Introduction The starting point is that ethical competence is the basis for ethical healthcare practices and quality of care. Simultaneously, there is a need for research and development from a holistic multi-professional perspective. Aim The aim is to create a proposed model for multi-professional ethical competence grounded in clarified meanings and dimensions of ethical competence studied from a multi-professional healthcare perspective. The research questions are, what is ethical competence from a multi-professional healthcare perspective and what strengthens a multi-professional ethical healthcare (...) practice? Research design The research has a qualitative approach and hermeneutic application research design. Two groups with six participants from clinical practice and two scientific researchers in each group met four times for dialogue. Thematic analysis was used as an analysis method. Ethical considerations The research is approved by the Declaration of Helsinki, the General Data Protection Regulations, and ethical permission was asked from the Norwegian Centre for Research Data (NSD). Results The proposed model for multi-professional ethical competence encompasses a three-dimensional ethical value base that is underpinned by: Ethical attitude – a personal desire to do good; Ethical basis – the best for the patient as a common goal and Ethical culture – common goals and values in the organization. Multi-professional ethical competence is strengthened by: Reflection – to see with new wondering eyes; Time for talk – interdisciplinary teamwork and Leadership – an ethical role model and support. Discussion Ethical competence has a strong link to the core of caring ethics and a deeper personal value base and attitude. Ethical competence involves the whole culture and is seen as a shared value base and a responsibility to do the best for the patient as a multi-professional team and organization. Ethical competence becomes active in healthcare practice by opening up for meaningful multi-professional talks and reflections. (shrink)

Unfortunately, business is often associated with unethical behavior. While research has offered a number of explanations for why business might encourage unethical behavior, we argue that how a person frames a situation may provide important insight. Drawing on the decision frame literature, the goal of the current research is to identify the differences in cognitive processing associated with two decision frames dominant in the business ethics literature—business and ethical—and, with that knowledge, examine ways to mitigate the detrimental influence of frame (...) on unethical behavior. We first demonstrate the causal link between frame and misrepresentation, and then identify several differences in cognitive processing—cost–benefit analyses, concern for others, and construal level—that distinguish business and ethical frames, and investigate their effects on misrepresentation. In our final set of studies, we demonstrate that the influence of these frames on misrepresentation can be altered by manipulating these cognitive processes, both mitigating and exacerbating a decision maker’s engagement in misrepresentation. We conclude by summarizing our findings and their potential impact on unethical behavior more broadly. (shrink)

Since the 1980s, there has been an increasing acknowledgement of the importance of recognising the ethical dimension of clinical decision-making. Medical professional regulatory authorities in some countries now include ethical knowledge and practice in their required competencies for undergraduate and post graduate medical training. Educational interventions and clinical ethics support services have been developed to support and improve ethical decision making in clinical practice, but research evaluating the effectiveness of these interventions has been limited. We undertook a systematic review of (...) the published literature on measures or models of evaluation used to assess the impact of interventions to improve ethical decision making in clinical care. We identified a range of measures to evaluate educational interventions, and one tool used to evaluate a clinical ethics support intervention. Most measures did not evaluate the key impact of interest, that is the quality of ethical decision making in real-world clinical practice. We describe the results of our review and reflect on the challenges of assessing ethical decision making in clinical practice that face both developers of educational and support interventions and the regulatory organisations that set and assess competency standards. (shrink)

The precarious rights of senior citizens, especially those who are highly educated and who are expected to counsel and guide the younger generations, has stimulated the creation internationally of advocacy associations and opinion leader groups. The strength of these groups, however, varies from country to country. In some countries, they are supported and are the focus of intense interest; in others, they are practically ignored. For this is reason we believe that the creation of a network of all these associations (...) is essential. The proposed network would act as a support for the already-existing policies of the United Nations’ High Commission for Human Rights, of independent experts, and of the Global Alliance for the Rights of Older People. All three have long ago recommended the creation of a recognized instrument for uniting presently scattered efforts. The proposed network, therefore, will seek to promote the international exchange of relevant expertise, and it will reinforce the commitments and actions that single countries are currently taking to meet these objectives. For example, informative public events can be organised to promote particular support initiatives and to provide an opportunity for new members of the network to be presented. The network will promote health for senior citizens, disease prevention, senior mobility, safe free time for seniors, alimentary education, protection against new risks and dangers, as well as equity in the services necessary for seniors to adopt new information and communication technologies. In the case of retired academic members, the network will promote equality with respect to continuing use of digital technologies (particularly email), continuing access to research libraries, and the guaranteed ability for seniors to fund their own research programs and to deliver free seminars. (shrink)

AimWhite matter changes in individuals at ultra-high risk for psychosis (UHR) may be involved in the transition to psychosis. Sleep-wake disturbances commonly precede the first psychotic episode and predict development of psychosis. We examined associations between white matter microstructure and sleep-wake disturbances in UHR individuals compared to healthy controls (HC), as well as explored the confounding effect of medication, substance use, and level of psychopathology.MethodsSixty-four UHR individuals and 35 HC underwent clinical interviews and diffusion weighted imaging. Group differences on global (...) and callosal mean fractional anisotropy (FA) was tested using general linear modeling. Sleep-wake disturbances were evaluated using the subjective measures disturbed sleep index (DSI) and disturbed awakening index (AWI) from the Karolinska Sleep Questionnaire, supported by objective sleep measures from one-night actigraphy. The primary analyses comprised partial correlation analyses between global FA/callosal FA and sleep-wake measures. Secondary analyses investigated multivariate patterns of covariance between measures of sleep-wake disturbances and FA in 48 white matter regions of interest using partial least square correlations.ResultsUltra-high risk for psychosis individuals displayed lower global FA (F = 14.56, p < 0.001) and lower callosal FA (F = 11.34, p = 0.001) compared to HC. Subjective sleep-wake disturbances were significantly higher among the UHR individuals (DSI: F = 27.59, p < 0.001, AWI: F = 36.42, p < 0.001). Lower callosal FA was correlated with increased wake after sleep onset (r = −0.34, p = 0.011) and increased sleep fragmentation index (r = −0.31, p = 0.019) in UHR individuals. Multivariate analyses identified a pattern of covariance in regional FA which were associated with DSI and AWI in UHR individuals (p = 0.028), but not in HC. Substance use, sleep medication and antipsychotic medication did not significantly confound these associations. The association with objective sleep-wake measures was sustained when controlling for level of depressive and UHR symptoms, but symptom level confounded the covariation between FA and subjective sleep-wake measures in the multivariate analyses.ConclusionCompromised callosal microstructure in UHR individuals was related to objectively observed disruptions in sleep-wake functioning. Lower FA in ventrally located regions was associated with subjectively measured sleep-wake disturbances and was partly explained by psychopathology. These findings call for further investigation of sleep disturbances as a potential treatment target. (shrink)

What role does birth play in the debate about elective abortion? Does the wrongness of infanticide imply the wrongness of late-term abortion? In this paper, I argue that the same or similar factors that make birth morally significant with regard to abortion make meaningful viability morally significant due to the relatively arbitrary time of birth. I do this by considering the positions of Mary Anne Warren and José Luis Bermúdez who argue that birth is significant enough that the wrongness (...) of infanticide does not imply the wrongness of late-term abortion. On the basis of the relatively arbitrary timing of birth, I argue that meaningful viability is the point at which elective abortion is prima facie morally wrong. (shrink)

This long-awaited two-volume set constitutes the definitive presentation of the system of classifying moral judgment built up by Lawrence Kohlberg and his associates over a period of twenty years. Researchers in child development and education around the world, many of whom have worked with interim versions of the system, indeed, all those seriously interested in understanding the problem of moral judgment, will find it an indispensable resource. Volume I reviews Kohlberg's stage theory, and the by-now large body of research on (...) the significance and utility of his moral stages. Issues of reliability and validity are addressed. The volume ends with detailed instructions for using the forms in Volume 2. Volume 2, in a specially-designed, user-friendly format, includes three alternative functionally-equivalent forms of the scoring system. (shrink)

Sensation of Movement explores the role of sensation in motor control, bodily self-recognition and sense of agency. The sensation of movement is dependent on a range of information received by the brain, from signalling in the peripheral sensory organs to the establishment of higher order goals. Through the integration of neuroscientific knowledge with psychological and philosophical perspectives, this book questions whether one type of information is more relevant for the ability to sense and control movement. Addressing conscious sensations of movement, (...) experimental designs and measures, and the possible functions of proprioceptive and kinaesthetic information in motor control and bodily cognition, the book advocates the integration of neuroscientific knowledge and philosophical perspectives. With an awareness of the diverse ideas and theories from these distinct fields, the book brings together leading researchers to bridge these divides and lay the groundwork for future research. -/- Contributors: Thor Grünbaum and Mark Schram Christensen Andreas Kalckert Myrto Mylopoulos Mads Jensen, Mia Dong, Mikkel C. Vinding, and Morten Overgaard Anne Kavounoudias Matthew R. Longo Hong Yu Wong. (shrink)

Book Reviws in this ArticleThe Human Body and the Law, 2nd edition by D.W. Meyers, Edinburgh University Press, 1990Classic Cases in Medical Ethics by Gregory E. Pence. New York: McGraw‐Hill Publishing Co. 1990Changing Values in Medical and Health Care Decision Making, edited by Uffejuul Jensen and Gavin Mooney. Chichester: John Wiley & Sons, 1990IVF and Justice by Teresa Iglesias, London: The Linacre Centre For Health Care Ethics, 1990The Practical, Moral and Personal Sense of Nursing: A Phenomenon‐ological Philosophy of Practice (...) by Anne H. Bishop and John R. Scudder, Jr. New York: State University of New York Press, 1990A Companion to Ethics, edited by Peter Singer. Oxford and Cambridge, Mass: Basil Blackwell, 1991.Ethics and Law in Health Care and Research edited by Peter Byrne, Chichester, UK: 1990The Human Embryo edited by G.R. Dunstan, Exeter: Exeter University Press, 1990Everyday Ethics: Resolving Dilemmas in Nursing Home Life by Rosalie A. Kane and Arthur L. Caplan. N.Y.: Springer Publishing Company, 1990Psychiatric Ethics, 2nd edition, edited by S. Bloch and P. Chodoff. Oxford, Oxford University Press, 1991Health Care and Gender by Charlotte Muller. New York: Russell Sage Foundation, 1990. (shrink)

This essay examines the development of descartes' literary aspirations, and the temporal and ironic structures of the "discourse" and "meditations". descartes emerges as an ingenious philosophical stylist, with complicated debts to montaigne. his texts are shown to employ a 'rhetoric of edification', embodying the view that metaphysical wisdom can be achieved only through a lengthy apprenticeship to error.

This article proposes that the urgent task for feminist sociology is to recuperate those lost or residual `body matters' which lurk, unattended to, on the sidelines of the social. Feminist sociology must carefully negotiate the complex space between sociality and corporeality. The new feminist philosophies of the body tend sometimes to grate against this project by valorizing the body but de-valorizing gender. The new sociology of the body is recuperating the body within sociology, but pays insufficient attention to the ways (...) in which gendered bodies have always enjoyed varying degrees of absence or presence in the sociological imaginary - in the guise of `female corporeality' and `male embodiment'. By revisiting the classical texts of sociology, such as those of Durkheim, Weber and particularly Simmel, I explore the textual strategies whereby `the body' and `the social' were dissociated in the first place and how, simultaneously, woman is saturated with, while man is divested of, corporeality and she is divested while he is invested with sociality. The absent women in sociology were the women in the body excluded from the social. It is male bodies which animate the social - they appear for a fleeting moment, only to disappear immediately, in the space between `corporeality' and `sociality'. Thus, it is not simply a case of recuperating bodies into the social, but of excavating the gendered subtexts whereby gendered bodies were differently inscribed into and out of the social in the first place. The crucial point here is not the more familiar story of her saturation with corporeality but the less familiar one of what happened to his body - how, that is, did male sociologists effect the disappearance of their own bodies in the textual strategies of sociology? (shrink)

How many individuals are present where we see a pregnant individual? Within a substance ontological framework, there are exactly two possible answers to this question. The standard answer—two individuals—is typically championed by scholars endorsing the predominant Containment View of pregnancy, according to which the foetus resides in the gestating organism like in a container. The alternative answer—one individual—has recently found support in the Parthood View, according to which the foetus is a part of the gestating organism. Here I propose a (...) third answer: a pregnant individual is neither two individuals nor one individual but something in between one and two. This is because organisms are better understood as processes than as substances. With a special focus on the Parthood View, I explain why a Process View of pregnancy, according to which a pregnant individual is a bifurcating hypercomplex process, surpasses the substance ontological approaches. (shrink)

A groundbreaking study of deafness, by a philosopher who combines the scientific erudition of Oliver Sacks with the historical flair of Simon Schama. There is nothing more personal than the human voice, traditionally considered the expression of the innermost self. But what of those who have no voice of their own and cannot hear the voices of others? In this tour de force of historical narrative, Jonathan Ree tells the astonishing story of the deaf, from the sixteenth century to the (...) present. Ree explores the great debates about deafness between those who believed the deaf should be made to speak and those who advocated non-oral communication. He traces the botched attempts to make language visible, through such exotic methods as picture writing, manual spellings, and vocal photography. And he charts the tortuous progress and final recognition of sign systems as natural languages in their own right. I See a Voice escorts us on a vast and eventful intellectual journey,taking in voice machines and musical scales, shorthand and phonetics, Egyptian hieroglyphs, talking parrots, and silent films. A fascinating tale of goodwill subverted by bad science, I See a Voice is as learned and informative as it is delightful to read. (shrink)

This book contains the first English translations of The Origin of the Moral Sensations and Psychological Observations the two most important works by the German philosopher Paul Re. These essays present Re's moral philosophy, which ...