This book reflects the growing influence of corpus linguistics in a variety of areas such as lexicography, translation studies, genre analysis, and language ...

Sustainability discourse offers a plethora of perspectives on the type of change needed to ensure a just development within planetary boundaries, and how that change could come about. Calls for radical transformations nonetheless underline the need to examine prevalent discursive structures in society, including challenging the 'ideology of growth', in order to formulate new and transformative policy approaches. Based on empirical insights as to how different actors - including grassroots, planners, officials and politicians - in Sweden perceive the transformations needed (...) to reach sustainability goals, this paper explores how narratives of change reproduce, make use of or show cracks in the eco-modern sustainability paradigm. (shrink)

Background:Providing oncological care to children is demanding and ethical issues concerning what is best for the child can contribute to moral distress.Objectives:To explore healthcare professionals’ experiences of situations that generate moral distress in Swedish paediatric oncology.Research design:In this national study, data collection was conducted using the Swedish Moral Distress Scale-Revised. The data analysis included descriptive statistics and non-parametric analysis of differences between groups.Participants and research context:Healthcare professionals at all paediatric oncology centres in Sweden were invited to participate. A total of (...) 278 healthcare professionals participated. The response rate was 89%.Ethical considerations:In its advisory statement, the Regional Ethical Review Board decided that the study was of such a nature that the legislation concerning ethical reviews was not applicable. All participants received written information about the aim of the study and confidentiality. Participants demonstrated their consent by returning the survey.Findings:The two situations with the highest moral distress scores concerned lack of competence and continuity of personnel. All professional groups reported high levels of disturbance. Nurses rated significantly higher frequencies and higher total Moral Distress Scale scores compared to medical doctors and nursing assistants.Discussion:Lack of competence and continuity, as the two most morally distressing situations, confirms the findings of studies from other countries, where inadequate staffing was reported as being among the top five morally distressing situations. The levels of total Moral Distress Scale scores were more similar to those reported in intensive care units than in other paediatric care settings.Conclusion:The two most morally distressing situations, lack of competence and continuity, are both organisational in nature. Thus, clinical ethics support services need to be combined with organisational improvements in order to reduce moral distress, thereby maintaining job satisfaction, preventing a high turnover of staff and ensuring the quality of care. (shrink)

Truth-telling in healthcare practice can be regarded as a universal communicative virtue; however, there are different views on what consequence it has for giving or diminishing hope. The aim of this article is to explore the relationship between the concepts of truth-telling and hope from a relational ethics approach in the context of healthcare practice. Healthcare staff protect themselves and others to preserve hope in the care of seriously sick patients and in end-of-life care. This is done by balancing truth-telling (...) guided by different conditions such as the cultural norms of patients, family and staff. Our main conclusion is that the balancing of truth-telling needs to be decided in a mutual understanding in the caring relationship, but hope must always be inspired. Instead of focusing on autonomy as the only guiding principle, we would like to propose that relational ethics can serve as a meaningful perspective in balancing truth-telling. (shrink)

The Hospital Ethical Climate Survey was developed in the USA and later shortened. HECS has previously been translated into Swedish and the aim of this study was to describe a process of translating and culturally adapting HECS-S and to develop a Swedish multi-professional version, relevant for paediatrics. Another aim was to describe decisions about retaining versus modifying the questionnaire in order to keep the Swedish version as close as possible to the original while achieving a good functional level and trustworthiness. (...) In HECS-S, the respondents are asked to indicate the veracity of statements. In HECS and HECS-S the labels of the scale range from ‘almost never true’ to ‘almost always true’; while the Swedish HECS labels range from ‘never’ to ‘always’. The procedure of translating and culturally adapting the Swedish version followed the scientific structure of guidelines. Three focus group interviews and three cognitive interviews were conducted with healthcare professionals. Furthermore, descriptive data were used from a previous study with healthcare professionals, employing a modified Swedish HECS. Decisions on retaining or modifying items were made in a review group. The Swedish HECS-S consists of 21 items including all 14 items from HECS-S and items added to develop a multi-professional version, relevant for paediatrics. The descriptive data showed that few respondents selected ‘never’ and ‘always’. To obtain a more even distribution of responses and keep Swedish HECS-S close to HECS-S, the original labels were retained. Linguistic adjustments were made to retain the intended meaning of the original items. The word ‘respect’ was used in HECS-S with two different meanings and was replaced in one of these because participants were concerned that respecting patients’ wishes implied always complying with them. The process of developing a Swedish HECS-S included decisions on whether to retain or modify. Only minor adjustments were needed to achieve a good functional level and trustworthiness although some items needed to be added. Adjustments made could be used to also improve the English HECS-S. The results shed further light on the need to continuously evaluate even validated instruments and adapt them before use. (shrink)

According to T. M. Scanlon's 'buck-passing' analysis of value, x is good means that x has properties that provide reasons to take up positive attitudes vis-à-vis x. Some authors have claimed that this idea can be traced back to Franz Brentano, who said in 1889 that the judgement that x is good is the judgement that a positive attitude to x is correct ('richtig'). The most discussed problem in the recent literature on buckpassing is known as the 'wrong kind of (...) reason' problem (the WKR problem): it seems quite possible that there is sometimes reason to favour an object although that object is not good and possibly very evil. The problem is to delineate exactly what distinguishes reasons of the right kind from reasons of the wrong kind. In this paper we offer a Brentano-style solution. We also note that one version of the WKR problem was put forward by G. E. Moore in his review of the English translation of Brentano's Vom Ursprung sittlicher Erkenntnis. Before getting to how our Brentano-style approach might offer a way out for Brentano and the buck-passers, we briefly consider and reject an interesting attempt to solve the WKR problem recently proposed by John Skorupski. (shrink)

BackgroundIn paediatric oncology, healthcare professionals face moral challenges. Clinical ethics support services, such as moral case deliberation, aim to assist them in dealing with these challenges. Yet, healthcare professionals can have different expectations and goals related to clinical ethics support services.MethodsIn this study, the perceptions held by healthcare professionals regarding the importance of possible outcomes of MCDs, prior to implementation of MCDs, were investigated. A multisite, cross-sectional, quantitative study was performed at all six Paediatric Oncology Centres in Sweden. Healthcare professionals (...) answered the Euro-MCD instrument with 26 potential MCD outcomes using a scale from Not important to Very important. Descriptive and comparative statistical analyses were carried out.ResultsAll outcomes were rated high, i.e., between 3.12 and 3.78. More open communication, developing skills to analyse ethically difficult situations, better mutual understanding, and deciding on concrete actions were rated as most important. Understanding of ethical theories and critical examination of policies were rated less important. Most often nursing assistants rated higher and physicians lower than the other professions did. Women and participants without previous experience of MCDs perceived outcomes as more important. There were differences between centres as one centre had significantly higher, and one centre had significantly lower ratings compared to the others.ConclusionIt is clear that healthcare professionals want MCDs to improve teamwork and skills in order to analyse and manage ethically difficult situations. When comparing to previous research about important MCD outcomes, there were similarities in what healthcare professionals consider to be important when handling moral challenges regardless of country and potential differences in healthcare settings and systems, such as paediatric vs. adult care. (shrink)

BackgroundIn childhood cancer care, healthcare professionals must deal with several difficult moral situations in clinical practice. Previous studies show that morally difficult challenges are related to decisions on treatment limitations, infringing on the child's integrity and growing autonomy, and interprofessional conflicts. Research also shows that healthcare professionals have expressed a need for clinical ethics support to help them deal with morally difficult situations. Moral case deliberations (MCDs) are one example of ethics support. The aim of this study was to describe (...) the MCD-related outcomes that healthcare professionals in childhood cancer care considered important, before MCDs were implemented, in order to facilitate the implementation of MCDs in childhood cancer care in Sweden.MethodsThis study is based on qualitative data. Healthcare professionals, mostly representing registered nurses, nursing assistants and physicians, working at childhood cancer care centres in Sweden, were invited to respond to the translated and content validated European MCD Outcomes Instrument, before participating in regular MCDs. Answers to the main open-ended question, included in the questionnaire, was analysed according to systematic text condensation.ResultsData was collected from 161 responses from the healthcare professionals. The responses included healthcare professionals’ perceptions of which MCD-related outcomes they found important for handling moral challenges. Three different themes of important outcomes from the analysis of the data are presented as follows:Interprofessional well-being in team interactionson a team level;Professional comfort when dealing with moral challengeson a personal level; andImproved quality of care for the child and the familyon a care level.ConclusionsHealthcare professionals in childhood cancer care considered it important that ethics support could enhance the well-being of interprofessional teams, support healthcare professionals on an individual level and improve quality of care. The results of this study can be used in current and future training for MCD-facilitators. When knowing the context specific important MCD-outcomes, the sessions could be adapted. Managers in childhood cancer care would benefit from knowing about the specific important outcomes for their target group because they could then create relevant working conditions for clinical ethics support. (shrink)

Honesty is essential for the care of seriously ill and dying patients. The current study aimed to describe how nurses experience honesty in their work with patients receiving palliative care at home. The interviews in this phenomenological study were conducted with 16 nurses working with children and adults in palliative home-based care. Three categories emerged from analyses of the interviews: the meaning of honesty, the reason for being honest and, finally, moral conflict when dealing with honesty. The essence of these (...) descriptions was that honesty is seen as a virtue, a good quality that a nurse should have. The nurses’ ethical standpoint was shown in the moral character they show in their work and in their intention to do good. This study could help nurses to identify different ways of looking at honesty to promote more consciousness and openness in ethical discussions between colleagues and other staff members. (shrink)

The procedures for structuring clinical ethics case reflections in a childhood cancer care setting are presented, including an eight-step model. Four notable characteristics of the procedures are: members of the inter-professional health care team, not external experts, taking a leading role in the reflections; patients or relatives not being directly involved; the model explicitly addressing values and moral principles instead of focussing exclusively on the interests of involved parties; using a case-based rather than principle-based method. By discusing the advantages and (...) disadvantages of the proposed procedures, our paper aims to contribute to the literature on models and procedures for ethical analysis that can be used in clinical settings. It is suggested that our proposed procedures have some advantageous features when it comes to promoting health care staff’s learning to structure their thinking about ethical issues. (shrink)

BackgroundOrganizations worldwide increasingly adopt inclusive talent management, and this approach appears to rhyme particularly well with the Nordic welfare model. Questions about its value remain understudied, however. The inclusive approach is rooted in positive psychology and focuses on recognizing each employee's individual talents and assessing whether they fit the long-term needs of the organization, since a fit is assumed to be associated with employees' wellbeing. In the present study, we test this assumption focusing specifically on a key talent management practice, (...) talent identification, and the social dimension of employee wellbeing.MethodData were collected through an employee survey conducted within the Finnish units of four international manufacturing organizations and analyzed using logistic regression.ResultsWe found that the recognition of individual talents for long-term deployment by the organization is positively associated with social wellbeing in terms of supervisor support and social climate in the work unit, as perceived by the employees.ConclusionOur results tentatively suggest that inclusive talent management creates value through the identification of employees' individual talents as this practice can be associated with their enhanced wellbeing. (shrink)

In this article, we develop critiques of the pipeline model which dominates Western science education policy, using discourse analysis of interviews with two Swedish young women focused on ‘identity work’. We argue that it is important to unpack the ways that the pipeline model fails to engage with intersections of gender, ethnicity, social class and nationality, and their impact on science and with debates about science as elitist and implicated in neoliberalism.

It is argued that Ross's Paradox in deontic logic is a problem which should be taken seriously, and which can be given a solution which also solves some other wellknown paradoxes and the traditional problems with conditional obligation.

Childhood cancers are life-threatening diseases that affect not only the child but the whole family. Although rates of survival are high with modern therapy, childhood cancers are still serious and...

Human perception is often believed to function holistically, especially in the tradition of Gestalt psychology, involving a focused item and its surrounding. This holistic approach can allow us to explain something that is not directly experienced in our perception, meaning that the absence as well as the presence of something can have a significant impact on how we perceive the world. The way we perceive the presence is more or less the same cross-culturally, but the prominence of the absence, or (...) what is termed emptiness in this volume, varies considerably from one culture to another. The aim of this volume is to identify what emptiness is like and how different cultures incorporate this concept from various perspectives. It turns out that emptiness plays a key role in identifying socio-cultural diversity in a broader sense, including arts and languages. This volume consists of contributions from different fields covering a wide range of topics such as history, literary studies, mythology, film studies, architecture, linguistics, social-anthropology, ethnology and cognitive science. Due to the range covered in this volume, studies presented here are highly interdisciplinary, but all chapters deal with the sense of emptiness, which suggest that the underlying idea of the significance of emptiness is pervasive. Yet, this topic has not previously been systematically compared across different disciplines. It is hoped that this volume will offer a first overview of the pervasiveness and integration of disciplines concerning the sense of emptiness. (shrink)

James Wm. Forrester, Being Good and Being Logical. Philosophical Groundwork for a New Deontic Logic. Armonk and London, M.E. Sharpe, 1996. Pp.x+332.

Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: (...) Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses. (shrink)

A frequent justification in the literature for using stated preference methods (SP) is that they are the only methods that can capture the so-called total economic value (TEV) of environmental changes to society. Based on follow-up interviews with SP survey respondents, this paper addresses the implications of that argument by shedding light on the construction of TEV, through respondents’ perspective. It illuminates the deficiencies of willingness to pay (WTP) as a measure of value presented as three aggregated themes considering respondents’ (...) unintentionality, their retraction once they understood that their WTP could be decisive in cost-benefit analysis and the inherent incompleteness of WTP. We discuss why the TEV discourse persists, how it conceals rather than reveals broader notions of value and in what ways our results support the development of alternative approaches that truly endorse plurality in environmental valuation and decision-making. (shrink)