Background Implementing person-centred care (PCC) in nursing homes is challenging due to a gap between theory and practice. Bridging this gap requires suitable education, which focuses on learning how to attune care to the values and preferences of residents and take moral, relational, and situational aspects into account. Staff’s stories about the care they provide (i.e. caring stories) may deliver valuable insights for learning about these aspects. However, there is limited research on using staff's narratives for moral learning. Objective This (...) study aims to provide insight into the perspectives of nursing staff on using their caring stories to learn about PCC. Research design In this qualitative research, we conducted two rounds of interviews with 17 participants working in nursing homes. We wanted to obtain nursing staff’s perceptions of working with their caring stories and the impact on PCC. Ethical considerations Participation was voluntary, and participants provided written consent. The study protocol is approved by The Institutional Review Board of the Medical Ethical Committee Leiden-Den Haag-Delft. Findings Working with caring stories enables nursing staff to provide PCC and improves job satisfaction. It increases awareness of what matters to residents, fosters information rich in context and meaning, and enhances voice and vocabulary. Through in-depth team reflections, nursing staff discussed the significant moments for residents, which centralizes the discussions on the moral quality of care. Discussion Working with caring stories fosters dialogue on PCC and enhances reflection on ethical situations in daily encounters, contributing to the moral development of nursing staff. Putting nursing staff’s narratives at the centre of learning suits their daily practice and intrinsic motivation. Therefore, the outcomes of this study are an addition to the existing literature about using narratives in long-term care. Conclusion Using nursing staff's narratives contributes to PCC and positively impacts nursing staff. We recommend using staff's caring stories as a vehicle for moral learning in the transition to PCC. (shrink)

Research skills are important for university graduates, but little is known about undergraduates’ motivation for research. In this study, self-efficacy beliefs and intrinsic motivation for several research activities were measured three times during an undergraduate research project. In order to promote self-efficacy for writing and collaboration, a collaboration script was developed and tested on half of the students. Twelve students were interviewed three times to gather in-depth information about motivational and self-efficacy beliefs. All measures except intrinsic motivation for research increased (...) significantly during the project. Interview results suggest that enactive mastery and positive social interdependence promoted self-efficacy. Feelings of relatedness seemed to promote intrinsic motivation for writing. Lack of autonomy and low perceived relevance may explain why motivation for research remained stable. The script had no impact on self-efficacy beliefs. Relatedness,... (shrink)

Environmental pollution, animal diseases, and food scandals have marked the agricultural sector in the Netherlands and elsewhere in the 1990s. The sector was high on the political and societal agenda and plans were developed to redesign the sector into a more sustainable direction. Generally, monitoring of the agricultural sector is done by means of quantitative indicators to measure social, ecological, and economic performance. To give more attention to the normative character of sustainable development, the Dutch Ministry of Agriculture, Nature, and (...) Food Quality requested for a participatory approach to evaluate Dutch agriculture, which was characterized by stakeholder workshops, dialogue, and learning. This article describes and reflects on this approach, using the Fourth Generation Evaluation framework developed by Guba and Lincoln (Fourth generation evaluation, 1989). Although there are several improvements to be made, the evaluation approach was successful in the way that it gave insight into perceptions, visions, and ambitions of agricultural stakeholders with regard to sustainability. It also encouraged learning about ways to make the agricultural sector more sustainable. And it contributed to the development of a monitoring approach that is complementary to the quantitative, indicator-based, evaluation approach that is generally used and that can be used every few years to see how perceptions and ambitions of stakeholders have developed. (shrink)

On the 24th of november 1991 the Belgian voters elected the 716 members of the nine provincial councils.The socialists are the biggest losers of this election, with the Volksunie as a close second. Also the Christian Democrats suffered a serious decline, mainly caused by the loss of the CVP in Flanders. The electoral gain of the Flemish Liberals is neutralized by the decline of the Liberal party in Wallonia. The Greens gain 32 seats, the Far Right 35. These national aggregates (...) hide striking regional differences. The national success of the Green is mainly due to the spectacular growth of Ecolo in the Walloons. The success of the Far Right is the sole result of a multiplication of votes for Vlaams Blok in Flanders. These results show that both the Flemish and the Walloon voters have sanctioned the traditional parties in a similar way. They opted, however, for totally different alternatives: the Flemish for the Far Right, the Walloons for the ecologists.The outcome of the provincial elections in the bilingual province of Brabant neatly mirrors these tendencies.In 1991 the outcome of the provincial elections showed a profile quite different from that of the national elections which were held on the same day. This is explained by the fact that the Flemish party Rossem, which won 3.2% of the votes, only ran for the national elections and not for the provincial elections. Hence, a considerable difference in voting behaviour on the national versus the local level. The comparison of the results of the national elections with those of the provincial confirms the claim that smaller parties generally score better at a lower level. In 1991 it can, however, not be said that the bigger parties did better on the national level. (shrink)

Despite the fact that various authors have expressed concern about a general decline of civic engagement in Western societies, other indicators portray a transition from traditional and formal participation formats to more informal participation forms. This replacement thesis, however, entails the question whether these new forms can still be regarded as a form of political participation. The Alternative Food Circles in Belgium can be considered as a typical grass-roots example of 'political consumerism', which is portrayed as a contemporary alternative for (...) institutionalised politics. In a member survey, 163 members of the Circles were questioned about their motives to participate. They clearly paid little attention to influencing the political system, but notions of solidarity and social change were clearl y present. This form of political consumerism therefore cannot be considered a full form of political participation, but it clearly is a form of 'life style politics'. (shrink)

Family values are argued to enable ethical family business conduct. However, how these arise, evolve, and how family leaders articulate them is less understood. Using an ‘identity work’ approach, this paper finds that the values underpinning identity work: arise from multiple sources, evolve in tandem with the context; and, that their articulation is relational and aspirational, rather than merely historical. Prior research mostly understood family values as rooted in the past and relatively stable, but our rhetorical analysis unlocks a more (...) dynamic and promising research direction advancing family business ethics. (shrink)

The goal of this paper is to introduce the false hope harms (FHH) argument, as a new concept in healthcare. The FHH argument embodies a conglomerate of specific harms that have not convinced providers to stop endorsing false hope. In this paper, it is submitted that the healthcare profession has an obligation to avoid collaborating or participating in, propagating or augmenting false hope in medicine. Although hope serves important functions—it can be ‘therapeutic’ and important for patients’ ‘self-identity as active agents’— (...) the presentation of false hope along the hope continuum entails a misconstrued balancing act. By not speaking up against unrealistic patient and family requests—including some requests for rights to try, resuscitative efforts in terminally ill patients, or other demands for non-beneficial treatments—healthcare providers precipitate harms, i.e., the FHH. These harms arise on both individual and communal levels and cannot be ignored. The goal of this paper is not to offer a definition of false hope, because the phenomenon of false hope is too complex for any simple definition. Instead, this paper seeks to make four points while outlining the FHH argument: consumer medicine and false hope are connected; providers and patients are very vulnerable in the system of consumer medicine; providers have a responsibility to stand up against false hope; and how the FHH argument could perhaps offer a footing to resist giving in to false hope. (shrink)

‘SWAMPLAB’ is a strong case for intuitive insights through arts, sciences, and technologies to engage the self and establish meaningful social interactions including humans and non-humans. While zigzagging through processes of privatization, globalization, ecological, economic, social and political challenges, the power of such residencies or labs stems from the interplay with the local context and its habitants, in this case, nature reserve De Zegge, a 111 hectares swamp in the Northern part of Belgium. Mediation and participation are a core condition (...) for the design of knowledge and engagement since without informed consent and participants understanding the nature of the process, no change is possible. The more individuals express and explore their knowledge through social encounters, narratives, and dialogs, the more crucial tacit knowledge can be shared. Making things disputable is another responsibility. In society at large, there are very few examples where people feel interconnected and yet at the same time can disagree. The notion of Swamplab is rather a call for wonderment, for not using each other as a stepping stone but setting up open dialogs, listening and reflecting together, playing around, tinkering, since messiness is allowed. Including non-humans, be they wolves, moles or avatars, and virtual agents, is key to cracking the individual resistance to change understandings, opinions, and behavior. The result may lead to deeper engagement and Buckminster Fuller’s “comprehensive anticipatory design science” or what Bruno Latour calls a “progressive composition of the good common world”. (shrink)

Background: Patient participation in clinical ethics support services has been marked as an important issue. There seems to be a wide variety of practices globally, but extensive theoretical or empirical studies on the matter are missing. Scarce publications indicate that, in Europe, patient participation in CESS varies from region to region, and per type of support. Practices vary from being non-existent, to patients being a full conversation partner. This contrasts with North America, where PP seems more or less standard. While (...) PP seems to be on the rise in Europe, there is no data to confirm this. This study sought a deep understanding of both habits and the attitudes towards PP in the Netherlands, including respondents’ practical and normative perspectives on the matter. Methods and Results: We developed a national survey on PP for Dutch CESS staff. Our survey comprised a total of 25 open and close-ended questions, focused on four topics related to PP goals of CESS, status quo of PP, ideas and ideals concerning PP, and obstacles for PP. Discussion: The four most important findings were that: Patient participation in Dutch CESS is far from standard. Views on patient participation are very much intertwined with the goals of ethics support. Hesitations, fears and perceived obstacles for PP were not on principle and Most respondents see PP as a positive opportunity, yet requiring additional training, practical guidance and experience. Conclusions: Various normative reasons require PP. However, PP seems far from standard and somewhat rare in Dutch CESS settings. Our respondents did not raise many principled objections to PP. Instead, reasons for the lack of PP are intertwined with viewpoints on the goals of CESS, which seemingly focus on supporting health care professionals. Training and practical guidance was thought to be helpful for gaining experience for both CESS staff and HCPs. (shrink)

Name der Zeitschrift: Journal of Ancient History Jahrgang: 4 Heft: 2 Seiten: 158-190.

Snyder’s book ‘Exploiting hope’ is as relevant as ever. His book is about the hope of desperate individuals seeking treatments that cannot be found in conventional medicine. The book engages with hope in the setting of phase I cancer trials, stem cell interventions, right-to-try laws and crowd funding, offering a new language to explain our discomfort with some of these quests. At the same time the book seems particularly relevant given current events. While despair and quests for novel interventions touched (...) only a few patients with specific conditions up to a year ago, they are now familiar to us all. Early on in the COVID-19 pandemic all of us probably experienced hope for interventions that could save us... (shrink)

Environmental pollution, animal diseases, and food scandals have marked the agricultural sector in the Netherlands and elsewhere in the 1990s. The sector was high on the political and societal agenda and plans were developed to redesign the sector into a more sustainable direction. Generally, monitoring of the agricultural sector is done by means of quantitative indicators to measure social, ecological, and economic performance. To give more attention to the normative character of sustainable development, the Dutch Ministry of Agriculture, Nature, and (...) Food Quality requested for a participatory approach to evaluate Dutch agriculture, which was characterized by stakeholder workshops, dialogue, and learning. This article describes and reflects on this approach, using the Fourth Generation Evaluation framework developed by Guba and Lincoln (Fourth generation evaluation, 1989). Although there are several improvements to be made, the evaluation approach was successful in the way that it gave insight into perceptions, visions, and ambitions of agricultural stakeholders with regard to sustainability. It also encouraged learning about ways to make the agricultural sector more sustainable. And it contributed to the development of a monitoring approach that is complementary to the quantitative, indicator-based, evaluation approach that is generally used and that can be used every few years to see how perceptions and ambitions of stakeholders have developed. (shrink)

In her first book, Marleen Rozemond explicates Descartes's aim to provide a metaphysics that would accommodate mechanistic science and supplant scholasticism.

This article presents a social learning perspective as a means to analyze and facilitate collective decision making and action in managed resource systems such as platforms. First, the social learning perspective is developed in terms of a normative and analytical framework. The normative framework entails three value principles, namely, systems thinking, experimentation, and communicative rationality. The analytical framework is built up around the following questions: who learns, what is learned, why it is learned, and how. Next, this perspective is used (...) to analyze two managed resource systems: Fishery management in Lake Aheme, Benin and water resources management in Gelderland, The Netherlands. To assess platform performance in resource use negotiation, emerging lessons from the case studies are combined with propositions concerning membership of platforms, accessibility of platform meetings, skills and relations of platform members, realization of platforms, and third party facilitation of platform activities. (shrink)

Lyman Tower Sargent has had a personal and professional impact upon me. I cannot separate the effects of reading his work from engaging with him as a mentor—and more. Hence, this piece will focus on personal and professional texts and their contexts. I revisit Sargent's “An Ambiguous Legacy: The Role and Position of Women in the English Eutopia,” an essay he contributed to my Future Females: A Critical Anthology. I include passages from my novels Oy Pioneer! and Oy Feminist Planets: (...) A Fake Memoir which describe protagonist Sondra Lear's relationship with Thurston Howell III, interactions stemming from my longstanding association with Sargent. I describe a prominent male scholar's positive—almost utopian—influence on what I am here calling a retrospective autobiographical portrait of the professor as a young woman. This piece emphasizes that a festschrift contribution is about reciprocity between author and honoree. (shrink)

The nurse asks the ethics consultant what can be done to stop the patient’s blogging. R.J.’s messages on the public forum are taking their toll on the care environment and the health care providers...

A pandemic may cause a sudden imbalance between available medical resources and medical needs where fundamental care to a patient cannot be delivered. Inability to fulfil a professional commitment to deliver care as needed can lead to distress among caregivers and patients. This distress is sometimes alleviated through mechanisms that hide the facts that care is rationed and not all medical needs are met. We have identified three mechanisms that jeopardise accountable and optimal allocation of resources: hidden value judgements that (...) allow rationing under the disguise of triage or prioritisation, disguised conflict of interest between societal and individual patient’s needs and concealed biases in the application of medical tools. Under these three pitfalls decisions of resource allocation and who gets treated are handled as medical decisions: normative decisions are concealed and perceived as falling with the realm of medical judgement. Value judgements and moral agency are hidden to offer a ‘false sense of medical judgement’, while in fact there are several ethical judgements and biases at stake. The three pitfalls entail hidden normative deliberation and are inappropriate for sustainable healthcare delivery and resource allocation. We believe it is necessary to maintain transparency in decision making under conditions of insufficient resources to maintain trust in professional care givers and secure fair treatment allocation. Recognition of the pitfalls, by applying our recommendations, may help to ensure transparent and accountable distribution of care and contribute to public acceptance of the ethics behind rationing. (shrink)

This chapter contains section titled: Descartes's Novel Conception of the Mind Dualism, Substances, and Principal Attributes Thinking Without a Body Principal Attributes and the Nature of Body Conclusion References and Further Reading.

In recent years more and more scholars of early modern philosophy have come to acknowledge that our understanding of Descartes’s thought benefits greatly from consideration of his intellectual background. Research in this direction has taken off, but much work remains to be done. Dennis Des Chene offers a major contribution to this enterprise. This erudite book is the result of a very impressive body of research into a number of late Aristotelian scholastics, some fairly well known, such as Suárez, others (...) quite obscure. Two thirds of the book is devoted to the Aristotelians, with occasional references to Descartes; the last third focuses on Descartes, although there still much Aristotelian ground is covered. Des Chene indicates three major themes for his book: natural change and agency, the structure of material substance, and finality. (shrink)

I argue that Descartes treated the action of body on mind differently from the action of mind on body, as was common in the period. Descartes explicitly denied that there is a problem for interaction but his descriptions of interaction seem to suggest that he thought there was a problem. I argue that these descriptions are motivated by a different issue, the seemingly arbitrary connections between particular physical states and the particular mental states they produce. Within scholasticism there was already (...) a (yet different) problem concerning action of body on mind. I offer a comparison between Descartes and the scholastics. (shrink)

The Clarke-Collins correspondence was widely read and frequently printed during the 18th century. Its central topic is the question whether matter can think. Samuel Clarke defends the immateriality of the human soul against Anthony Collins’ materialism. Clarke argues that consciousness must belong to an indivisible entity, and matter is divisible. Collins contends that consciousness could belong to a composite subject by emerging from material qualities that belong to its parts. While many early modern thinkers assumed that this is not possible, (...) this correspondence offers an unusually detailed discussion of this issue. Clarke rejects emergentism because real qualities of a composite must be homogeneous with the qualities of the parts. This rejection is based on considerations about the nature of causation. In addition, the disagreement derives in part from a disagreement between Clarke and Collins about the limits of our knowledge. (shrink)

In this paper I analyze Descartes's puzzling claim that the mind is whole in the whole body and whole in its parts, what Henry More called "holenmerism". I explain its historical background, in particular in scholasticism. I argue that like his predecessors, Descartes uses the idea for two purposes, for mind-body interaction and for the union of body and mind.

In the Monadology Leibniz has us imagine a thinking machine the size of a mill in order to show that matter can’t think. The argument is often thought to rely on the unity of consciousness and the notion of simplicity. Leibniz himself did not see matters this way. For him the argument relies on the view that the qualities of a substance must be intimately connected to its nature by being modifications, limitations of its nature. Leibniz thinks perception is not (...) a modification of matter because it is active and matter is passive. At the same time, there are traces in Leibniz of a different argument that relies on the notion of internal action, which may involve the notion of simplicity. Critics have sometimes charged that the Mill Argument is an argument from ignorance, but Leibniz was aware of this problem and made clear that he did not make that mistake. (shrink)

IN this paper I explain how Descartes's conception of the mind was novel in relation to Aristotelian scholasticism. I also argue against the standard view that Descartes believed in transparency of the mental, the view that one cannot make mistakes about one's own mental states.

The Clarke-Collins correspondence was widely read and frequently printed during the 18th century. Its central topic is the question whether matter can think, or be conscious. Samuel Clarke defends the immateriality of the subject of the mental against Anthony Collins’ materialism. This paper examines important assumptions about the nature of body that play a role in their debate. Clarke argued that consciousness requires an “individual being”, an entity with some sort of significant unity as its subject. They agree that body (...) does not have this type of unity, because it consists of actually distinct parts. (shrink)