Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights and (...) challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

How should one react when one has a belief, but knows that other people—who have roughly the same evidence as one has, and seem roughly as likely to react to it correctly—disagree? This paper argues that the disagreement of other competent inquirers often requires one to be much less confident in one’s opinions than one would otherwise be.

This paper explores an initially attractive principle connecting beliefs in general with beliefs about what beliefs are rational. The principle turns out to be violated by intuitively rational beliefs in some situations. The paper lays out some options for reacting to this fact.

Formally inclined epistemologists often theorize about ideally rational agents—agents who exemplify rational ideals, such as probabilistic coherence, that human beings could never fully realize. This approach can be defended against the well-known worry that abstracting from human cognitive imperfections deprives the approach of interest. But a different worry arises when we ask what an ideal agent should believe about her own cognitive perfection (even an agent who is in fact cognitively perfect might, it would seem, be uncertain of this fact). (...) Consideration of this question reveals an interesting feature of the structure of our epistemic ideals: for agents with limited information, our epistemic ideals turn out to conflict with one another. This suggests that we must revise the way we see ideal agents in epistemic theorizing. (shrink)

Præsentation af Johannes Hohlenberg -- Udvalgte artikler af Johannes Hohlenberg i J.A.I.-Bladet 1935-1936 -- Johannes Hohlenberg i perspektiv.

It is commonly acknowledged that, in order to test a theoretical hypothesis, one must, in Duhem' s phrase, rely on a "theoretical scaffolding" to connect the hypothesis with something measurable. Hypothesis-confirmation, on this view, becomes a three-place relation: evidence E will confirm hypothesis H only relative to some such scaffolding B. Thus the two leading logical approaches to qualitative confirmation--the hypothetico-deductive (H-D) account and Clark Glymour' s bootstrap account--analyze confirmation in relative terms. But this raises questions about the philosophical interpretation (...) of the technical conditions these accounts describe. What does it mean to say that E confirms H "relative to B"? How should we interpret the relation we are trying to analyze? (shrink)

This inclusive cross-cultural study rethinks the nexus between engineering education and context. In so doing the book offers a reflection on contextual boundaries with an overall boundary crossing ambition and juxtaposes important cases of critical participation within engineering education with sophisticated scholarly reflection on both opportunities and discontents. Whether, and in what way engineering education is or ought to be contextualized or de-contextualized is an object of heated debate among engineering educators. The uniqueness of this study is that this debate (...) is given comprehensive coverage - presenting both instrumentally inclined as well as radical positions on transforming engineering education. In contextualizing engineering education, this book offers diverse commentary from a range of disciplinary, meta- and interdisciplinary perspectives on how cultural, professional, institutional, and educational systems contexts shape histories, structural dynamics, ideologies and challenges as well as new pathways in engineering education. Topics addressed include examining engineering education in countries ranging from India to America, to racial and gender equity in engineering education and incorporating social awareness into the area. Using context as "bridge" this book confronts engineering education head on. Contending engineering ideologies and corresponding views on context are juxtaposed with contending discourses of reform. The uniqueness of the book is that it brings together scholars from the humanities, the social sciences and engineering from Europe - both East and West - with the United States, China, Brazil, India and Australia. (shrink)

In order to reach a better understanding of relationships in pedagogical practices the authors believe their language about relationships needs to be broadened and deepened. This chapter draws upon American philosopher Harry G. Frankfurt who writes about ‘care’ and how what we care about represents a volitional drive. It explores his notion of love in relation to his notion of care, and elaborates more fully what is at stake in our pedagogical interactions. The chapter also offers some thoughts on why (...) a more complex theory of actions is needed in order to broaden and deepen our language of pedagogical relations and what this means for reimagining pedagogical relationships. Finally, it discusses two statements from two school leaders: ‘you have to give of yourself’ and keeping ‘an open door’. These led the authors to investigate some aspects of human relationships in education that are rarely touched upon in pedagogical literature. (shrink)

Oregon is the only state in the United States where a physician may legally prescribe a lethal dose of barbiturate for a patient intending suicide. The Oregon Death with Dignity Act was passed by voters in 1994 and came into effect after much legal wrangling in October of 1997. At the same time, a cabinetmaker named Pat Matheny was struggling with progressive weakness from amyotrophic lateral sclerosis, or ALS. I met with Pat and his family for a lengthy interview in (...) October 1998 in Coos Bay, Oregon, for a television news report on his decision to get a lethal prescription. Below is an extract from that interview. On the day this introduction was written, 10 March 1999, Pat took the prescribed lethal overdose of barbiturates and died at home. His illness was taking his voice, he could not move his hands or legs, and breathing was becoming very difficult. His mother told me he knew that was for him. (shrink)

Sterelny’s Thought in a Hostile World ([ 2003 ]) presents a complex, systematically structured theory of the evolution of cognition centered on a concept of decoupled representation. Taking Godfrey-Smith’s ([ 1996 ]) analysis of the evolution of behavioral flexibility as a framework, the theory describes increasingly complex grades of representation beginning with simple detection and culminating with decoupled representation, said to be belief-like, and it characterizes selection forces that drive evolutionary transformations in these forms of representation. Sterelny’s ultimate explanatory target (...) is the evolution of human agency. This paper develops a detailed analysis of the main cognitive aspects. It is argued that some of the major claims are not correct: decoupled representation as defined doesn’t capture belief-like representation, and, properly understood, decoupled representation turns out to be ubiquitous among multicellular animals. However, some of the key ideas are right, or along the right lines, and suggestions are made for modifying and expanding the conceptual framework. (shrink)

Im Gegensatz zum drei Jahre jüngeren Schelling, dem er sein Leben lang verbunden blieb, wird Steffens nach seinem Tod nahezu vergessen; in der landläufigen Überlieferung hat er als der Überbringer der Romantik nach Dänemark überlebt. Erst mit Beginn des 21. Jahrhunderts wird er als Naturforscher, als Philosoph und Universitätsreformer wiederentdeckt, nicht zuletzt auch im Diskurs-Zusammenhang um das Anthropozän. Steffens-Forscherinnen und Forscher aus Norwegen, Dänemark und Deutschland setzen sich mit dem romantischen Denken der Zeit, mit den Aspekten der nationalen Wiedergeburt in (...) Kultur, Politik und Wissenschaft auseinander, mit Naturgeschichte und Kunst: Marit Bergner, Marie-Theres Federhofer, Bernd Henningsen, Lore Hühn, Daniel Fulda, Norman Kasper, Jesper Lundsfryd Rasmussen, Jessika Piechocki, Anna Lena Sandberg und Elisabeth Décultot. (shrink)

Re-Imagining Relationships in Education re-imagines relationships in contemporary education by bringing state-of-the-art theoretical and philosophical insights to bear on current teaching practices. Introduces theories based on various philosophical approaches into the realm of student teacher relationships Opens up innovative ways to think about teaching and new kinds of questions that can be raised Features a broad range of philosophical approaches that include Arendt, Beckett, Irigaray and Wollstonecraft to name but a few Includes contributors from Norway, England, Ireland, Scotland, Spain, Sweden, (...) and the U.S. (shrink)

A letter protesting the publication of a homophobic rant in the Proceedings of the APA.

Background:Ethics rounds are one way to support healthcare personnel in handling ethically difficult situations. A previous study in the present project showed that ethics rounds did not result in significant changes in perceptions of how ethical issues were handled, that is, in the ethical climate. However, there was anecdotal evidence that the ethics rounds were viewed as a positive experience and that they stimulated ethical reflection.Aim:The aim of this study was to gain a deeper understanding of how the ethics rounds (...) were experienced and why the intervention in the form of ethics rounds did not succeed in improving the ethical climate for the staff.Research design:An exploratory and descriptive design with a qualitative approach was adopted, using individual interviews.Participants and research context:A total of 11 healthcare personnel, working in two different psychiatry outpatient clinics and with experience of participating in ethics rounds, were interviewed.Ethical considerations:The study was based on informed consent and was approved by one of the Swedish Regional Ethical Review Boards.Findings:The participants were generally positive about the ethics rounds. They had experienced changes by participating in the ethics rounds in the form of being able to see things from different perspectives as well as by gaining insight into ethical issues. However, these changes had not affected daily work.Discussion:A crucial question is whether or not increased reflection ability among the participants is a good enough outcome of ethics rounds and whether this result could have been measured in patient-related outcomes. Ethics rounds might foster cooperation among the staff and this, in turn, could influence patient care.Conclusion:By listening to others during ethics rounds, a person can learn to see things from a new angle. Participation in ethics rounds can also lead to better insight concerning ethical issues. (shrink)

A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five studies were included. The ethics support activities described were moral case deliberations and ethics rounds. Different qualitative and quantitative research methods were utilized. The results show that (a) participants felt that they gained an increased insight into (...) moral issues through systematic reflection; (b) there was improved cooperation among multidisciplinary team members; (c) it was uncertain whether clinical ethics support services led to better patient care; (d) the issue of patient and client participation is complex; and (e) the implementation process is challenging. Clinical ethics support services have mainly been studied through the experiences of the participating facilitators and healthcare professionals. Hence, there is limited knowledge of whether and how various types of clinical ethics support services influence the quality of care and how patients and relatives may evaluate clinical ethics support services. Based on the six excluded ‘grey zone articles’, in which there was an implicit focus on ethics reflection, other ways of working with ethical reflection in practice are discussed. Implementing and evaluating clinical ethics support services as approaches to clinical ethics support that are more integrated into the development of good practice are in focus. In order to meet some of the shortcomings of the field of clinical ethics support services, a research project that aims to strengthen ethics support in the mental health services, including patients’ and caregivers’ views on ethical challenges, is presented. (shrink)

For some time we have seen a shift away from direct marketing, a core feature and dominant exchange form in the alternative food world, towards a greater role for intermediation. Yet, we still need to better understand to what extent and in what ways new mediated Alternative Food Networks represent an evolution of or departure from core tenets of alternative food systems. This paper focuses on AFNs with new intermediaries that connect small-scale producers with urban end-consumers. Based on original research (...) in Frankfurt, Berlin, and Calgary, we analyze three different types of mediated AFNs: one driven by consumers, one by an external intermediary, and one by producers. Our cases include non-capitalist, capitalist, and alternative capitalist economic practices as identified by Gibson-Graham. Conceptually, we base our analysis on the three-pillar-model of alternative agri-food systems, which we further refine. Besides comparing our cases with each other, for heuristic purposes we also compare them with an ideal-type model that adheres to core tenets of alterity in all three pillars. Our empirical analysis shows that intermediary organizations can bring important benefits and that mediated AFNs are in principle able to hold true to the core tenets of alternative agri-food systems. However, it is very important to develop models of democratic control and ownership as well as economic arrangements in which created value is fairly shared. Only then can the potentials of new mediated models be realized while the pitfalls of the conventional systems they seek to replace be avoided. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

In recent decades, the Organisation for Economic Co-operation and Development has become a powerful forum for trade liberalization and regulatory harmonization. OECD members have worked to reconcile divergent national regulatory approaches, applying a single framework across sovereign states, in effect determining whose knowledge-making practices would guide regulatory action throughout the industrialized world. Focusing on US regulators, industry associations, and environmental groups, this article explores the participatory politics of OECD chemical regulation harmonization in the late 1970s to early 1980s. These efforts (...) were conditioned by differential institutional access and resources among stakeholders who sought to shape regulatory knowledge rules. Facing competing European and US approaches to chemical data—a minimum “base set” of test data versus case-by-case determinations—OECD members chose the European approach in 1980. However, US regulatory politics shifted with the election of President Reagan, prompting industry associations to lobby the US government to block the agreement. Examining the micropolitics of these standards in the making, I demonstrate that while long-term structures advantaged industrial actors, ideological alignment with the US government precipitated their decisive influence. The case illustrates the importance of attending to the distinctive politics of international harmonization and the effects on transnational knowledge-making and regulatory intervention. (shrink)

Background:To better understand the kinds of ethical challenges that emerge when using coercion in mental healthcare, and the importance of these ethical challenges, this article presents a systematic review of scientific literature.Methods:A systematic search in the databases MEDLINE, PsychInfo, Cinahl, Sociologicals and Web of Knowledge was carried out. The search terms derived from the population, intervention, comparison/setting and outcome. A total of 22 studies were included.Ethical considerations:The review is conducted according to the Vancouver Protocol.Results:There are few studies that study ethical (...) challenges when using coercion in an explicit way. However, promoting the patient’s best interest is the most important justification for coercion. Patient autonomy is a fundamental challenge facing any use of coercion, and some kind of autonomy infringement is a key aspect of the concept of coercion. The concepts of coercion and autonomy and the relations between them are very complex. When coercion is used, a primary ethical challenge is to assess the balance between promoting good and inflicting harm. In the included studies, findings explicitly related to justice are few. Some studies focus on moral distress experienced by the healthcare professionals using coercion.Conclusion:There is a lack of literature explicitly addressing ethical challenges related to the use of coercion in mental healthcare. It is essential for healthcare personnel to develop a strong awareness of which ethical challenges they face in connection with the use of coercion, as well as challenges related to justice. How to address ethical challenges in ways that prevent illegitimate paternalism and strengthen beneficent treatment and care and trust in connection with the use of coercion is a ‘clinical must’. By developing a more refined and rich language describing ethical challenges, clinicians may be better equipped to prevent coercion and the accompanying moral distress. (shrink)