The theory of self-organization of complex systems studies laws of sustainable co-evolutionary development of structures having different speeds of development as well as laws of assembling of a complex evolutionary whole from parts when some elements of “memory” must be included. The theory reveals general rules of nonlinear synthesis of complex evolutionary structures. The most important and paradoxical consequences of the holistic view, including an approach to solving the riddle of human personality, are as follows: 1) the explanation why and (...) under what conditions a part can be more complex than a whole ; 2) in order to reconstruct society it is necessary to change an individual but not by cutting off the supposed undesirable past, since a human being as a microcosm is the synthesis of all previous stages of evolution, and as a result of repression of, it would seem, the wild past one can extinguish a “divine spark” in his soul; 3) in the physical sense, singularity denotes a moment of instability, phase transition; one can talk about the human singularity of co-evolutionary processes, since in such a moment of instability individual actions of a human can play a key role in determining a channel of further development as well as in appearance of a new pattern of collective behavior in society; 4) as the models of nonlinear dynamics, elaborated at the Keldysh Institute of Applied Mathematics of the Russian Academy of Sciences in Moscow, show, there is a possibility of a direct influence of the future and even a touch of an infinitely remote future in certain evolutionary regimes and under rigorously definite conditions, more over, it turns out that such a possibility exists only for a human but not for the human society. (shrink)

The philosophical consequences of synergetics, the interdisciplinary theory of evolution and self-organization of complex systems, are being drawn in the paper. The idea of discreteness of evolutionary paths is in the focus of attention. Although the future is open, and there are many alternative evolutionary paths for complex systems, not any arbitrary (either conceivable or desirable) evolutionary path is feasible in a given system. There are discrete spectra of possible evolutionary paths which are determined exclusively by inner properties of the (...) corresponding systems. Synergetics allows us to reveal general laws of self-organization and, therefore, certain limits of arbitrariness of nature in choosing possible paths of evolution as well as in constructing of a complex evolutionary whole. A comparative analysis between the modern synergetic notions and a few ideas of the Western philosophy (F. Nietzsche, N. Hartmann, M. Heidegger) and of the Eastern teachings (Taoism, Buddhism) is made. (shrink)

Today a change is imperative in approaching global problems: what is needed is not arm-twisting and power politics, but searching for ways of co-evolution in the complex social and geopolitical systems of the world. The modern theory of self-organization of complex systems provides us with an understanding of the possible forms of coexistence of heterogeneous social and geopolitical structures at different stages of development regarding the different paths of their sustainable co-evolutionary development. The theory argues that the evolutionary channel to (...) the observed increasing complexity is extremely narrow and only certain discrete spectra of relatively stable self-maintained structures are feasible in complex systems. There exists a restricted set of ways of assembling a complex evolutionary whole from diverse parts. The law of nonlinear synthesis of complex structures reads: the integration of structures in more complex ones occurs due to the establishment of a common tempo of their evolution. On the basis of the theory, we can see not only desirable but also attainable futures. (shrink)

Main principles of the complex nonlinear thinking which are based on the notions of the modern theory of evolution and self-organization of complex systems called also synergetics are under discussion in this article. The principles are transdisciplinary, holistic, and oriented to a human being. The notions of system complexity, nonlinearity of evolution, creative chaos, space-time definiteness of structure-attractors of evolution, resonant influences, nonlinear and soft management are here of great importance. In this connection, a prominent contribution made to system analysis (...) and to a necessary reform of education and thinking by Edgar Morin is considered. (shrink)

Owing to intensive development of the theory of self-organization of complex systems called also synergetics, profound changes in our notions of time occur. Whereas at the beginning of the 20th century, natural sciences, by picking up the general spirit of Einstein's theory of relativity, consider a geometrization as an ideal, i.e. try to represent time and force interactions through space and the changes of its properties, nowadays, at the beginning of the 21st century, time turns to be in the focus (...) of attention. It turns to be possible to represent space through time, because synergetics shows that historical and evolutionary stages of development of a complex structure can be found now, in its present spatial configuration. A whole series of paradoxical notions, such as "the influence of the future upon the present", a "possibility of touching of a rather remote future today", "availability of the past and the future now, in praesenti", "irreversibility and elements of reversibility in the course of evolutionary processes in time", "discrete unites, quanta of time", appear in synergetics. (shrink)

The hope of finding new methods of predicting the course of historical processes could be connected with the recent developments of the theory of self-organisation, also called synergetics. It provides us with knowledge of constructive principles of co-evolution of complex social systems, co-evolution of countries and geopolitical regions being at different stages of development, integration of the East and the West, the North and the South. Due to the growth of population on the Earth in blow-up regime, the general and (...) local instability of development is increasing. The social world seems to go towards a unity, a sustainable commonwealth through pulsations rather than monotonously. It goes via alternation of disintegration, even if partial, and getting more powerful integrations of structures. There is a path of multiple reduction of temporal and material expenses, a path of a resonant excitation of desirable and — no less important — feasible in a given social system structure. In the case of the right topology of integration of geopolitical structures an arising whole organisation can accelerate its tempo of evolution. 1999 Elsevier Science Ltd. All rights reserved. (shrink)

The heuristic value of synergetic models of evolving and self-organizing complex systems as well as their application to epistemological problems is shown in this paper. Nonlinear synergetic models turn out to be fruitful in comprehending epistemological problems such as the nature of human creativity, the functioning of human intuition and imagination, the historical development of science and culture. In the light of synergetics creative thinking can be viewed as a selforganization and self-completion of images and thoughts, filling up gaps in (...) the nets of knowledge. Insight, fast and sudden solutions of scientific problems, instabilities when “an idea is in the air” are considered as examples of blow-up regimes in the cognitive field. (shrink)

Some properties of cognitive networks are discussed in the article in the context of the modern achievements of the network science. It is the study in network structures and their surprising properties that gives a new impetus to the development of the theory of complex systems. The analysis of cognitive processes from the point of view of the network structures that arise in them not only fits with such concepts already existing in cognitive science and epistemology, as cognitive niches, cognitive (...) maps, cognitive coherence, etc.), but also brings some new aspects to the understanding of interactivity, intersubjectivity, synergy in cognition and creative activities, empathy. (shrink)

The modern conception of enactive cognition is under discussion from the standpoint concerning the notions of nonlinear dynamics and synergetics. The contribution of Francisco Varela and his precursors is considered. It is shown that the perceptual and mental processes are bound up with the “architecture” of human body and nonlinear and circular connecting links between the subject of cognition and the world constructed by him can be metaphorically called a nonlinear cobweb of cognition. Cognition is an autopoietic activity because it (...) is directed to the search of elements that are missed; it serves to completing integral structures. (shrink)

The modern theory of the self-organization of complex systems, or synergetics, is considered in the context of historical traditions of natural philosophy. It is substantiated that it is unfairly to treat synergetics as a modern “speculative physics”, i.e. the natural philosophy of a new type. However, there is no doubt that on the basis of synergetics a certain worldview is built, and this worldview oversteps the boundaries of basic scientific disciplines and reaches a meta-scientific level of research. The paper presents (...) an attempt of a critical analysis of the claims of the theory of complex systems selforganization (synergetics) and the interdisciplinary generalizations and the universal efficacy of its models. The grounds of synergetic models transfer to different disciplinary fields are discussed. It is argued that synergetics is rather a mental scheme or a heuristic approach to exploring the complex behavior of systems, and not a universal key of solving concrete scientific problems. Some prospects of the development and the possible future of synergetics in the next decades are estimated. (shrink)

The modern theory of the self-organization of complex systems, or synergetics, is considered in the context of historical traditions of natural philosophy. It is substantiated that it is unfairly to treat synergetics as a modern “speculative physics”, i.e. the natural philosophy of a new type. However, there is no doubt that on the basis of synergetics a certain worldview is built, and this worldview oversteps the boundaries of basic scientific disciplines and reaches a meta-scientific level of research. The paper presents (...) an attempt of a critical analysis of the claims of the theory of complex systems selforganization (synergetics) and the interdisciplinary generalizations and the universal efficacy of its models. The grounds of synergetic models transfer to different disciplinary fields are discussed. It is argued that synergetics is rather a mental scheme or a heuristic approach to exploring the complex behavior of systems, and not a universal key of solving concrete scientific problems. Some prospects of the development and the possible future of synergetics in the next decades are estimated. (shrink)

An attempt to critically analyse the claims of the theory of self-organization of complex systems (synergetics) to the interdisciplinary generalizations and the universal efficacy of its models is made in the paper. The grounds for transfer of synergetic models to different disciplinary fields are under discussion. It is argued that synergetics is a mental scheme or a heuristic approach to exploring the complex behaviour of systems, rather than a universal key to solving concrete scientific problems. The prospects for development and (...) the possible future of synergetics in the coming decades are estimated. Copyright 2002 John Wiley & Sons, Ltd. (shrink)

The dynamic approach to understanding of the human consciousness, its cognitive activities and cognitive architecture is one of the most promising approaches in the modern epistemology and cognitive science. The conception of embodied mind is under discussion in the light of nonlinear dynamics and of the idea co-evolution of complex systems developed by the Moscow scientific school. The cognitive architecture of the embodied mind is rather complex: data from senses and products of rational thinking, the verbal and the pictorial, logic (...) and intuition, the analytical and synthetic abilities of perception and of thinking, the local and the global, the analogue and the digital, the archaic and the post-modern are intertwined in it. In the process of cognition, co-evolution of embodied mind as an autopoietic system and its surroundings takes place. The perceptual and mental processes are bound up with the structure of human body. Nonlinear and circular connecting links between the subject of cognition and the world constructed by him can be metaphorically called a nonlinear cobweb of cognition. Cognition is an autopoietic activity because it is directed to the search of elements that are missed; it serves to completing integral structures. According to the theory of blow-up regimes in complex systems elaborated by Sergey P.Kudyumov and his followers, the idea of co-evolution is connected with the concept of tempoworlds. To co-evolve means to start to develop in one and the same tempoworld and to use the possibility – in case of a proper intergation into a whole structure – to accelerate the tempo of evolution. The cognitive activities of the human being can be considered as a movement (active walk) in landscapes of co-evolution when he cognizes and changes environment and is changed himself by the very activities. The similar conclusion can be drawn from Francisco Varela’s conception of enactive cognition. (shrink)

The synthetic, integrative significance of biosemiotics as a modern interdisciplinary research program is under discussion in the article. Aimed at studying the cognitive and life activity of living beings, which are capable of recognizing signals and extracting the meanings, biosemiotics serves as a conceptual node that combines some important notions of theoretical biology, evolutionary epistemology, cognitive science, phenomenology, neuroscience and neurophilosophy as well as the theory of complex adaptive systems and network science. Worlds of perception and actions of living beings (...) are built in the process of co-evolution, in structural coupling and in enactive interaction with the surrounding natural environment (Umwelt). Thereby the biosemiotic theories developed by the founders of biosemiotics (J. von Uexküll, Th. Sebeok, G. Prodi, H. Pattie) are conceptually closed to the system-structural evolutionary approach developed in synergetics by H. Haken and S.P. Kurdyumov, the conception of autopoiesis (H. Maturana and F. Varela), second-order cybernetics (H. von Foerster), the conception of enactivism in cognitive science (F. Varela, E. Thompson, A. Noë). The key to comprehending the processes of extracting and generating meanings is that every living organism lives in the subjectively built world (Umwelt), so that its Umwelt and its internal psychic organization become parts of a single autopoietic system. According to the well-known expression of G. Bateson, information is a not indifferent difference or a difference that makes a difference. Differences become information when a cognitive agent as an interpreter, acting as part of an autopoietic system, sees signs in these differences that make meanings. (shrink)

In order to develop further the methods of scenario building and to facilitate the paths towards desirable and sustainable futures, we cannot do without a nonlinear evolutionary thinking. The theory of self-organization of complex systems, called also synergetics, is a scientific basis for such a thinking, the main principles of which are under consideration in the paper. Synergetics provides us with the knowledge of constructive principles of coevolution of the complex social systems, coevolution of countries and geopolitical regions being at (...) different stages of development, integration of the East and the West, the North and the South. (shrink)

An extended approach to the comprehension of virtual reality is developed in the article. Virtual reality is understood not only as a logically possible or cybernetically constructed reality but also as continuous turbulence of potencies of the complex natural and social world we live in, the wandering of complex systems and organizations over a field of possibilities, such a realization of forms and structures in which many formations remain in latent, potential forms, and are in the permanent process of making (...) and multiplying a spectrum of possibilities, lead to the growth of the evolutionary tree of paths of development. It is shown that such an understanding of virtual reality corresponds to concepts and notions developed in the modern science of complexity. The most significant concepts are considered, such as the nonlinearity of time, the relationship of space and time, the uncertainty of the past and the openness of the future, the choice and construction of the future at the moments of passing the bifurcation points. Some cultural and historical prototypes of these modern ideas of virtual reality are given. It is substantiated that the vision of virtual reality being developed today can play the role of a heuristic tool for understanding the functioning and stimulation of human creativity. (shrink)

This article focuses on the general theoretical issue of realism versus constructivism in politics, with a case of the present-day Russia as the main and most telling example. We present four assertions that we are going to defend. First, we claim that in the sphere of international relations, political realism of the offensive type, after decades of more tempered USA–USSR relations, is again challenging its opponent: political constructivism. Second, political realism is winning in the sphere of domestic politics and policy (...) in the leading countries as well. Third, we touch upon theoretical issues and discuss the ontological nature of political realism in comparison with political constructivism and the kindred of the latter with normativism, legalism, constitutionalism and liberalism. Political constructivism as a concept is underestimated and rarely used. Our article explicates the concept of political constructivism, which is a novel contribution to political theory and political philosophy. Fourth, we show that political constructivism, being the most advanced achievement of political civilization compared to archaic realism, has not lost the game so far and should be upheld in its battle with the remnants of the wild political past. Sliding back to political realism would turn humankind into another degraded animal species instead of making it the pilot in continuing human progress. (shrink)

Die philosophischen Folgerungen der Synergetik, einer interdisziplinären Theorie der Evolution und Selbstorganisation komplexer nichtlinearer Systeme, werden in diesem Artikel zur Diskussion gestellt. Das sind der weltanschauliche Sinn des Begriffs von der „Nichtlinearität“, die konstruktive Rolle des Chaos in der Evolution, eine neue Vorstellung von diskreten Spektren evolutionärer Wege in komplexen Systemen, die Prinzipien des Aufbaus von komplexem evolutionärem Ganzen, der Integration von komplexen Strukturen, die sich mit verschiedenen Geschwindigkeiten entwickeln, die Methoden des nichtlinearen Managements komplexer Systeme. Die Synergetik entdeckt allgemeingültige (...) Gesetzmäßigkeiten der Strukturbildung, der Selbstorganisation und der Evolution komplexer Systeme und gehört deswegen zu der Richtung des Universalismus. Sie nimmt eine Mittlerrolle zwischen Reduktionismus und Holismus ein. -/- . (shrink)

This study assessed the International Critical Thinking Essay Test (ICTET-A) for inter-rater reliability, internal reliability, and criterion validity. A self-selecting sample of participants (N = 100) completed the ICTET-A and a comparison test online. We found the ICTET-A items to have moderate to good levels of inter-rater reliability, and overall excellent inter-rater consistency for total test scores. The test had good internal reliability. There was a strong correlation between scores on the ICTET-A and the comparison test. Factor analysis showed that (...) scores were best explained with one factor, suggesting the test measures a single construct. The ICTET-A can therefore be considered a valid measure of critical thinking. Additionally, we propose a short form of the test. (shrink)

This article is about experiences of a cemetery landscape: a physical space that was chosen as a depository for human remains, and where different memorial and disposal practices have developed behavioural patterns that together form a cemetery culture. Through qualitative research at St Eskil’s, Eskilstuna, Sweden, encompassing field observations and interviews (N=14) with stakeholders and people from the general public, we aim to describe and discuss the cemetery as a place and environment experienced from a perspective of people of diverse (...) backgrounds. The study reveals important characteristics that facilitate designing, caretaking, developing and using cemeteries more generally. Findings show that most interviewees, independent for example of cultural or religious adherence, describe the cemetery as a beautiful natural or garden-like place. The well-maintained landscape is emphasized as a self-evident or impressive quality. The cemetery is experienced as ‘typically Swedish’ and described in terms of order and sense of care. Diversity in both design and multi-cultural and individual expressions are observed, acknowledged and welcomed. We conclude that nature (including a garden approach), care and diversity are key concepts that should be considered in design and development of future cemeteries. (shrink)

The aim of this study was to identify the ethical problems that nurse managers encounter in their work and the role of codes of ethics in the solutions to these difficulties. The data were collected using a structured questionnaire and analysed statistically. The target sample included all nurse managers in 21 specialized health care or primary health care organizations in two hospital districts in Finland (N = 501; response rate 41%). The most common ethical problems concerned resource allocation as well (...) as providing and developing high quality care. This was the case in different managerial positions as well as in types of organization. Professional codes of ethics were used more often for problems related to patients’ care compared with issues of resource allocation. Nurse managers at middle or strategic management levels used codes of ethics more often than those in charge of a ward. More research is required to investigate ethical decision making in nursing management, especially with regard to problem solving. In addition, new guidelines and continuing education in ethics are important for management personnel. (shrink)

The spatial composition of human portraits obeys historically changing cultural norms. We show that it is also affected by cognitive factors that cause greater spontaneous attention to what is in front rather in the back of an agent. Scenes with more space in front of a directed object are both more often produced and judged as more aesthetically pleasant. This leads to the prediction that, in profile‐oriented human portraits, compositions with more space in front of depicted agents (a “forward bias”) (...) should be over‐represented. By analyzing a large dataset (total N of 1,831 paintings by 582 unique identified European painters from the 15th to the 20th century), we found evidence of this forward bias: Painters tended to put more free space in front of, rather than behind, the sitters. Additionally, we found evidence that this forward bias became stronger when cultural norms of spatial composition favoring centering became less stringent. (shrink)

Depuis 2001, lorsque la Chine fut sélectionnée pour accueillir les Jeux Olympiques de 2008, ce choix n’a cessé de susciter de nombreuses controverses autour de la question des droits de l’homme. À ces critiques, le gouvernement chinois a répondu à partir de 2003 par un amendement à la constitution se référant aux « valeurs asiatiques » et par la mise en place du programme de « société harmonieuse » de Hu Jintao. L’étude se concentre principalement sur les aspects interculturels du (...) débat sur l’état des droits de l’homme en Chine. Elle analyse d’abord les questions principales et compare les différentes façons d’aborder les droits de l’homme, en Chine comme à l’international. Elle analyse ensuite les incohérences de ces jugements dans deux cadres fondamentaux : celui de la doctrine des droits de l’homme universels et celui de la doctrine d’une société harmonieuse, fondée sur la perspective confucianiste. Elle examine enfin les débats actuels relatifs aux problèmes des droits de l’homme à travers la confrontation interculturelle des deux cadres pré-cités et l’possibilité d’un dialogue entre ces deux positions. (shrink)

Cet article explore le potentiel non-institutionnel du concept de communauté tel qu'il a été formulé dans la philosophie française contemporaine. Une attention particulière est accordée à l'expérience historique, particulièrement dans un monde en voie de globalisation. Les fantasmes de l'historique qui témoignent d'une telle expérience sont estimés constitutifs d'une communauté anonyme qui n'est définie ni par une identité fixe ni par une substance donnée. En dépit de son anonymat, la communauté exige d'être exprimée et traduite, en produisant, pour reprendre le (...) terme kantien, diverses "présentations comme-si.". (shrink)

Cet article explore le potentiel non-institutionnel du concept de communauté tel qu'il a été formulé dans la philosophie française contemporaine. Une attention particulière est accordée à l'expérience historique, particulièrement dans un monde en voie de globalisation. Les fantasmes de l'historique qui témoignent d'une telle expérience sont estimés constitutifs d'une communauté anonyme qui n'est définie ni par une identité fixe ni par une substance donnée. En dépit de son anonymat, la communauté exige d'être exprimée et traduite, en produisant, pour reprendre le (...) terme kantien, diverses "présentations comme-si.". (shrink)

This article looks at the relevance of the concept of self-determination to psychiatric patients by studying the existence, importance and manifestations of self-determination. The data were collected by interviewing long-term patients (n = 72) in one mental health care organization, which included a psychiatric hospital and an outpatient department. Self-determination was defined in terms of the right to decision-making, the right to information, the right of consent, the right to refuse treatment, and the right to be heard and taken into (...) account. It was found that, with the exception of the right to refuse and consent, these rights are indeed present in the practice of psychiatric nursing and that they are relevant and important to psychiatric patients. The patients typically gave ethical, practical and legal reasons for a psychiatric patient's right to self-determination. The main reasons why psychiatric patients said they lacked the right to self-determination were illness and staff authority. Recommendations for educational, clinical and methodological implications for the future in nursing are discussed. (shrink)

This article discusses the rights of patients who are attending hospital for the most common laboratory examinations and who may also be taking part in research studies. A distinction is made between five kinds of rights to: protection of privacy, physical integrity, mental integrity, information and self-determination. The data were collected ( n = 204) by means of a structured questionnaire specifically developed for this study in the clinical chemistry, haematological, physiological and neurophysiological laboratories of one randomly selected university hospital (...) in Finland. The analysis of the data was statistical. On the whole, patients’ rights were realized reasonably well. This was most particularly the case with protection of privacy, as well as with the rights of physical and mental integrity. The rights to information and self-determination were less well realized. There are various steps that health care professionals and organizations can take to make sure that patients can enjoy their full rights, by counselling the patient, by giving opportunities to plan the examinations in advance, and by arranging a sufficient number of small examination rooms. (shrink)

BackgroundPatients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists.MethodA self-evaluation instrument (Physiotherapist’s Ethical Competence Evaluation Tool) based on (...) an analysis of a concept “ethical competence” was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire.ResultsBased on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct.ConclusionsThis was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients’ viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient. (shrink)

Ethical issues in the care of elderly people have been identified in many countries. We report the findings of a comparative research project funded by the European Commission, which took place between 1998 and 2001. The project explored the issues of autonomy (part I), privacy (part II) and informed consent (part III) in nursing practice. Data were collected from elderly residents/patients (n = 573) and nursing staff (n = 887) in five European countries: Finland, Spain, Greece, Germany and the UK (...) (Scotland). Questionnaires were used as the data collection tool (self-completion questionnaires for staff, structured interviews for the elderly participants). Four basic nursing interventions in the care of elderly people were targeted: hygiene, fluid intake and nutrition, medication, and elimination. The data were analysed statistically. The results indicated differences within all five countries between staff and patient perceptions of autonomy, privacy and informed consent. There were also similar differences between individual countries. Conclusions were reached concerning practice, education and research. This is the first of a set of five articles published together in this issue of Nursing Ethics in which the results of this comparative research project are presented. (shrink)

The aim of this study was to explore ethically problematic situations in the long-term nursing care of elderly people. It was assumed that greater awareness of ethical problems in caring for elderly people helps to ensure ethically high standards of nursing care. To obtain a broad perspective on the current situation, the data for this study were collected among elderly patients, their relatives and nurses in one long-term care institution in Finland. The patients (n=10) were interviewed, while the relatives (n=17) (...) and nurses (n=9) wrote an essay. Interpretation of the data was based on qualitative content analysis. Problematic experiences were divided into three categories concerning patients’ psychological, physical and social integrity. In the case of psychological integrity, the problems were seen as being related to treatment, self-determination and obtaining information; for physical integrity, they were related to physical abuse and lack of individualized care; and for social integrity, to loneliness and social isolation. This study provided no information on the prevalence of ethical problems. However, it is clear from the results that patient integrity warrants more attention in the nursing care of elderly patients. (shrink)

In nursing, the concept of advocacy is often understood in terms of reactive or proactive action aimed at protecting patients' legal or moral rights. However, advocacy activities have not often been researched in the context of everyday clinical nursing practice, at least from patients' point of view. This study investigated the implementation of nursing advocacy in the context of procedural pain care from the perspectives of both patients and nurses. The cross-sectional study was conducted on a cluster sample of surgical (...) otolaryngology patients (n = 405) and nurses (n = 118) from 12 hospital units in Finland. The data were obtained using an instrument specially designed for this purpose, and analysed statistically by descriptive and non-parametric methods. According to the results, patients and nurses have slightly different views about which dimensions of advocacy are implemented in procedural pain care. It seems that advocacy acts are chosen and implemented rather haphazardly, depending partly on how active patients are in expressing their wishes and interests and partly on nurses' empowerment. (shrink)

This article discusses the rights of patients who are attending hospital for the most common laboratory examinations and who may also be taking part in research studies. A distinction is made between five kinds of rights to: protection of privacy, physical integrity, mental integrity, information and self-determination. The data were collected (n = 204) by means of a structured questionnaire specifically developed for this study in the clinical chemistry, haematological, physiological and neurophysiological laboratories of one randomly selected university hospital in (...) Finland. The analysis of the data was statistical. On the whole, patients’ rights were realized reasonably well. This was most particularly the case with protection of privacy, as well as with the rights of physical and mental integrity. The rights to information and self-determination were less well realized. There are various steps that health care professionals and organizations can take to make sure that patients can enjoy their full rights, by counselling the patient, by giving opportunities to plan the examinations in advance, and by arranging a sufficient number of small examination rooms. (shrink)

Neste esboço de teodiceia que deveria intitular-se "Amorim Viana", Sampaio Bruno critica o optimismo leibniziano daquele autor para quem o mal não tinha essência real.nesta "teosofia", ou "teurgia" mística e heterodoxa, Bruno contesta a "creatio ex nihilo", propondo a Cisão como mistério primordial, causa da degradação do Espírito puro e de todos os outros seres. Aliado aos temas da Cisão e do Mal, o Tempo surge como categoria fundamental.A razão e a revelação, a "sofia" e a profecia, entrelaçam-se paradoxalmente nesta (...) "teurgia" mística em que a Cisão, o Tempo e o Mal são as coordenadas ônticas de uma viagem quase iniciática do visível ao invisível, do racional ao meta-racional, da razão ao místério. /// Dans cette esquisse de théodicée qui devrait s'intituler "Amorim Viana", Sampaio Bruno critique l'optimisme leibnizien de cet auteur, pour lequel le mal n'avait pas d'essence réelle.Dans cette "théosophie" ou "théurgie" mystique et hétérodoxe, Bruno conteste la dégradation du pur Esprit et de tous les autres êtres. En liaison avec les thèmes de la Scission et du Mal, le Temps surgit comme catégorie fondamentale.La raison et la révélation, la "sophia" et la prophétie, s'entrelacent paradoxalement en cette "théurgie" mystique dans laquelle la Scission, le Temps et le Mal sont les coordonnées ontiques d'un voyage pour ainsi dire initiatique du visible à l'invisible, du rationnel au métarationnel, de la raison au mystère. /// In this sketch of theodicy which should rather be entitled "Amorim Viana", Sampaio Bruno does criticize the leibnizian optimism of that author for whom the evil had no real essence.In this "theosophy" or mystical and heterodoxal "theurgy", Bruno denies the "creatio ex nihilo", and proposes the Scission as primary mystery, cause of the degradation of pure Spirit and all other beings. Associated to the subjects of Scission and Evil, Time appears as a fundamental category.The reason and the revelation, the "sophia" and the prophecy, interlace themeselves paradoxally in this mystical "theurgy" in wich the Scission, the Time and Evil are ontical coordenates of a fast initial journey from the visible to the invisible, from the rational to the meta-rational, from reason to the mystery. (shrink)

¿Qué hacer cuando el matrimonio quiere tener un hijo y éste tarda en venir, o simplemente no viene? La naprotecnología, como estudio médico de la fertilidad masculina y femenina, ofrece una respuesta válida para afrontar esta situación de infertilidad/esterilidad. Seguimos como camino el método triangular propuesto por Elio Sgreccia: ver los datos científicos para realizar un análisis antropológico y una valoración ética que oriente el actuar concreto.La naprotecnología, como ciencia médica, constituye un abordaje médico y científico que busca resolver los (...) trastornos reproductivos y ginecológicos del varón y de la mujer, identificando las principales causas que afectan a la verdadera salud reproductiva. A partir de este diagnóstico, busca corregir las posibles alteraciones y restaurar la salud y fertilidad. Este modo de afrontar la infertilidad/esterilidad se ilustra con varios casos clínicos y los resultados obtenidos en España durante los años 2015 a 2021. A continuación, realizamos un análisis antropológico del modo de afrontar la infertilidad, analizando el sujeto que la padece: ¿Quién es el ser humano? ¿Cómo es su sexualidad? ¿En qué entorno se realiza primordialmente la procreación? Con esta base esbozamos un juicio ético ante este modo de afrontar los problemas de infertilidad/esterilidad. (shrink)

The purpose of this study was to compare nursing students' perceptions of self-determination in elderly patients before and after clinical training in long term care institutions as a part of their course in gerontological nursing. A pre- post-test design was employed. The data were collected by questionnaires completed by students at one nurse education organization college in Finland (pre-test n ± 120, response rate 95%; post-test n ± 115, response rate 91%). The students' perceptions of elderly patients' self-determination were more (...) positive after their clinical training period concerning to what extent elderly patients are able to control their treatment and what kind of support they received from nurses to exercise their self-determination. The students' perceptions remained stable concerning how important self-determination is to elderly patients, and how willing and knowledgeable they are about using their self-determination. Ethics teaching, together with high quality clinical training placements, should be assured early during nursing studies. (shrink)

Este trabajo presenta un contrapunto entre dos filosofías que participan en el debate que se establece, a propósito de la pregunta por la vida buena, entre los ámbitos ético -tradicionalmente unido a la razón- y estético -tradicionalmente unido a la sensibilidad-, tratando de determinar hasta qué punto es posible y conveniente sobrepasar los límites, bien definidos por la modernidad, de ambos campos. Ambas concepciones, la de Martha Nussbaum, en nombre de la literatura, y la de Ursula Wolf, en nombre de (...) la filosofía, remiten a Aristóteles y aceptan que para deliberar acerca de la vida buena es necesaria la comprensión que aportan tanto la obra literaria como la obra de arte; sin embargo, cada una de ellas asume un énfasis particular y ello permite una consideración amplia del estado actual de la discusión. (shrink)

Este ensayo considera, dentro de un contexto narrativo, el asunto de cómo llegar a saber de nuestro amor a partir de una comparación entre el comportamiento escéptico y desconfiado del lector de filosofía y el abierto y confiado del lector de relatos. El artículo explica cómo la filosofía permite clarificar la idea del conocimiento del amor por medio del análisis de los conceptos, descubriendo específicamente que es el amor en el alma y como es su conocimiento; y cómo el relato, (...) señala que el carácter las multiples formas de los aspectos en desarrollo y la evolución temporal de lo narrado, no están presentes en las teorías explícitas y reflexivas. Martha Nussbaum afirma que el corazón humano necesita de la reflexión activa, y que para poderle abrir un espacio a las historias de amor, la filosofía debe ser más literaria, debe tener una relación más estrecha con las narraciones y considerar respetuosamente el misterio y los finales abiertos de las mismas. (shrink)

Perceiving a pay system as just has been suggested to be a precondition for individualized pay to have a motivating effect for employees. Supervisors’ enacted justice is central for understanding the effects that pay setting can have on employee attitudes and behavior. Yet, enacted justice has received little research attention, in regard to both organizational justice and pay-related topics. This study examines the effects of employees’ perceived pay justice and supervisors’ enacted justice, as well as the degree of congruence, on (...) employees’ work-related attitudes and behaviors. Questionnaire data from employees (N = 566) matched with data from their pay-setting supervisors (N = 208), employed in a Swedish manufacturing company, were analyzed. Results of polynomial regression with response surface analysis show that employees’ perceptions of pay justice were important for their work-related attitudes and behaviors and that supervisor–employee congruence regarding pay justice was positively related to employees’ attitudes and behavior, particularly when the ratings concerned high levels of justice. The results not only highlight the importance of developing a pay system that is perceived as just by employees but also emphasize the importance of reaching a congruence between supervisors’ and employees’ perceptions of high fairness, as this has positive implications for employees’ attitudes and behaviors. (shrink)

BackgroundThere is a permanent need to evaluate and develop the ethical quality of scientific research and to widen knowledge about the effects of ethical issues. Therefore we evaluated whether informed consent is related to implementation and success in a lifestyle intervention study with older research participants. There is little empirical research into this topic.MethodsThe subjects (n = 597) are a subgroup of a random population sample of 1410 men and women aged 57-78 years who are participating in a 4-year randomized (...) controlled intervention trial on the effects of physical exercise and diet on atherosclerosis, endothelial function and cognition. Data were collected in two steps: A questionnaire about informed consent was given to all willing participants (n = 1324) three months after the randomization. Data on implementation and success in the exercise and diet interventions were evaluated at 12 months by intervention-group personnel. The main purpose of the analysis procedure performed in this study was to identify and examine potential correlates for the chosen dependent variables and to generate future hypotheses for testing and confirming the independent determinants for implementation and success. The nature of the analysis protocol is exploratory at this stage.ResultsAbout half of the participants (54%) had achieved good results in the intervention. Nearly half of the participants (47%) had added to or improved their own activity in some sector of exercise or diet. Significant associations were found between performance in the interventions and participants' knowledge of the purpose of the study (p < 0.001), and between success in interventions and working status (p = 0.02), and the participants' knowledge of the purpose of the study (p = 0.04).ConclusionThe main finding of this study was that those participants who were most aware or had understood the purpose of the study at an early stage had also attained better results at their 12-month intervention evaluation. Therefore, implementation and success in intervention is related to whether subjects receive a sufficient amount and are able to comprehend the information provided i.e. the core principles of informed consent.Trial Registration(ISRCTN 45977199). (shrink)

RESUME Jean-Paul Sartre débute comme dramaturge durant la Seconde Guerre mondiale alors qu'il est prisonnier de guerre en Allemagne, dans un camp de 25.000 détenus. Durant sa captivité, le philosophe écrit une pièce de théâtre réunissant des victimes et leurs bourreaux, des juifs, des prisonniers et des allemands. Bariona est la toute première pièce de Sartre et elle restera une référence pour le théâtre de situations que l'auteur ne cessera de réaliser pendant toute sa vie. Traditionnellement la pensée sartrienne est (...) analysée, dans un premier temps, sous le prisme de la philosophie abstraite et individualiste dont L'être et le néant est l'expression fondamentale, puis, dans un second temps, après la Seconde Guerre mondiale, à travers le marxisme dont la Critique de la raison dialectique serait le principal ouvrage. L'objectif essentiel de cet article est de mettre à l'épreuve cette idée en analysant les concepts de l'homme seul et de la collectivité dans la première pièce dramaturgique de Sartre. On verra que l'interprétation que divise la pensée de Sartre en deux n'est pas si juste. RESUMO Jean-Paul Sartre estreia como dramaturgo durante a Segunda Guerra Mundial, quando é feito prisioneiro de guerra na Alemanha em um campo de concentração com outras 25 mil pessoas. Durante seu cárcere, o filósofo escreve uma peça de teatro reunindo vítimas e seus algozes, judeus e alemães. Bariona é a primeira peça de Sartre e permanecerá a referência do teatro de situações que o autor continuará a perseguir por toda a vida. Tradicionalmente, o pensamento sartriano é considerado, em um primeiro momento, sob o prisma da filosofia abstrata e individualista, que teria na obra O ser e o nada a expressão fundamental; em seguida, em um segundo momento, depois da Segunda Guerra Mundial, o é por meio do marxismo, do qual a Crítica da razão dialética seria a obra principal. O objetivo fundamental do presente artigo é o de colocar à prova essa ideia, analisando os conceitos de homem solitário e de coletividade na primeira peça de teatro de Sartre. Veremos que a interpretação que divide o pensamento de Sartre em dois não é, com efeito, justa. (shrink)

Every year medical researchers make contact with a large number of cancer survivors with the aim of evaluating cancer treatment. For this reason we decided to investigate how Swedish cancer survivors perceived their participation in research studies focusing on the long-term consequences of being a survivor of gynaecological or urinary bladder cancer. Data were collected by means of two study-specific postal questionnaires, both consisting of questions covering physical symptoms, well-being and the experience of being a cancer survivor. Both questionnaires also (...) included questions evaluating the participants’ experience of being research subjects. The questionnaires were developed in close co-operation with cancer survivors. The study population consisted of 1068 cancer survivors. Of these, 95% (n=1003) reported that they thought the study was valuable and 54% (n=559) that they had been positively affected by participating. Four per cent (n=39) expressed that they had been negatively affected by their participation in the study. The vast majority of the cancer survivors thought that participating in their particular study was valuable. (shrink)

Patient’s duties are a topical but little researched area in nursing ethics. However, patient’s duties are closely connected to nursing practice in terms of autonomy, the best purpose of care and rethinking from the patient’s perspective. This article is a metasynthesis (N = 11 original articles) of patient’s duties, aimed to create a tentative model. In this article, a tentative model called ‘right-based duties of a patient’ was constructed. With its aid, a coherent structure of patient’s duties within different roles (...) and objects of a patient can be defined. In addition, the ethical basis, prerequisites, outcomes and risks of patient’s duties can be named. In conclusion, so-called right-based duties of a patient constitute the basic argument. Patient’s duties are not unambiguous for all patients, and the global perspective to duties has been challenged. However, due to both conceptual and practical reasons, rethinking of patient’s duties is needed. (shrink)

This study identified and described ethical problems encountered by physiotherapists in their practice and physiotherapists’ moral sensitivity in ethical situations. A questionnaire-based survey was constructed to identify ethical problems, and the Moral Sensitivity Questionnaire Revised version was used to measure moral sensitivity. Physiotherapists (n = 116) working in public health services responded to the questionnaire. Based on the results, most of the physiotherapists encounter ethical problems weekly. They concern mainly financial considerations, equality and justice, professionalism, unethical conduct of physiotherapists or (...) other professions and patients’ self-determination. The dimension of moral strength was emphasised in physiotherapists’ self-evaluations of their moral sensitivity. As a conclusion, ethical problems do occur not only at individual level but also at organisational and society level. Physiotherapists seem to have moral strength for speaking on behalf of the patient. Scarce resources make them feel insufficient but much could still be done to provide quality care in co-operation with other health-care professionals. (shrink)

Background:Moral courage is defined as courage to act according to one’s own ethical values and principles even at the risk of negative consequences for the individual. In a complex nursing practice, ethical considerations are integral. Moral courage is needed throughout nurses’ career.Aim:To analyse graduating nursing students’ moral courage and the factors associated with it in six European countries.Research design:A cross-sectional design, using a structured questionnaire, as part of a larger international ProCompNurse study. In the questionnaire, moral courage was assessed with (...) a single question (visual analogue scale 0–100), the questionnaire also covered several background variables.Participants and research context:The sample comprised graduating nursing students (n = 1796) from all participating countries. To get a comprehensive view about graduating nursing students’ moral courage, the views of nurse managers (n = 538) and patients (n = 1327) from the same units in which the graduating nursing students practised were also explored, with parallel questionnaires.Ethical considerations:Ethical approvals and research permissions were obtained according to national standards in every country and all participants gave their informed consent.Results:The mean of graduating nursing students’ self-assessed moral courage was 77.8 (standard deviation 17.0; on a 0–100 scale), with statistically significant differences between countries. Higher moral courage was associated with many factors, especially the level of professional competence. The managers assessed the graduating nursing students’ moral courage lower (66.5; standard deviation 18.4) and the patients slightly higher (80.6; standard deviation 19.4) than the graduating nursing students themselves.Discussion and conclusions:In all countries, the graduating nursing students’ moral courage was assessed as rather high, with differences between countries and populations. These differences and associations between moral courage and ethics education require further research. (shrink)