NAIRN S. Nursing Inquiry 2012; 19: 6–17 A critical realist approach to knowledge: implications for evidence‐based practice in and beyond nursingThis paper will identify some of the key conceptual tools of a critical realist approach to knowledge. I will then apply these principles to some of the competing epistemologies that are prevalent within nursing. There are broadly two approaches which are sometimes distinct from each other and sometimes inter‐related. On one side, there is the view that all healthcare interventions (...) should be judged on the principles of randomised controlled trials and the other is a preoccupation with language in which healthcare interventions are subjected to a discursive interrogation. These debates are configured through the idea of a hierarchy of knowledge that is accorded uncritical acceptance by some and virulent distaste by others. I will argue that the notion of hierarchy is problematic and is largely argued for in unproductive epistemological terms. What is required is a shift towards a theory that emphasises the contextual nature of the ways that knowledge is produced and disseminated. In other words, there is no single hierarchy of knowledge, but there are multiple hierarchies of knowledge. (shrink)

Catholic ethicists assess the development, reception, and relevance of Cardinal Joseph Bernardin's writings on the consistent ethic of life. The late Archbishop of Chicago, Joseph Bernardin, is best remembered for his "seamless garment" approach linking abortion, capital punishment, war, and social justice - and bringing insights from the New Testament and Catholic tradition to bear on the burning issues of our age. Book jacket.

Coletânea de artigos em homenagem a Guido Antonio de Almeida e Raul Ferreira Landim Filho.

As a system of knowledge, nursing has utilized a range of subjects and reconstituted them to reflect the thinking and practice of health care. Often drawn to a holistic model, nursing finds it difficult to resist the reductionist tendencies in biological and medical thinking. In this paper I will propose a relational approach to knowledge that is able to address this issue. The paper argues that biology is not characterized by one stable theory but is often a contentious topic and (...) employs philosophically diverse models in its scientific research. Biology need not be seen as a reductionist science, but reductionism is nonetheless an important current within biological thinking. These reductionist currents can undermine nursing knowledge in four main ways. Firstly, that the conclusions drawn from reductionism go far beyond their data based on an approach that prioritizes biological explanations and eliminates others. Secondly, that the methods employed by biologists are sometimes weak, and the limitations are insufficiently acknowledged. Thirdly, that the assumptions that drive the research agenda are problematic, and finally that uncritical application of these ideas can be potentially disastrous for nursing practice. These issues are explored through an examination of the problems reductionism poses for the issue of gender, mental health, and altruism. I then propose an approach based on critical realism that adopts an anti‐reductionist philosophy that utilizes the conceptual tools of emergence and a relational ontology. (shrink)

Women philosophers have not received their due in the discipline's reference works. Kersey's international biographical dictionary of women philosophers from ancient times up until the present redresses that situation.... This very capably fills a very evident gap in the philosophy reference corpus. Wilson Library Bulletin This work developed from Kersey's discovery that there existed no biographical dictionaries of women philosophers, and few references to women in textbooks on the history of philosophy. Intended to fill that void, this source book covers (...) more than 170 women born before 1920 who wrote about or pondered questions of Western intellectual life. Using broad criteria, Kersey has included any woman who conducted serious work in the traditional fields of philosophy, including metaphysics, ethics, aesthetics, or logic. Although acknowledging that the field has been dominated by men, the author excluded feminist scholars on the grounds that they have been given serious attention elsewhere, and also omitted women theologians or devotional writers. The volume includes extensive bibliographies of both primary and secondary works about each philosopher. An in-depth introduction establishes the context for the reference, and an appendix provides charts showing women philosophers by century, nationality, and discipline. An index of names completes the source book. This reference will be an important addition to university and public libraries, and a valuable reference for courses in philosophy and women's studies. (shrink)

The contributors to this volume address global, regional, and local landscapes, cosmopolitan and indigenous cultures, and human and more-than-human ecology as they work to reveal place-specific tensional dynamics. This unusual book, which covers a wide-ranging array of topics, coheres into a work that will be a valuable reference for scholars of geography and the philosophy of place.

Gender scholars argued that gendered organizations theory needs updating as organizational logic has shifted amid neoliberal workplace transformations. This qualitative case study of a high-tech firm reveals how features of the traditional work logic remain resilient. I analyze the gendered implications of a high-tech startup restructuring and going public, finding the flexible organization to bureaucratize, implementing specialized jobs and a hierarchy with standardized career ladders. Going public creates conflicting gendered logics that place women at a structural disadvantage, relegating them to (...) low-status, narrow jobs while simultaneously demanding masculine ideal worker norms of visibility and self-promotion. Despite networking, women experience job insecurity and a glass ceiling, while men are assumed ideal workers and advance. By tracing one high-tech firm’s restructuring from a startup to public company, I demonstrate how the collision of new and traditional workplace logics perpetuates gender inequalities. (shrink)

The concept of social structure is ill defined in the literature despite the perennial problem and ongoing discussion about the relationship between agency and structure. In this paper I will provide an outline of what the term social structure means, but my main focus will be on emphasizing the value of the concept for nursing research and demonstrate how its erasure in some research negatively effects on our understanding of the nurses' role in clinical practice. For example, qualitative research in (...) nursing has largely focused on agency through such theories as phenomenology, hermeneutics, and symbolic interactionism. The result is that social structure may be erased or seen as epiphenomena of agency. My purpose is to provide a theoretical discussion of social structure and how such a discussion can help us to understand how nurses live and experience clinical practice. While not denying the importance of agency, I will argue that the thinned out approach to social structure places limits on our understanding of the constraints nurses experience in their working lives. The result is that nurses' attitudes and clinical failings are individualized, resulting in ever more calls for improved education, when a more thorough examination of structural issues may elucidate more fundamental problems. (shrink)

O objetivo deste texto é apresentar duas possíveis interpretações relativas ao que é revelado pelo argumento do cogito apresentado nas Meditações de Descartes, mostrando que, se aceitarmos a tese wittgensteiniana relativa ao sentido das expressões linguísticas, então será necessário concluir que ambas as interpretações envolvem pelo menos uma dificuldade cuja solução não é possível de ser dada no interior de uma filosofia da consciência.

A standard view would suggest that research is a neutral apolitical activity. It neutralizes external pressures by its fidelity to robust scientific methods. However, politics is an inevitable part of human knowledge. Our knowledge of the world is always mediated by human priorities. What matters is therefore a contested and political debate rather a neutral accumulation of factual data. How researchers manage this varies. Research paradigms are one way in which research engages with knowledge. They frame knowledge within epistemological and (...) ontological philosophies. In this paper, I will explore this view in relation to neo‐positivism, qualitative research, Foucault and critical realism. I will argue that if nursing knowledge is to be effective it needs to acknowledge the political, particularly in the context of neoliberalism. Healthcare systems are having to cope with a social world increasingly dominated by market fundamentalism, extreme levels of inequality and a rise in xenophobia. These forces are undermining the provision of ethically sound health care, misdirecting research practice and contributing to a discourse of dehumanization. These forces need to be challenged politically and I will argue that epistemologically diverse approaches, alongside a realist ontology can provide a way forward for nursing research. (shrink)

O objetivo do artigo é examinar o argumento cartesiano em favor da distinção corpo/alma à luz da tese, também cartesiana, da união corpo/alma no homem. A hipótese a ser defendida é a de que a prova da distinção real entre corpo e alma envolve um conceito de substância segundo o qual um atributo principal não pode coexistir com outro numa mesma substância. Mais ainda, será sustentado que interpretando assim o argumento em favor da distinção é possível admitir que Descartes ao (...) provar a união entre essas duas substâncias distintas não abandona nem enfraquece sua tese dualista. (shrink)

Ofrecemos una lectura de Un hogar sólido de Elena Garro en relación con los postulados de la tragedia griega, en particular las nociones de destino, culpa y conocimiento, para resaltar la posición femenina que presenta la autora a través de la cual cuestiona las convenciones de su época. Primero presentamos la idiosincrasia de los personajes para resaltar la materia trágica que aporta la protagonista de la pieza y fundamentar su carácter de heroína. En la circunstancia existencial de las mujeres se (...) plantea la oposición del destino y la libertad, aunque la búsqueda de la autonomía será el camino de la afirmación de la identidad. La autora confronta a la protagonista con la determinación del destino, expone su decisión y verifica su caída; en las diferencias propuestas entre la tragedia griega y la tragedia mexicana, se critican las estructuras socioculturales y los estereotipos de género. Elena Garro confirma el papel político del teatro y la misión del héroe en la comunidad. (shrink)

ABSTRACTNew Zealanders were presented with the opportunity to change the national flag and opted to retain the current New Zealand flag, despite arguments that it was unable to reflect national identity adequately. This article unpacks the particular version of national identity constructed in discourse in the infographic, Our Nation. Your Choice. which was released prior to the final referendum that determined the outcome of the Flag Consideration Project. We used Fairclough’s critical discourse analysis to examine the discursive construction of national (...) identity by the Flag Consideration Panel that oversaw the process. The authoritative assertion of national identity on behalf of New Zealanders emphasised inclusiveness and unity by acknowledging cultural diversity. Biculturalism was confined to an old understanding of New Zealand identity while the ideology of multiculturalism, not yet officially implemented, was positioned as common-sense. There was a focus on situating New Zealand in a global context to distance New Zealand from colonisation and connection to Britain. The positive, cohesive conceptualisation of New Zealand suggested that the Flag Consideration Project was, in fact, an exercise in re-positioning New Zealand in the global context, in which the national flag would represent the national brand rather than contribute to national identity. (shrink)

Bourdieu is an important thinker within the sociological tradition and has a philosophically sophisticated approach to theoretical knowledge and research practice. In this paper, we examine the implication of his work for nursing and the health sciences more broadly. We argue that his work is best described as a reflexive realist who provides a space for a nonpositivist approach to knowledge that does not fall into the trap of idealism or relativism. We emphasize that Bourdieu was not an abstract theorist, (...) but only utilized theories to understand and explain the social world in all its empirical complexity. Theory is emphasized over method without denying the importance of method. We then provide a brief overview of some of his key concepts: habitus, field and capital. His work is a scientifically astute practice that has an emancipatory purpose, with particular resonance to the problems of nursing as a social practice. Some have criticized Bourdieu for undermining agency and we briefly address this issue, but argue that his conceptual framework helps us to understand what endures in social practice and why change is often problematic. In short, this paper argues that Bourdieu's work is a fruitful resource for critiquing existing nursing approaches that are preoccupied with agency over structure. (shrink)

Resumen: De las muchas posibilidades de lectura de Antígona de Sófocles destacamos la naturaleza del conflicto trágico, que tiene sus raíces en valores anteriores al orden social establecido y que puede considerarse material útil para una refundación del estatuto político en la posmodernidad. A partir del comentario de texto señalamos que Antígona no atenta contra el orden social, sino que espera consolidarlo en un fundamento imperturbable; que encarna la crítica de la racionalidad instrumental, inaugurada por la sofística y reavivada sucesivamente (...) en la modernidad; que afirma existencialmente una ética del amor fraterno como humanización del orden del universo. Proponemos ampliar la noción de hermano consanguíneo y extenderla a la idea de hermano como “el otro” en el marco de las sociedades posmodernas, espacios de intención multicultural, para tener un principio de rescate ético. En esta re-lectura se actualizan las nociones arcaicas de religiosidad, honra fúnebre y piedad familiar.: Of the many possible readings of Sophocles' Antigone, we highlight the nature of the tragic conflict, which has its roots in previous values to the established social order, and which can be considered useful material for re-founding the political status in postmodernity. From the text commentary, we note that Antigone does not attack the social order, but she hopes to consolidate it on an imperturbable basis that embodies the critique of instrumental rationality, inaugurated by sophistry and revived successively in modernity. This affirms existentially the ethics of fraternal love as a humanization of the order of the universe. We propose to extend the notion of consanguineous brother and extend it to the idea of brother as “the other” in the framework of postmodern societies, spaces of multicultural intention, to have a principle of ethical rescue. In this re-reading, the archaic notions of religiosity, funeral honor, and family piety are updated. (shrink)

This paper will explore the relationship between Mezirow's concept of reflexivity and Bourdieu's theory of habitus in order to develop a more robust framework within which critical reflection can take place. Nurse educators have sought to close the theory practice gap through the use of critical reflection. However, we are not convinced that this has produced the depth and quality of reflection required. Furthermore, the contexts in which critical reflection takes place is often sidelined or erased so that the whole (...) impetus in the literature is to educate nurses in reflection rather than empower nurses to understand the complex circumstances and barriers that obstruct critical reflection. This paper argues that the reason for this position is that nurse education does not always acknowledge the role that personal and cultural values systems have on reflective practices. The literature search was undertaken using CINHAL and MEDLINE. Keywords included: values systems, habitus, and critical reflection. Inclusion criteria were determined by the theoretical approach and included seminal texts, from as far back as 1956, to identify key themes. Although critical reflection is a potentially powerful way of enhancing care it has often failed to do so. It is suggested that this is because nurse educators have frequently used models of reflection without considering the impact that student's personal values systems has on their perceptions of care and subsequently care delivery. The purpose of this paper is to promote deeper levels of reflection and is part of a programme of research aimed at developing a more robust approach to reflection in educational practice. (shrink)

The aim of this study was to explore experiences of participation in treatment planning decisions from the perspective of patients recently treated for colorectal cancer. Ten patients were purposively selected and interviewed. Constant comparative analysis, the core concept of grounded theory, was used. The dimensions were developed and organized into the main theme of ‘compliant participation in serious decisions’, which was composed of the two variations: complying with participation; and complying without participation. Complying with participation was characterized by feelings of (...) self-confidence and self-competence and by open dialogue between the participants, significant others and the physician. Complying without participation was characterized by participants’ feelings of uncertainty and distress, and of being rushed into submitting to decisions without having time to reflect on the information provided or the opportunity to influence the treatment and care process. To participate builds on open and affirming dialogue, information and knowledge about the illness. Patient participation in treatment and care decision making is interpreted as a health promoting way of coping with illness. (shrink)

This qualitative research examines the influence of animosity on physicians during clinical encounters and its ethical implications. Semi-structured interviews were conducted with ten Israeli-Jewish physicians: four treated Syrians and six treated Palestinian terrorists/Hezbollah militants or Palestinian civilians. An interpretive phenomenological analysis was used to uncover main themes in these interviews. Whereas the majority of physicians stated they are obligated to treat any patient, physicians who treated Syrians exhibited stronger emotional expression and implicit empathy, while less referring to the presence of (...) the Israeli-Arab conflict. In contrast, physicians who treated enemy combatants or Palestinian civilians showed the exact opposite. Linking these results to the “Implicit Bias” theory, the role of empathy and the beneficence principle in medical ethics, we argue that: the unconscious decreased emotional involvement among the latter group of physicians is a deficiency that needs to be recognized; and this deficiency undermines the principle of beneficence, thereby possibly influencing the fulfillment of the commitment to treat patients. Acknowledging and addressing the potential emotional and ethical deficiencies entailed in encounters with the so-called enemy-patients are of importance to the global medical community, since such encounters are increasingly an integral part of the current political realities faced by both the developed and developing worlds. (shrink)

Présentation:L’année 2015 marque le dixième anniversaire de la mort de Raymond Klibansky, philosophe et historien des idées canadien. La revueDialoguelui rend hommage en publiant le texte qui suit de Mme Ethel Groffier, veuve de Raymond Klibansky et chercheure émérite au Centre de recherche Paul-André Crépeau en droit privé et comparé de l’Université McGill. Dans cette intervention, Mme Groffier rappelle l’importance de l’engagement dans la vie et l’œuvre de ce remarquable philosophe.Né en France au mois d’octobre 1905 dans une famille (...) allemande, éduqué en Allemagne à partir de la Première guerre, exilé en Angleterre en 1933, Raymond Klibansky s’installa à Montréal dès 1946, à l’invitation de l’Université McGill. Sa carrière académique au Canada et à l’étranger fut admirable et reconnue par de nombreux hommages. Il laisse derrière lui une œuvre imposante, tant en philosophie qu’en histoire des idées modernes; parmi ces idées, il s’attacha particulièrement à la tolérance et à la liberté, qui inspirèrent toute sa vie.Luc LangloisPresentation:The year 2015 marked the 10thanniversary of Raymond Klibansky’s death. As a tribute to this prominent Canadian philosopher and historian of ideas,Dialogueis proud to publish the following intervention by Ethel Groffier, Raymond Klibansky’s widow and Emeritus scholar at McGill University’s Paul-André Crépeau Centre for Private and Comparative Law. Groffier reminds us of the importance of engagement—understood in the strong, philosophical sense—in this philosopher’s life and works.Born in France in October 1905 to a German family, raised in Germany from World War I to 1933, and then forced to move to the United Kingdom, Klibansky settled in Montreal in 1946 following an invitation from McGill University. His academic career in Canada and abroad is admirable and has been acclaimed on numerous occasions. He left behind an impressive body of work in philosophy and in the history of modern ideas; among these ideas, freedom and tolerance inspired his entire life.Luc Langlois. (shrink)

Em harmonia com sua tese acerca do conhecimento de um modo geral, Tomás de Aquino sustenta que o conhecimento que o intelecto tem de si é também dependente dos sentidos. Segundo Tomás, há pelo menos dois modos de o intelecto se conhecer (ambos em virtude do ato do intelecto de conhecer): o conhecimento singular da existência do intelecto e o conhecimento universal da natureza do intelecto, isto é, o conhecimento de seus princípios de operações, ambos dependentes, ainda que de modo (...) remoto, das percepções sensíveis. Apresento uma leitura da Segunda Meditação segundo a qual Descartes inicia seu projeto de recusa do modelo tomista-aristotélico de conhecimento. Ele demonstra não só a incorporeidade do todo da alma mas, mais ainda, demonstra que embora o conhecimento da existência e o da natureza do intelecto consistam no conhecimento de suas operações fundamentais — a saber, conceber, julgar e inferir — esse conhecimento não tem origem em qualquer impressão sensível. Ao contrário: ele é prioritário a estas e se dá mesmo à revelia do que é dado por elas. (shrink)

Neste artigo, pretendo examinar a tese cartesiana da livre criação das verdades eternas a partir da conjugação dos atributos divinos que, segundo Descartes, são conhecidos por nós e sua tese de que, entre as verdades eternas livremente criadas por Deus, estão incluídos os princípios lógicos. A partir desse exame, concluo que, até onde o intelecto finito do homem pode conceber, a tese cartesiana da livre criação das verdades eternas envolve ao menos as seguintes teses: a) Deus, por ser infinito e (...) puro pensamento em ato, estabelece necessariamente em si todas as essências e verdades, incluindo essências e verdades que para o intelecto finito parecem impossíveis, já que lhe aparecem como contraditórias; b) ao estabelecer as essências e verdades, Deus instancia algumas (e assim as cria) como conteúdos de ideias inatas nas mentes finitas, que são criadas com estrutura lógica; c) ao estabelecer as essências e verdades, Deus instancia no mundo atual ao menos algumas das essências e verdades não contraditórias instanciadas nas mentes finitas; e d) embora a mente humana finita não as possa conceber clara e distintamente, é certo que Deus instancia no mundo atual ao menos algumas das essências e verdades que aparecem como contraditórias, isto é, instancia no mundo atual ao menos algumas das essências e verdades que para a mente finita aparecem como impossíveis por serem por ela inconcebíveis, o que é confirmado por ao menos dois casos mencionados por Descartes. In this article I intend to examine the Cartesian view on the free creation of the eternal truths considering the conjunction of the divine attributes, which according to the Cartesian thesis, are known to us and his thesis that logical principles are among the eternal truths freely created by God. From this examination I conclude that, as far as the finite intellect of man can conceive, the Cartesian view of the free creation of the eternal truths involves at least the following theses: a) being pure and infinite thinking in action, God necessarily sets in himself all the form of essence and truth, including all essence and truth that for, the finite intellect, seem impossible since they may appear to him as contradictory; b) while establishing all essence and truth, God instantiates some of them (and thus creates some of them) as contents of innate ideas in finite minds, which are created with a logical structure; c) while establishing all essence and truth God instantiates in the actual world at least some of the non-contradictory essences which are instantiated in the finite mind; and d) although the finite human mind cannot conceive it clearly and distinctly, it is certain that God instantiates in the actual world at least some of essence and truth that seem to be contradictory for the human mind, that is, God instantiates at least some of the essences and truths which appear to the finite mind as impossible since inconceivable, which is confirmed by at least two cases mentioned by Descartes. (shrink)

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