How does talk work, and can we engage the public in a dialogue about the scientific study of talk? This article presents a history, critical evaluation and empirical illustration of the public science of talk. We chart the public ethos of conversation analysis that treats talk as an inherently public phenomenon and its transcribed recordings as public data. We examine the inherent contradictions that conversation analysis is simultaneously obscure yet highly cited; it studies an object that people understand intuitively, yet (...) routinely produces counter-intuitive findings about talk. We describe a novel methodology for engaging the public in a science exhibition event and show how our ‘conversational rollercoaster’ used live recording, transcription and public-led analysis to address the challenge of demonstrating how talk can become an informative object of scientific research. We conclude by encouraging researchers not only to engage in a public dialogue but also to find ways to actively engage people in taking a scientific approach to talk as a pervasive, structural feature of their everyday lives. (shrink)

BackgroundSexual boundary violations in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore (...) their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.ResultsWe found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: setting rules and regulations, engaging in dialogue about sexuality, and addressing systemic and organizational dimensions.ConclusionOur findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations. (shrink)

Designing policy for climate change requires analyses which integrate the interrelationship between the economy and the environment. We argue that, despite their dominance in the economics literature and influence in public discussion and policymaking, the methodology employed by Integrated Assessment Models (IAMs) rests on flawed foundations, which become particularly relevant in relation to the realities of the immense risks and challenges of climate change, and the radical changes in our economies that a sound and effective response require. We identify a (...) set of critical methodological problems with the IAMs which limit their usefulness and discuss the analytic foundations of an alternative approach that is more capable of providing insights into how best to manage the transition to net-zero emissions. (shrink)

Whether any non-human animal can attribute mental states to others remains the subject of extensive debate. This despite the fact that several species have behaved as if they have a ‘theory of mind’ in various behavioral tasks. In this paper, we review the reasons of skeptics for their doubts: That existing experimental setups cannot distinguish between ‘mind readers’ and ‘behavior readers’, that results that seem to indicate ‘theory of mind’ may come from studies that are insufficiently controlled, and that our (...) own intuitive biases may lead us to interpret behavior more ‘cognitively’ than is necessary. The merits of each claim and suggested solution are weighed. The conclusion is that while it is true that existing setups cannot conclusively demonstrate ‘theory of mind’ in non-human animals, focusing on this fact is unlikely to be productive. Instead, the more interesting question is how sophisticated their social reasoning can be, whether it is about ‘unobservable inner experiences’ or not. Therefore, it is important to address concerns about the setup and interpretation of specific experiments. To alleviate the impact of intuitive biases, various strategies have been proposed in the literature. These include a deeper understanding of associative learning, a better knowledge of the limited ‘theory of mind’ humans actually use, and thinking of animal cognition in an embodied, embedded way; that is, being aware that constraints outside of the brain, and outside of the body, may naturally predispose individuals to produce behavior that looks smart without requiring complex cognition. To enable this kind of thinking, a powerful methodological tool is advocated: Computational modeling, namely agent-based modeling and, particularly, cognitive modeling. By explicitly simulating the rules and representations that underlie animal performance on specific tasks, it becomes much easier to look past one’s own biases and to see what cognitive processes might actually be occurring. (shrink)

This article reflects on the contribution that stakeholder involvement could give to circular bioeconomy transformation (CBE). By comparing argument for stakeholder involvement in literature as well as on our own experiences in six stakeholder involvement workshops, we argue that it is probably unrealistic to fully achieve both normative and co-design goals in a single workshop. Furthermore, stakeholder involvement can help to acquire insight into dependencies in the market and offer an opportunity to connect people to deal with them. Therefore we (...) propose for future stakeholder involvement initiatives for CBE to focus on (1) identify relationships of dependency which make it hard for players in the market to change, (2) develop strategies to change while mitigating the detrimental effects on already existing relationships and (3) gradually breaking down relationships and building new ones that support CBE. (shrink)

Clinical Ethics, Ahead of Print. This paper is a response to a recent BMJ Blog: ‘The duty to treat: where do the limits lie?’ Members of the Surrey Heartlands Integrated Care Service Clinical Ethics Group reflected on arguments in the Blog in relation to resuscitation during the COVID-19 pandemic.Clinicians have had to contend with ever-changing and conflicting guidance from the Resuscitation Council UK and Public Health England regarding personal protective equipment requirements in resuscitation situations. St John Ambulance had different guidance (...) for first responders.The situation regarding resuscitation led the CEG to consider ethical aspects of health care professionals’ responses to the need for resuscitation during COVID-19. Members agreed that professionals should, ideally, have the level of PPE required for an aerosol generating procedure. However, there was no consensus regarding professionals’ duty to care when this is not available. On the one hand, it was agreed that the casualty/patient’s interests regarding resuscitation should be prioritised due to professionals’ contract with the public and professional privilege. On the other hand, risk thresholds were considered relevant to individual decision-making and professionals’ duty to care. All agreed that decision-making should not be influenced by rewards or reprimands. It was agreed also that decisions to resuscitate should not be considered as moral heroism or supererogatory - regardless of PPE availability - but rather as ‘minimally decent’. We agreed that it may be acceptable for professionals, with good reasons, to opt out of resuscitation attempts and these should be reflected on and discussed before the event. (shrink)

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Body and World is the definitive edition of a book that shouldnow take its place as a major contribution to contemporary existentialphenomenology. Samuel Todes goes beyond Martin Heidegger and MauriceMerleau-Ponty in his description of how independent physical natureand experience are united in our bodily action. His account allows himto preserve the authority of experience while avoiding the tendencytoward idealism that threatens both Heidegger and Merleau-Ponty.Todes emphasizes the complex structure of the human body ;front/back asymmetry, the need to balance (...) in a gravitational field, and so forth ;and the role that structure plays in producing the spatiotemporal field of experience and in making possible objective knowledge of the objects in it. He shows that perception involves nonconceptual, but nonetheless objective forms of judgment. One can think of Body and World as fleshing out Merleau-Ponty's project while presciently relating it to the current interest in embodiment, not only in philosophy but also in psychology, linguistics, cognitive science, artificial intelligence, neuroscience, and anthropology. Todes's work opens new ways of thinking about problems such as the relation of perception to thought and the possibility of knowing an independent reality ;problems that have occupied philosophers since Kant and still concern analytic and continental philosophy. (shrink)

Recent longitudinal observations show that human menstrual cycles, sleep‐wake cycles and manic‐depressive cycles can become synchronized with lunar cycles, but do so in uniquely complex and heterogeneous ways that are unlikely to have been detected by past studies. Past studies’ negative results have given rise to a scientific consensus that human biology and behavior are unaffected by lunar cycles. The recent observations show that synchrony can be temporary, and can occur with more than one type of lunar cycle, more than (...) one phase of a lunar cycle and more than one resonant frequency of a lunar cycle. Given the variability of human responses to lunar cycles, aggregate analyses used in almost all previous studies would likely have cancelled out individuals’ responses and led to false negative results. In light of these observations, the question of lunar influence should be investigated further, with longitudinal observations and case‐by‐case analyses of individuals’ data. (shrink)

The inconsistency between pro-environmental attitudes and behaviours, known as the “attitude-behaviour” gap, is exceptionally pronounced in scenarios associated with “green” choice. The current literature offers numerous explanations for the reasons behind the “attitude-behaviour” gap, however, the generalisability of these explanations is complex. In addition, the answer to the question of whether the gap occurs between attitudes and intentions, or intentions and behaviours is also unknown. In this study, we propose the moral dimension as a generalisable driver of the “attitude-behaviour” gap (...) and investigate its effectiveness in predicting attitudes, pro-environmental intentions and subsequent behaviours. We do so by using Hunt–Vitell’s moral philosophy-based framework of ethical decision-making, which conceptualises morality as the central decision-making parameter. The results from 557 US MTurk participants revealed that the manipulation of moral dimensions, specifically deontology and teleology, impacted ethical evaluation of presented dilemmas, however, failed to translate into subsequent intentions and behaviours. This finding suggests (i) that the moral dimension has an effect in shaping attitudes toward environmental issues, and (ii) that gap occurs between attitudes and intentions rather than intentions and behaviours. Further investigation of what strengthens and/or overrides the effects of the moral dimension would help understand the reasons why moral attitudes do not always translate into subsequent intentions and behaviours in the pro-environmental domain. (shrink)

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

Medical educators recognize the value of reflection for medical students and the role creative writing can play in fostering this. However, direct creative writing tasks can be challenging for many students, particularly those with limited experience in the arts and humanities. An alternative strategy is to utilize an indirect approach, engaging students with structured tasks that obliquely encourage reflection. This paper reports one such approach. We refer to this approach as in-verse reflection, playing on both the structure of the writing (...) and its novel approach to reflection. Students were invited to write, in verse-like structures, about their personal and clinical experiences as medical students. Thematic analysis of their creative outputs and reactions identified four principal themes: the challenges of life as a medical student, the emotional demands of the medical course, a sense of connectedness and solidarity with fellow students, and a sense of marginality within the hospital system. Students generally found the tasks highly engaging and conducive to reflection, producing texts representing significant insights into their experiences as medical students. The reported method offers a relatively simple, structured, and guided approach to reflective writing, adding to the repertoire of methods available to educators in the medical humanities. (shrink)

BackgroundInstrumented gait analysis post-stroke is becoming increasingly more common in research and clinics. Although overall standardized procedures are proposed, an almost infinite number of potential variables for kinematic analysis is generated and there remains a lack of consensus regarding which are the most important for sufficient evaluation. The current aim was to identify a discriminative core set of kinematic variables for gait post-stroke.MethodsWe applied a three-step process of statistical analysis on commonly used kinematic gait variables comprising the whole body, derived (...) from 3D motion data on 31 persons post-stroke and 41 non-disabled controls. The process of identifying relevant core sets involved: exclusion of variables for which there were no significant group differences; systematic investigation of one, or combinations of either two, three, or four significant variables whereby each core set was evaluated using a leave-one-out cross-validation combined with logistic regression to estimate a misclassification rate.ResultsThe best MR for one single variable was shown for the Duration of single-support or Duration of 2nd double-support phase, corresponding to an 89–90% probability of correctly classifying a person as post-stroke/control. Adding Pelvis sagittal ROM to either of the variables Self-selected gait speed or Stride length, alternatively adding Ankle sagittal ROM to the Duration of single-stance phase, increased the probability of correctly classifying individuals to 93–94%. Combining three variables decreased the MR further to 0.04, suggesting a probability of 96% for correct classification. These core sets contained: a spatial or a temporal variable, Pelvis sagittal ROM or Ankle plantarflexion during push-off, and Arm Posture Score or Cadence or a knee/shoulder joint angle variable. Adding a fourth variable did not further improve the MR.ConclusionA core set combining a few crucial kinematic variables may sufficiently evaluate post-stroke gait and should receive more attention in rehabilitation. Our results may contribute toward a consensus on gait evaluation post-stroke, which could substantially facilitate future diagnosis and monitoring of rehabilitation progress. (shrink)

Knee proprioception deficits and neuroplasticity have been indicated following injury to the anterior cruciate ligament. Evidence is, however, scarce regarding brain response to knee proprioception tasks and the impact of ACL injury. This study aimed to identify brain regions associated with the proprioceptive sense of joint position at the knee and whether the related brain response of individuals with ACL reconstruction differed from that of asymptomatic controls. Twenty-one persons with unilateral ACL reconstruction of either the right or left knee, as (...) well as 19 controls matched for sex, age, height, weight and current activity level, performed a knee joint position sense test during simultaneous functional magnetic resonance imaging. Integrated motion capture provided real-time knee kinematics to activate test instructions, as well as accurate knee angles for JPS outcomes. Recruited brain regions during knee angle reproduction included somatosensory cortices, prefrontal cortex and insula. Neither brain response nor JPS errors differed between groups, but across groups significant correlations revealed that greater errors were associated with greater ipsilateral response in the anterior cingulate, supramarginal gyrus and insula. This is the first study to capture brain response using fMRI in relation to quantifiable knee JPS. Activated brain regions have previously been associated with sensorimotor processes, body schema and interoception. Our innovative paradigm can help to guide future research investigating brain response to lower limb proprioception. (shrink)

Who is a native signer? Since around 95% of deaf infants are born into a hearing family, deaf signers are exposed to a sign language at various moments of their life, and not only from birth. Moreover, the linguistic input they are exposed to is not always a fully fledged natural sign language. In this situation, is the notion of native signer as someone exposed to language from birth of any use? We review the results of the first large-scale cross-linguistic (...) investigation on the effects of age of exposure to sign language. This research involved about 45 Deaf adult signers in each of three sign languages (Catalan Sign Language, French Sign Language, and Italian Sign Language). Across the three languages, participants were divided into three groups – those exposed from birth, those between 1 and 5 years of age, and those exposed between 6 and 15 years of age – and received a battery of tests designed for each language targeting various aspects of morphosyntactic competence. In particular, the tests focused on both those morphosyntactic phenomena that are known from the spoken language literature to be good detectors of language impairment or delay (i.e.,wh-interrogatives and relative clauses) and on morphosyntactic phenomena that are sign language specific (i.e., role shift and directional verbs). The results showed a clear effect of being native, with significant differences across languages and tests between signers exposed to sign language from birth and those exposed in the 1st years of life. This confirms the life-long importance of language exposure from birth and the reliability of the notion of “nativeness”, at least for syntax. On the other hand, while in most domains the differences observed between populations might be differences in performance, for some specific constructions, signers belonging to the three groups may have different grammars. This latter finding challenges the generalized use of native signers’ grammar as the baseline for language description and language assessment. (shrink)

In November 2011, Citizenship and Immigration Canada paused the parents/grandparents (PGP) sponsorship immigration and announced a new Super Visa program simultaneously to facilitate family reunification, specifically among older adults waiting to be reunified with their children in Canada. We conducted a qualitative study to understand the experiences of immigrant families with the Super Visa Program. In total, 19 semi-structured interviews were conducted in Toronto with Chinese immigrants and parents holding a Super Visa. Our findings revealed that Super Visa program is (...) helpful for family reunification, especially for those whose regular visa applications are not successful. However, Super Visa is still a visitor visa and parents/grandparents have to leave after a maximum of two years. This temporary status of their parents does not promote among immigrants a sense of belonging in Canada, but reinforces their feeling of being treated as “foreigner”. They also debunked the stigma that older parents/grandparents come to Canada for better welfare and are non-contributor and a burden to Canadian society. We observe older parents/grandparents are categorized as “undesirable” and their unpaid contributions to immigrant family and Canada society are rendered invisible. We argue there exits an inherent link between PGP policy changes and social injustice. Behind the negative portrayal of older parents/grandparents and policy changes on them is State’s neoliberal governmentality grounded upon market norms and mechanism. The immigration and social injustice inflicting on older PGP migrants manifests that neoliberal immigration regime is still structurally raced, gendered, classed, and may be intertwined with other stigmatizing dynamics such as ageist, ableist etc. within the State’s power relationship. (shrink)

Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

The Metaphysics of Gender is a book about gender essentialism: what it is and why it might be true.

Charlotte Witt extracts from this text a coherent and provocative view about sensible substance by focusing on Aristotle's account of form or essence.

The past twenty five years have seen an explosion of feminist writing on the philosophical canon, a development that has clear parallels in other disciplines like literature and art history. Since most of the writing is, in one way or another, critical of the tradition, a natural question to ask is: Why does the history of philosophy have importance for feminist philosophers? This question assumes that the history of philosophy is of importance for feminists, an assumption that is warranted by (...) the sheer volume of recent feminist writing on the canon. This entry explores the different ways that feminist philosophers are interacting with the Western philosophical tradition. (shrink)

Aristotle's defense of Dunamis -- Power and potentiality -- Rational and nonrational powers -- The priority of actuality -- Ontological hierarchy, normativity, and gender.

In a criminal trial, a judge or jury needs to reason about what happened based on the available evidence, often including statistical evidence. While a probabilistic approach is suitable for analysing the statistical evidence, a judge or jury may be more inclined to use a narrative or argumentative approach when considering the case as a whole. In this paper we propose a combination of two approaches, combining Bayesian networks with scenarios. Whereas a Bayesian network is a popular tool for analysing (...) parts of a case, constructing and understanding a network for an entire case is not straightforward. We propose an explanation method for understanding a Bayesian network in terms of scenarios. This method builds on a previously proposed construction method, which we slightly adapt with the use of scenario schemes for the purpose of explaining. The resulting structure is explained in terms of scenarios, scenario quality and evidential support. A probabilistic interpretation of scenario quality is provided using the concept of scenario schemes. Finally, the method is evaluated by means of a case study. (shrink)

Boltzmannian statistical mechanics partitions the phase space of a sys- tem into macro-regions, and the largest of these is identified with equilibrium. What justifies this identification? Common answers focus on Boltzmann’s combinatorial argument, the Maxwell-Boltzmann distribution, and maxi- mum entropy considerations. We argue that they fail and present a new answer. We characterise equilibrium as the macrostate in which a system spends most of its time and prove a new theorem establishing that equilib- rium thus defined corresponds to the largest (...) macro-region. Our derivation is completely general in that it does not rely on assumptions about a system’s dynamics or internal interactions. (shrink)

This study focuses on how moral aspects of purpose shape collaborative processes. It does so by analyzing the unfolding of 21 relationships between four nonprofits and their funders using a framework based on French pragmatist sociology to help uncover the deeply held, ideological and moral beliefs that underscore assumptions about what the overarching purpose of a collaborative effort is or should be. This study contributes to the literature on single and cross-sectoral collaboration by showing that the way partners handle and (...) reconcile differences about purpose is related to the forms of agreement likely to be achieved. It also suggests that certain forms of agreement are inherently more enduring than others. Taken as a whole, this study provides some plausible explanations as to why so many collaborations fail despite their seeming benefits for all the parties involved. (shrink)

We argue that concerns about double-counting -- using the same evidence both to calibrate or tune climate models and also to confirm or verify that the models are adequate --deserve more careful scrutiny in climate modelling circles. It is widely held that double-counting is bad and that separate data must be used for calibration and confirmation. We show that this is far from obviously true, and that climate scientists may be confusing their targets. Our analysis turns on a Bayesian/relative-likelihood approach (...) to incremental confirmation. According to this approach, double-counting is entirely proper. We go on to discuss plausible difficulties with calibrating climate models, and we distinguish more and less ambitious notions of confirmation. Strong claims of confirmation may not, in many cases, be warranted, but it would be a mistake to regard double-counting as the culprit. (shrink)

Charlotte Sabourin | : Cet article se penche sur la contribution de Gabrielle Suchon à la célèbre « querelle des femmes ». J’y démontre que, quoique Suchon défende l’égalité des deux sexes en ce qui a trait à leurs capacités à la liberté, à la science et à l’autorité, elle vise ultimement à montrer que les femmes peuvent se rendre supérieures aux hommes. Je montrerai que son projet d’élévation des femmes ne peut être accompli qu’en soustrayant les femmes à (...) l’influence des hommes, les relations entre les deux sexes étant foncièrement préjudiciables aux premières. | : This paper examines Gabrielle Suchon’s contribution to the famous “querelle des femmes”. I argue that although Suchon is a proponent of the equality of the sexes with respect to their capacities for freedom, science and authority, she ultimately suggests that there is a way in which women can make themselves superior to men. I will show that her project for the elevation of women can be accomplished only by isolating women from men, given that the relationships between the sexes will always be detrimental to women. (shrink)

Feminist Metaphysics is the first collection of articles addressing metaphysical issues from a feminist perspective.

From the beginning of chaos research until today, the unpredictability of chaos has been a central theme. It is widely believed and claimed by philosophers, mathematicians and physicists alike that chaos has a new implication for unpredictability, meaning that chaotic systems are unpredictable in a way that other deterministic systems are not. Hence, one might expect that the question ‘What are the new implications of chaos for unpredictability?’ has already been answered in a satisfactory way. However, this is not the (...) case. I will critically evaluate the existing answers and argue that they do not fit the bill. Then I will approach this question by showing that chaos can be defined via mixing, which has never before been explicitly argued for. Based on this insight, I will propose that the sought-after new implication of chaos for unpredictability is the following: for predicting any event, all sufficiently past events are approximately probabilistically irrelevant. (shrink)

The aim of the article is to illustrate concrete problems in the asymmetrical nurse–patient power relationship. It is an ethical demand that the nurse is faced with the challenges that the power in the relation is administered so that the patient's room for action is expanded and trust maintained. It is an essential message in care philosophy, but in clinical practice, success is not always achievable. A hidden and more or less unconscious restriction of the patient's room for action may (...) result in the excesses of care. Three selected aspects: dependence, trust, and power described by the Danish philosopher K.E. Løgstrup and the Norwegian nursing philosopher Kari Martinsen's care philosophy has inspired this empirically based examination of some current barriers in the asymmetrical nurse–patient relationship. On the basis of qualitative interviews with six patients and six nurses, the research thus provides an identifying and problem‐exploratory examination of some current obstacles in which the handling of trust and power reflects the excesses of care. The findings develop three themes. ‘Being a burden’ acknowledges that the balance of power will always tip to the nurse's advantage. The second theme, ‘Doing only what's absolutely necessary’, shows how a fixation with ‘technicalism’ creates a distance between people that may constrain the patient's room for action. The last theme is concerning the nurse's ability to navigate between closeness and distance is essential in avoiding ‘the excesses of care’, paternalism, and overprotectiveness. A situation in which distance takes the upper hand and care turns into paternalism. A different situation would arise if the nurse's emotions became sentimental or intimate with the result that closeness gets the upper hand. To avoid a harmful exercise of power and the excesses of care, the findings have demonstrated that a relationship‐based caring is a demand for situation‐specific sensitive attention skills. (shrink)

Resilience factors have been suggested as key mechanisms in the relation between symptoms and disability among individuals with chronic pain. However, there is a need to better operationalize resilience and to empirically evaluate its role and function. The present study examined psychological flexibility as a resilience factor in relation to symptoms and functioning among 252 adults with chronic pain applying for participation in a digital ACT-based self-help treatment. Participants completed measures of symptoms (pain intensity, anxiety), functioning (pain interference, depression), as (...) well as the hypothesized resilience factor psychological flexibility (measured as avoidance, value obstruction, and value progress). As expected, symptoms, functioning and resilience factors were significantly associated. Hierarchical linear regression analyses showed that psychological flexibility significantly contributed to the prediction of pain interference and depression when adjusting for age, pain and anxiety. Also, participants with low levels of psychological flexibility were more likely to be on sick leave. Furthermore, a series of multiple mediation analyses showed that psychological flexibility (avoidance, value obstruction, value progress) had a significant indirect effect on the relationship between symptoms and functioning. Avoidance was consistently shown to contribute to the indirect effect. Results support previous findings and suggest the importance of psychological flexibility as a resilience factor among individuals with chronic pain and anxiety. (shrink)

Garrett Cullity contends that fairness is appropriate impartiality (See Cullity (2004) Chapters 8 and 10 and Cullity (2008)). Cullity deploys his account of fairness as a means of limiting the extreme moral demand to make sacrifices in order to aid others that was posed by Peter Singer in his seminal article ‘Famine, Affluence and Morality’. My paper is founded upon the combination of (1) the observation that the idea that fairness consists in appropriate impartiality is very vague and (2) the (...) fact that psychological studies show the self-serving bias is especially likely to infect one’s judgements when the ideas involved are vague. I argue that Cullity’s solution to extreme moral demandingness is threatened by these findings. I then comment on whether some other theories of fairness are vulnerable to the same objection. (shrink)

*I would like to thank Michel ter Hark, Lodi Nauta and James Connelly, for their critical reading of earlier versions of this paper and for their comments. Gilbert Ryle and R. G. Collingwood are no...