Name der Zeitschrift: Kierkegaard Studies Yearbook Jahrgang: 2016 Heft: 1 Seiten: 39-50.

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their (...) role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost‐effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice. (shrink)

An initial distinction is made between two ways of referring in thought to a particular object. One can think of an object in virtue of having a descriptive condition in mind which uniquely denotes that object. Alternatively, one can think about a particular in a more direct way. It is with the nature of this more direct sort of reference that the subsequent discussion is primarily concerned. ;It has been argued that the relation of direct reference is purely causal in (...) nature. A number of difficulties are raised for this causal view. A diagnosis of these difficulties suggests that the causal view ignores the cognitive aspects of direct reference. ;The idea that direct reference is a cognitive relation is not new. Bertrand Russell's notion of knowledge by acquaintance can be thought of as involving the idea of a relation of reference which is direct and cognitive. A good place to begin an exploration of the cognitive dimensions of direct reference is with Russell's notion of acquaintance. Thus this notion is analysed in some depth. ;An objection to the effect that acquaintance is a relation incapable in principle of playing a role in an account of reference is shown to be unfounded. This clears the way for an extended discussion of the nature of acquaintance. This discussion suggests that we should posit a special demonstrative way in which objects can be presented to us. This demonstrative way of being presented with an object is in turn explored by way of an extended metaphor, in which it is suggested that becoming acquainted with an object should be thought of as the opening of a mental file of a special sort for that object. ;Some indirect support for this account of demonstrative modes of presentation and the associated account of direct reference comes from the fact that these notions can help solve the problem of cognitive significance that has been thought to pose a serious threat to theories that somehow treat reference as direct. ;Finally, some potential counterexamples are examined and shown not to seriously threaten the acquaintance theory of direct reference. (shrink)

Documentary film, in the words of Bill Nichols, is one of the "discourses of sobriety" that include science, economics, politics, and history-discourses that claim to describe the "real," to tell the truth. Yet documentary film, in more obvious ways than does history, straddles the categories of fact and fiction, art and document, entertainment and knowledge. And the visual languages with which it operates have quite different effects than does the written text. In the following interview conducted during the winter of (...) 1997, historian Ann-Louise Shapiro raises questions about genre-the relationship of form to content and meaning-with documentary filmmaker Jill Godmilow.In order to explore the possibilities and constraints of non-fiction film as a medium for representing history, Godmilow was asked: What are the strategies and techniques by which documentary films make meaning? In representing historical events, how does a non-fiction filmmaker think about accuracy? authenticity? invention? What are the criteria you have in mind when you call a film like The Wonderful, Horrible Life of Leni Riefenstahl "dishonest"? How does the tension between making art and making history affect documentary filmmaking? Should documentary filmmakers think of themselves, in the phrase of Ken Burns, as "tribal storytellers"? What kind of historical consciousness is produced by documentary film? (shrink)

Documentary film, in the words of Bill Nichols, is one of the "discourses of sobriety" that include science, economics, politics, and history-discourses that claim to describe the "real," to tell the truth. Yet documentary film, in more obvious ways than does history, straddles the categories of fact and fiction, art and document, entertainment and knowledge. And the visual languages with which it operates have quite different effects than does the written text. In the following interview conducted during the winter of (...) 1997, historian Ann-Louise Shapiro raises questions about genre-the relationship of form to content and meaning-with documentary filmmaker Jill Godmilow.In order to explore the possibilities and constraints of non-fiction film as a medium for representing history, Godmilow was asked: What are the strategies and techniques by which documentary films make meaning? In representing historical events, how does a non-fiction filmmaker think about accuracy? authenticity? invention? What are the criteria you have in mind when you call a film like The Wonderful, Horrible Life of Leni Riefenstahl "dishonest"? How does the tension between making art and making history affect documentary filmmaking? Should documentary filmmakers think of themselves, in the phrase of Ken Burns, as "tribal storytellers"? What kind of historical consciousness is produced by documentary film? (shrink)

Since the turn of the millennium, a new phenomenon has arisen on the global stage, as girls have increasingly begun to raise their voices. In an effort to achieve new philosophical understandings of contemporary childhoods in a post-truth era, the present article examines this Girl Rising movement from an existential perspective. In doing so, the article aims to problematise children’s right to be heard and listened to, as enshrined in Article 12 of the Convention on the Rights of the Child. (...) More specifically, the article explores children as rights-holders and their rights-subject position and how these positions are supported (or not) by adults in different ways. Throughout the analysis, Greta Thunberg is used as a case study to illustrate the phenomenon under study. This new movement highlights children’s right to be heard as a valuable right. The defence of this view relies on the claim that at the heart of adult’s acknowledgement lies the uniqueness of each child and the implications of this uniqueness. Taking into consideration the realisation of children’s rights, powerful stakeholders who seek to silence children’s voices are also identified, as are worldwide adult acknowledgements intended to empower girls to exist ‘in’ and ‘with’ the world in a ‘grown-up’ way. (shrink)

For nearly a century, the French have entertained an unshakable conviction that their ability to recognize themselves-to know and transmit the essence of Frenchness-depended on the teaching of the history of France. In effect, history was a discourse on France, and the teaching of history-"la pédagogie centrale du citoyen"-the means by which children were constituted as heirs and carriers of a common collective memory that made them not only citizens, but family. In this essay, I examine the rhetorical and conceptual (...) effects on history writing that emerge out of this preoccupation with the elaboration of a continuous, coherent national identity. Focusing on schoolbooks, I begin by looking at the dominant, nearly hegemonic model of French history created by Ernest Lavisse in the 1890s-a model informed by the dream of a unified, unitary French nation, embodied in and articulated through the history of France-and at the disruption of this paradigm in the aftermath of the Great War. I then consider a text written in the 1990s specifically to repudiate the kind of nationalist narratives that prevailed for most of this century-a new supranational history of Europe. I argue that, in their different experiments with fixing history, both Lavisse and the contemporary textbook authors did not so much repair a deficient history as produce a historical fixation, creating mythicized histories that are complete, closed, predictable, and at bottom ahistorical. Finally, I turn to a recent World War I novel, A Very Long Engagement by Sébastien Japrisot, in order to suggest ways in which the narrative strategies of a fiction writer may be useful to historians in thinking about a different kind of historical project. (shrink)

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The theoretical and empirical link between leadership and workplace bullying needs further elaboration. The aim of the study is to examine the relationship between quality of leadership and the occurrence of workplace bullying 2 years later. Furthermore, we aim to examine a possible mechanism from leadership to bullying using social community at work as mediator. Using survey data that were collected at two different points in time among 1664 workers from 60 Danish workplaces, we examined the total, direct and indirect (...) effects between quality of leadership and workplace bullying. Our results indicate that quality of leadership plays a role in establishing working conditions that lead to workplace bullying. Furthermore, social community at work fully mediates the effect of poor quality of leadership on workplace bullying. This longitudinal study adds to previous cross-sectional studies on the substantial role played by leaders in the bullying process. Within the leadership–bullying relationship, social community at work acts as a full mediator, adding a significant contribution to the discussion of mechanisms involved in the bullying process. Plausible explanations of this mechanism and practical implications are discussed. (shrink)

BackgroundDealing with end of life is challenging for patients and health professionals alike. The situation becomes even more challenging when a patient requests a legally permitted medical service that a health professional is unable to provide due to a conflict of conscience. Such a scenario arises when Victorian health professionals, with a conscientious objection (CO) to voluntary assisted dying (VAD), are presented with patients who request VAD or merely ask about VAD. The Voluntary Assisted Dying Act 2017 (Vic) recognizes the (...) inherent conflict of conscience that may arise for some health professionals when asked to provide VAD and responds by affording broad protection to conscientious objectors who wish to refuse to take part in the VAD process.MethodsSeventeen semi-structured qualitative interviews were conducted with Victorian health professionals with a self-identified CO to VAD in the lead-up to the implementation of VAD in Victoria. Interviews explored how participants anticipated they would manage their CO in practice. Interviews were transcribed verbatim and analyzed thematically.ResultsOur results reveal that the way in which health professionals claimed they would approach CO conversations is variable and was dependant on the strength of their opposition to VAD. We categorized conscientious objectors according to their approach as either dissuasive non-referrers, passive non-referrers, facilitators or negotiators. Our study also explores the perceived difficulties of exercising one’s CO as identified by our participants.ConclusionThe broad protection offered by the Voluntary Assisted Dying Act 2017 (Vic) encourages a range of behaviors from conscientious objectors, due to the minimal obligations imposed. In order to assist conscientious objectors, more policy, institutional guidance, and education needs to be available to conscientious objectors explicitly addressing how to effectively manage one’s CO. Such guidance is imperative to ensuring that their moral integrity is preserved and that they are exercising their CO appropriately. (shrink)

In Victoria, Australia, the law regulating abortion was reformed in 2008, and a clause was introduced requiring doctors with a conscientious objection to abortion to refer women to another provid...

The evolutionary theory of threat simulation during dreaming indicates that themes appropriate to ancestral survival concerns (threats) should be disproportionately represented in dreams. Our studies of typical dream themes in students and sleep-disordered patients indicate that threatening dreams involving chase and pursuit are indeed among the three most prevalent themes, thus supporting Revonsuo's theory. However, many of the most prevalent themes are of positive, not negative, events (e.g., sex, flying) and of current, not ancestral, threat scenarios (e.g., schoolwork). Moreover, many (...) clearly ancestral themes (e.g., snakes, earthquakes) are not prevalent at all in dreams. Thus, these findings challenge the specificity of the threat simulation theory. [Revonsuo]. (shrink)

There are wide individual differences in the ability to detect a stimulus contingency embedded in a complex paradigm. The present study used a cognitive masking paradigm to better understand individual differences related to contingency learning. Participants were assessed on measures of electrodermal arousal and on working memory capacity before engaging in the contingency learning task. Contingency awareness was assessed both by trial-by-trial verbal reports obtained during the task and by a short post-task recognition questionnaire. Participants who became aware had fewer (...) non-specific skin conductance responses and tended to score higher on a digit span assessment. Skin conductance level was not significantly lower in the aware group than in the unaware group. These findings are consistent with studies showing that lower arousal and greater cognitive processing capacity facilitate conscious perception of a greater breadth of information within a scene or a task. (shrink)

Much attention has been devoted to ethical issues related to randomized controlled trials for HIV treatment and prevention. However, there has been less discussion of ethical issues surrounding families involved in observational studies of HIV transmission. This paper describes the process of ethical deliberation about how best to obtain informed consent from sex partners of injection drug users (IDUs) tested for HIV, within a recent HIV study in Eastern Europe. The study aimed to assess the amount of HIV serodiscordance among (...) IDUs and their sexual partners, identify barriers to harm reduction, and explore ways to optimize intervention programs. Including IDUs, either HIV-positive or at high risk for HIV, and their sexual partners would help to gain a more complete understanding of barriers to and opportunities for intervention. (shrink)

Whilst care imperatives have arisen across the breadth of Western societies, within the education sector they appear both prolific and urgent. This paper explores the deployment of care discourses within education generally and draws upon the case of Australian Health and Physical Education (HPE) more specifically, to undertake a Foucauldian interrogation of care. In so doing I demonstrate the usefulness of Foucault's pastoral power lens and its capacity to provide insight into the moral and ethical work conducted by caring teachers (...) on behalf of the state (Acker, 1995). Following a brief overview of the advocacy, challenges and debates surrounding the issue of caring teaching within education, I draw on the work of Hunter (1994) and three case studies from a genealogical interrogation of HPE that employed Foucualt's ethical fourfold as a heuristic device to reveal the ethical practices and objectives of the good HPE teacher. Drawing on this genealogical work, I argue that HPE teachers and their colleagues have been purposefully incited to constitute themselves as agents of pastoral power. From this Foucauldian perspective, I conclude with an exploration of the unintended and possibly ‘dangerous’ practices of caring teaching that may emerge within the complex and messy nexus of contemporary self‐constitution. (shrink)

The paper contributes to previous studies of identity as locally and interactionally produced by pointing to some of the multimodal resources employed by participants to achieving, challenge and manage the professional identity of ‘leader’ in different workplace settings. We examine professional identity work in sequential environments where it provides a resource for handling the resistance to improvement displayed by another participant. We show how leader identity work gets embedded within a four-part structure of: identifying a problem, proposing improvements, misaligning with (...) others’ proposals, and managing the misalignment. The paper is based on video ethnographic fieldwork and recordings of face-to-face institutional interaction at two different institutional settings in Denmark. The study provides insight about the role of identity work in the interactional achievement of institutional procedures. (shrink)

Abstract2020 saw the rapid onset of a global pandemic caused by the SARS‐CoV‐2 virus. For healthcare systems worldwide, the pandemic called upon quick organization ensuring treatment and containment measures for the new virus disease. Nurses were seen as constituting a vital instrumental professional component in this study. Due to the pandemic's unpredictable and potentially dangerous nature, nurses have faced unprecedented risks and challenges. Based on interviews and free text comment from a survey, this study explores how ethical challenges related to (...) “being a nurse” during the COVID‐19 pandemic was experienced and understood by Danish hospital‐based nurses. Departing from anthropologist Jarett Zigon's notion of moral breakdown, the study demonstrates how the rapid onset of the pandemic constitutes a moral breakdown raising ethical demands for nurses. Analytically we identify three different ethical demands experienced by the nurses. These ethical demands are Nursing and societal ethical demands, Nursing and personal ethical demands, and Nursing and conflicting ethical demands. These demands represent not only very different understandings of ethical demands but also different understandings of ethical acts that are seen as necessary to respond to these demands. (shrink)

The amount of data available to healthcare practitioners is growing, and the rapid increase in available patient data is becoming a problem for healthcare practitioners, as they are often unable to fully survey and process the data relevant for the treatment or care of a patient. Consequently, there are currently several efforts to develop systems that can aid healthcare practitioners with reading and processing patient data and, in this way, provide them with a better foundation for decision-making about the treatment (...) and care of patients. There are also efforts to develop algorithms that provide suggestions for such decisions. However, the development of these systems and algorithms raises several concerns related to the privacy of patients, the patient–practitioner relationship, and the autonomy of healthcare practitioners. The aim of this article is to provide a foundation for understanding the ethical challenges related to the development of a specific form of data-processing systems, namely clinical algorithms. (shrink)

This paper seeks to analyse small- and medium-sized enterprise (SME) managers' representations of corporate social responsibility (CSR) and CSR communication in a corporate communication perspective. The basic question is: how strategic is CSR communication in SMEs? Corporate communication and CSR theories are used to establish an ideal typology of CSR concepts informing an analysis of qualitative data in the form of interviews with three middle managers in two Danish SMEs. A CSR communication model published earlier by the authors is challenged (...) from a SME perspective. Results from an Internet-based questionnaire survey of 1071 SMEs pave the way for the analysis. Our analysis shows that SME managers clearly have an inside-out approach to CSR, with a strong emphasis on the internal (corporate culture) dimension. However, SMEs and/or SME managers tend not to communicate externally about the CSR activities of the company. Based on these findings, the paper argues that CSR communication in SMEs is challenged by the global economy and is under revision. The contribution of the paper is to provide an insight into SMEs' present stage in relation to a possible future approach to strategic CSR communication. The paper also reminds us that SMEs have no interest in turning their local and authentic practice into a forced marketing and branding exercise, leaving them with an artificial picture of who they are and strive to be in the future. They should keep on acting locally but force themselves to think globally. (shrink)

This paper seeks to analyse small‐ and medium‐sized enterprise (SME) managers' representations of corporate social responsibility (CSR) and CSR communication in a corporate communication perspective. The basic question is: how strategic is CSR communication in SMEs? Corporate communication and CSR theories are used to establish an ideal typology of CSR concepts informing an analysis of qualitative data in the form of interviews with three middle managers in two Danish SMEs. A CSR communication model published earlier by the authors is challenged (...) from a SME perspective. Results from an Internet‐based questionnaire survey of 1071 SMEs pave the way for the analysis. Our analysis shows that SME managers clearly have an inside‐out approach to CSR, with a strong emphasis on the internal (corporate culture) dimension. However, SMEs and/or SME managers tend not to communicate externally about the CSR activities of the company. Based on these findings, the paper argues that CSR communication in SMEs is challenged by the global economy and is under revision. The contribution of the paper is to provide an insight into SMEs' present stage in relation to a possible future approach to strategic CSR communication. The paper also reminds us that SMEs have no interest in turning their local and authentic practice into a forced marketing and branding exercise, leaving them with an artificial picture of who they are and strive to be in the future. They should keep on acting locally but force themselves to think globally. (shrink)

Based on an integrative discourse methodology, this study examines the organizational role expectancies of CSR professionals as articulated in CSR job advertisements, focusing specifically on what organizations expect CSR professionals to change. Four types of change were identified and organized into a matrix based on the inside or outside stimuli for these changes and their expected effects, which can materialize inside or outside the organization. Specifically, the four types of change include organizational development (aligning practices with organizational values), compliance (aligning (...) practices with external norms), social approval (changing public perceptions), and agenda setting (changing the environment). These four types of change highlight the transformative as well as the self-serving nature of the changes organizations expect CSR professionals to accomplish. On the practical side, the types of change provide insights into CSR as an occupation, as they highlight desired skills and competences of CSR professionals. (shrink)

This article focuses on a crucial development in genetic research that occurred in the 1990s: the identification of the first two of the genes responsible for hereditary breast and ovarian cancer. Issues addressed touch on the evolution of the subfield, its potential impact on cancer treatment, and industry involvement. The article follows the activities of the various research groups competing in the race to identify the genes and depicts the frequent conflicts between them. Data are derived chiefly from a bibliometric (...) database. The results show a diversity of research practices. Industrial researchers interacted within far more tightly knit networks than their counterparts working in public organizations. The patenting and commercial exploitation of results led to fierce battles, with one group capturing most of the benefits. (shrink)

That PTSD nightmares are highly realistic threat simulations triggered by trauma is difficult to reconcile with the disturbed, sometimes debilitating sleep and waking functioning of PTSD sufferers. A theory that accounts for fundamental forms of imagery other than threat scenarios could explain the selection of many more adaptive human functions – some still pertinent to survival today. For example, interactive characters, a virtually ubiquitous form of dream imagery, could be simulations of attachment relationships that aid species survival in many different (...) ways. [Revonsuo]. (shrink)

Some low-income social housing neighborhoods are undergoing radical transformations in Denmark. Classified as “ghettos” and “parallel societies,” and marked by area-specific legislation, we identify a triple exposure in these neighborhoods. The residents are exposed to inequality, stigmatization, and discriminatory inter-ventions. Parallel to this, cultural policies and programs have ap-proached these same neighborhoods based on the assumption that they can be “elevated” through art. Drawing upon a broader re-search in art project in four social housing areas (Eriksson, Nielsen, Sørensen and (...) Yates, 2022), this article focuses on Gellerup Park in Aarhus and considers how two site-specific art platforms address the site and time-specific conditions of the area, offering alterna-tive relations and forms of engagement. (shrink)

Working from Fredric Jameson’s quote and recognizing his suggestion of a need for ‘the invention and projection of a global cognitive mapping’ as an integral part of what comes after postmodernism,...