Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

People with dementia have previously not been active participants in research, with ethical difficulties often being cited as the reason for this. A wider inclusion of people with dementia in research raises several ethical and methodological challenges. This article adds to the emerging debate by reflecting on the ethical and methodological issues raised during an interview study involving people with dementia and their spouses. The study sought to explore the impact of living with dementia. We argue that there is support (...) for the inclusion of people with dementia in research and that the benefits of participation usually far outweigh the risks, particularly when a `safe context' has been created. The role of gatekeepers as potentially responsible for excluding people with dementia needs further consideration, with particular reference to the appropriateness of viewing consent as a primarily cognitive, universalistic and exclusionary event as opposed to a more particularistic, inclusive and context relevant process. (shrink)

This monograph on the capability approach does two things. First, it provides an advanced introduction to the capability approach, as an account used in philosophy, as well as other disciplines. Second, it provides an account of the capability approach which is able to encompass all existing views and theories on the capability approach, including the writings on the capability approach by Martha Nussbaum and Amartya Sen.

This paper offers a critique of Martha Nussbaum’s description of the capability approach, and offers an alternative. I will argue that Nussbaum’s characterization of the capability approach is flawed, in two ways. First, she unduly limits the capability to two strands of work, thereby ignoring important other capabilitarian scholarship. Second, she argues that there are five essential elements that all capability theories meet; yet upon closer analysis three of them are not really essential to the capability approach. I also offer (...) an alternative description of the capability approach, which is called the cartwheel view of the capability approach. This view is at the same time radically multidisciplinary yet also contains a foundationally robust core among its various usages, and is therefore much better able to make the case that the capability approach can be developed in a very wide range of more specific normative theories. Finally, the cartwheel view is used to argue against Nussbaum's claim that all capabilitarian political theory needs to be politically liberal. (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee in (...) Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

This paper examines the role of clinical practitioners and clinical researchers internationally in establishing the utility of harm-reduction approaches to substance use. It thus illustrates the potential for clinicians to play a pivotal role in health promoting structural interventions based on harm-reduction goals and public health models. Popular media images of drug use as uniformly damaging, and abstinence as the only acceptable goal of treatment, threaten to distort clinical care away from a basis in evidence, which shows that some ways (...) of using drugs are far more harmful than others and that punitive approaches and insistence on total abstinence as the only goal of treatment often increases the harms of drug use rather than reducing drug use. Therefore the leadership and scientific authority of clinicians who understand the health impact of harm-reduction strategies is needed. Through a review of harm-reduction interventions in Canada, the United Kingdom, the United States, Australia, Switzerland, and the Netherlands, we identify three ways that clinicians have helped to achieve a paradigm shift from punitive approaches to harm-reduction principles in clinical care and in drug policy: through clinical research to provide data establishing the effectiveness and feasibility of harm-reduction approaches, by developing innovative clinical programmes that employ harm reduction, and thereby changing the standard of care to include routine use of these evidence-based approaches in their practices. We argue that through promotion of harm-reduction goals and methods, clinicians have unique opportunities to improve the health outcomes of vulnerable populations. (shrink)

This article analyses the general ethical milieu in a nursing home for elderly residents and provides a decision-making model for analysing the ethical situations that arise. It considers what it means for the residents to live together and for the staff to be in ethically problematic situations when caring for residents. An interpretative phenomenological approach and Sandman’s ethical model proved useful for this purpose. Systematic observations were carried out and interpretation of the general ethical milieu was summarized as ‘being in (...) the same world without meeting’. Two themes and four subthemes emerged from the analysis. Three different ethical problems were analysed. The outcome of using the decision-making model highlighted the discrepancy between the solutions used and well-founded solutions to these problems. An important conclusion that emerged from this study was the need for a structured tool for reflection. (shrink)

En quoi le corps participe-t-il de l'entente que l'homme a du monde? Que signifie dès lors écouter? Comment établir un rapport juste à l'animal? Quel sens prêter aux couleurs? Pourquoi la tonalité décisive de notre rapport au monde peut-elle advenir à la faveur d'expériences olfactives et gustatives? En quoi la tactilité incite-t-elle à considérer le corps vif comme une donnée originaire et à reconnaître qu'il est bien une vulnérabilité dotée d'aptitudes qui nous dispose au monde? Comment l'angoisse, révélée et cachée (...) tout à la fois par la maladie, est-elle chevillée au corps de l'être-au-monde, le Dasein? Qu'en est-il du corps dans la nostalgie, dans la mélancolie, dans l'ennui et dans la joie? Pourquoi la coexistence, supposant relations et rencontres, implique-t-elle l'articulation des corporéités vives comme dans le tact sensitif ou dans la jalousie amoureuse et dans l'amour pensé en terme de tonalité érotique? Comment comprendre la mobilité et parvenir ainsi jusqu'à l'éminente dignité ontologique du mouvement? De quoi la pensée est-elle redevable au corps? Telles sont les questions qui jalonnent cet ouvrage. Par son orientation résolument phénoménologique, l'Intelligence du corps entend renouveler l'entente du phénomène le plus proprement humain et, cependant, le plus malmené par la métaphysique. Prenant librement appui sur les vues inouïes de Martin Heidegger, consciente de l'actuelle soumission du corps de l'homme à l'arraisonnement technique, Ingrid Auriol ouvre une voie d'accès à l'intelligence du corps libérée de cette violence. (shrink)

Do unto others -- Don't pester the pigeons -- Try it, you'll like it -- Be science fair -- Chicken out -- Save the whales -- Be good to bugs -- Fur is un-fur-giveable -- Don't pass the product tests -- Horsing around -- It's raining cats and dogs -- "Companimals" are priceless -- Pen pals for animals -- Watch out for animals -- Dump wasteful habits -- Free the fishes -- Art impact -- Help turtles out of trouble -- (...) Stick it to 'em! -- Call for compassion -- Check out the entertainment -- Dress to a 't' -- Sing for the animals -- Be an elefriend--get the elefacts -- Write on! -- Born free, bored stiff -- Saying goodbye to uninvited guests -- Talk to the animals -- Get your class into the act -- Hooray for holidays! -- Dressing cool to be kind -- Pig out! -- Take care of hot dogs -- Oh, deer! -- Give a well-come gift -- Critter chatter -- Pack a lunch with punch -- Be a bookworm -- Reflecting on dissecting -- Step up on your soapbox -- Lost and found -- It's your turn to set the table -- School's out -- Develop a good roadside manner -- Add a little spice to their lives -- Make sure fair is fair -- Get poetic -- Join the club -- Hang in there -- One last thing you can do to help the animals. (shrink)

Ethical dilemmas are part of medicine, but the type of challenges, the frequency of their occurrence and the nuances in the difficulties have not been systematically studied in low-income settings. The objective of this paper was to map out the ethical dilemmas from the perspective of Ethiopian physicians working in public hospitals. A national survey of physicians from 49 public hospitals using stratified, multi-stage sampling was conducted in six of the 11 regions in Ethiopia. Descriptive statistics were used and the (...) responses to the open-ended question “If you have experienced any ethical dilemma, can you please describe a dilemma you have encountered in your own words?” were analyzed using a template analysis process. A total of 587 physicians responded, and 565 met the inclusion criteria. Twelve of 24 specified ethically challenging situations were reported to be experienced often or sometimes by more than 50% of the physicians. The most frequently reported challenge concerned resource distribution: 93% agreed that they often or sometimes had to make difficult choices due to resource limitation, and 83% often or sometimes encountered difficulties because patients were unable to pay for the preferred course of treatment. Other frequently reported difficulties were doubts about doing good or harming the patient, relating to conflicting views, concern for family welfare, disclosure issues and caring for patients not able to consent. Few reported dilemmas related to end-of-life issues. The 200 responses to the open-ended question mirrored the quantitative results. Ethiopian physicians report ethical challenges related more to bedside rationing and fairness concerns than futility discussions and conflicts about autonomy as described in studies from high-income countries. In addition to the high report of experienced challenges, gravity of the dilemmas that are present in their narratives are striking. Recognition of the everyday experiences of physicians in low-income settings should prompt the development of ethics teaching and support mechanisms, discussion of ethical guidelines as well as increase our focus on how to improve the grave resource scarcity they describe. (shrink)

Journal of Economic Methodology, Volume 19, Issue 2, Page 159-163, June 2012.

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:You Can't Say "No" to That!(A "Difficult Patient" Story)Ingrid BergAs a sequela of COVID-19, my rural Wisconsin hospital has been jam-packed for months with patients for whom we routinely provide care and many for whom we do not. An exodus of health care workers and other constraints have made the transfer of critically ill patients very difficult. In this disquieting "new-normal" of our work life, we routinely must (...) call bigger cities throughout our state to find beds for complex patients.So, it was not surprising when a young patient, an IV drug user in sepsis from a heart infection, was admitted to me in the middle of the night. In less disheartening times, before the pandemic, this patient would have been transferred promptly to the big-city hospital. Now, though, the possibility of finding an open bed is next to impossible. Resigned, I placed admission orders, continued antibiotics and fluids, and crossed my fingers. Then the unexpected happened: a bed opened up, and we could send her at once!The patient had a harsh heart murmur. It was likely that a "vegetation" was clinging to the valve, between the right upper and lower chambers of her heart. A vegetation is a clump of debris, such as platelets, clotting proteins, and bacteria that is a menace to the body. Her chest imaging looked like her infection had already spread to her lungs.A definitive diagnosis for endocarditis requires a special ultrasound with a probe that goes down through the esophagus, a procedure performed by cardiologists. It's a serious infection, one that requires weeks of IV antibiotics and is best monitored by infectious disease specialists. Sometimes, cardiothoracic surgeons are called upon to strip away the infection at the site, depending on how badly the valve has been slayed or the size of the vegetation. My only recommendation for a young, otherwise healthy patient in this scenario, is transfer.All of these reasons for transfer were lolling around in my tired head when the night-time [End Page 14] nursing supervisor approached me and said, "We have a problem." When the patient was updated about the transfer, she balked: "She says she is tired and refusing to go," the supervisor began. "She doesn't feel like getting into an ambulance in the middle of the night and she doesn't care if her condition is life-threatening. She knows we can't force her to go and she will only talk about it again in the morning."The cartoon version of myself at that moment had bugged-out eyes, a dropped jaw, fists tight and clenched at my sides, and steam coming out of my head. I can look past a patient's self-neglect, poor medication adherence, abysmal communication, alcohol and drug addiction, and other crimes. But saying no to a bed at a tertiary care facility? Unacceptable!I marched down the quiet hallway and into her room. She was lying on her side, facing the door, one IV in a thin arm. I was confident I could reason with her once I explained the scarcity of beds and the medical necessity of transfer. But she was having none of it. I was calm until I could no longer maintain my cool: "You can't give up this bed!""Maybe in the morning," she insisted, yawning. "But not now. I am tired and want to rest!""But there might not be a bed in the morning," I countered. "And your infection can be life-threatening." (This is true, but we both knew she wasn't dying at this very moment.)"I am not going anywhere!" She raised her voice and then closed her eyes.And she was right. I had no choice but to keep her. I could not kick her out of the hospital because she was making a poor choice, and I was frustrated for having to manage the fallout of that decision. Giving her antibiotics and fluid boluses to bolster her blood pressure was certainly within my scope of practice. And fretting. Fretting is always within my scope of practice; not that my scope of practice matters when all the big... (shrink)

One of the most important issues today is the conflict between identity groups. Can the concept of toleration provide resources for thinking about this? The standard definition of toleration – rejection or disapproval of a practice or belief followed by a constraint of oneself from repressing it –has limits. If we seek to make political and social conditions of toleration among diverse people a stable reality, we need to flesh out more deeply and widely what that depends upon. The essence (...) to which it has been reduced was not toleration’s original impulse. In the sixteenth century, the objective was to create conditions of peaceful collective life among diverse groups of believers. I examine one strand of change in moral valuation underpinning political toleration: ideas about the body, time and the self as explored by Michel de Montaigne. We can extract from this analysis a way to think about grounding toleration today: a recognition of the value of particular, embodied selves. (shrink)

During the past decade, screening tests using computed tomography have disseminated into practice and been marketed to patients despite neither conclusive evidence nor professional agreement about their efficacy and cost-effectiveness at the population level. This phenomenon raises questions about physicians' professional roles and responsibilities within the setting of medical innovation, as well as the appropriate scope of patient autonomy and access to unproven screening technology. This article explores how physicians ought to respond when new screening examinations that lack conclusive evidence (...) of overall population benefit emerge in the marketplace and are requested by individual patients. To this end, the article considers the nature of evidence and how it influences decision-making for screening at both the public policy and individual patient levels. We distinguish medical and ethical differences between screening recommended for a population and screening considered on an individual patient basis. Finally, we discuss specific cases to explore how evidence, patient risk factors and preferences, and physician judgment ought to balance when making individual patient screening decisions. (shrink)

Continuing medico-technical progress has led toan increasing medicalisation of pregnancy andchildbirth. One of the most common technologiesin this context is ultrasound. Based on someidentified `pro-technology feminist theories',notably the postmodernist feminist discourse,the technology of ultrasound is analysedfocusing mainly on social and political ratherthan clinical issues. As empirical researchsuggests, ultrasound is welcomed by themajority of women. The analysis, however, showsthat attitudes and decisions of women areinfluenced by broader social aspects. Furthermore, it demonstrates how the visualtechnology of ultrasound, in addition to otherreproductive technology (...) in maternity care, islinked to the `personification' of the foetusand has therefore contributed to a new image ofthe foetus. The exploration of these issueschallenges some arguments of feministdiscourse. It draws attention to possibleadverse implications of the technology forwomen's reproductive freedom and indicates theimportance of the topic for politicaldiscussions. (shrink)

With more than two million members and supporters, People for the Ethical Treatment of Animals (PETA) is the world’s largest animal-rights organization, and its founder and president, Ingrid Newkirk, is one of the most well-known and most effective activists in America. She has spearheaded worldwide efforts to improve the treatment of animals in manufacturing, entertainment, and elsewhere. Every day, in laboratories, food factories, and other industries, animals by the millions are subjected to inhumane cruelty. In this accessible guide, Newkirk (...) teaches readers hundreds of simple ways to stop thoughtless animal cruelty and make positive choices. For each topic, Newkirk provides hard facts, personal insight, inspiration, ideas, and resources, including: • How to eat healthfully and compassionately • How to adopt animals rather than support puppy mills • How to make their vote count and change public opinion • How to switch to cruelty-free cosmetics and clothing • How to choose amusements that protect rather than exploit animals. With public concern for the well-being of animals greater than ever—particularly among young people—this timely, practical book offers exciting and easy ways to make a difference. (shrink)

In the philosophy of well-being, there is hardly anything written on the lives of people with autism or on the question whether existing philosophical theories of well-being are suited for understanding how well the lives of autistic persons are going. This paper tries to make some progress towards filling this gap. I start by giving a concise account of autism, which highlights the huge heterogeneity among autistics. I discuss some basic features of autism, ask whether there are good reasons why (...) we would need an account of well-being specifically for autistics and what philosophical well-being research could learn from being informed by autistic experiences and phenomenology. I then investigate to what extent the capability approach gives us a helpful theory of well-being for autistics, and what looking through an autism-lens can contribute to the further development of the capabilitarian well-being. In particular, I show that some capabilities that are crucially relevant for autistics are also relevant for the lives of non-autistic people. The final part of the paper looks at an important difficulty in using the capabilitarian account of well-being for autistics, namely: should the normative focus be on achievements (functionings) or real opportunities (capabilities)? (shrink)

Having Too Much is the first academic volume devoted to limitarianism: the idea that the use of economic or ecosystem resources should not exceed certain limits. This concept has deep roots in economic and political thought. One can find similar statements of such limits in thinkers such as Plato, Aquinas, and Spinoza. But Having Too Much is the first time in contemporary political philosophy that limitarianism is explored at length and in detail. Bringing together in one place the best writing (...) from key theorists of limitarianism, this book is an essential contribution to political philosophy in general, and theories of distributive justice in particular. Including some of the key published articles as well as new chapters, Having Too Much is necessary reading for scholars and students of political theory and philosophy, as well as anyone interested in questions of distributive justice. (shrink)

Are global poverty and inequality on the rise or are they declining? And is the quality of life of the world's poorest people getting worse or better? These questions are often given conflicting answers by economists, the World Bank, and social activists. One reason for this is that assessments of quality of life can be made in terms of people's income, their resources, or their functionings and capabilities. This essay discusses the pros and cons of these evaluative approaches, and it (...) argues that all approaches have complementary strengths and should therefore in principle all be considered. Moreover, being aware that assessments of poverty and inequality can be made using these different frameworks helps us to understand the conflicting claims. (shrink)

People who make graveside promises consider themselves bound by them, which raises the question of whether a promise can morally obligate a promisor directly to a promisee who cannot acknowledge the promise. I show that it can by using the theoretical framework provided by “transaction accounts” of promising. Paradigmatically, these accounts maintain that the creation of a promissory obligation requires that the promisee consent to the promise. I extend these accounts to capture promises made by proxy and self-promises, and conclude (...) that we can make promises to absent promisees when we bear responsibility for their moral and personal development. (shrink)

Christian Jakob Kraus (1753–1807), political economist and Professor of Practical Philosophy at the University of Königsberg, has long been neglected by historians, dismissed as a translator, a teacher, and a derivative disciple of Adam Smith. This article posits sociability as a useful category for understanding Kraus’s life, thought, and legacy. It aims to thereby reposition him as a meaningful figure in the late German Enlightenment. First, Kraus is presented as a natural Einsiedler who, surrounded by the commercially vibrant Königsberg, comes (...) to champion a methodology foregrounding praxis, lived experience, and the application of ideas for communal benefit. This ‘sociable’ approach to knowledge is contextualised within broader critiques of scholarly esotericism across Germany. Second, his work is treated as a case study elucidating the interdependence of individualism and sociability in the wider European Enlightenment. I argue that Kraus expressed a ‘sociable individualism,’ drawing upon Smith and Immanuel Kant, which harmonised autonomy and community. (shrink)

Abstract:This article employs the concept of “transformative experience” to develop a radical version of aesthetic cognitivism, according to which engaging with literary perspectives might lead the reader to experience not only an epistemic but also a personal transformation. It is argued that the reader’s imaginative and empathic abilities when subjected to the aesthetic norms that govern a literary work can mobilize other aspects of their psychology, eliciting in this way a change in their core values and, consequently, in the way (...) in which they engage with the world. After introducing the topic (section 1), the article discusses the scope of literary perspectives in terms of the character’s subjective experiences (section 2). Next, it offers an analysis of the depth of literary perspectives in terms of the degree of involvement of the reader’s imaginative and empathic abilities (section 3). It proceeds to examine how the interplay between the scope and depth in the reader’s engagement with a literary perspective can explain their epistemic and personal transformation (section 4). In the final part, the article analyzes how the personal transformation changes the reader’s value system (section 5). The main findings are summarized in the conclusion (section 6). (shrink)

The aim of this study is to understand how governance mechanisms in cross-sector collaborations (CSCs) for sustainability affect value creation and capture and subsequently the survival of this organizational form. Drawing on a longitudinal, participatory, single-case study of collaborative action in the textile industry, we identify three governance mechanisms—safeguarding, bundling and connecting—that coevolve with the rising and waning of collaborative tensions and the shifting levels of action in the CSC we studied. These mechanisms aided value creation and helped facilitate private (...) value capture. We integrate these insights into a process model that visualizes the interplay between governance mechanisms of tensions and systems of value creation and capture in CSCs for sustainability. Our study contributes to the cross-sector collaboration literature by providing a dynamic and nuanced understanding of how governance mechanisms influence outcomes in CSCs for sustainability. We also add to the business model for sustainability literature by theorizing the value creation and capture system of collaborative rather than individual organizations. Our findings have important implications for policymakers who fund collaborative organizations and practitioners who manage or participate in them. (shrink)

This article reveals a 91-year-old cognitively intact man’s lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient’s basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played (...) the role of an ‘old cognitively impaired man’, which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver’s ability to respect and confirm each and every patient for who he or she is and would like to be. (shrink)

The paper at hand analyzes the economic implications of service robots as expected important future technology. The considerations are embedded into global trends, focusing on the interdependencies between services and industry not only in the context of the provision of services but already starting at the level of the innovation process. It is argued that due to the various interdependencies combined with heterogenous application fields, the resulting implications need to be contextualized. Concerning the net labor market effects, it is reasonable (...) to assume that the field of service robotics will generate overall job creation that goes along with increasing skill requirements demanded from involved employees. It is analyzed which challenges arise in evaluating and further developing the new technology field and some policy recommendations are given. (shrink)

This study investigated attitudes toward the use of deception in negotiation, with particular attention to the distinction between deception regarding the informational elements of the interaction (e.g., lying about or misrepresenting needs or preferences) and deception about emotional elements (e.g., misrepresenting one's emotional state). We examined how individuals judge the relative ethical appropriateness of these alternative forms of deception, and how these judgments relate to negotiator performance and long-run reputation. Individuals viewed emotionally misleading tactics as more ethically appropriate to use (...) in negotiation than informational deception. Approval of deception predicted negotiator performance in a negotiation simulation and also general reputation as a negotiator, but the nature of these relationships depended on the kind of deception involved. (shrink)

Pragmatic difficulties are considered a hallmark of autism spectrum conditions (ASC), but remain poorly understood. We discuss and evaluate existing hypotheses regarding the literalism of ASC individuals, that is, their tendency for literal interpretations of non‐literal communicative intentions. We present evidence that reveals a developmental stage at which neurotypical children also have a tendency for literalism and suggest an explanation for such behaviour that links it to other behavioural, rule‐following, patterns typical of that age. We discuss evidence showing that strict (...) adherence to rules is also widespread in ASC, and suggest that literalism might be linked to such rule‐following behaviour. (shrink)

This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients’ possibly harmful choices is discussed, the focus is on ‘forced’ autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively (...) participate neither in the treatment offered nor in making choices regarding that treatment. Nurses’ demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person’s autonomy is also respect for the person, one’s respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second- order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why. (shrink)

Utilizes Heidegger in rethinking common environmental paradigms.

Choosing a compassionate lifestyle that makes you feel good and positively impacts on the environment and on animals has never been easier. In this practical and accessible handbook, loaded with resources for all products that are mentioned, Ingrid Newkirk presents fabulous options that will not only enhance your life, but those of your neighbors, your community, animals, and the earth itself. From comfortable home furnishings, to delicious foods, to fashionable clothing there are a myriad of choices to be made (...) that can have a lasting positive effect on the well-being of animals and the environment, including: - recognizing hidden animal ingredients in cosmetics and household products - raising ecologically aware and animal-friendly kids - creating healthy, environmentally-friendly meals for everyday and special occasions - dressing with style without using leather or other animal products - dealing kindly with mice, insects, and other 'pests' in home or garden - adopting the right animal companion for you - volunteering and investing in eco- and animal-friendly companies - traveling with Eco-consciousness. (shrink)

Two theme–setting quotations introduce this essay—that of Yeats's falcon, deaf to the falconer's call, adrift in space above the blood–dimmed tide, counterpoised to Pierre Teilhard de Chardin's call to abandon old nationalistic prejudices and build the earth. With primary references to the thought of Teilhard, along with, among others, to Ewert Cousins, Andrew M. Greeley, Karl Jaspers, Marshall McLuhan, Ilya Prigogine, Karl Rahner, Leonard Swidler, David Tracy, and Alfred North Whitehead, I argue that the most crucial intellectual paradigm shift of (...) the twenty–first century will challenge humanity to take the turn from uncritical attachment to rigid absolutism or atomistic fragmentation toward a sense of open–ended, off–centered centeredness and fluid connections—from a static to a dynamic model of reality. Central to my argument is the Teilhardian reinterpretation of the Christian metaphors of creation, fall, incarnation, salvation, and the eschaton in the evolutionary terms of the emergence of cosmic consciousness from the chrysalis of the world of the past—from chaos to order, from biosphere via noosphere to theosphere. Facilitated by the exponential growth of populations, collaborative research, science, technology, and global communication (most dramatically manifested by the Internet), this emergent understanding of what it means to be human can, first, foster the awareness that in humanity evolution has become conscious of itself, and then, gradually, precipitate the formation of “the global village” (the mystical body of Christ), as respectful dialogue replaces diatribe and the dualistic pugilism of Samuel Huntington's “Clash of Civilizations” is gradually transformed into a nonadversarial mentality that values shared humanity and a common purpose. Thus, eons hence, empowered by love–energy, the transmutation of the human into the ultra–human can take the ultimate quantum leap into a yet higher dimension where spirit/energy is no longer in need of flesh/mass, and Earth can be safely left behind. (shrink)