Nudging is a concept in behavioural science, political theory and economics that proposes indirect suggestions to try to achieve non-forced compliance and to influence the decision making and behaviour of groups and individuals. Researchers in medical ethics are currently discussing whether nudging is ethically permissible in healthcare. In this article, we examine current knowledge about how different decisions are made and how this decision-making process pertains to patients. We view this knowledge in light of the nursing project and the ongoing (...) debate regarding the ethical legitimacy of nudging in healthcare. We argue that it is insufficient to discuss nudging in nursing and healthcare in light of free will and patient autonomy alone. Sometimes, nurses must take charge and exhibit leadership in the nurse–patient relationship. From the perspective of nursing as leadership, nudging becomes a useful tool for directing and guiding patients towards the shared goals of health, recovery and independence and away from suffering. The use of nudging in nursing to influence patients’ decisions and actions must be in alignment with the nursing project and in accordance with patients’ own values and goals. (shrink)
Our contribution in this paper is to highlight the ethical implications of workforce engagement strategies in an age of austerity. Hard or instrumentalist approaches to workforce engagement create the potential for situations where engaged employees are expected to work ever longer and harder with negative outcomes for their well-being. Our study explores these issues in an investigation of the enactment of an engagement strategy within a UK Health charity, where managers and workers face paradoxical demands to raise service quality and (...) cut costs. We integrate insights from engagement, paradox, and ethic of care literatures, to explore these paradoxical demands—illustrating ways in which engagement experiences become infused with tensions when the workforce faces competing requirements to do ‘more with less’ resources. We argue that those targeted by these paradoxical engagement strategies need to be supported and cared for, embedded in an ethic of care that provides explicit workplace resources for helping workers and managers cope with and work through corresponding tensions. Our study points to the critical importance of support from senior and frontline managers for open communications and dialogue practices. (shrink)
Objective: Basic temporal dysfunctions have been described in patients with schizophrenia, which may impact their ability to connect and synchronize with the outer world. The present study was conducted with the aim to distinguish between interval timing and synchronization difficulties and more generally the spatial-temporal organization disturbances for voluntary actions. A new sensorimotor synchronization task was developed to test these abilities. Method: Twenty-four chronic schizophrenia patients matched with 27 controls performed a spatial-tapping task in which finger taps were to be (...) produced in synchrony with a regular metronome to six visual targets presented around a virtual circle on a tactile screen. Isochronous (time intervals of 500 ms) and non-isochronous auditory sequences (alternated time intervals of 300/600 ms) were presented. The capacity to produce time intervals accurately versus the ability to synchronize own actions (tap) with external events (tone) were measured. Results: Patients with schizophrenia were able to produce the tapping patterns of both isochronous and non-isochronous auditory sequences as accurately as controls producing inter-response intervals close to the expected interval of 500 and 900 ms, respectively. However, the synchronization performances revealed significantly more positive asynchrony means (but similar variances) in the patient group than in the control group for both types of auditory sequences. Conclusion: The patterns of results suggest that patients with schizophrenia are able to perceive and produce both simple and complex sequences of time intervals but are impaired in the ability to synchronize their actions with external events. These findings suggest a specific deficit in predictive timing, which may be at the core of early symptoms previously described in schizophrenia. (shrink)
This paper charts the history of the Rockefeller Foundation’s participation in the collection and long-term preservation of genetic diversity in crop plants from the 1940s through the 1970s. In the decades following the launch of its agricultural program in Mexico in 1943, the Rockefeller Foundation figured prominently in the creation of world collections of key economic crops. Through the efforts of its administrators and staff, the foundation subsequently parlayed this experience into a leadership role in international efforts to conserve so-called (...) plant genetic resources. Previous accounts of the Rockefeller Foundation’s interventions in international agricultural development have focused on the outcomes prioritized by foundation staff and administrators as they launched assistance programs and especially their characterization of the peoples and “problems” they encountered abroad. This paper highlights instead how foundation administrators and staff responded to a newly emergent international agricultural concern—the loss of crop genetic diversity. Charting the foundation’s responses to this concern, which developed only after agricultural modernization had begun and was understood to be produced by the successes of the foundation’s own agricultural assistance programs, allows for greater interrogation of how the foundation understood and projected its central position in international agricultural research activities by the 1970s. (shrink)
Helen Beebee, Anne-Marie McCallion ABSTRACT: Louise Antony draws a now well-known distinction between two explanatory models for researching and addressing the issue of women’s underrepresentation in philosophy – the ‘Different Voices’ and ‘Perfect Storm’ models – and argues that, in view of PS’s considerably higher social value, DV should be abandoned. We argue ….
Lorsqu’il fait référence, dans les traités 31 (V,8) et 48 (III,3) à la beauté d’Hélène, Plotin reprend un topos de la littérature grecque antique. Après avoir rappelé les différentes interprétations de cette figure controversée, on examine ici la façon dont Plotin, tout en rejoignant certaines de ces interprétations, retravaille ce topos (dans le cadre de sa polémique contre les Gnostiques) pour lui donner un sens nouveau.
In an outline of a paper found amongst his philosophical papers and correspondence after his untimely death in 2001—“Nihil Obstat: An Analysis of Ability,” reproduced in this volume—David Lewis sketched a new compatibilist account of abilities, according to which someone is able to A if and only if there is no obstacle to their A-ing, where an obstacle is a ‘robust preventer’ of their A-ing. In this paper, we provide some background context for Lewis’s outline, a section-by-section commentary, and a (...) general discussion of the account’s main features. (shrink)
Louise Antony draws a now well-known distinction between two explanatory models for researching and addressing the issue of women’s underrepresentation in philosophy – the ‘Different Voices’ and ‘Perfect Storm’ models – and argues that, in view of PS’s considerably higher social value, DV should be abandoned. We argue that Antony misunderstands the feminist framework that she takes to underpin DV, and we reconceptualise DV in a way that aligns with a proper understanding of the metaphilosophical framework that underpins it. On (...) the basis of that reconceptualisation – together with the rejection of her claim that DV posits ‘cognitive’ differences between women and men – we argue that Antony’s negative assessment of DV’s social value is mistaken. And, we argue, this conclusion does not depend on endorsing the relevant feminist metaphilosophical framework. Whatever our metaphilosophical commitments, then, we should all agree that DV research should be actively pursued rather than abandoned. (shrink)
The western philosophical tradition, with its focus on universal concepts and a presumed neuter, but ultimately male subject, has only relatively recently become open to the question of alterity, in particular the alterity of woman as the other of man. The essays of this volume reflect in particular on the ethical implications of taking the feminine other into account. This necessitates a rethinking of the implicit structures of Western philosophy which continue to exclude women as subjects who contribute to the (...) conceptualization of world and society. This volume, which gives voice to women philosophers, is a contribution to that task. (shrink)
A new Clinical Ethics Advisory Group was created to contribute to NHS Trust policies and guidelines in response to ethical issues arising from the COVID-19 pandemic. An ethical analysis fram...
Within the rough ground that is the field of education there is a complex web of ethical obligations: to prepare our students for their future work; to be ethical as educators in our conduct and teaching; to the ethical principles embedded in the contexts in which we work; and given the Southern context of this work, the ethical obligations we have to this land and its First Peoples. We put out a call to colleagues whose work has been concerned with (...) the pedagogies of professional ethics, the ethical burdens of institutional injustice, and the application of ethical theory to education’s applied fields. In the responses we received it can be seen that ethical concerns in education are broad ranging, covering terrain varying from the preparation of preservice teachers, ethics in higher education, early childhood and care, educational leadership, relational and communicative ethics. Perhaps it could also be argued that this paper demonstrates Gibbon’s observation that ‘Assumptions about the particularity of this time as new and ripe with opportunity to make a difference through philosophy of education are not new and there’s much to learn from the persistence of wanting to imagine that they are’. However, while the field of ethics is perennially concerned with human relations and pedagogical interventions to improve these, the responses collected here show that educational ethics is far from static. Educational ethics is a field that continues to develop in response to changing contexts. (shrink)
Despite the growing interest in developing a micro-level understanding of strategy practices, there are few studies focusing on the official textual expression of these practices in the form of strategic plans. Using a large corpus of strategic plans from public and third sector organizations, this article examines the particular features of the strategic plan genre of communication. This corpus is systematically compared with nine other corpora derived from the same general domain or having similar expected characteristics. Our analysis combines linguistic (...) analysis with an analysis of the moves characteristic of the genre. The article seeks to advance a genre-based view of strategy practices to study the professional and institutional practices of strategists. (shrink)
Following the introduction of do-not-resuscitate orders in the 1970s, there was widespread misinterpretation of the term among healthcare professionals. In this brief report, we present findings from a survey of healthcare professionals. Our aim was to examine current understanding of the term do-not-attempt-resuscitate, decision-making surrounding DNAR and awareness of current guidelines. The survey was distributed to doctors and nurses in a university teaching hospital and affiliated primary care physicians in Dublin via email and by hard copy at educational meetings from (...) July to December 2014. A total of 519 completed the survey. The response rate in the hospital doctors group was 35.5%, 19.8% in the nurses group but 68.8% in the specialist nurses group and 40% in the primary care physician group.Alarmingly, our results demonstrate that 26.8% of staff nurses and 30% of primary care physicians surveyed believed that a patient with a DNAR order could not receive any/at least one of a list of simple treatments including antibiotics, physiotherapy, intravenous fluids, pain relief, oxygen, nasogastric feeding or airway suctioning, which were higher percentages compared to the other hospital doctors and experienced nurses groups with statistically significant differences. Furthermore, a higher percentage of staff nurses and primary care physicians believed that a patient with a DNAR order could not be referred to hospital from home/a nursing home, when compared with other healthcare groups. Our findings highlight continued misunderstanding and over-interpretation of DNAR orders. Further collaboration and information is required for meaningful Advance Care Plans. (shrink)
There is increasing recognition of the role pets play in the management of mental health conditions. Evidence suggests that pets promote social interaction and provide secure and intimate relationships which support the management of symptoms. This paper aimed to extend this evidence by exploring the phenomenological understanding of relationships and relationality with companion animals as therapeutic agents in the context of people’s wider social networks.A qualitative study was undertaken incorporating 35 interviews with 12 participants with a diagnosis of severe mental (...) illness who identified a pet as being important in the management of mental health. Participants took part in three in-depth interviews centred on ego network mapping over a 12-month period. A critical discourse analysis examined therapeutic relationships with pets in relation to mental health and compared these to other types of support over time. Summative discourse analyses were combined with a cross-case thematic analysis to look for commonalities and differences across individuals.Compared with interactions with other therapeutic agents, relationships with pets were free from the obligations and complexities associated with other types of network members and provided an extension and reinforcement to an individual’s sense of self which militated against the negative experiences associated with mental illness. Relationships with human network members were more variable in terms of consistency and capacity to manage demands and the emotions of others associated with fluctuations in mental health.This study adds weight to research supporting the inclusion of companion animals in the lexicon of mental health self-management through the therapeutic value attributed to them by participants within a wide personal network of support. The findings point to how consideration might usefully be given to how relationships with companion animals can be incorporated into healthcare planning and delivery. (shrink)
