The concept of moral distress comes from nursing ethics, and was initially defined as ‘…when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action’. There is a large body of literature associated with moral distress, yet multiple definitions now exist, significantly limiting its usefulness. We undertook a systematic review of the argument-based bioethics literature on this topic as the basis for a critical appraisal, identifying 55 papers for analysis. (...) We found that moral distress is most frequently framed around individual experiences of distress in relation to local practices and constraints, and understood in terms of power relations and workplace hierarchies. This understanding is directly derived from, and often still seen as specific to, nursing. Frequently the perspective of the morally distressed individual is privileged. Understandings of moral distress have evolved towards an ‘occupational health approach’, with the assumption that moral distress should be measured and prevented. Counter-perspectives were identified, highlighting conceptual problems. Based on our review, we propose a redefinition of moral distress: ‘Ethical unease or disquiet resulting from a situation where a clinician believes they have contributed to avoidable patient or community harm through their involvement in an action, inaction or decision that conflicts with their own values’. This definition is specific enough for research use, anchored in clinicians’ professional responsibilities and concerns about harms to patients, framed relationally rather than hierarchically, and amenable to multiple perspectives on any given morally distressing situation. (shrink)

Christian Smith's What Is a Person? calls for a normative turn in sociology—the grounding of sociology in a theory of human nature. While offering a systematic account of a thick view of personhood—what it should look like, how it can be applied, and why it is needed—the book proposes a critical realist personalism as the best metatheoretical direction for sociology. The author of this essay agrees with the main questions and direction of Smith's project. However, by historicizing the origins and (...) sociological implications of personalist moral theory, the author problematizes the personalism that is one of the foundations of Smith's project. She contrasts personalism with humanism, suggesting that the latter might possess both the normative robustness and comparative potential needed for contemporary sociological theory and practice. She ends her response to Smith's book by raising questions about the relationship between critical realist personalism and theoretical pluralism. (shrink)

Cilj istraživanja bio je ispitati iskustva stresa kod odgojitelja i nastavnika tijekom COVID-19 pandemije te ispitati prediktivnu vrijednost nekih osobnih obilježja odgojitelja/nastavnika, izvora stresa, strategija suočavanja i socijalne podrške u objašnjenju doživljaja stresa, sagorijevanja na poslu i nade u budućnost. Online upitnik primijenjen je na uzorcima od 491 nastavnika i 316 odgojitelja. Rezultati su pokazali da su odgojitelji i nastavnici najvišu razinu stresa doživljavali tijekom prvog vala pandemije korona virusa te da je razina doživljenog stresa tijekom pandemije veća nego prije (...) pandemije. Odgojitelji uobičajene izvore stresa doživljavaju snažnijim nego specifične izvore stresa vezane za pandemiju korona virusa, dok je kod nastavnika obrnuto. Osobna obilježja odgojitelja/nastavnika, izvori stresa, strategije suočavanja i socijalna podrška povezani su s razinom stresa i sagorijevanjem na poslu te nadom u budućnost, ali se prediktivna vrijednost odnosno značajni prediktori razlikuju ovisno o kriteriju i skupini ispitanika. Rezultati ukazuju na pozitivan doprinos samoefikasnosti, strategija suočavanja i socijalne podrške u doživljaju stresa kod odgojitelja i nastavnika tijekom pandemije korona virusa. (shrink)

This paper presents a case study that explores the application of systemic family therapy in working with children who are victims of violence within their family. The case study focuses on the Johnson family, comprising a father, mother, and their two children, who sought therapy after a traumatic incident of domestic violence. The therapeutic approach utilized a systemic family therapy framework, aiming to address the complex dynamics resulting from the violence and its impact on family members. The goals include providing (...) a safe environment for children to process their experiences, enhancing communication, promoting non-violent parenting, and strengthening the family’s support network. The interventions involved individual sessions with the children, family sessions, psychoeducation, and collaborative goal setting. Throughout the therapy process, significant improvements were observed, including enhanced communication, improved emotional well-being for the children, non-violent parenting strategies, and the development of a support network. The findings of this case study highlight the effectiveness of systemic family therapy in promoting healing, fostering healthy relationships, and creating a nurturing environment for children affected by family violence. (shrink)

BackgroundPatient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, is (...) currently undergoing this particular process.MethodsQualitative research was conducted by means of six focus group discussions held in the years 2012 and 2013 in Croatia. Focus groups were held separately with each of the following: first year and final year medical students, physicians engaged in medical ethics education, physicians practicing in a clinical hospital, family medicine residents and individuals representing patients with chronic disease. This research specifically addresses issues related to patient autonomy, in particular, the principles of truth telling, confidentiality, and informed consent. All focus group discussions were audio taped and then transcribed verbatim and systematized according to acknowledged qualitative analysis methods.Results and discussionPatient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.Conclusions Knowing how to respect the various facets of patients’ autonomy should be part of physician’s professional duties, and also be reflected in his or her core clinical competencies. For this reason greater importance should be dedicated to patient autonomy issues in medical education in Croatia. (shrink)

The monograph under review, written as a doctorate in 1999 and later revised and supplemented, offers a searching analysis of the form and function of rhetoric in the Pascal-Pentecost cycle of the 12th century homilist Cyril of Turov, together with an examination of the Byzantine sources. Lunde scrutinizes eight festal homilies for the period from Palm Sunday to the Sunday before Pentecost, using the edition by Igor' Erëmin [TODL 11–13,15 (1955–1958), reprinted as Literaturnoe nasledie Kirilla Turovskogo: Archeologičeskij obzor I izdanie (...) tekstov in 1989]. All Slavonic fragments are accompanied by English translations, predominantly drawn from Simon Franklin's Sermon and Rhetoric of Kievan Rus' [1991, reviewed by Francis Thomson in Slavica Gandensia 19], with minor alterations (e.g. p. 266, note 11) and critical remarks (e.g. p. 180, note 37). The study is positioned along the line that marks a shift in focus from philological and historical commentary towards the literary analysis of Cyril's sermons. Lunde's approach is clearly indebted to various developments in modern literary criticism, from structural linguistics to discourse analysis and communication theory. Questions of dating, attribution, and textual criticism are consciously left aside. (shrink)

The following contribution is an overview of the gradual and systematic establishment of the institutional foundations of Slovak Slavistics. It looks at how the research focus and programme were developed and its coordination centre set up, beginning in 1988.Following that, the Slovak Committee of Slavists was established and its were statutes drawn up. Preparations then began for the 11th International Congress of Slavists in 1993. The Department of Slavistics at the Slovak Academy of Sciences was also established, becoming the Ján (...) Stanislav Institute of Slavistics in 2005. The article describes in detail the initial beginnings of the programmatic focus of research in Slovak Slavistics, highlighting the difficulties encountered and the various twists and turns that complicated the process of establishing the research programme and institutionalising Slovak Slavistics. It also stresses the results produced thus far and its future prospects. (shrink)

This is an intellectual-biographical research essay on D. I. Chyzhevśkyi (1894-1977), the internationally renowned Ukraine scholar, expert on the history of philosophy, on Russian and Ukrainian philology and Slavic-German intercultural relations. He studied at Saint Petersburg University 1911-1913 and at Kyiv University 1916-1919 where he graduated with distinction. His would have been a promising academic career, however, in 1921, for political reasons Chyzhevśkyi felt compelled to leave Ukraine. He went to Germany, studied with E. Husserl in Freiburg/Breisgau, met M. Heidegger, (...) H.-G. Gadamer and other young influential German philosophers. But political transformations again changed the course of his life. Despite the hardships he had to cope with in the following years he was incredibly productive in publishing, engaged actively in the famous Prague Linguistic Circle and in the first Conferences of the Hegel Association. He became Assistant Professor of Slavonic studies at Harvard University and from 1956 professor at Heidelberg University. Still, his success was not without a drop of bitterness. As an émigré Chyzhevśkyi remained a foreigner in his adopted country. The essay is based on original documents from German archives: institutional files and private letters, many of them yet unknown. Moreover, the article benefits from its author’s personal acquaintance with Chyzhevśkyi in his late Heidelberg years, 1960s and 1970s. (shrink)