The dominant theory of elite power, grounded in Weberian bureaucracy, has analyzed elites in terms of stable positions at the top of enduring institutions. Today, many conditions that spawned these stable ‘command posts’ no longer prevail, and elite power thus warrants rethinking. This article advances an argument about contemporary ‘influence elites’. The way they are organized and the modus operandi they employ to wield influence enable them to evade public accountability, a hallmark of a democratic society. Three cases are presented, (...) first to investigate changes in how elites operate and, second, to examine varying configurations in which the new elites are organized. The cases demonstrate that influence elites intermesh hierarchies and networks, serve as connectors, and coordinate influence from multiple, moving perches, inside and outside official structures. Their flexible and multi-positioned organizing modes call for reconsidering elite theory and grappling with the implications of these elites for democratic society. (shrink)

Background: Clinical ethics support instruments aim to support healthcare professionals in dealing with moral challenges in clinical practice. CURA is a relatively new instrument tailored to the wishes and needs of healthcare professionals in palliative care, especially nurses. It aims to foster their moral resilience and moral competences. Aim: To investigate the effects of using CURA on healthcare professionals regarding their Moral Resilience and Moral Competences. Design: Single group pre-/post-test design with two questionnaires. Methods: Questionnaires used were the Rushton Moral (...) Resilience Scale measuring Moral Resilience and the Euro-MCD, measuring Moral Competences. Respondents mainly consisted of nurses and nurse assistants who used CURA in daily practice. Forty-seven respondents contributed to both pre- and post-test with 18 months between both tests. Analysis was done using descriptive statistics and Wilcoxon signed rank tests. This study followed the SQUIRE checklist. Ethical considerations: This study was approved by the Institutional Review Board of Amsterdam UMC. Informed consent was obtained from all respondents. Results: The total Moral Resilience score and the scores of two subscales of the RMRS, that is, Responses to Moral Adversity and Relational Integrity, increased significantly. All subscales of the Euro-MCD increased significantly at posttest. Using CURA more often did not lead to significant higher scores on most (sub) scales. Conclusion: This study indicates that CURA can be used to foster moral resilience and moral competences of healthcare professionals. CURA therefore is a promising instrument to support healthcare professionals in dealing with moral challenges in everyday practice. (shrink)

This study investigated potential risk factors (coping, perfectionism and self-regulation) for substantial injuries in contemporary dance students using a prospective cohort design, as high-quality studies focusing on mental risk factors for dance injuries are lacking. Student characteristics (age, sex, BMI, educational program and history of injury) and psychological constructs (coping, perfectionism and self-regulation) were assessed using the Performing artist and Athlete Health Monitor (PAHM), a web-based system. Substantial injuries were measured with the Oslo Sports Trauma Research Center (OSTRC) Questionnaire on (...) Health Problems and recorded on a monthly basis as part of the PAHM system. Univariate and multivariate logistic regression analyses were conducted to test the associations between potential risk factors (i.e. student characteristics and psychological constructs) and substantial injuries. 99 students were included in the analyses. During the academic year 2016-2017, 48 students (48.5%) reported at least one substantial injury. Of all factors included, coping skills (OR: 0.91; 95% CI: 0.84–0.98), age (OR: 0.67; 95% CI: 0.46–0.98) and BMI (OR: 1.38; 95% CI: 1.05–1.80) were identified as significant risk factors in the multivariate analysis. The model explained 24% of the variance in the substantial injury group. Further prospective research into mental risk factors for dance injuries with larger samples sizes is needed to develop preventive strategies. Yet, dance schools could consider including coping skills training as part of injury prevention programs and, perhaps, providing special attention to younger dancers and those with a higher BMI through transitional programs to assist them in managing the stress they experience throughout their (academic) career. (shrink)

The study examines gradation as a central mode of 18th century thought. Originally a structural notion in the natural sciences, gradation underwent a change in the 17th century to become a major descriptive trope for gradually intensifying patterns of change. As a trope that extends across disciplinary boundaries, gradation became an important aesthetic concept of the period in areas as diverse as rhetoric, aesthetics, dramatic art, and music."--Provided by publisher.

In the wake of the most recent financial crisis, corporations have been criticized as being self-interested and unmindful of their relationship to society. Indeed, the blame is sometimes placed on the corporate legal form, which can exacerbate the tension between duties to shareholders and interests of stakeholders. In comparison, the Benefit Corporation (BC) is a new legal business entity that is obligated to pursue public benefit in addition to the responsibility to return profits to shareholders. It is legally a for-profit, (...) socially obligated, corporate form of business, with all the traditional corporate characteristics combined with societal responsibilities. Considering the history and perception of shareholder primacy in United States law, it is argued that this new business structure is an ethical step toward empowering socially committed commercial entities. The contribution of this research is to provide a fundamental base of knowledge about the new legal form of business, the BC, upon which further study may rely. First, the legal history of the corporation is briefly reviewed in order to provide context to the relationship of the corporate form to society, including exploration of the premise that shareholder wealth maximization is its best and only purpose. Second, the BC is described in detail, and state statutes are compared. Third, the BC is placed within the context of corporate social responsibility. Finally, opportunities for future research are discussed. (shrink)

When shared decision making breaks down and parents and medical providers have developed entrenched and conflicting views, ethical frameworks are needed to find a way forward. This article reviews the evolution of thought about the best interest standard and then discusses the advantages of the harm principle (HP) and the zone of parental discretion (ZPD). Applying these frameworks to parental refusals in situations of complexity and uncertainty presents challenges that necessitate concrete substeps to analyze the big picture and identify key (...) questions. I outline and defend a new decision-making tool that includes three parts: identifying the nature of the disagreement, checklists for key elements of the HP and ZPD, and a “think list” of specific questions designed to enhance use of the HP and ZPD in clinical decision making. These tools together will assist those embroiled in complex disagreements to disentangle the issues to find a path to resolution. (shrink)

This paper examines the impact of integrated reporting on the integration of environmental, social, and governance issues into the business model and the related economic and ESG performance changes. To investigate these internal and external transformational effects of IR, important differences between IR and alternative ESG reporting strategies are worked out. Using three matched samples of companies from around the world for the sample period 2002–2011, IR companies are matched with companies applying no ESG reporting, stand-alone ESG reporting, or ESG (...) reporting in the annual report. The results suggest that IR is a superior mechanism only for the integration of ESG issues into the core business model when comparing IR with the ESG reporting strategies of no ESG reporting and ESG reporting in annual reports. In comparison with, stand-alone ESG reporting, the results indicate that IR is negatively associated with the ESG integration level and with the economic and ESG performance. Moreover, this negative impact is lower for companies that have already implemented ESG management tools prior to the initiation of IR and is stronger for companies residing in countries with legal requirements for the disclosure of ESG information. A separate change analysis reveals that companies do not benefit from a switch from stand-alone ESG reporting to IR. Thus, this paper provides empirical evidence that contradicts the general notion of IR as a superior reporting mechanism, as the benefits of IR are driven by several factors. (shrink)

Reports of children participating in hunger strikes while detained in offshore detention centres raise interrelated ethical issues and recognizable challenges for the medical decision-makers at these sites. A composite case study, informed by reports in the public domain, is employed to explore the unique challenges of consent and decision-making in these circumstances and the perennial issues inherent in adolescents’ developing capacity and autonomy. We present an amalgamated case of a fourteen-year-old adolescent who refused to consent to medical reversal of her (...) hunger strike protest. The medical team became the final arbiter when her parents, who were also in detention, could not agree with each other even after mediation. The case explores the complexity of evaluating the adolescent’s capacity to provide informed consent while influenced by the opinions of co-detainees in this extreme setting. We argue that the parents and the child had compromised decisional capacity due to the effects of detention. The challenges to the medical team are recognized and discussed. The team members faced a difficult dilemma and considered the competing values of the multiple cultural and ethical factors. Each team member integrated his or her own roles, duties, and discipline-specific professional guidelines with the primary goal of mitigating potential harms. (shrink)

O artigo apresenta e analisa as representações acerca da espiritualidade presentes nos relatos de mulheres usuárias de substâncias que buscam acolhimento em comunidades terapêuticas (CTs) de perfil religioso. Os dados observados são provenientes de entrevistas semiestruturadas realizadas ao longo do segundo semestre de 2020 com mulheres acolhidas em duas CT’s, sendo uma delas de perfil católico carismático e outra vinculada a uma igreja que compõe o protestantismo histórico. As lideranças dessas instituições foram igualmente ouvidas com a intenção de alcançar informações (...) a respeito da maneira como religião e espiritualidade são acionadas e articuladas no método empregado por essas CTs. A principal conclusão desse trabalho indica que as estratégias institucionais aplicadas para afastar essas mulheres do uso de substâncias fundamentam-se em narrativas religiosas que, muitas vezes, são ressignificadas pelas acolhidas por meio de suas próprias experiências subjetivas ao longo da permanência na CT. Ainda, deve-se ressaltar que a espiritualidade vivenciada pelas entrevistadas parece, em algumas situações, confrontar as orientações institucionais. (shrink)

This paper examines whether and to what extent the overall business strategy influences the firm’s mismanagement of sustainability. Specifically, an empirical measure for the mismanagement of sustainability is developed by exploiting the newly available materiality guidelines for US firms to define industry-specific material sustainability issues. Using this measure, this paper shows that mismanagement of sustainability can represent unethical business behavior when firms intentionally perform better on immaterial issues than on material issues by diverting stakeholders’ attention from the firm’s low overall (...) sustainability performance. This paper assumes that the right business strategy can prevent such unethical actions. Based on Miles and Snow’s organizational theory, this paper distinguishes between Prospector and Defender business strategies. By employing multiple firm-level panel regressions, the findings suggest that Prospector-type firms are more likely to mismanage sustainability issues compared to Defender-type firms intentionally. The results give implications for researchers, regulators and standard setters, auditors, sustainability practitioners, and scholars. (shrink)

This article unfolds in three stages. First, it locates the emergence of modern conceptions of social justice in industrializing Europe, and especially in the discovery of the “social,” which provided a particular idiom for the liberal democratic politics for most of the twentieth century. Second, the article links this particular conception of the social to the political rationalities of the postwar welfare state and the identity of the social citizen. Finally, the article discusses the myriad ways in which this legacy (...) of the social and social justice has been disrupted, although not yet fully displaced, by the economic orthodoxies and individualization that inform the contemporary neoliberal governing project in Canada. The result, the article concludes, has been the institutionalization of insecurity, which demands the renewal of a social way of seeing and a politics of social justice on local and global scales. (shrink)

Any worlds semantics for intentionality has to provide a plenitudinous theory of impossibility: For any impossible proposition, it should provide a world where it is true. Hence, also any semantics for impossibility statements that extends Lewis’s concretism about possible worlds should be plenitudinous. However, several such proposals for impossibilist semantics fail to accommodate two kinds of impossibility that, albeit not unheard of, have been largely neglected in the literature on impossible worlds, but that are bound to arise in the Lewisian (...) context. The proposals discussed here stop short of plenitude because they adhere to what Lewis occasionally referred to as ‘ontological truth’, as they lack the semantic ability to misrepresent ontological facts. The paper develops a framework for systematic misrepresentations on the basis of Mares’s situation-based account of impossible ‘worlds’, and which confines ‘ontological truth’ to possibility. It thus illustrates how a plenitude of impossibilities can be achieved. (shrink)

En prenant pour exemple mon parcours personnel allant du travail de la cure à celui de l’écriture, des violences politiques reflétées dans celles de la famille à la douleur de leurs inscriptions psychiques et textuelles, la première partie de l’exposé montrera en quoi le travail d’élaboration et d’écriture que doit effectuer un descendant de survivants, s’il cherche à psychiser, historiciser et inscrire le trauma de ses ascendants, constitue une démarche violente et transgressive. La seconde partie dégagera quelques aspects des déterminants (...) psychiques qui affectent les descendants de survivants : le caractère double du vécu traumatique, l’expérience d’une délocalisation psychique en l’absence d’image narcissisante, le souvenir de la terreur dans le rapport aux autres, la mutilation ou l’incapacité d’être. (shrink)

Stories of young children who make up exaggerated stories provide questions for a discussion about lying.

Qu’est-ce que le travail? La question posée par le titre de ce recueil offre un tremplin pour des réponses multiples et nuancées, fruits de recherches sur un large spectre temporel et spatial. Les articles qui le composent répondent à cette question en interrogeant la façon dont le genre définit notre compréhension du travail. Se trouvent donc placés au premier plan les problèmes relatifs à l’égalité, le rôle du marché versus l’espace privé, la question des capacités de production comparée a...

Ayahuasca is a psychoactive beverage that is mostly used in ritualized settings (Santo Daime rituals, neo-shamanic rituals, and even do-it-yourself-rituals). It is a common practice in the investigated socio-cultural field to call these settings “healing rituals.” For this study, 15 people who underwent ayahuasca (self-)therapy for a particular disease like chronic pain, cancer, asthma, depression, alcohol abuse, or Hepatitis C were interviewed twice about their subjective concepts and beliefs on ayahuasca and healing. Qualitative data analysis revealed a variety of motivational (...) patterns, subjective effects, and user types. Most participants were convinced that ayahuasca had influenced their illness positively or improved their coping with their illness. More importantly, it had enhanced their well being in general. As a result, we concluded that the effects of ayahuasca should not be reduced to a pharmacological model. The substance should be conceptualized as a psychological catalyst that unfolds within different fields of sociocultural ideas. (shrink)

This essay argues that Marshall McLuhan’s most important ideas on the media are to be found in the early writings of the 1940s and 1950s. McLuhan’s work did not provide policy makers with concrete recommendations, nor did he leave communication scholars with a theory of the media; but he developed new methodological ‘probes’ for thinking through the effects of a variety of media on environments and bodies in the newly mediated context of North America in the post-WWII period. His approach (...) to media technology was aesthetic, interdisciplinary, transnational, phenomenological and driven by a commitment to pedagogy. His work was prophetic in terms of recognizing that electronic media would transform experiences of space and time, and the interrelation between global and local cultures. (shrink)

Professional providers of mental health services are motivated to help people, including, or especially, vulnerable people. We analyse the ethical implications of mental health providers accepting employment at detention centres that operate out of the normal regulatory structure of the modern state. Specifically, we examine tensions and moral harms experienced by providers at the Australian immigration detention centre on the island of Nauru. Australia has adopted indefinite offshore detention for asylum-seekers arriving by boat as part of a deterrence strategy that (...) relies on making detainment conditions harsh. This has known deleterious mental health effects. As a token to fiduciary care obligations, Australia employs mental health professionals to work on Nauru. These providers are often motivated to make a positive difference for detainees’ lives. We examine the overall impact of the providers’ work with detainees and the implications of their presence. The strongest evidence supports that the small mitigation of harms offered by these providers does not outweigh the harms of supporting a system designed to perpetuate human suffering. For mental health professionals considering working in offshore detention, we offer specific topics to scrutinise and weigh prior to employment. Because optimising detainee’s mental health is beyond the capacity of individual providers, we call for the organisations standardising and supporting mental health professionals to oppose employment of their associates in offshore detention. Lessons from this case study are generalisable to other jurisdictions to help inform organisations that licence and support mental health providers and individual providers considering work in similar settings. (shrink)

Downie and Schuklenk1 provide a clear narrative of the development of Canadian policy on medically assisted dying. This is very helpful for considering specific aspects of the continuing deliberations in Canada. This commentary presents an alternative perspective on the authors’ argument that narrow eligibility criteria for medical assistance in dying are discriminatory and unjustified. I argue that disability or mental illness as sole reason for accessing MAiD removes protections for all people who have times in their life when they have (...) mental illness or disability combined with intolerable suffering. I claim that individuals do not make their best, self-actualising decisions at those times and the supposed protections of vague terms such as incurable, advanced and decline are not clinically useful for evaluating eligibility for individuals with chronic health conditions. Within discussion of the impact of social determinants of health on access to MAiD, the authors present the argument that decisionally capable people with mental illness or disabilities as their sole underlying condition should be allowed to access MAiD. The authors state that opposing this access sacrifices patient rights and strips people of their agency. To support their argument, they embrace the idea that people with mental illness or disabilities belong to an identifiable cohort. They claim that …. (shrink)