We extend Tomasello's discussion of children's developing sense of obligation to testimonial learning. First, we review a battery of behaviors in testimonial exchanges that parallel those described by Tomasello. Second, we explore the variable ways in which children hold others accountable, suggestive that children's evaluations of moral and epistemic responsibilities in joint collaborative activities are distinct.

Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence‐based fast‐track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients’ individual perspectives in an evidence‐based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence‐based recommendations, which specify a set (...) of rules that the patient must follow rigorously. The other is a course of democratization based on patients’ involvement in care. Referring to the analysis of the narrative, we argue that, in the current implementation of evidence‐based practice, the proposed involvement of patients resembles empty rhetoric. We argue that the principles and values from evidence‐based medicine are being lost in the transformation into the current evidence‐based hospital culture which potentially leads to a McDonaldization of nursing practice reflected as ‘one best way’. We argue for reviving ethics of care perspectives in today's evidence practice as the fundamental values of nursing may potentially bridge conflicts between evidence‐based practice and the ideals of patient participation thus preventing a practice of ‘McNursing’. (shrink)

The present paper explores patients’ experience of lived space at the hospital and at home. To expand the understanding of the existential meaning of lived space the study revisited two empirical studies and a study of a meta-synthesis on health and caring. Phenomenological philosophy was chosen as a theoretical framework for an excursive analysis. The paper demonstrates that existential dimensions of lived space at the hospital and at home differ significantly. For the patients, the hospital space means alien territory as (...) opposed to the familiar territory of home. To some extent the experienced differences are due to the physical environment; however, as our analysis shows, other and more significant meanings are also involved. For patients, lived space at the hospital primarily concerns the influence of complex institutional power structures and specific cultural and social conventions, e.g. the role of the good patient and the ambiance of hospitals. Home, on the other hand, offers familiar lived space in which patients feel protected and safe. Further, the paper relates patients’ experience of lived space to a phenomenological view of lived space in order to illustrate the radical influence of illness on patients’ lifeworld and experience of lived space. The combination of illness and general discomfort may influence patients’ experience of home negatively; the former experience of home as a sanctuary changes into feelings of being left on one’s own and burdened by too much responsibility. Consequently, in the light of the increasing focus on patients’ self-monitoring at home, it is important for healthcare professionals to recognize the influence of spatial aspects on patients’ well-being both at the hospital and at home. (shrink)

Based upon a brief outline of existential-phenomenological ontology we present a theoretical and practical understanding of humanbeing, which is suited for a methodologically reflected approach to qualitative research. We present the phenomenological distinction between threedimensions of corporeal intentionality(structural, generative and dialectic intentionality) that form elementary events and structures of meaning. Various aspects of human being are better scrutinized with these concepts of intentionality, such as the association of individual being or collective being (e.g. groups) with the less differentiated anonymity of (...) human being. The aim of our framework is to support the qualitative researcher in grasping the experience of the human life in closer accord with how this being actually unfolds and is lived. Application of the presented framework is illuminated with empirical examples from educational, health and psychological contexts. Finally, we discuss the methodological implications that our approach has for qualitative investigations of human being. (shrink)

This paper makes a conceptual inquiry into the notion of ‘publics’, and forwards an understanding of this notion that allows more responsible forms of decision-making with regards to technologies that have localized impacts, such as wind parks, hydrogen stations or flood barriers. The outcome of this inquiry is that the acceptability of a decision is to be assessed by a plurality of ‘publics’, including that of a local community. Even though a plurality of ‘publics’ might create competing normative demands, its (...) acknowledgment is necessary to withstand the monopolization of the process of technology appraisal. The paper presents four ways in which such an appropriation of publicness takes place. The creation of dedicated ‘local publics’, in contrast, helps to overcome these problems and allows for more responsible forms of decision-making. We describe ‘local publics’ as those in which stakeholders from the different publics that are related to the process of technology implementation are brought together, and in which concerns and issues from these publics are deliberated upon. The paper will present eight conditions for increasing the effectiveness of such ‘local publics’. (shrink)

Emotions are often met with suspicion in political debates about risky technologies, because they are seen as contrary to rational decision making. However, recent emotion research rejects such a dichotomous view of reason and emotion, by seeing emotions as an important source of moral insight. Moral emotions such as compassion and feelings of responsibility and justice can play an important role in judging ethical aspects of technological risks, such as justice, fairness, and autonomy. This article discusses how this idea can (...) be integrated into approaches for political decision making about risk. The article starts with an analysis of the dichotomous view of reason and emotion in risk theory, in approaches to participatory risk assessment as well as in relevant approaches to political philosophy. This article then presents alternative approaches in political philosophy and political theory that do explicitly endorse the importance of emotions. Based on these insights, a procedural approach for policy making is presented, in which emotional responses to technological risks, and the ethical concerns that lie behind them, are taken seriously. This approach allows for morally better political decisions about risky technologies and a better understanding between experts and laypeople. (shrink)

Knowing that technologies are inherently value-laden and systemically interwoven with society, the question is how individual engineers can take up the challenge of accepting the responsibility for their work? This paper will argue that engineers have no institutional structure at the level of society that allows them to recognize, reflect upon, and actively integrate the value-laden character of their designs. Instead, engineers have to tap on the different institutional realms of market, science, and state, making their work a ‘hybrid’ activity (...) combining elements from the different institutional realms. To deal with this institutional hybridity, engineers develop routines and heuristics in their professional network, which do not allow societal values to be expressed in a satisfactory manner. To allow forms of ‘active’ responsibility, there have to be so-called ‘accountability forums’ that guide moral reflections of individual actors. The paper will subsequently look at the methodologies of value-sensitive design and constructive technology assessment and explore whether and how these methodologies allow engineers to integrate societal values into the design technological artifacts and systems. As VSD and CTA are methodologies that look at the process of technological design, whereas the focus of this paper is on the designer, they can only be used indirectly, namely as frameworks which help to identify the contours of a framework for active responsibility of engineers. (shrink)

New network technologies are framed as eliminating ‘transaction costs’, a notion first developed in economic theory that now drives the design of market systems. However, the actual promise of the elimination of transaction costs seems unfeasible, because of a cyclical pattern in which network technologies that make that promise create processes of institutionalization that create new forms transaction costs. Nonetheless, the promises legitimize the exemption of innovations of network technologies from critical scrutiny.

In this paper, we take inspiration from original institutional economics (OIE) as an approach to study value change within the highly complex assembly of sociotechnical transformations that make up the energy transition. OIE is examined here as a suitable perspective, as it combines Dewey’s pragmatist philosophy and a methodological interactionist perspective on value change, behavior and institutions, with technology figuring as a transformational factor. This combination overcomes conceptual and methodological shortcomings of alternative accounts of values. We will present the contours (...) of an OIE based conceptual framework connecting nature, humans, technology, the economic process, society, culture and institutions and habits, valuation and behavior. We illustrate how to use this framework to examine and understand how environmental, ecologic, safety, economic, and social concerns about the energy transition are (re)framed as (new) values in the belief systems and habits of individuals and groups. Moreover, we will explore how that may give rise to collective action, via the institutionalization of such revised values in the procedures, arrangements, norms and incentives guiding transactions. As such, this approach allows us in a fine-grained manner to conceptually and theoretically understand the way in which values change in the energy-transition, as a complex interaction of technology development and social relations. (shrink)

The way pollution is managed in Western countries is based on the preservation of the taboo character of waste, which is conceived to be privately produced and seen as a threat to public health. Public authorities have been given the responsibility to isolate waste and hide it from public eyes. However, this dominant approach is challenged by the emergence of new forms of pollution. New conceptual and policy frameworks to manage environmental degradation have to be developed. The prevailing institutional structures, (...) however, obstruct the successful societal uptake of alternative frameworks. (shrink)

This paper examines the intrinsic relation between institutions and social justice. Its starting point is that processes of institutionalization invoke societal groups to articulate justice demands which, in their turn, give rise to processes of institutional redesign. In liberal democracies, demands for justice are articulated as a pursuit for emancipation and empowerment of groups that feel excluded by dominant categorizations. The imminent presence of this twin pursuit for justice can be explained by the conceptual inconsistencies that characterize the distinction between (...) the public and private sphere. These inconsistencies also explain why demands for emancipation and empowerment are intrinsically ambiguous and inconsistent. In order to reconsider the question how institutions are to be adapted to allow for social justice while acknowledging the plurality, ambiguity and volatility of justice demands, the paper will propose an empirical and normative research agenda. (shrink)

The introduction of new energy technologies may lead to public resistance and contestation. It is often argued that this phenomenon is caused by an inadequate inclusion of relevant public values in the design of technology. In this paper we examine the applicability of the value sensitive design approach. While VSD was primarily introduced for incorporating values in technological design, our focus in this paper is expanded towards the design of the institutions surrounding these technologies, as well as the design of (...) stakeholder participation. One important methodological challenge of VSD is to identify the relevant values related to new technological developments. In this paper, we argue that the public debate can form a rich source from which to retrieve the values at stake. To demonstrate this, we have examined the arguments used in the public debate regarding the exploration and exploitation of shale gas in the Netherlands. We identified two important sets of the underlying values, namely substantive and procedural values. This paper concludes with two key findings. Firstly, contrary to what is often suggested in the literature, both proponents and opponents seem to endorse the same values. Secondly, contestation seems to arise in the precise operationalization of these values among the different stakeholders. In other words, contestation in the Dutch shale gas debate does not arise from inter-value conflict but rather from intra-value conflicts. This multi-interpretability should be incorporated in VSD processes. (shrink)

Excessive alcohol consumption can have adverse effects on health, and patients who suffer from alcohol use disorders are subject to much stigmatization. Nurses are often the first point of contact when patients enter the acute medical unit, and it is pivotal that this contact establishes the basis for future collaboration. The aim of this study is to elucidate nurses’ lived experience of providing care to patients suffering from alcohol use disorders. This present study has a qualitative research design, anchored in (...) phenomenological and hermeneutical methodology as described in reflective lifeworld research. Ten in‐depth, open‐ended interviews with nurses working in an acute medical unit were conducted. The analysis showed that providing care to patients suffering from alcohol use disorders was a highly complex task to accomplish. This required the nurse to engage with the patient in a sensitive cooperation in order to be dealing with the intricacy of the patient's life situation and balancing care between standardized procedures and the complexity of the patients. Further, a two‐sided feeling of responsibility emerged: a professional responsibility and a personal responsibility causing the provision of care as being caught between feelings of despondency and resignation. Nurses lack opportunities for being creative in determining how to provide care; instead, patients' perspectives of well‐being should be taken into account and should guide the provision of a meaningful care. Nurses must call for opportunities to deviate from the firmly established procedures restraining the care of this population. (shrink)

Soft X‐ray tomography (SXT) is an imaging technique capable of characterizing and quantifying the structural phenotype of cells. In particular, SXT is used to visualize the internal architecture of fully hydrated, intact eukaryotic and prokaryotic cells at high spatial resolution (50 nm or better). Image contrast in SXT is derived from the biochemical composition of the cell, and obtained without the need to use potentially damaging contrast‐enhancing agents, such as heavy metals. The cells are simply cryopreserved prior to imaging, and (...) are therefore imaged in a near‐native state. As a complement to structural imaging by SXT, the same specimen can now be imaged by correlated cryo‐light microscopy. By combining data from these two modalities specific molecules can be localized directly within the framework of a high‐resolution, three‐dimensional reconstruction of the cell. This combination of data types allows sophisticated analyses to be carried out on the impact of environmental and/or genetic factors on cell phenotypes. (shrink)