The Swedish welfare debate increasingly focuses on market liberal notions and its healthcare perspective aims for more patient‐centered care. This article examines the new Swedish Patient Act describing and analyzing how the patient is constructed in government documents. This study takes a Foucauldian discourse analysis approach following Willig's analysis guide. The act contains an entitlement discourse for patients and a requirement discourse for healthcare personnel. These two discourses are governed by a values‐based healthcare discourse. Neo‐liberal ideology, in the form of (...) New Public Management discourse, focusing on the value of efficiency and competition, is given a hegemonic position as laws and regulations are used to strengthen it. The new Swedish Patient Act seems to further strengthen this development. The Act underlines the increased entitlement for patients, but it is not legally binding as it offers patients only indirect entitlement to influence and control their care. To safeguard the patient's entitlement under the Patient Act, healthcare personnel should be made aware of the contents of the Act, so that they can contribute to the creation of systems and working methods that facilitate respect of the Act's provisions in daily healthcare work. (shrink)

This study aimed to explore the conditions for nurses' daily patient education work by focusing on managers' way of speaking about the patient education provided by nurses in hospital care. An explorative, qualitative design with a social constructionist perspective was used. Data were collected from three focus group interviews and analysed by means of critical discourse analysis. Discursive practice can be explained by the ideology of hegemony. Due to a heavy workload and lack of time, managers could ‘see’ neither their (...) role as a supporter of the patient education provided by nurses, nor their role in the development of nurses' pedagogical competence. They used organisational, financial, medical and legal reasons for explaining their failure to support nurses' provision of patient education. The organisational discourse was an umbrella term for ‘things’ such as cost‐effectiveness, which were prioritised over patient education. There is a need to remove managerial barriers to the professional development of nurses' patient education. Managers should be responsible for ensuring and overseeing that nurses have the prerequisites necessary for providing patient education as well as for enabling continuous reflective dialogue and opportunities for learning in practice. (shrink)

Education is important in shaping professional identity, including how one approaches norms and normalisation. In the analysis presented in this study, nursing students' own constructions of norms and normality from the outlook of their education are highlighted and problematised. To deepen the understanding of these matters, the aim of this study was to explore constructions of norms and normality among students in nursing education. Students studying in a nursing department at a Swedish university college were approached and asked to consider (...) open survey questions targeting their views on norms and normality; 154 of them replied. After a discourse analytic approach to the data, we could see how the students constructed norms and normality as (a) instrumental instructions, consisting of easy‐to‐digest statements grounded in the profession's obvious moral and ethical values, (b) limiting and frustrating obstacles for personal freedom that were important to challenge, (c) rules to be obeyed for the stability of society and (d) a matter of reflection, with each individual being responsible for understanding differences in norms, perspectives and opinions. We conclude that nursing education would benefit from norm‐critical perspectives, problematising students' own positions to norms, power and privilege. (shrink)

The aim of this study was to analyse how the patient is constructed and socially positioned in Swedish patient information. Corpus‐assisted critical discourse analysis methodology was utilised on a sample of 56 online patient information texts about cancer containing a total of 126,711 words. The findings show an overarching discourse of informed consent guided by specific features to produce a patient norm that we name “the reasonable patient”, who is receptive to arguments, emotionally restrained and makes decisions based on information. (...) Through the discourse of informed consent, the norm of the reasonable patient emerges, apparently to even out the imbalance of power between patient and professional, but in reality, more likely to construct a patient who is easily controlled and managed. When the self‐responsibility towards health is incorporated into the everyday domestic spaces via digital health technologies, the ideas and concepts of the patient role need to be reconsidered based on these new conditions. We conclude that it is important for nursing researchers to broaden the research on patients to include the relationship of power created through language. This study demonstrates both methodological and empirical possibilities to do so. (shrink)

Nursing education is in the process of incorporating critical thinking, social justice, and health inequality perspectives into educational structures, aspiring to help nursing students develop into professional nurses prepared to provide equal care. Norm criticism is a pedagogical philosophy that promotes social justice. This qualitative case study aimed to gain an understanding of and elaborate on an educational development initiative in which norm criticism was incorporated into the composition of a new campus‐based clinical learning environment for nursing education. By analyzing (...) documents and interviews with the help of reflexive thematic analysis three themes were generated: “Intention to educate beyond nursing education,” “Educating in alliance with society,” and “The educative ambiguity of the Clinical Learning Centre.” The case study indicates that the incorporation of norm criticism into a campus‐based clinical learning environment may encourage nursing students to evolve social skills for nursing practice that support health equality within healthcare. By collaborating with society, nursing education can considerably improve its educational frameworks in alignment with societal demands. However, the inclusion of norm criticism in a setting such as a campus‐based clinical learning environment entails a clash with established institutionalized norms and being perceived as too proximate to politics. (shrink)

Mobsters and others engaged in risky forms of social coordination and coercion often communicate by saying something that is overtly innocuous but transmits another message ‘off record’. In both ordinary conversation and political discourse, insinuation and other forms of indirection, like joking, offer significant protection from liability. However, they do not confer blanket immunity: speakers can be held to account for an ‘off record’ message, if the only reasonable interpreta- tions of their utterance involve a commitment to it. Legal liability (...) for speech in the service of criminal behavior displays a similar profile of significant protection from indirection along with potential liability for reasonable interpretations. Specifically, in both ordinary and legal contexts, liability depends on how a reasonable speaker would expect a reasonable hearer to interpret their utterance in the context of utter- ance, rather than on the actual speaker’s claimed communicative intentions. (shrink)

We sley Salmon, in his influential and detailed book, Four Decades of Scientific Explanation, argues that the pragmatic approach to scientific explanation, “construed as the claim that scientific explanation can be explicated entirely in pragmatic terms” (1989, 185) is inadequate. The specific inadequacy ascribed to a pragmatic account is that objective relevance relations cannot be incorporated into such an account. Salmon relies on the arguments given in Kitcher and Salmon (1987) to ground this objection. He also suggests that Peter Railton’s (...) concepts of the ideal explanatory text and explanatory information (Railton 1981) can provide what the pragmatic approach lacks. This suggestion is not a conclusion of course; we read it as the promotion of part of a research program aimed at forging a greater consensus on scientific explanation-an admirable goal. However, we do not see the pragmatic approach as inadequate. We will show that a synthetic account inspired by Salmon’s adaptation of Railton would be equivalent to van Fraassen’s pragmatic account in three respects: accepting or rejecting requests for explanation; the practice of giving scientific explanations; and the evaluation of the goodness of explanations. We include all three under the general rubric of explanatory “practice.” Admittedly these are not the only three features by which an account of explanation might be evaluated. Roughly, we mean to show that a synthetic account cannot do a better job of accounting for the scientific practices which are of importance to the constructive empiricist, and therefore no argument can be presented to the constructive empiricist to convince her that by her own standards the synthetic account is superior. (shrink)

In recent years, the integration of philosophical with scientific theorizing has started to yield new insights. This chapter surveys some recent philosophical and empirical work on the nature and structure of action, on conscious agency, and on our knowledge of actions.

Readings in Health Care Ethics provides a wide-ranging selection of important and engaging contributions to the field of health care ethics. The second edition adds a chapter on health care in Canada, and the introduction has been expanded to include discussion of a new direction in feminist naturalized ethics. The book presupposes no prior knowledge, only an interest in the bioethical issues that are shaping our world.

Most of us create and use a panoply of non-sentential representations throughout our ordinary lives: we regularly use maps to navigate, charts to keep track of complex patterns of data, and diagrams to visualize logical and causal relations among states of affairs. But philosophers typically pay little attention to such representations, focusing almost exclusively on language instead. In particular, when theorizing about the mind, many philosophers assume that there is a very tight mapping between language and thought. Some analyze utterances (...) as the outer vocalizations of inner thoughts (e.g. Grice 1957, Devitt 2005), while others treat thought as a form of inner speech (e.g. Sellars 1956/1997, Carruthers 2002). But even philosophers who take no stand on the relative priority of language and thought still tend to individuate mental states in terms of the sentences we use to ascribe them. Indeed, Dummett (1993) claims that it is constitutive of analytic philosophy that it approaches the mind by way of language. In many ways, this linguistic model is salutary. Our thoughts are often intimately intertwined with their linguistic expression, and public language does provide a comparatively tractable proxy for, and a window into, the messier realm of thought. However, an exclusive focus on thought as it is expressed in language threatens to leave other sorts of thought unexplained, or even to blind us to their possibility. In particular, many cognitive ethologists and psychologists find it useful to talk about humans, chimpanzees, birds, rats, and even bees as employing cognitive maps. We need to make sense of this way of talking about minds as well as more familiar sentential descriptions. In what follows, I investigate the theoretical and practical possibility of non-sentential thought. Ultimately, I am most interested in the contours of distinctively human thought: what forms does human thought take, and how do those different forms interact? How does human thought compare with that of other animals? In this essay, however, I focus on a narrower and more basic theoretical question: could thought occur in maps? Many philosophers are convinced that in some important sense, thought per se must be language-like.. (shrink)

Der Tagungsband zielt auf Grundsatzliches in der Verwendung von Begriffen ab und versteht sich als Beitrag zu einer interdisziplinar gefuhrten Diskussion um Genese und Geltung von Kategorien in der gegenwartigen geistes-, kultur- und sozialwissenschaftlichen Forschung. Ausgehend von einer vorlaufigen Differenzierung in metaphysische, analytische oder kulturhistorische Kategorien zeigen die versammelten Beitrage gerade die Verschranktheit und wechselseitige Abhangigkeit dieser Dimensionen auf. Kategorien als methodische Werkzeuge zur wissenschaftlichen Einordnung und Unterscheidung von beobachteten Phanomenen stehen neben Kategorien als Untersuchungsgegenstand der Begriffs- und Ideengeschichte und (...) werfen daruber hinaus die Frage nach der Kategorialitat in den Bedingungen menschlichen Denkens und den allgemeinen Aufbauprinzipien von Welt auf. Unterschiedliche theoretische und methodologische Ansatze sowie konkrete Anwendungsbeispiele aus Anglistik, Amerikanistik, Filmwissenschaft, Germanistik, Wissenschaftsgeschichte, Kunstwissenschaft, Philosophie und Sprachwissenschaft zeugen von der Brisanz des Themas. (shrink)

From antiquity, Galenic physicians extensively discussed the active powers of simple and compound drugs. In their views, simple drugs, that is, single ingredients, acted according to their material qualities and the properties of their substance. As for compound drugs, their efficacy resulted from the mutual interaction of their ingredients and their modes of preparation. In the late Renaissance, Galenic physicians and naturalists, such as Leonhart Fuchs and Pietro Andrea Mattioli, attempted to explain these pharmacological properties or “faculties” at the intersection (...) of medicine, botany, and natural philosophy. This chapter examines the case of the Italian physician and botanist Andrea Cesalpino. His pharmacological treatise De medicamentorum facultatibus [On the Faculties of Drugs, 1593] was particularly significant for its reception of ancient and medieval texts on drug properties, materia medica, and the role of the senses in the knowledge of bodies. (shrink)

Elisabeth Porter's guide to the development of feminist thought on ethics & moral agency surveys feminist debates on the nature of feminist ethics, intimate relationships, professional ethics, politics, sexual politics, abortion and reproductive choices.

A vital and timely contribution to the growing scholarship on the political thought of Alain Badiou.

I take up three puzzles about our emotional and evaluative responses to fiction. First, how can we even have emotional responses to characters and events that we know not to exist, if emotions are as intimately connected to belief and action as they seem to be? One solution to this puzzle claims that we merely imagine having such emotional responses. But this raises the puzzle of why we would ever refuse to follow an author’s instructions to imagine such responses, since (...) we happily imagine many other implausible things. A natural response to this second puzzle is that our responses to fiction are real, and so can’t just be conjured up in response to an author’s demands. However, this simple response is inadequate, because we often respond differently to people and events in fiction than we would if we encountered them in real life. Solving these three puzzles in a consistent way requires the notion of a “perspective” on a fictional world. I sketch an account of this intuitive but frustratingly amorphous notion: perspectives are tools for organizing our thinking, which can in turn alter our emotional and evaluative responses. Cultivating a perspective can be illuminating, entertaining, or corrupting — or all three at once. (shrink)

La période périnatale suscite un bouleversement psychique de la famille où le passé, le présent et le futur s’entremêlent. Quand des traumatismes ont affecté des générations en amont, il est possible qu’un passé non élaboré resurgisse à la naissance d’un enfant. Des organisations défensives délétères se transmettent sans transformation. Une confusion des temps peut s’installer, entre passé et présent, obturant le futur, plongeant la nouvelle famille dans de la désorganisation, faisant apparaître des symptômes. Les autrices proposent un éclairage théorique, puis (...) des vignettes cliniques dont un accompagnement de thérapie familiale psychanalytique périnatale pour permettre à la nouvelle famille de se différencier et de construire un avenir détoxifié et « déconfusionné ». Le développement favorable de l’enfant et une parentalité plus harmonieuse peuvent en découler au bénéfice de tous. (shrink)

I compare two of Davidson's main discussions of metaphor. I argue, first, that despite some puzzling inconsistencies, the overall thrust of “What Metaphors Mean” is a radical form of noncogitivism, on which speakers of metaphors merely cause their hearers to perceive certain features in the world, but do not claim or implicate that things are any particular way. By contrast, in “A Nice Derangement of Epitaphs,” Davidson endorses a neo‐Gricean account of metaphor as a form of speaker's meaning. However, he (...) also now advocates a radical anticonventionalism about linguistic meaning in general, which threatens to undermine his new view of metaphor. Finally, I articulate and evaluate a neo‐Davidsonian view of metaphor, which retains as much as possible from both papers. (shrink)

Widmer sheds light on a neglected aspect of the Western philosophical tradition. Following an era of Hegelianism, the members of the neo-Kantian "Marburg School," such as Friedrich Albert Lange, Hermann Cohen, Rudolf Stammler, Paul Natorp, and Ernst Cassirer defended socialism or left-wing ideals on Kantian principles. In doing so, Widmer breaks with two mistaken assumptions. First, Widmer demonstrates that the left-Hegelian and Marxist traditions were not the only significant philosophical sources of socialist critique in nineteenth-century Germany, as the left-Kantians identified (...) problems of normativity that the left-Hegelians could not adequately address. Second, Widmer challenges the prevailing assumption that the political philosophies developed in the Marburg School can be comprehensively characterized as a unified school of "ethical socialism." By showing that they varied fundamentally regarding their political views and their philosophical foundations of socialism, Widmer fills a gap in the studies of neo-Kantianism that is long overdue. (shrink)

On a familiar and prima facie plausible view of metaphor, speakers who speak metaphorically say one thing in order to mean another. A variety of theorists have recently challenged this view; they offer criteria for distinguishing what is said from what is merely meant, and argue that these support classifying metaphor within 'what is said'. I consider four such criteria, and argue that when properly understood, they support the traditional classification instead. I conclude by sketching how we might extract a (...) workable notion of 'what is said' from ordinary intuitions about saying. (shrink)

Ten years ago, one of us proposed a dynamic hierarchical model of intentions that brought together philosophical work on intentions and empirical work on motor representations and motor control (Pacherie, 2008). The model distinguished among Distal intentions, Proximal intentions, and Motor intentions operating at different levels of action control (hence the name DPM model). This model specified the representational and functional profiles of each type of intention, as well their local and global dynamics, and the ways in which they interact. (...) A core insight of the model was that action control is the result of integrated, coordinated activity across these levels of intention. Since the proposal of the model, empirical and theoretical works in philosophy and cognitive science have emerged that would seem to support and expand on this central insight. In particular, an updated understanding of the nature of sensorimotor processing and motor representations, as well as of how the different levels of intention and control interface and interact, allows for the further specification and precisification of the original DPM model. (shrink)

Traditional theories of sarcasm treat it as a case of a speaker's meaning the opposite of what she says. Recently, 'expressivists' have argued that sarcasm is not a type of speaker meaning at all, but merely the expression of a dissociative attitude toward an evoked thought or perspective. I argue that we should analyze sarcasm in terms of meaning inversion, as the traditional theory does; but that we need to construe 'meaning' more broadly, to include illocutionary force and evaluative attitudes (...) as well as propositional content. I distinguish four subclasses of sarcasm, individuated in terms of the target of inversion. Three of these classes raise serious challenges for a standard implicature analysis. (shrink)

I argue that we can reconcile two seemingly incompatible traditions for thinking about concepts. On the one hand, many cognitive scientists assume that the systematic redeployment of representational abilities suffices for having concepts. On the other hand, a long philosophical tradition maintains that language is necessary for genuinely conceptual thought. I argue that on a theoretically useful and empirically plausible concept of 'concept', it is necessary and sufficient for conceptual thought that a thinker be able to entertain many of the (...) potential thoughts produced by recombining her representational abilities apart from a direct confrontation with the states of affairs being represented. Such representational abilities support a cognitive engagement with the world that is flexible, abstract, and active. (shrink)

Metaphors are powerful communicative tools because they produce ”framing effects’. These effects are especially palpable when the metaphor is an insult that denigrates the hearer or someone he cares about. In such cases, just comprehending the metaphor produces a kind of ”complicity’ that cannot easily be undone by denying the speaker’s claim. Several theorists have taken this to show that metaphors are engaged in a different line of work from ordinary communication. Against this, I argue that metaphorical insults are rhetorically (...) powerful because they combine perspectives, presupposition, and pragmatics in the service of speech acts with assertoric force. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

Gerechtigkeit ist ein ebenso bedeutsames wie umstrittenes Ideal menschlichen Umgangs.