This study reports the findings of a 2.5 year intervention project to reduce psychosocial risks and increase employee well-being in 15 emergency departments in the Netherlands. The project uses the psychosocial risk management approach “PRIMA” which includes cycles of risk assessment, designing and implementing changes, evaluating changes and adapting the approach if necessary. In addition, principles of participative action research were used to empower the departments in designing and implementing their own actions during the project. Next to determining overall effects, (...) the study aims to assess potential moderators including the level of intervening, process variables and partaking in a Psychosocial Safety Climate intervention offered during the second half of the project. The results of linear mixed-model analyses showed that all job factors improved with the exception of autonomy, which did increase halfway the project but not when considering the entire timeframe. In addition, work engagement decreased and symptoms of burnout remained stable. Emergency departments that implemented more fitting actions, communicated better and involved their employees more in the process, had more favorable changes in job factors and more stable well-being. More activity and a multilevel approach regarding stress management did not lead to greater improvements. The Psychosocial Safety Climate intervention was effective in improving Psychosocial Safety Climate, but a longer follow-up period seems required to evaluate its effect on job factors and well-being. Overall, the project resulted in positive changes in most job factors, and its findings emphasize the importance of process variables in stress management interventions. Longer follow-up and higher quality multilevel interventions seem essential to also improve well-being. (shrink)

Céline Pérol nous offre un parcours quasiment initiatique pour comprendre dans la longue durée le destin si singulier de Marthe, la sœur de Marie-Madeleine et de Lazare. Marthe est longtemps restée dans l’ombre de sa glorieuse fratrie et son culte ne s’est que rarement individualisé. Dans les Évangiles, elle est l’hôtesse du Christ à Béthanie (Lc 10, 38-42), qu’elle accueille activement dans sa maison alors que Marie ne se préoccupe que de rester aux pieds du Christ. Elle est celle qui (...) a tant... (shrink)

Introduction : Dialogue et diatribe, influences réciproques -- Réflexion théorique et construction d'outils d'analyse antique et moderne -- La prétendue "diatribe" antique : fantôme ou instrument herméneutique ? -- Diatribè, quelques jalons dans l'histoire d'un mot controversé -- Le style diatribe dans les Diatribai d'Épictète/Arrien -- "Que bel harnais ne fait pas bon cheval" : un topos de la philosophie morale et "populaire" entre dialogue, diatribe et protreptique -- Manipulations horatiennes de la diatribe cynico-stoïcienne dans les Satires : reprises et (...) mises à distance -- Du dialogue lucianesque à la diatribe philosophique : le Charon de Giovanni Pontano -- Diatribe et dialogisme : La voix de l'autre, quelle place et quelle voix accorder à l'interlocuteur ? -- Interrogatoire judiciaire et interrogation dialectique en partant d'Aristote, Rhétorique III 18 -- "Le partage des voix" dans les Entretiens d'Épictète -- La fonction de l'adresse dans le De Ira de Sénèque -- Le dialogue en échec chez Dion de Pruse -- Diatribe et Sermon, une fausse question ? -- Étude des dialogues fictifs dans quelques sermons d'Augustin. (shrink)

Prison work creates ethical challenges for which a training program was initiated for Dutch prison staff to foster their Moral Craftsmanship (MCS). The concept of MCS is not yet defined and operationalized in literature. This explorative study aims to 1) define MCS, 2) identify conceptual elements of MCS, and 3) develop a measurement tool for MCS. A document and literature study provided input for the definition and selection of conceptual elements related within DCIA policy documents, identifying three conceptual levels of (...) MCS: individual (cognition, attitude, and actions), team, and leadership. This first MCSQ consists of seventy-one items distributed across the domains: values and norms, judgment and reasoning, consultation, implementation, looking back, interactions, and leadership. We tested its usability via ‘think-aloud interviews.’ Validation of the current version of the MCS-Questionnaire and consensus among experts about what to include or exclude in the concept of MCS are needed for further development. (shrink)

BackgroundCRISPR-Cas9, a technology enabling modification of the human genome, is developing rapidly. There have been calls for public debate to discuss its ethics, societal implications, and governance. So far, however, little is known about public attitudes on CRISPR-Cas9. This study contributes to a better understanding of public perspectives by exploring the various holistic perspectives Dutch citizens have on CRISPR-Cas9.MethodsThis study used Q methodology to identify different perspectives of Dutch citizens (N = 30) on the use of CRISPR-Cas9. The Q-sort method (...) aims at segmenting audiences based on the structural characteristics of their perspectives. Participants individually ranked 32 statements about CRISPR-Cas9 and discussed their rankings in small groups. By-person factor analysis was performed using PQMethod. Participants’ contributions to the discussions were used to further make sense of the audience segments identified.ResultsFive perspectives on CRISPR-Cas9 were identified: (1) pragmatic optimism (2) concerned scepticism; (3) normative optimism; (4) enthusiastic support; and (5) benevolent generalism. Each perspective represents a unique position motivated by different ranking rationales. Sorting rationales included improving health, preventing negative impacts on society, and fear of a slippery slope. Overall, there is broad, but not universal support for medical uses of CRISPR-Cas9.ConclusionsResearch on CRISPR-Cas9 should prioritise the broadly supported applications of the technology. Research and public debates on CRISPR-Cas9, its uses, its broader implications, and the governance of CRISPR-Cas9 are recommended. A discourse that includes all perspectives can contribute to the embedding of future uses of CRISPR-Cas9 in society. This study shows that Q methodology followed by group discussions enables citizens to contribute meaningfully to discourses about research. (shrink)

Die vorliegende Schrift unternimmt eine Revision des vorherrschenden Bildes der Rolle und der Konzeptionen von Moral und Ethik im Wiener Kreis. Dieses Bild wird als zu einseitig und undifferenziert zurückgewiesen. Die Ansicht, die Mitglieder des Wiener Kreises hätten kein Interesse an Moral und Ethik gezeigt, wird widerlegt. Viele Mitglieder waren nicht nur moralisch und politisch interessiert, sondern auch engagiert. Des Weiteren vertraten nicht alle die Standardauffassung logisch-empiristischer Ethik, die neben der Anerkennung deskriptiv-empirischer Untersuchungen durch die Ablehnung jeglicher normativer und inhaltlicher (...) Ethik und der Verfechtung eines extremen Nonkognitivismus geprägt ist. Am meisten entspricht die Standardauffassung den Ansichten Rudolf Carnaps, weniger bereits jenen Karl Mengers, Otto Neuraths oder Philipp Franks. Am weitesten weichen Moritz Schlick, Victor Kraft sowie Herbert Feigl von der Standardauffassung ab. Entgegen dem herkömmlichen Bild weltabgewandter Logiker und Metaethiker wurde im Wiener Kreis sogar Angewandte Ethik betrieben, und dies bereits unter diesem Namen. Neben den ethischen Hauptthemen und Ansichten der jeweiligen Philosophen in ihrer Entwicklung im Rahmen ihres persönlichen und kulturellen Kontextes zeigt die Untersuchung, dass allen Ansätzen eine aufgeklärte und humanistische Version von Moral und Ethik gemeinsam ist. Dieser wissenschaftliche Humanismus, der sich schon in der Programmschrift Wissenschaftliche Weltauffassung. Der Wiener Kreis findet, liegt jedoch in verschiedenen Ausprägungen vor. Was die Abweichungen von der Standardauffassung wesentlich betrifft, ist ihre unterschiedliche Auffassung von Moral als gemeinsames oder individuelles Unternehmen. Carnap führt ein extremer Individualismus zu einem extremen Nonkognitivismus, in dem ihm Menger folgt. Bei Schlick ist die Lage zweideutig, was sich in unterschiedlichen Moralbegriffen widerspiegelt. Bei Kraft und Feigl tritt das Verständnis von Moral als gemeinschaftlich geteilte Praxisform klar hervor. Auf der Basis eines gemeinsamen Begriffs des moralisch Guten, der auch eine Sachkomponente enthält, ist eine Verständigung über moralische Fragen möglich. Von einem extremen Nonkognitivismus kann dort nicht mehr die Rede sein. Mit diesen Ergebnissen verbietet es sich, dem Wiener Kreis allgemein eine Ablehnung normativer Ethik und einen extremen Nonkognitivismus zuzuschreiben. Eine systematische Ethik, die Moral als Gemeinschaftspraxis begreift, steht einigen im Wiener Kreis näher, als das vorherrschende Bild suggerieren möge. Wer meint, mit engem Bezug zur Tradition des Wiener Kreises nur Carnap folgen zu können und Ethik als suspektes Unternehmen betrachten zu müssen, irrt. Ethik war in der Tradition Analytischer Philosophie nicht immer so marginalisiert, wie sie es in manchen ihrer Teilrichtungen heute noch ist und Gegner(innen) der Analytischen Philosophie vorwerfen. Die vorliegende Untersuchung liefert die nötige Revision einer verfänglichen Fehlentwicklung. (shrink)

Was passiert, wenn die Bevölkerung die Möglichkeit erhält, sich ungeschminkt und ungefiltert zu bioethischen Problemstellungen zu äußern?

BackgroundWith the emergence of Brain Computer Interfaces, clinicians have been facing a new group of patients with severe acquired brain injury who are unable to show any behavioral sign of consciousness but respond to active neuroimaging or electrophysiological paradigms. However, even though well documented, there is still no consensus regarding the nomenclature for this clinical entity.ObjectivesThis systematic review aims to 1) identify the terms used to indicate the presence of this entity through the years, and 2) promote an informed discussion (...) regarding the rationale for these names and the best candidates to name this fascinating disorder.MethodsThe Disorders of Consciousness Special Interest Group of the International Brain Injury Association launched a search on Pubmed and Google scholar following PRISMA guidelines to collect peer-reviewed articles and reviews on human adults published in English between 2006 and 2021.ResultsThe search launched in January 2021 identified 4,089 potentially relevant titles. After screening, 1,126 abstracts were found relevant. Finally, 161 manuscripts were included in our analyses. Only 58% of the manuscripts used a specific name to discuss this clinical entity, among which 32% used several names interchangeably throughout the text. We found 25 different names given to this entity. The five following names were the ones the most frequently used: covert awareness, cognitive motor dissociation, functional locked-in, non-behavioral MCS and higher-order cortex motor dissociation.ConclusionSince 2006, there has been no agreement regarding the taxonomy to use for unresponsive patients who are able to respond to active neuroimaging or electrophysiological paradigms. Developing a standard taxonomy is an important goal for future research studies and clinical translation. We recommend a Delphi study in order to build such a consensus. (shrink)

Scholars and policymakers have increasingly advocated to engage citizens more substantially in the development of science and technology. However, to a large extent it has remained unknown how citizens can contribute to technology development. In this study, we systematically characterized citizens’ contributions in the development of nanotechnology for health. We explored to which technology aspects citizens are able to provide suggestions on and on which values their suggestions are based. Fifty citizens in the Netherlands were asked to discuss different applications (...) of nanotechnology for health. They were divided over eight focus groups, which lasted approximately 6.5h each. The citizens were able to contribute to various technology aspects; they mainly focused on the technologies’ implementation and use, they paid some attention to the development and system aspects, and also addressed, but less, the design and communication aspects. Their suggestions were often derived from concerns about the potential effects of the technologies and were predominantly based on the values of well-being, autonomy, and privacy. (shrink)

Voraussetzungen -- Carla Henius, Cathy Berberian und Roy Hart : drei vokale Fallbeispiele -- Interpretationen : Konklusionen -- Verzeichnis der Archive -- Abbildungsverzeichnis -- Literaturverzeichnis.

Renvoyant au rapport de force entre le Droit et l’Économie, l’ordre public économique a plusieurs natures. En premier lieu, l’on doit distinguer l’ordre public « gardien des marchés », de l’ordre public « promoteur des marchés », de l’ordre public « architecte des marchés ». En passant de l’un à l’autre, la dimension politique, voire souveraine, de l’ordre public économique s’accroît. En second lieu, l’on doit distinguer l’ordre public de « constitution des marchés » de l’ordre public posant des « (...) octrois aux marchés ». En effet, à l’intérieur des marchés, c’est par des règles d’ordre public que le Droit garde les marchés, les bâtit ou les conçoit. Mais un ordre public économique premier plus radical construit des « octrois de marchés » pour empêcher que les objets de désir, objets naturels d’échanges, deviennent de ce seul fait objets de marché. Cet ordre public économique hautement politique brise des élans de désir. Si on ne l’admet pas, alors que cette nature-là concrétise la prétention que constitue l’ordre public économique, le Droit ne serait plus que l’agent d’effectivité de l’Économie, donnant efficacité à une simple société d’ajustement des désirs individuels. (shrink)

La locution vision du monde est aujourd'hui très régulièrement utilisée dans la presse écrite et dans les sciences humaines, mais sait-on que c'est au linguiste allemand, Wilhelm von Humboldt (1767-1835), que nous devons le concept de ...

Peindre si bien que la toile est un objet vivant est un exploit technique qui fut atteint par peu. Francis Bacon obtint de la toile qu’elle fasse son affaire de préserver en elle la vie, tandis que Carbonnier, avec une semblable modestie devant la toile et le métier, obtint que la Loi ne soit qu’un cadre, mais qu’elle ne laisse pourtant cette place-là à personne et surtout pas à l’opinion publique, afin que chacun puisse à sa façon et dans ce (...) cadre-là faire son propre droit, sur lequel le législateur dans sa délicatesse et pour reprendre les termes du Doyen n’appose qu’un « mince vernis ». Ces deux maîtres de l’art construisaient des cadres avec des principes rudimentaires pour que, sur cette toile, le mouvement advienne par lui-même. Ainsi la Législation créée par Carbonnier offrit à chaque famille la liberté de tisser chaque jour son droit. Mais c’est pourtant bien au Législateur seul que revint et doit revenir l’enfance de l’art consistant à tendre la toile sur le métier. Il est alors possible, comme le fit Bacon, d’obtenir un objet immobile qui permet que surgissent sans cesse les figures mobiles. Les gribouillis réglementaires sont à mille lieues de cet Art législatif-là. (shrink)

Un regard rétrospectif permet de distinguer quatre phases dans l'émergence de la bioéthique. D'abord (dans les années 1960), une phase d'indignation, qui fait suite à la découverte de conduites scandaleuses dans la recherche biomédicale. Vient ensuite une période d'institutionnalisation, qui voit naître les premières institutions nationales et internationales de régulation. Nous sommes désormais dans une phase de mise en application, où l'on s'efforce de faire passer dans la pratique les règies ainsi dégagées. Cet effort collectif de normalisation n'élimine pas le (...) pluralisme des références éthiques ultimes, mais il témoigne d d'un refus du nihilisme et d'un relatif consensus autour d'un certain nombre de grands principes. Looking back at the emergence of bioethics, four periods can be distinguished. First (during the sixties), an indignation stage, following the disclosure of scandalous misconducts in biomedical research. Then comes a period of institutionalization, where the first national and international regulation institutions were born. We are now in a stage of implementation, trying to put into practice the rules that were thus brought out. This collectively attempted normalization does not eliminate the pluralism of the ultimate ethical references, but it shows both a rejection of nihilism and an almost consensual agreement concerning a number of great principles. (shrink)

Duties to reduce global poverty are often portrayed as collective duties to assist. At first glance this seems to make sense: since global poverty is a problem that can only be solved by a joint effort, the duty to do so should be considered a collective duty. But what exactly is meant by a ‚joint‘ or ‚collective‘ duty? This paper introduces a distinction between genuinely cooperative and cumulative collective actions. Genuinely cooperative actions require mutually responsive, carefully adjusted contributory actions by (...) cooperating agents, while contributions to cumulative actions are largely independent. The global affluent’s obligation to combat global poverty is not an obligation to perform a genuinely cooperative action. Instead, for most of us the morally best response is to contribute to existing cumulative endeavours. Our obligation to donate money to suitable organisations is a duty to contribute to cumulative action. Collective actions can produce fixed-sum or incremental goods. A collective obligation to produce a fixed-sum good is not distributive, that is, it is an obligation of the plurality of agents as such. This applies to obligations requiring both genuinely cooperative and cumulative actions. I call these kinds of obligations strongly collective obligations. However, for incremental goods the implications are less clear. There, the parameters for moral compliance are not dictated by problem for remedy as such. Rather, the magnitude of the required good is the sum of individually adequate contributions. What is collectively required depends on what is individually required. I propose to call these kinds of obligations weakly collective obligations. It turns out that we – the affluent – have a collective obligation to combat global poverty only in the weak sense. The obligation is collective in the sense that there is joint necessity and that we must contribute to a collective endeavour. Our donations are intended as contributions to a shared goal. But our duty to combat poverty is not a collective duty in the non-distributive, strong sense. This means that we need not necessarily take up the slack left by others or else stop contributing when others do more than their fair share. (shrink)

Neue Formen der Telekommunikation lassen die Sorge um Privatheit wieder aufkeimen. Zu diesen zählen E-Mails im Internet. Wie können Privatheitsrechte bezüglich E-Mails ethisch begründet werden? Eine differenzierte Formulierung der relevanten Privatheitsrechte ermöglicht die analytische Rechtstheorie von Stig Kanger. Für die Begründung dieser Rechte in unterschiedlichen Beziehungen (z.B. gegenüber Systembetreuer/inne/n, dem Staat oder Arbeitgeber/inne/n) spielen Personsein, persönliche und intime Beziehungen, aber auch politische und soziale Freiheiten eine wesentliche Rolle. Wann verzichten Menschen jedoch auf diese Rechte und von welchen Überlegungen werden sie (...) zurückgedrängt? Die Autorin behandelt nicht nur diese Ethischen Fragen, sondern gibt ebenso eine Reihe aktueller Informationen über technische, positiv-rechtliche und politische Entwicklungen. (shrink)

Theodor W. Adornos posthum veröffentlichte Ästhetische Theorie exponiert die Krise der Kunst im Zeitalter ihrer gesellschaftlichen Integration. Gesättigt mit der Erfahrung konkreter Kunstwerke, hinterfragt sie das tradierte Kategoriensystem philosophischer Ästhetik. Der vorliegende Band unternimmt erstmals eine kommentierende Auslegung, um den dichten Text aufzuschließen und ein Weiterdenken von Adornos kritischer Ästhetik anzuregen.

The concept of phronesis is venerable and is experiencing a resurgence in contemporary discourses on professional life. Aristotle’s notion of phronesis involves reasoning and action based on ethical ideals oriented towards the human good. For Aristotle, humans possess the desire to do what is best for human flourishing, and to do so according to the application of virtues. Within health care, the pervasiveness of economic agendas, technological approaches and managerialism create conditions in which human relationships and moral reasoning are becoming (...) increasingly de‐valued. This creates a tension for nurses, and nursing leaders, as the desire to do what is morally right is often in conflict with contextual demands. In this paper, Aristotle’s writing on phronesis is examined with a focus on his classic conceptions of eudaimonia, the virtues, deliberation, judgement, and praxis. Building on Aristotle’s work, a number of contemporary views are explored with a focus on what various conceptualizations offer for the discipline of nursing. These expanded conceptions of phronesis include attention to: embodiment in practice; open‐mindedness including the capacity to stay curious and open to recognizing what we do not know; perceptiveness as a disposition towards insight and aesthetic understanding; and reflexivity as an ongoing process of interrogation and inquiry into ourselves and our actions. Drawing on these concepts, we discuss the affordances of phronesis as a morally informed guiding force to attend to modern‐day challenges in nursing practice and nursing leadership. (shrink)