Relatives play an important role in human reproduction according to evolutionary theories of reproductive behavior, but previous empirical studies show large differences in the effects of kin on fertility outcomes. In our paper we examine the effect of co-resident kin and non-kin on the length of birth intervals over the reproductive life course of Dutch women born between 1842 and 1920. We estimate Cox proportional hazard models for parity progression based on the presence of kin and non-kin in the household (...) while controlling for a large number of individual and community-level characteristics. We find that couples living with their brothers experienced shorter birth intervals whereas couples residing with a widowed father had relatively longer birth intervals. The effects of these types of kin on reproduction were most pronounced up to the birth of the fifth child, but not thereafter. We found no effect for mothers or other types of kin. (shrink)

This book explores the social practice of holding each other in our identities, beginning with pregnancy and on through the life span. Lindemann argues that our identities give us our sense of how to act and how to treat others, and that the ways in which we we hold each other in them is of crucial moral importance.

The Patient in the Family diagnoses the ways in which the worlds of home and hospital misunderstand each other. The authors explore how medicine, through its new reproductive technologies, is altering the stucture of families, how families can participate more fully in medical decision-making, and how to understand the impact on families of medical advances to extend life but not vitality.

In the Eudemian Ethics II 1, 1219a34–b8, Aristotle defines happiness as ‘the activity of a complete life in accordance with complete virtue’. Most scholars interpret a complete life as a whole lifetime, which means that happiness involves virtuous activity over an entire life. This article argues against this common reading by using Aristotle’s notion of ‘activity’ (energeia) as a touchstone. It argues that happiness, according to the Eudemian Ethics, must be a complete activity that reaches its end at any and (...) every moment. The upshot of this reading is that life reaches completeness within a lifetime and that death cannot be the requirement for making life complete. (shrink)

Introduction With an ageing population, end-of-life care is increasing in importance. The present work investigated characteristics and time trends of older peoples' attitudes towards euthanasia and an end-of-life pill. Methods Three samples aged 64 years or older from the Longitudinal Ageing Study Amsterdam (N=1284 (2001), N=1303 (2005) and N=1245 (2008)) were studied. Respondents were asked whether they could imagine requesting their physician to end their life (euthanasia), or imagine asking for a pill to end their life if they became tired (...) of living in the absence of a severe disease (end-of-life pill). Using logistic multivariable techniques, changes of attitudes over time and their association with demographic and health characteristics were assessed. Results The proportion of respondents with a positive attitude somewhat increased over time, but significantly only among the 64–74 age group. For euthanasia, these percentages were 58% (2001), 64% (2005) and 70% (2008) (OR of most recent versus earliest period (95% CI): 1.30 (1.17 to 1.44)). For an end-of-life pill, these percentages were 31% (2001), 33% (2005) and 45% (2008) (OR (95% CI): 1.37 (1.23 to 1.52)). For the end-of-life pill, interaction between the most recent time period and age group was significant. Conclusions An increasing proportion of older people reported that they could imagine desiring euthanasia or an end-of-life pill. This may imply an increased interest in deciding about your own life and stresses the importance to take older peoples' wishes seriously. (shrink)

This essay takes a close look at a species of care that is particularly needed by people with progressive dementias but that has not been much discussed in the bioethics literature: the activity of holding the person in her or his identity. It presses the claim that close family members have a special responsibility to hold on to the demented person's identity for her or him, and offers some criteria for doing this morally well or badly. Finally, it considers how (...) even those with dementia can hold others in their identities, and suggests that this kind of holding too can have great moral worth. (shrink)

Background: Troubled conscience among nurses and other healthcare workers represents a significant contributor to healthcare worker moral distress, burnout and attrition. While research in this area has examined critical care in hospitals, less knowledge has been obtained from long-term care contexts such as nursing homes, despite widely recognised challenges with regard to vulnerable patients, increasing workload and maintaining workforce sustainability among nurses. Objective: The aim of this study was to illuminate and interpret the meaning of the lived experience of troubled (...) conscience among registered nurses (RNs) working in nursing homes. Research design: This qualitative research employed narrative interviews with eight nurses to obtain essential meanings of their lived experiences of troubled conscience. The interview texts were analysed using a phenomenological hermeneutic approach. Ethical considerations: Participation was voluntary, informed and was conducted with written consent. The Norwegian Centre for Research Data approved the data processing of personal data. Findings: The analysis uncovered two themes: (1) troubled conscience means abandoning ideals, with the subthemes: failing dependent patients; being disloyal to colleagues; being inadequate in the performance of work tasks and (2) troubled conscience means facing realities, with the subthemes: accepting being part of the system; responding to barriers. Discussion: Troubled conscience meant experiencing continuous and simmering tension between one’s ideals and realities and feeling a drive to preserve accountability and one’s moral integrity. Endangered ideals were often under cross-pressure and included humanistic values, professional values, working life values and the values of the organisation. Conclusion: Nurses’ troubled conscience refers to a struggle, but also a force that plays out at various levels and arenas in long-term care. Openness and dialogue about how professional values and the welfare state’s intentions can be realised within the given framework are important for individual nurses’ occupational health as well as the quality of care provided to patients. (shrink)

Hilde Lindemann Nelson focuses on the stories of groups of people--including Gypsies, mothers, nurses, and transsexuals--whose identities have been defined by those with the power to speak for them and to constrain the scope of their actions. By placing their stories side by side with narratives about the groups in question, Nelson arrives at some important insights regarding the nature of identity. She regards personal identity as consisting not only of how people view themselves but also of how others (...) view them. These perceptions combine to shape the person's field of action. If a dominant group constructs the identities of certain people through socially shared narratives that mark them as morally subnormal, those who bear the damaged identity cannot exercise their moral agency freely.Nelson identifies two kinds of damage inflicted on identities by abusive group relations: one kind deprives individuals of important social goods, and the other deprives them of self-respect. To intervene in the production of either kind of damage, Nelson develops the counterstory, a strategy of resistance that allows the identity to be narratively repaired and so restores the person to full membership in the social and moral community. By attending to the power dynamics that constrict agency, Damaged Identities, Narrative Repair augments the narrative approaches of ethicists such as Alasdair MacIntyre, Martha Nussbaum, Richard Rorty, and Charles Taylor. (shrink)

Enthusiasm over technology is found among men. Or, at least, that is the impression we get from the main body of earlier research, which leaves us with an understanding of men as computer enthusiasts, while women are more reluctant and ‘rational’ in their relation to the computer. In this paper I will argue that women do in fact enjoy working with computers. The empirical material is from a study of a group of students taking a computer course. We will meet (...) women who enjoy working with computers, and explore how they express their pleasure in relation to the computer. Contrary to earlier claims that ‘computing is incompatible with being a girl’, we will find that many of the 21 women in this study are not afraid to articulate their pleasure in computing. (shrink)

This paper is a revised version of the essay that won the Zapffe Prize in 2017. -/- In «The Last Messiah» and On the tragic, Peter Wessel Zapffe suggests that humankind should cease to reproduce, as the meaning of life cannot be found and human life at its best is tragic. The theory has been criticized for assuming that the meaning of life must be explained by an external cause and implicitly asks for an infinite causal chain. In this paper, (...) I argue that it is possible to escape this critique by adding a new element to the definition of the tragic: namely, the insight that the tragic cannot come into existence if the subject does not demonstrate its greatness. Precisely because a human, on Zapffe’s understanding, must prove its brilliance if tragedy is to arise, I argue that the tragic cannot be devoid of meaning. In contrast, the individual seems to be provided with a tragic meaning of life, rather than being deprived of it. Furthermore, the new definition of the tragic affects Zapffe’s antinatalism, because a tragic meaning of life does not necessitate that humankind should cease to reproduce. Yet, the definition does not suggest that humans should reproduce either. Instead, it confronts us with the following question: Should one bring new life into the world, when the meaning of life only can be found in the tragic? (shrink)

If personhood involves the construction of a narrative identity, then what are we to say of someone who is seriously ill or disabled? How can her life have any narrative when she is unable to write one?

The authority of surrogates—often close family members—to make treatment decisions for previously capacitated patients is said to come from their knowledge of the patient, which they are to draw on as they exercise substituted judgment on the patient’s behalf. However, proxy accuracy studies call this authority into question, hence the Patient Preference Predictor (PPP). We identify two problems with contemporary understandings of the surrogate’s role. The first is with the assumption that knowledge of the patient entails knowledge of what the (...) patient’s choice of treatment would be. The second is with the assumption that a good decision reproduces the content of that choice. If we are right, then the PPP, helpful though it might be in guiding surrogates’ decisions, nevertheless would hold them to the wrong standards and in that way could add to, rather than relieve, the stress they experience as they try to do their job. (shrink)

Narratives have always played a prominent role in both bioethics and medicine; the fields have attracted much storytelling, ranging from great literature to humbler stories of sickness and personal histories. And all bioethicists work with cases--from court cases that shape policy matters to case studies that chronicle sickness. But how useful are these various narratives for sorting out moral matters? What kind of ethical work can stories do--and what are the limits to this work? The new essays in Stories and (...) Their Limits offer insightful reflections on the relationship between narratives and ethics. (shrink)

The primary contribution of feminism to bioethics is to note how imbalances of power in the sex‐gender system play themselves out in medical practice and in the theory surrounding that practice. I trace the ten‐year history of feminist approaches to bioethics, arguing that while feminists have usefully critiqued medicine's biases in favor of men, they have unmasked sexism primarily in the arena of women's reproductive health, leaving other areas of health care sorely in need of feminist scrutiny. I note as (...) well that feminist bioethicists have contributed very little to bioethical theory. In the second part of the paper I suggest two future directions for feminist bioethics. The first is to expand its critique of gender bias beyond reproductive medicine, devoting attention to the same issues raised by advances in biomedical technology as are taken up by mainstream bioethicists. The second is to develop bioethical theory that is more responsive than are mainstream moral theories to the social practices that subordinate women and minority groups. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: (...) We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

The essays in this volume critically analyze and revitalize agrarian philosophy by tracing its evolution in the classical American philosophy of key figures such as Franklin, Jefferson, Emerson, Thoreau, Dewey, and Royce.

The first decisive steps of medicine towards becoming a science in its present shape happen to coincide with “the rise of the novel” in the eighteenth century. Before this well known and in our days still growing scientific specialization of medicine, the connections between literature and medicine were both many and close. By reading and analyzing a contemporary novel, The Death of a Beekeeper by the Swedish author Lars Gustafsson (1978), this article is an attempt to explore to which extent (...) a fictional narrative about a unique case of cancer may illuminate challenges associated with the experience of serious illness. Our claim is that medicine might draw wisdom from literature, its ability to create connections through narrative, to illuminate the complexity of ethical dilemmas, and to intertwine symptoms, life stories, and contexts. We argue that by being in the company of literary narratives and philosophical questions, physicians as well as other health care professionals may acquire clinically relevant skills which help them reach the ethically defined goals of their profession. (shrink)

Machine generated contents note: -- Acknowledgements -- Disrupting the Impression of Stability in the Gender-Technology Relation -- Changing Images of Computers and its Users since 1980 -- Discursive Developments Within Computer Education -- Variations in Gender-ICT Relations Among Male and Female Computer Students -- Stories About Individual Change and Transformation -- Layered Meanings and Differences Within -- Is there an Elsewhere? -- References -- Endnotes -- Index.

ABSTRACT Do physicians have a duty to sustain the pregnancies of women who die during the first or second trimester? Physicians cannot simply assume that the woman would have wished the pregnancy to continue, nor (in the U. S., at any rate) is it clear that the state has any interest in fetal life before viability. The conditions for beneficence‐based duties of fetal rescue will often be unmet, both because sustaining the pregnancy is not always a clear gain to the (...) born child and because it may impose a substantial burden on the benefactor. And duties of special relationship cannot readily be applied in these cases, as it is difficult to see how the relationship between someone who no longer exists and someone who does not yet exist can breed special duties. Further, to draw on Marx's distinction between the architect, who builds purposefully, and the bee, who cannot help what she is doing, I argue that human pregnancy is in a number of respects purposeful, creative, and deliberate, and that postmortem pregnancy, which follows the model of the bee, is a destructive icon that undercuts women's agency. (shrink)

Naturalized bioethics represents a revolutionary change in how health care ethics is practised. It calls for bioethicists to give up their dependence on utilitarianism and other ideal moral theories and instead to move toward a self-reflexive, socially inquisitive, politically critical, and inclusive ethics. Wary of idealisations that bypass social realities, the naturalism in ethics that is developed in this volume is empirically nourished and acutely aware that ethical theory is the practice of particular people in particular times, places, cultures, and (...) professional environments. These essays situate the bioethicist within the clinical or research context, take seriously the web of relationships in which all human beings are nested, and explore a number of the different kinds of power relations that inform health care encounters. Naturalized Bioethics aims to help bioethicists, doctors, nurses, allied health professionals, disability studies scholars, medical researchers, and other health professionals address the ethical issues surrounding health care. (shrink)

In Poetics 13, Aristotle claims that the protagonist in the most beautiful tragedies comes to ruin through some kind of ‘failure’—in Greek, hamartia. There has been notorious disagreement among scholars about the moral responsibility involved in hamartia. This article defends the old reading of hamartia as a character flaw, but with an important modification: rather than explaining the hero's weakness as general weakness of will (akrasia), it argues that the tragic hero is blinded by temper (thumos) or by a pursuit (...) for fine, good and desirable things—that is, by what may be labelled ‘qualified’ weakness of will. The upshot is that hamartia ends up as being less blameworthy than ‘proper’ akrasia, but still explains why morally outstanding people are unsuitable for the most beautiful tragedies. (shrink)

Introducing the main theories of distributional justice the book covers utilitarianism and welfare economics, moving on to Rawls's social contract and the Sen/Nussbaum capability approach with a refreshingly readable style. There is a chapter covering the position of mothers and children in theories of justice. The book then studies empirical methods used in analysing the distribution of economic goods, covering Lorenz curves and inequality measures. The concepts of income, wealth and economic goods are comprehensively discussed, with a particular view to (...) their role in theories of justice. This book is an important read for economists and other social scientists, as well as philosophers who want to quantify social and economic justice. (shrink)

L’injustice est, chez Spinoza, transgression de la loi positive et la rébellion populaire toujours contraire à la loi : jamais la multitude ne peut être légitimée à se révolter. Pourtant elle est caractérisée comme specie juris, apparence ou fausse apparence de droit, contraire à l’interprétation vraie des lois. Gouvernants comme gouvernés sont donc capables d’injustice. Il faut donc expliquer ce à quoi sont tenus les uns comme les autres pour comprendre comment les normes juridiques sont produites.

This article explores Eli Sisters as a reinvigorated rogue who finds his artistic calling in Patrick deWitt’s The Sisters Brothers, published in 2011. With the help of insights from narratology and genre theory, the article provides a textual analysis of Eli’s discourse, perspective and behaviour. Eli casts a critical light on the senseless violence, unbridled greed, ecological devastation, and hyper-masculinity inherent to America’s Frontier myth. As a reinvigorated rogue, he raises questions about what it means to be human and reflects (...) upon morality. With hindsight, the rogue as an artist creates a generically hybrid narrative that parodically imitates and transforms the genre conventions of the Western and the picaresque tale. The article also draws attention to the power that Eli assigns to women in a story about male heroic conquest. These include otherworldly female figures from classical mythology and the brothers’ mother. (shrink)

Starting from the intuition, shared by many women, that the legal right to an abortion must be defended but that they themselves could never undergo one, I offer an account of why pregnancy is morally valuable and why, nevertheless, it is often permissible to end one. Developing the idea that human pregnancy centrally involves the activity of calling a fetus into personhood, I argue that the permissibility of stopping this activity hinges on the goodness or badness of one's moral luck.

Stories do many different kinds of moral work. Because they can depict time passing, feature certain details while downplaying others, draw connections among their internal elements, display causal relationships, and connect themselves to other stories, they are particularly well suited to the task of modeling a puzzling clinical situation. A story maps the situation's contours, picking out the details that, together, constitute the moral reasons for doing what may or must be done. When moral deliberators construct a story, they come (...) to understand the situation in a certain way, and that, in turn, guides their sense of how they should act in or with respect to it.But stories don't just represent situations‐they can also misrepresent them. For that reason, if we are to use stories as guides to action, we have to be sure we get them right. In what follows I offer three clinical situations that are either about to be or have already been narratively misrepresented. I'll explain how the stories go wrong, point out the undesirable consequences of acting on them, and offer alternative ways of depicting the situations that could bring them to a morally successful resolution. (shrink)

Este texto se centra en la génesis de las ciencias sociales a través de una reflexión analítico- descriptiva sobre la sistematización de la ciencia. La ciencia es una creación del ser humano y constituye la mejor herramienta para adquirir conocimientos acerca de su entorno, de sí mismo, del universo... Debe ser interdisciplinaria y para dar soporte a este empeño, hemos tenido que elegir, y hemos optado por comparar la sociología con la filosofía buscando aportaciones (implícitas o explícitas) de prestigiosos pensadores.

_ Source: _Volume 39, Issue 2, pp 139 - 164 The aim of the present study is to explore the significance of religiousness for patients suffering from first-episode psychosis. Our study is a thematic analysis. The study illustrates how the patients understood their hallucinations as mystical experiences. Even so, many of the patients describe their religiousness to be helpful in coping with their disorder, giving meaning to life as well as a relationship to a sacred figure. However, their religiousness often (...) contained religious omnipotent delusions, and built on hallucinations, displayed an unsecure relationship to the sacred figure. From a psychiatric point of view, the misinterpretation of hallucinations as mystical experiences may reinforce their delusional system and cause an obstacle to recovery. This misinterpretation may also cause problems for patients’ religious coping. Our findings underline the importance of taking patients’ religiousness into account in psychotherapy. (shrink)

Nowadays, special attention is given to the hazards associated with genetic engineering and new inventions in biotechnology, and in fear of severe consequences, researchers, institutions and governments are required to act responsibly. The term “responsibility” may be defined in numerous ways. The definition considered in this paper, is one we believe is in common use: “Generally speaking, a person has a special responsibility for a particular outcome if they knowingly brought it about and it would not exist if not for (...) what they did”. This concept of moral responsibility rests on what we term the three ‘I's’: individual, intentional and informed. Responsibility is individual in the sense that it must be directed towards someone. A second requirement of moral responsibility presupposes the ability to do otherwise, i.e. it presupposes each human being as an intentional actor, capable of acting according to his/her own free will. In order for someone to be responsible for their actions, the choice between alternatives must be informed. The article focus' on these three aspects of responsibility in order to reveal how difficult it is to apply and make sense of this definition with regard to new inventions in science. (shrink)

"Isms" can be misleading. . . . Whether negatively or positively intended, the terminal identification--the "ism"--bestows significance upon a category that may never have existed as a concept prior to the viral appendage of its "ism." "Feminism" is a word that expresses such semantic innovation. . . . Feminist aesthetics may well be the prologue of feminist theory understood more broadly. I shall argue that this is the case and that, indeed, feminist theory is at present hindered by the lack (...) of an adequate aesthetic theory. Current discussions of feminist aesthetics tend to be deconstructionist and piecemeal. We have barely begun to consider positively what the prominent features of feminist aeshtietcs--that is, an aesthetic theory that is feminist--would be. The problem is intensified by its frequent confusion with the quest for _a_ feminine aesthetics a distinction that must be clarified before proceeding further. (shrink)

An Invitation to Feminist Ethics is a hospitable approach to the study of feminist moral theory and practice. Designed to be small enough to be used as a supplement to other books, it also provides the theoretical depth necessary for stand-alone use in courses in feminist ethics, feminist philosophy, and women's studies. The "overviews" section introduces important concepts in feminist ethical theory and contrasts that theory with the standard moral theories. The "close-ups" section looks at three topics--bioethics, violence, and the (...) globalized economy--to help students put the theories presented in the Overviews section to practical use. (shrink)