This article examines the involvement of residents and their relatives in end-of-life decisions and care in Norwegian nursing homes. It also explores challenges in these staff—family relationships. The article is based on a nationwide survey examining Norwegian nursing homes’ end-of-life care at ward level. Only a minority of the participant Norwegian nursing home wards ‘usually’ explore residents’ preferences for care and treatment at the end of their life, and few have written procedures on the involvement of family caregivers when their (...) relative is in the terminal phase. According to the respondents, most staff seem to comfort relatives well. However, several challenges were described. The study revealed a need for better procedures in the involvement of residents and relatives in nursing home end-of-life care. The findings emphasize a need to strengthen both the involvement of nursing home physicians and staff communication skills. (shrink)
_A penetrating study of the sister who betrayed and endangered her famous brother's legacy_ In 1901, a year after her brother Friedrich's death, Elisabeth Förster-Nietzsche published _The Will to Power,_ a hasty compilation of writings he had never intended for print. In _Nietzsche's Sister and the Will to Power,_ Carol Diethe contends that Förster-Nietzsche's own will to power and her desire to place herself--not her brother--at the center of cultural life in Germany are centrally responsible for (...) class='Hi'>Nietzsche's reputation as a belligerent and proto-Fascist thinker. Offering a new look at Nietzsche's sister from a feminist perspective, this spirited and erudite biography examines why Elisabeth Förster-Nietzsche recklessly consorted with anti-Semites, from her own husband to Hitler himself, out of convenience and a desire for revenge against a brother whose love for her waned after she caused the collapse of his friendship with Lou Salomé. The book also examines their family dynamics, Nietzsche's dismissal of his sister's early writing career, and the effects of limited education on intelligent women. Diethe concludes by detailing Förster-Nietzsche's brief marriage and her subsequent colonial venture in Paraguay, maintaining that her sporadic anti-Semitism was, like most things in her life, an expedient tool for cultivating personal success and status. _A volume in the series International Nietzsche Studies, edited by Richard Schacht_. (shrink)
Holobionts, consisting of a host and diverse microbial symbionts, function as distinct biological entities anatomically, metabolically, immunologically, and developmentally. Symbionts can be transmitted from parent to offspring by a variety of vertical and horizontal methods. Holobionts can be considered levels of selection in evolution because they are well-defined interactors, replicators/reproducers, and manifestors of adaptation. An initial mathematical model is presented to help understand how holobionts evolve. The model offered combines the processes of horizontal symbiont transfer, within-host symbiont proliferation, vertical symbiont (...) transmission, and holobiont selection. The model offers equations for the population dynamics and evolution of holobionts whose hologenomes differ in gene copy number, not in allelic or loci identity. The model may readily be extended to include variation among holobionts in the gene identities of both symbionts and host. (shrink)
In Nietzsche, Tension, and the Tragic Disposition, Matthew Tones undertakes an ambitious journey through Nietzsche’s writings, dealing with, among other things, Nietzsche’s notion of tragedy, his relation to ancient Greek thought, his naturalism, and the concept of nobility developed in GM and BGE. Tones thus gives a detailed and insightful reconstruction of Nietzsche’s philosophy. But this strength of the book is unfortunately also its limit. Tones highlights the complexities of the problems he discusses, but one gets (...) the impression that he succumbs to his “will” to systematize Nietzsche’s thinking: he creates harmonies where there are tensions and gives answers where Nietzsche leaves us with questions.... (shrink)
In many Western countries, studies have demonstrated extensive use of coercion in nursing homes, especially towards patients suffering from dementia. This article examines what kinds of strategies or alternative interventions nursing staff in Norway used when patients resist care and treatment and what conditions the staff considered as necessary to succeed in avoiding the use of coercion. The data are based on interdisciplinary focus group interviews with nursing home staff. The study revealed that the nursing home staff usually spent a (...) lot of time trying a wide range of approaches to avoid the use of coercion. The most common strategies were deflecting and persuasive strategies, limiting choices by conscious use of language, different kinds of flexibility and one-to-one care. According to the staff, their opportunities to use alternative strategies effectively are greatly affected by the nursing home’s resources, by the organization of care and by the staff’s competence. (shrink)
The contributions to this sparkling new book conclude that Neurath touched on many of the most critical problems of economic theory during its formative years as a modern discipline.
By subjecting Nietzsche to a Platonic critique, author William H. F. Altman punctures his “pose of untimeliness” while making use of Nietzsche’s own aphoristic style of presentation. Friedrich Wilhelm Nietzsche—named for a Prussian King—is thereby revealed to be the representative philosopher of the Second Reich.
Background: Studies have demonstrated the extensive use of coercion in Norwegian nursing homes, which represents ethical, professional as well as legal challenges to the staff. We have, however, limited knowledge of the experiences and views of nursing home patients and their relatives. Objectives: The aim of this study is to explore the perspectives of nursing home patients and next of kin on the use of coercion; are there situations where the use of coercion can be defended, and if so, under (...) which circumstances? Methods: The data are based on individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 60 relatives. Ethical considerations: Participation was based on written informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Results: More than half of the patients and the majority of the relatives accepted the use of coercion, trusting the staff to act in the patient’s best interest. However, the acceptance of coercion is strongly related to the patients’ lack of understanding, to prevent health risks and to preserve the patient’s dignity. Conclusion: The majority of nursing home patients and relatives accepted the use of coercion in specific situations, while at the same time they emphasised the need to try alternative strategies first. There is still a need for good qualitative research on the use of coercion in nursing homes, especially with a closer focus on the perspectives and experiences of nursing home patients. (shrink)
De senere år har pleie- og omsorgstjenesten i mange norske kommuner startet med ulike former for etikkarbeid, oftest initiert av KS’ prosjekt “Samarbeid om etisk kompetanseheving”. Hensikten med vår studie var å evaluere innsatsen i de kommunene som deltok i prosjektet fra starten av, med vekt på hvilke tiltak som var iverksatt, hvilke virksomheter dette omfattet, og om tiltakene har fortsatt utover prosjektperioden. Studien har et kvalitativt design. Materialet er hovedsakelig basert på telefonintervjuer med kontaktpersoner for etikksatsingen i 34 kommuner. (...) Det transkriberte materialet er analysert ved kvalitativ innholdsanalyse. Med unntak av fem kommuner som aldri kom i gang med etikkarbeidet, hadde de fleste startet etikkrefleksjon innenfor flere tjenester, oftest i sykehjem og hjemmetjenester. Noen kommuner hadde imidlertid ikke klart å videreføre etikkarbeidet utover en prosjektperiode. Det var stor variasjon både i etikkarbeidets forankring i kommunen, omfang, hyppighet og metoder. Et gjennomgående funn er vektlegging av behovet for etikkkompetanse og oppfølging av dem som skal lede etikkarbeidet. Flertallet av kommunene som fortsatt gjennomfører etikkrefleksjon, tar utgangspunkt i egen praksis, men et mindretall anvender strukturerte metoder. Dersom etikkarbeidet i kommunen skal være levedyktig over tid, bør arbeidet forankres på flere nivåer i organisasjonen, og de som skal lede dette arbeidet, bør få styrket sin kompetanse i etikk og etikkrefleksjon.Nøkkelord: etikk, evaluering, kommunehelsetjenestenEnglish summary: Building ethical competence in Norwegian municipalities: What has been done and what has been sustainable?“Cooperation for building ethics competence” is a national project aimed to stimulate moral reflection and build competence in ethics in community health services in Norway. This article is based on an evaluation of the activities implemented by the first 34 participating municipalities, exploring which measures were implemented, which services and employees were involved, and if the measures are sustainable. The study has a qualitative design, and the data mainly consists of telephone interviews with “key” persons in 34 municipalities. With the exception of five municipalities that never really started ethics work, the majority had implemented ethical reflection in several areas, most often in nursing homes and home care services. There was great variation with regard to the implementation. Many had tried a variety of reflection models, and only a minority of the municipalities were using a structured method of ethical reflection. A consistent finding is the need for more competence; many of those who run ethical reflection are reported to need more competence both in ethics and methods for systematic reflection. There were also great variations in how well the ethics projects were anchored within the municipality. To make ethical interventions sustainable, this study indicates the importance of strong anchoring within the municipality, the need for ethical competence, as well as good methods for structuring ethical reflection. (shrink)
ABSTRACT The article examines Nietzsche’s evaluation of D. F. Strauss’ progressive theology. It argues firstly, that Nietzsche identified a nihilistic strain in Strauss’ vision, a strain which renders his views ultimately untenable and that this strain is detectable in latter-day atheistic activism. This claim is supported by identifying two major contradictions in Strauss’ thought. The first is a misreading of Hegel which renders Strauss’ own reliance on Hegel illegitimate and incoherent. The second is Strauss’ failure to appreciate the (...) full impact of Darwin’s naturalistic shift. It is demonstrated that Strauss’ attempt to forge a new progressive religion on scientific principle still rests upon Christian moral principle. Like his latter-day inheritors, Strauss ultimately fails to make a convincing argument. The article shows the nihilistic consequences of Strauss’ continuous reliance on Christianity. (shrink)
