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)

Stress in health care is affected by moral factors. When people are prevented from doing ‘good’ they may feel that they have not done what they ought to or that they have erred, thus giving rise to a troubled conscience. Empirical studies show that health care personnel sometimes refer to conscience when talking about being in ethically difficult everyday care situations. This study aimed to construct and validate the Stress of Conscience Questionnaire (SCQ), a nine-item instrument for assessing stressful situations (...) and the degree to which they trouble the conscience. The items were based on situations previously documented as causing negative stress for health care workers. Content and face validity were established by expert panels and pilot studies that selected relevant items and modified or excluded ambiguous ones. A convenience sample of 444 health care personnel indicated that the SCQ had acceptable validity and internal consistency (Cronbach’s alpha exceeded 0.83 for the overall scale). Explorative factor analysis identified and labelled two factors: ‘internal demands’ and ‘external demands and restrictions’. The findings suggest that the SCQ is a concise and practical instrument for use in various health care contexts. (shrink)

Health care often involves ethically difficult situations that may disquiet the conscience. The purpose of this study was to develop a questionnaire for identifying various perceptions of conscience within a framework based on the literature and on explorative interviews about perceptions of conscience (Perceptions of Conscience Questionnaire). The questionnaire was tested on a sample of 444 registered nurses, enrolled nurses, nurses’ assistants and physicians. The data were analysed using principal component analysis to explore possible dimensions of perceptions of conscience. The (...) results showed six dimensions, found also in theory and empirical health care studies. Conscience was perceived as authority, a warning signal, demanding sensitivity, an asset, a burden and depending on culture. We conclude that the Perceptions of Conscience Questionnaire is valid for assessing some perceptions of conscience relevant to health care providers. (shrink)

The aim of this study was to deepen nurses’ understanding of the importance of carefully managing the first nurse-patient encounter in a psychiatric setting according to each patient’s suffering and future hopes. The study was carried out using an action research approach. The action planned was the implementation of a conceptual model reflecting Eriksson’s caring theory. Data were collected by interviews with nurses and observational notes kept in a research diary. The data analysis followed the procedure of qualitative content (...) analysis. A generalization of the entire learning process shows the first nurse-patient encounter to be a moral commitment in nursing. A theoretical framework of nursing assessment conveying knowledge about the patient as unique and being a whole person can support the nurse in encouraging the patient to enter into a relationship. This insight stimulated the nurses in this study to reflect on the moral responsibility of continuing the relationship and initiating an ongoing nursing process. Awareness of this responsibility made them reflect more on the possibility of nurses taking autonomous actions in order not to abandon the patient and to avoid feeling guilty. (shrink)

The aim of this study was to deepen nurses’ understanding of the importance of carefully managing the first nurse-patient encounter in a psychiatric setting according to each patient’s suffering and future hopes. The study was carried out using an action research approach. The action planned was the implementation of a conceptual model reflecting Eriksson’s caring theory. Data were collected by interviews with nurses and observational notes kept in a research diary. The data analysis followed the procedure of qualitative content (...) analysis. A generalization of the entire learning process shows the first nurse-patient encounter to be a moral commitment in nursing. A theoretical framework of nursing assessment conveying knowledge about the patient as unique and being a whole person can support the nurse in encouraging the patient to enter into a relationship. This insight stimulated the nurses in this study to reflect on the moral responsibility of continuing the relationship and initiating an ongoing nursing process. Awareness of this responsibility made them reflect more on the possibility of nurses taking autonomous actions in order not to abandon the patient and to avoid feeling guilty. (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)

Although organizational and situational factors have been found to predict burnout, not everyone employed at the same workplace develops it, suggesting that becoming burnt out is a complex, multifaceted phenomenon. The aim of this study was to elucidate perceptions of conscience, stress of conscience, moral sensitivity, social support and resilience among two groups of health care personnel from the same workplaces, one group on sick leave owing to medically assessed burnout (n = 20) and one group who showed no indications (...) of burnout (n = 20). The results showed that higher levels of stress of conscience, a perception of conscience as a burden, having to deaden one’s conscience in order to keep working in health care and perceiving a lack of support characterized the burnout group. Lower levels of stress of conscience, looking on life with forbearance, a perception of conscience as an asset and perceiving support from organizations and those around them (social support) characterized the non-burnout group. (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)

Norms are a pervasive yet mysterious feature of social life. In Explaining Norms, four philosophers and social scientists team up to grapple with some of the many mysteries, offering a comprehensive account of norms: what they are; how and why they emerge, persist and change; and how they work.

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.

Over the past few decades, a body of research has developed examining the academic dishonesty of university and college students. While research has explored academic dishonesty amongst American criminal justice and policing students, no research has specifically focused on investigating the dynamics and correlates of academic dishonesty amongst Australian criminology students. This study drew upon data obtained from a survey of 79 undergraduate criminal justice and policing students studying at an Australian university. Overall, the results suggest that male gender, viewing (...) academic dishonesty as less serious and holding justifications for engaging in this type of behaviour were significant predictors of self-reported academic dishonesty. The findings suggest that more proactive strategies need to be implemented by universities to prevent student involvement in academic dishonesty. (shrink)

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.

People taking part in research vary in the extent to which they understand information concerning their participation. Since they may choose to limit the time and effort spent on such information, lack of understanding is not necessarily an ethical problem. Researchers who notice a lack of understanding are in the quandary of not knowing whether this is due to flaws in the information process or to participants’ deliberate choices. We argue that the two explanations call for different responses.A tool for (...) identifying those research participants who want limited information is presented. This consists of a restricted number of questions about trust in and appraisal of research, priority of time and privacy, and perception of a duty to participate. It is argued that an important group of participants who purposely lack understanding of the study can be identified with this tool. Some limitations to this approach are also discussed. (shrink)

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.

abstract ‘Time is money’, Benjamin Franklin's ‘Poor Richard’ tells us. But instead of converting time expenditures into monetary equivalents, it makes more sense in many cases to convert money into temporal equivalents. The difficulty in putting a monetary value on time in unpaid household labour, when adjusting the National Accounts, points to the problems of the first approach. The advantages of the latter approach are illustrated by the Swedish system of specifying criminal fines in terms of the number of days (...) the offender would have to work to pay them off. (shrink)

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)