This article is intended to raise the question of whether sacrifice can be regarded as constituting a deep ethical structure in the relationship between patient and carer. The significance of sacrifice in a patient-carer relationship cannot, however, be fully understood from the standpoint of the consistently utilitarian ethic that characterizes today’s ethical discourse. Deontological ethics, with its universal principles, also does not provide a suitable point of departure. Ethical recommendations and codices are important and can serve as general sources of (...) knowledge when making decisions, but they should be supplemented by an ethic that takes into consideration contextual and situational factors that make every encounter between patient and carer unique. Caring science research literature presents, on the whole, general agreement on the importance of responsibility and devotion with regard to sense of duty, warmth and genuine engagement in caring. That sacrifice may also constitute an important ethical element in the patient-carer relationship is, however, a contradictory and little considered theme. Caring science literature that deals with sacrifice/self-sacrifice indicates contradictory import. It is nevertheless interesting to notice that both the negative and the positive aspects bring out the importance of the concept for the professional character of caring. The tradition of ideas in medieval Christian mysticism with reference to Lévinas’ ethic of responsibility offers a deeper perspective in which the meaningfulness of sacrifice in the caring relationship can be sought. The theme of sacrifice is not of interest merely as a carer’s ethical outlook, but sacrifice can also be understood as a potential process of transformation towards health. The instinctive or conscious experience of sacrifice on the part of the individual patient can, on a symbolic level, be regarded as analogous to the cultic or religious sacrifice aiming at atonement. Sacrifice appears to the patient as an act of transformation to achieve atonement and healing. Atonement then implies finding meaningfulness in one’s suffering. The concept of sacrifice, understood in a novel way, opens up a deeper dimension in the understanding of suffering and makes caring in ‘the patient’s world’ possible. (shrink)

Hermeneutics and narration: a way to deal with qualitative data This article focuses a hermeneutic approach on the interpretation of narratives. It is based on the French philosopher Paul Ricoeur's theory of interpretation but modified and used within a caring science paradigm. The article begins with a presentation of the theoretical underpinnings of hermeneutic philosophy and narration, as well as Ricoeur's theory of interpretation, before going on to describe the interpretation process as modified by the authors. The interpretation process, which (...) consists of several stages, is exemplified and discussed using a single case from a larger study on suffering. The results of that study indicate that the struggle of suffering is perceived as a struggle formed between shame and dignity, and that nurses must engage in the process of preserving and restoring the dignity of their suffering patients. The authors suggest that Ricoeur's theory of interpretation is useful when trying to understand narrative data if the researcher realises that the process of distanciation, although central in Ricoeur's thinking, is not the goal of the process but rather a means to deal with the researcher's pre‐understandings. According to Ricoeur, distanciation is accomplished by putting the context aside and dealing with the text ‘as text’ and thereby explaining its meaning. Explanation thus becomes the dialectic counterpart to understanding in the interpretation process. The researchers further argue that distanciation must be followed by reflection, where the interpretations are linked back to the empirical context. (shrink)

Psychopathology in children cannot be understood without considering developmental processes and transactional relationships, particularly the relationship with caregivers. Time-limited intersubjective child psychotherapy is a developmental and transactional approach aimed at helping children and caregivers get back on healthier developmental trajectories. Core developmental processes, such as self-other-regulation and affect integration, are considered particularly important for healthy function and transactions with caregivers and contexts. Therefore, TIC seeks to strengthen core developmental processes in the child and the caregivers’ ability to scaffold the child’s (...) development. This is achieved through parallel child therapy and parent sessions. The current study is a qualitative study of parents’ experiences of change after TIC. The study explores parents’ perception of change in their child, themselves, and their transactions, and what they experienced as helpful in therapy.Materials and MethodsNine semi-structured qualitative interviews were conducted with parents of nine children aged 9–12 years with internalizing difficulties after completing TIC. The data were analyzed with thematic analysis.ResultsThe parents described positive changes in the children’s ability to understand, regulate and express themselves. The parents also described positive changes in their parenting, and for all nine children the parents reported positive changes in the transactions between themselves and the child. Most parents saw the parallel child and parental sessions as particularly important, while several parents mentioned play and the therapeutic focus.DiscussionParents’ description of changes after TIC indicate that the parents perceived their children as strengthened in core developmental processes important for intersubjective exchanges such as self-regulation and affect integration. In addition, parents saw their children and their own contributions more clearly, and their transactions were described as more supportive and positive.ConclusionThe results from this study give support to TIC as a developmentally supportive approach to therapy, with potential effects on children’s core developmental processes, their parents’ ability to both see and scaffold the child’s development and positive effects on the transactions between children and parents. The positive effects likely result from the integration of the different parts of TIC and the synergies taking place between them, rather than any one component by itself. (shrink)

The lack of consistency between people’s engagement in ethical issues and their food choices has received considerable attention. Consumption as “choice” dominates this discourse, understood as decision-making at the point of purchase. But ideas concentrating on individual choice are problematic when trying to understand how social and ethical issues emerge and are dealt with in the practices of buying and eating food. I argue in this paper that “consumer choice” is better understood as a political ideology addressing a particular way (...) in which everyday practices can be directed so as to solve social problems. It is a way that makes questions of power particularly challenging. Some assume consumer sovereignty, emphasizing consumer choice as a reflection of neoliberal deregulation and commercialization. Others worry that ongoing changes increase consumers’ powerlessness. None of these seem to capture that there is active regulation, where public as well as commercial and civil actors are making strong efforts to make people do the right thing—voluntarily. Labeling is the key measure. In practice, the individualized and rationalized model of responsibility depends not only on market opportunities, but even political and social expectations and trust. People may lack concrete capabilities and power to follow up on moral calls, but they may also have a different understanding of who is responsible and what is a “good deed,” or their actions may, in a Foucauldian sense, represent resistance. The paper will, with examples from European empirical studies, discuss how mobilization as well as inertia and disinterest emerge within specific political constellations and practical contexts. (shrink)

When people are asked to estimate the probabilities of uncertain events, they often neglect the additivity principle, which requires that the probabilities assigned to an exhaustive set of outcomes should add up to 100%. Previous studies indicate that additivity neglect is dependent on response format, self-generated probability estimates being more coherent than estimates on rating scales. The present study made use of eye-tracking methodology, recording the movement, frequency and duration of fixations during the solution of ten additivity problems and two (...) control tasks. Participants produced more non-additive estimates in the Scale format than in the Self-generated format. Self-generated estimates also led to longer decision time and a higher number of repeated inspections, suggesting a deliberate comparison process. In contrast, the Scale format seemed to encourage a case-based approach where each outcome is evaluated in isolation. (shrink)

This article explores the duality of law with regard to the LGBTQ+ community, examining both its historical regulation of non-heteronormative genders and sexualities and its contradictory potential to transcend such regulations over time. Situated within a postcolonial analytical framework, it undertakes a thematic overview and narrative appraisal of research materials, drawn from a diverse array of social science disciplinary intersections, spanning the timeline from 1990 to 2022, that expounds on the intricate and overlapping imbrications between law and the LGBTQ+ community (...) in India. It was observed that the extant academic deliberations on the subject are dispersed across disciplinary boundaries within the larger scope of humanities and social sciences, necessitating an integrative approach. By delving into the historical antecedents of the subject matter, the current findings are situated within four domains, namely: i) the colonial nexus; ii) the postcolonial public redress; and iii) other domains of sustained legal contestation, such as healthcare, workplace, media censorship, and the fraught terrain of identity and legal lexicon. (shrink)

This study presents findings from an ontological and contextual determination of the concept of dignity. The study had a caritative and caring science perspective and a hermeneutical design. The aim of this study was to increase caring science knowledge of dignity and to gain a determination of dignity as a concept. Eriksson’s model for conceptual determination is made up of five part-studies. The ontological and contextual determination indicates that dignity can be understood as absolute dignity, the spiritual dimension characterized by (...) responsibility, freedom, duty, and service, and relative dignity, characterized by the bodily, external aesthetic dimension and the psychical, inner ethical dimension. Dignity exists in human beings both as absolute and relative dignity. (shrink)

In this article, we present findings from a qualitative study examining how young women experience being long‐term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long‐term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative (...) methodological approach involving the analysis of interviews with 13 women, aged 16–29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long‐term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness. (shrink)

Due to constraints on institutional capacity and financial resources, the road to universal health coverage (UHC) involves difficult policy choices. To assist with these choices, scholars and policy makers have done extensive work on criteria to assess the substantive fairness of health financing policies: their impact on the distribution of rights, duties, benefits and burdens on the path towards UHC. However, less attention has been paid to the procedural fairness of health financing decisions. The Accountability for Reasonableness Framework (A4R), which (...) is widely applied to assess procedural fairness, has primarily been used in priority-setting for purchasing decisions, with revenue mobilization and pooling receiving limited attention. Furthermore, the sufficiency of the A4R framework’s four criteria (publicity, relevance, revisions and appeals, and enforcement) has been questioned. Moreover, research in political theory and public administration (including deliberative democracy), public finance, environmental management, psychology, and health financing has examined the key features of procedural fairness, but these insights have not been synthesized into a comprehensive set of criteria for fair decision-making processes in health financing. A systematic study of how these criteria have been applied in decision-making situations related to health financing and in other areas is also lacking. This paper addresses these gaps through a scoping review. It argues that the literature across many disciplines can be synthesized into 10 core criteria with common philosophical foundations. These go beyond A4R and encompass equality, impartiality, consistency over time, reason-giving, transparency, accuracy of information, participation, inclusiveness, revisability and enforcement. These criteria can be used to evaluate and guide decision-making processes for financing UHC across different country income levels and health financing arrangements. The review also presents examples of how these criteria have been applied to decisions in health financing and other sectors. (shrink)

In 2017, Ukraine’s Parliament passed legislation establishing a single health benefit package for the entire population called the Programme of Medical Guarantees,‎ financed through general taxes and administered by a single national purchasing agency. This legislation was in line with key principles for financing universal health coverage. However, health professionals and some policymakers have been critical of elements of the reform, including its reliance on general taxes as the source of funding. Using qualitative methods and drawing on deliberative democratic theory (...) and criteria for procedural fairness, this study argues that the acceptance and sustainability of these reforms could have been strengthened by making the decision-making process fairer. It suggests that three factors limited the extent of stakeholders’ participation in this process: first, a perception among reformers that fast-paced decision-making was required because there was only a short political window for much needed reforms; second, a lack of trust among reformers in the motives, representativeness, and knowledge of some stakeholders; and third, an under-appreciation of the importance of dialogic engagement with the public. These findings highlight a profound challenge for policymakers. In retrospect, some of those involved in the reform’s design and implementation believe that a more meaningful engagement with the public and stakeholders who opposed the reform might have strengthened its legitimacy and durability. At the same time, the study shows how difficult it is to have an inclusive process in settings where some actors may be driven by unconstrained self-interest or lack the capacity to be representative or knowledgeable interlocutors. It suggests that investments in deliberative capital (the attitudes and behaviours that facilitate good deliberation) and in civil society capacity may help overcome this difficulty. (shrink)

This World Bank Report offers a new conception of fair decision processes in health financing. It argues that such procedural fairness can contribute to fairer outcomes, strengthen the legitimacy of decision processes, build trust in authorities, and promote the sustainability of reforms on the path to health coverage for all.

Paul Ricoeur's hermeneutic phenomenology has proved to be very helpful in guiding nursing researchers’ qualitative analysis of interview transcripts. Modifying Ricoeur's philosophy, a number of nursing researchers have developed their own interpretive methods and shared them, along with their experience, with research community. Major contributors who published papers directly presenting their modifications of Ricoeur's theory include Rene Geanellos (2000), Lena Wiklund, Lisbet Lindholm and Unni Å. Lindström (2002), Anders Lindseth and Astrid Norberg (2004) and Pia Sander Dreyer and (...) Birthe D Pedersen (2009). The aim of this article was to delineate differences among these methods. Descriptive presentation of each method side by side makes clear the differences among them. In addition, Ricoeur's hermeneutic theory is portrayed and compared with the modifications. It is believed that differences that are found can stimulate further thoughts on how to apply Ricoeur's theory in qualitative research in nursing. (shrink)

Les Prolegomenes a la Philosophie de Platon sont un manuel d'ecole neoplatonicien. Il s'inspire d'un modele dont Proclus a du etre l'auteur, mais l'origine de ce texte est presque surement alexandrine et doit dater de la premiere moitie du Vle siecle. Cette oeuvre est essentielle pour comprendre comment etait diffuse l'enseignement platonicien, et pour mieux saisir le mouvement des idees de l'Antiquite finissante. Dans une importante introduction, L. O. Westerink a retrace l'histoire de l'ecole d'Alexandrie et celle du genre litteraire (...) de ces introductions a Platon et a Aristote. (shrink)

This junior/senior level text is devoted to a study of first-order logic and its role in the foundations of mathematics: What is a proof? How can a proof be justified? To what extent can a proof be made a purely mechanical procedure? How much faith can we have in a proof that is so complex that no one can follow it through in a lifetime? The first substantial answers to these questions have only been obtained in this century. The most (...) striking results are contained in Goedel's work: First, it is possible to give a simple set of rules that suffice to carry out all mathematical proofs; but, second, these rules are necessarily incomplete - it is impossible, for example, to prove all true statements of arithmetic. The book begins with an introduction to first-order logic, Goedel's theorem, and model theory. A second part covers extensions of first-order logic and limitations of the formal methods. The book covers several advanced topics, not commonly treated in introductory texts, such as Trachtenbrot's undecidability theorem. Fraissé's elementary equivalence, and Lindstroem's theorem on the maximality of first-order logic. (shrink)

Tuberculosis (TB) is a potentially fatal infectious disease that, in Aotearoa New Zealand (NZ), inequitably affects Asian, Pacific, Middle Eastern, Latin American, and African (MELAA), and Māori people. Medical research involving genome sequencing of TB samples enables more nuanced understanding of disease strains and their transmission. This could inform highly specific health interventions. However, the collection and management of TB isolate samples for research are currently informed by monocultural biomedical models often lacking key ethical considerations. Drawing on a qualitative kaupapa (...) Māori–consistent study, this paper reports on preliminary discussions with groups of Māori, Pacific, and Afghan people in NZ, whose communities have been harmed by TB and TB stigma. Participants’ discussions highlight key concerns and meanings that ought to inform the development of guidelines and a more robust consultative process for the governance of how TB isolate samples are collected and used both retrospectively and in future research. We argue for ethical processes to be culturally nuanced and community-generated, flexible and meaningful, and situated in relation to the physical and symbolic effects of TB. We discuss the significance of Indigenous data sovereignty, rights, and kāwanatanga (governorship) in shaping a multicultural data sovereignty model. (shrink)

Trope theory is a leading metaphysical theory in analytic ontology. One of its classic statements is found in the work of Donald C. Williams who argued that tropes qua abstract particulars are the very alphabet of being. The concept of an abstract particular has been repeatedly attacked in the literature. Opponents and proponents of trope theory alike have levelled their criticisms at the abstractness of tropes and the associated act of abstraction. In this paper I defend the concept of a (...) trope qua abstract particular by rejecting arguments that purport to show that tropes should not be understood as abstract and by arguing that the abstractness of tropes plays an indispensable role in one of our more promising trope-theoretic analyses of universals and of concrete objects. (shrink)

Modern scholars have been concerned with the hostility shown to Alexander by the Hellenistic schools of philosophy. Two literary portraits have been distinguished, the Peripatetic and the Stoic, the former deriving from Theophrastus' book on Callisthenes, or starting with this work the Peripatetics worked out a theory of and applied it to Alexander, in order to belittle his achievements. It was a case of giving sophisticated expression to the kind of crude resentment expressed by Demades.

The locus classicus for Plutarch's own views on his methods is in the Alexander He has begun by asking for the indulgence of his readers if they do not find all the exploits of Alexander and Caesar recounted by the biographer or if they discover him not reporting some famous incident in detail (); and he goes on to compare his own search for evidence which will indicate the kind of soul, with the activity of the painter, who, in order (...) to create a likeness, concentrates on the eyes and pays little attention to the other parts. Commentators and critics have been right to take this as a key text for the purpose of understanding Plutarch's attitude towards his biographical work; nevertheless there are other passages in the Lives where we can at least glimpse his attitude to his subject, and we can only see the Alexander-remarks in correct perspective if we take these other passages into account. I propose therefore, starting with the Alexander, to see how far these critical remarks apply to Plutarch's theory and practice elsewhere in the Lives. (shrink)

According to the Ars Amatoria the notorious rape took place on the occasion of a primitive dramatic entertainment staged in a theatre, in which the seats and furnishings were also primitive. There is no time for a description of the arts of the performers—a tibicen and a ludius—before the Romans, impatient for action, receive their signal from Romulus. Nor is there any mention of a god in whose honour the entertainment had been provided.

The concept of instantiation is realized differently across a variety of metaphysical theories. A certain realization of the concept in a given theory depends on what roles are specified and associated with the concept and its corresponding term as well as what entities are suited to fill those roles. In this paper, the classic realization of the concept of instantiation in a one-category ontology of abstract particulars or tropes is articulated in a novel way and defended against unaddressed objections.

Sexual violence against women is an issue of urgency that arises in all cultures locally, nationally, globally and transnationally. This problem has broad dimensions in both the public and private domains, both cases that are reported or not reported to law enforcement. Factually, the trend of this problem has been identified as increasing every year in Maluku, Indonesia. Therefore, the church requires serious attention to prevention and systematic treatment to overcome it. This sensitivity and awareness are a manifestation of the (...) church’s sense of calling and responsibility for the restoration of human dignity. The pastoral sermon service model is the church’s strategic approach to handling this problem. This research aimed to develop a model of pastoral sermons for victims of sexual violence against women in Maluku. This research focused on identifying and exploring the tragic experiences and impacts of sexual violence against women. Furthermore, a cross-cultural pastoral model was created for victims of violence.Contribution: This article provided a new perspective from the post-modern homiletics to approach social issues. This new homiletical approach to dealing with the problem of women’s sexual violence is one of the main focuses of ‘Women’s Theological Studies’ in HTS. (shrink)

Effective public policy to mitigate climate change footprints should build on data-driven analysis of firm-level strategies. This article’s conceptual approach augments the resource-based view of the firm and identifies investments in four firm-level resource domains to develop capabilities in climate change impact mitigation. The authors denote the resulting framework as the GISTe model, which frames their analysis and public policy recommendations. This research uses the 2008 Carbon Disclosure Project database, with high-quality information on firm-level climate change strategies for 552 companies (...) from North America and Europe. In contrast to the widely accepted myth that European firms are performing better than North American ones, the authors find a different result. Many firms, whether European or North American, do not just “talk” about climate change impact mitigation, but actually do “walk the talk.” European firms appear to be better than their North American counterparts in “walk I,” denoting attention to governance, information management, and systems. But when it comes down to “walk II,” meaning actual Technology-related investments, North American firms’ performance is equal or superior to that of the European companies. The authors formulate public policy recommendations to accelerate firm-level, sector-level, and cluster-level implementation of climate change strategies. (shrink)

Written not by a journalist or politician but rather by a theology professor with a Ph.D. in New Testament studies, Voting by the Bible: The Economic and Foreign Policy Issues begins with the assumption that God intended the Bible to give guidance to every area of life£including how governments should function. Derived from author Wayne Grudemþs magisterial Politics£According to the Bible, this book highlights those economic and foreign-policy issues that have dominated political debate recently. Throughout, author Wayne Grudem supports political (...) positions that would be called more 'conservative' than 'liberal.' However, 'it is important to understand that I see these positions as flowing out of the Bible's teachings rather than positions I hold prior to, or independently of, those biblical teachings,' he writes. 'My primary purpose in the book is not to be liberally or conservative, or Democrat or Republican, but to explain a biblical worldview and a biblical perspective on issues of politics, law, and government.' Concise yet carefully argued, this book is a must-read for any Christian concerned about current debates over the economy, the size and role of government, and the best way forward out of the current recession. Not every reader will agree with the book's conclusions. But by grounding his analysis deeply on Scripture, Grudem has equipped Christians to better understand and respond to some of today's key political debates wisely and in a manner consistent with their primary citizenship as members and ambassadors of the kingdom of God" -- Publisher description. (shrink)