiorno and Lisa Bortolotti; Berit Brogaard; Nicholas Allott; Jake Quilty-Dunn and Eric Mandelbaum; Corine Besson; Anders Nes; David Henderson, Terry Horgan, and Matjaž Potrč; Elijah Chudnoff; and Ram Neta. (shrink)

Recent proposals for a return to introspective methods make it necessary to review the central problems that led psychologists to abandon those methods as sources of scientific data in the early twentieth century. These problems and other related challenges to verbal reports collected during the cognitive revolution during the 1960s and 1970s were discussed in Ericsson and Simon's proposal for a theoretically motivated procedure to elicit valid and non- reactive concurrent verbalization of thoughts while subjects were performing tasks. The same (...) proposal explains why other verbal reports, such as introspections, detailed descriptions or explanations, require additional cognitive activity that often leads to reactivity and invalid reports. Finally, a new proposal is sketched for how the generation of introspective reports might be incorporated within a framework for non-reactive and valid verbalization of thoughts. (shrink)

Perceptual processes differ from cognitive, this paper argues, in functioning to be causally controlled by proximal stimuli, and being modular, at least in a modest sense that excludes their being isotropic in Jerry Fodor's sense. This claim agrees with such theorists as Jacob Beck and Ben Phillips that a function of stimulus-control is needed for perceptual status. In support of this necessity claim, I argue, inter alia, that E.J. Green's recent architectural account misclassifies processes deploying knowledge of grammar as perceptual. (...) _Pace_ Beck and Phillips, however, I argue a function of stimulus-control is insufficient for perceptual as opposed to cognitive status. One consideration in favour of such insufficiency, noted but (I argue) not convincingly rebutted by these theorists, concerns perpetually grounded demonstrative thought. Two other considerations trade on the fact that a function of stimulus-control can arise not from blind nature but intentional design or social institutions, where so-functioning processes may but need not be perceptual. I offer two cases where such processes are cognitive, viz. skilful play-by-play announcing of ongoing events, and voluntary visualizing of ongoing events under the guidance of apt play-by-play announcements, dubbed announcement-driven visualizing (ADV). The cognitive status of these three diverse phenomena cannot be explained by an absence of a perception-like representational format or content (for ADV has such) or by a presence of personal-level mental states causally mediating between stimuli and outputs (for perception has such). A bettter explanation invokes, I argue, the non-modular character of the generating process. (shrink)

Anders, Rudi To solve a problem such as wars between nations and civil wars it is necessary to discover what causes the problem.

Humanistic theory for more than the past 100 years is marked by extensive attention to practice and practices. Two prominent streams of thought sharing this focus are pragmatism and theories of practice. This volume brings together internationally prominent theorists to explore key dimensions of practice and practices on the background of parallels and points of contact between these two traditions. The contributors all are steeped in one or both of these streams and well-known for their work on practice. The collected (...) essays explore three important themes: what practice and practices are, normativity, and transformation. The volume deepens understanding of these three practice themes while strengthening appreciation of the parallels between and complementariness of pragmatism and practice theory. (shrink)

Anders, Rudi Sometimes it is nice to do something totally unconnected to the usual bustle of life, such as a walk in the park. This time I visit a German Lutheran church in Melbourne; I have never entered it before. The exterior and interior consistently retain the traditional design. The bluestone gives it a sense of permanence - timelessness. I rarely like modern churches; mixing modern and traditional never works for me. This church is not large and has an (...) intimate feel to it. The people are all smiles. I like people, regardless of their beliefs. Family groups look like they feel at home, and visitors like me are made welcome. I sit and admire the skill of the craftsmen who attended to every detail in the church. They didn't have the modern machines we take for granted. (shrink)

According to perceptualism, fluent comprehension of speech is a perceptual achievement, in as much as it is akin to such high-level perceptual states as the perception of objects as cups or trees, or of people as happy or sad. According to liberalism, grasp of meaning is partially constitutive of the phenomenology of fluent comprehension. I here defend an influential line of argument for liberal perceptualism, resting on phenomenal contrasts in our comprehension of speech, due to Susanna Siegel and Tim Bayne, (...) against objections from Casey O'Callaghan and Indrek Reiland. I concentrate on the contrast between the putative immediacy of meaning-assignment in fluent comprehension, as compared with other, less ordinary, perhaps translation-based ways of getting at the meaning of speech. I argue this putative immediacy is difficult to capture on a non-perceptual view (whether liberal or non-liberal), and that the immediacy in question has much in common with that which applies in other, less controversial cases of high-level perception. (shrink)

Anders, Rudi A Melbourne suburb A short speech Congratulations..

‘Language and End Time’ is a translation of Sections I, IV and V of ‘Sprache und Endzeit’, a substantial essay by Günther Anders that was published in eight instalments in the Austrian journal FORVM from 1989 to 1991. The original essay was planned for inclusion in the third volume of The Obsolescence of Human Beings. ‘Language and End Time’ builds on the diagnosis of ‘our blindness toward the apocalypse’ that was advanced in the first volume of The Obsolescence in (...) 1956. The essay asks if there is a language that is capable of making us fully comprehend the looming ‘man-made apocalypse’. In response to this, it offers a critique of philosophical jargon and of the putatively ‘objective’ language of science, which are both dismissed as unsuitable. Sections I, IV and V introduce this core problematic. The selection of this text for inclusion in this special journal issue responds to present-day realities that inscribe Anders’s reflections on nuclear science and the nuclear situation into new contexts. The critique that ‘Language and End Time’ advances resonates with the way in which the decisions of a few companies and individuals are shaping the future of life on earth. At the same time, the wider stakes of Anders’s turn against the language employed by scientists are newly laid bare by the realities and politics of climate change and fake news. In this new context, the language of science is all too readily dismissed as if it were a mere idiom that can be ignored without consequence. It is against the backdrop of a future that is, if anything, more uncertain than at the time of Anders’s writing, that the essay’s reflections on popularisation, the limits of language and the nature of truth gain added significance. (shrink)

In this paper, I argue that sufficientarian principles are indispensable in the set of principles that have bearing on issues in distributive ethics. I provide two arguments in favor of this claim. First, I argue that sufficientarianism is the only framework that allows us to appropriately analyze what sort of obligations we have toward individuals who are badly off due to their own faults and choices. Second, I argue that sufficientarianism is the only theory that provides an adequate framework for (...) thinking about the desperately badly off. (shrink)

Anders, Rudi The articles in AH I like best are the ones with which I disagree to a greater or lesser degree, because they force me to re-think and clarify my position. One such article was by John Perkins, titled 'Let's admit that Islam is a problem'. Although the article is very well-written, and I admire John's fact-finding regarding Islam, I think he misses the elephant in the room. Namely, Christian Europe and North America killed far more people than (...) Islam ever did. Buddhist and Shinto Japan did shocking things in the last world war. Jews in Israel ignore the rights of Palestinians. The atheist communist Soviet Union was as bad as Christian Czarist Russia. There is gross injustice in Hindu India. I don't think Islam should be singled out as a problem. I agree that religion can be a problem but the many atheist dictators, for example: Napoleon Bonaparte, Mussolini and Stalin, are also a problem, so atheism as such is not a guarantee of justice. (shrink)

Anders, Rudi Mathematics is objective and unambiguous, but as soon as mathematics is applied to anything in the human world, human values complicate the issues. Two apples for two people equals one apple for each person, but compassion for a starving person, or other human values, can alter the outcome.

The paper addresses the phenomenology of inference. It proposes that the conscious character of conscious inferences is partly constituted by a sense of meaning; specifically, a sense of what Grice called ‘natural meaning’. In consciously drawing the (outright, categorical) conclusion that Q from a presumed fact that P, one senses the presumed fact that P as meaning that Q, where ‘meaning that’ expresses natural meaning. This sense of natural meaning is phenomenologically analogous, I suggest, to our sense of what is (...) said in fluently comprehending everyday utterances in our first language. The proposal that conscious inference involves a sense of natural meaning is compared with views according to which conscious inference involves taking the premises (i) to be good reasons for the conclusion (as defended by Thomson and Grice), (ii) to support it (as argued by Audi and, recently, Boghossian), or (iii) to imply it (as lately contended by Broome). I argue our proposal can explain certain phenomena handled by alternatives (i) and (ii), but that some further phenomena is handled by our account but not these alternatives. In relation to alternative (iii), I argue that, in so far as implicational and natural-meaning relations come apart, the latter are a better fit for what we sense or take to be so in conscious inference. (shrink)

The starting point for the contemporary debate about theories of health should be the holistic theory of Lennart Nordenfelt, claims George Khushf, not the refuted theory of Christopher Boorse. The present paper is an attempt to challenge Nordenfelt and to present an alternative theory to his and other theories, including Boorse’s. The main problems with Nordenfelt’s theory are that it is relativistic, that it leads to counter-intuitive results as to what goals can count as healthy, that it focuses on the (...) wrong kind of abilities, that it makes measuring health extra difficult, and that it does not give us a sufficient account of health, at most a necessary one. The alternative theory proposed is two-dimensional. First, health is to have developed the abilities and dispositions that members of one’s culture typically develop, and be able to use them, in acceptable circumstances; and second, health is to experience positive moods and sensations, the kinds that have internal causes. The theory solves the problems attached to Nordenfelt’s theory by not being individual relativistic, by eliminating the goals in the definition, by giving an alternative interpretation of “ability,” by making health easier to measure, and by adding the dimension of well-being that, together with health as ability, not only gives us a necessary, but also a sufficient, account of health. (shrink)

Abstract Normative criteria for evaluations of economic and social outcomes are often formulated in terms of social welfare functions which are essentially and importantly non-satiable. However, there are good reasons to consider certain normative criteria and many policy objectives to be capped, i.e. bounded, and thus satiable provided sufficient resources are made available for their satisfaction. Inspired by the Foster–Greer–Thorbecke class of indicators, this paper uses an interdisciplinary approach to develop a model for assessing outcomes in terms of capped objectives (...) based on an understanding of individual shortfalls from the objective, denoted needs. We present an indicator to measure need satisfaction in a population of individuals with heterogeneous needs and highlight an aggregation problem under scarcity. For such situations, we develop three ways in which the indicator can be weighted that reflect respectively concerns over the frequency, depth and severity of the need shortfalls and show that normative evaluations based on these weighting schemes can conflict, yielding mutually inconsistent outcome rankings. The indicator can be adapted to measure a wide variety of phenomena, e.g. health needs, education shortfalls, deprivation, etc., and it is suited for targeting exercises and other policy implementations. In particular, it allows for exogenous weighting schemes, i.e. weights that can incorporate non-shortfall characteristics relevant for the evaluation, e.g. age, gender, ethnicity, etc. The indicator thus enables new ways for researchers to promote and study satiable objectives in a wide variety of contexts relevant to economic and social policy, e.g. human development programs, poverty reduction, healthcare policies, etc. (shrink)

I discuss how the scientificity characterizing Adam Smith’s political economy has to exteriorize social conflict in order to sustain its objectivation of social interaction in terms of regulative laws. I claim that this exteriorization constitutes an internal point of subversion, not only because it resists economic objectivation, but first and foremost because it forces Smith to employ political strategies that both contradict and guarantee the scientificity of his theory. I show how the place of conflict in modern economy, according to (...) Smith, can actually be determined in three different ways: as a concrete place when it comes to the confrontations between workers and capitalists; as a theoretical place in the sense of being an arbitrary disturbance of the spontaneous organization of the market; and as a place that, as being the intersection between economic naturalization and social contingency, problematizes the scientificity of Smith’s political economy. In this sense, I develop three cases where Smith invokes an argumentative circularity that reveals the paradoxical politics of his economic scientificity, beyond its official laissez-faire politics: State coercion, monetary power and capitalist competition. (shrink)

Background: Working as an ambulance nurse involves facing ethically problematic situations with multi-dimensional suffering, requiring the ability to create a trustful relationship. This entails a need to be clinically trained in order to identify ethical conflicts. Aim: To describe ethical conflicts in patient relationships as experienced by ambulance nursing students during clinical studies. Research design: An exploratory and interpretative design was used to inductively analyse textual data from examinations in clinical placement courses. Participants: The 69 participants attended a 1-year educational (...) programme for ambulance nurses at a Swedish university. Ethical consideration: The research was conducted in accordance with the Declaration of Helsinki. Participants gave voluntary informed consent for this study. Findings: The students encountered ethical conflicts in patient relationships when they had inadequate access to the patient’s narrative. Doubts regarding patient autonomy were due to uncertainty regarding the patient’s decision-making ability, which forced students to handle patient autonomy. Conflicting assessments of the patient’s best interest added to the conflicts and also meant a disruption in patient focus. The absence of trustful relationships reinforced the ethical conflicts, together with an inadequacy in meeting different needs, which limited the possibility of providing proper care. Discussion: Contextual circumstances add complexity to ethical conflicts regarding patient autonomy, dependency and the patient’s best interest. Students felt they were fluctuating between paternalism and letting the patient choose, and were challenged by considerations regarding the patient’s communication and decision-making ability, the views of third parties, and the need for prioritisation. Conclusion: The essence of the patient relationship is a struggle to preserve autonomy while focusing on the patient’s best interest. Hence, there is a need for education and training that promotes ethical knowledge and ethical reflection focusing on the core nursing and caring values of trust and autonomy, particularly in situations that affect the patient’s decision-making ability. (shrink)