Whistleblowing refers to the disclosure by organization members of illegal, immoral, or illegitimate practices to persons or organizations that may be able to effect action. Most studies on the topic have been conducted in North American or European private sector organizations, and less attention has been paid to regions such as Turkey. In this study, we study the whistleblowing intentions and channel choices of Turkish employees in private and public sector organizations. Using data from 327 private sector and 405 public (...) sector employees, we find that public sector employees are more idealistic and less inclined to whistleblow externally and anonymously. Higher idealism among public sector employees does not moderate these effects. We find that private sector employees are more relativistic, and that they are more inclined to whistleblow through external and anonymous channels. More relativistic private sector employees are more likely to prefer external whistleblowing; however sector does not moderate the propensity to whistleblow anonymously. (shrink)

Crick and Koch’s 1990 “neurobiological theory of consciousness” sparked the race for the physical correlates of subjective experience. 30 years later, cognitive sciences trend toward consideration of the brain’s electromagnetic field as the primary seat of consciousness, the “to be” of the individual. Recent advancements in laboratory tools have preceded an influx of studies reporting a synchronization between the neuronally generated EM fields of interacting individuals. An embodied and enactive neuroscientific approach has gained traction in the wake of these findings (...) wherein consciousness and cognition are theorized to be regulated and distributed beyond the individual. We approach this frontier to extend the implications of person-to-person synchrony to propose a process of combination whereby coupled individual agents merge into a hierarchical cognitive system to which they are subsidiary. Such is to say, the complex mammalian consciousness humans possess may not be the tip of the iceberg, but another step in a succeeding staircase. To this end, the axioms and conjectures of General Resonance Theory are utilized to describe this phenomenon of interpersonal resonant combination. Our proposal describes a coupled system of spatially distributed EM fields that are synchronized through recurrent, entraining behavioral interactions. The system, having achieved sufficient synchronization, enjoys an optimization of information flow that alters the conscious states of its merging agents and enhances group performance capabilities. In the race for the neurobiological correlates of subjective experience, we attempt the first steps in the journey toward defining the physical basis of “group consciousness.” The establishment of a concrete account of the combination of consciousness at a scale superseding individual human consciousness remains speculation, but our suggested approach provides a framework for empirical testing of these possibilities. (shrink)

The purpose of this article is to outline a systematic answer to the question of collective autonomy, its conceptual nature and lmimits, and apply it by way of example to the case of the engineering profession.In the first section, it is argued that a professional activity involves systematic knowledge and proficiency, a form of continuous improvement of the related bodies of knowledge and proficiency, as well as two levels of understanding: a local one, which is the ability to justify and (...) explain professional acts, and a global one, which involves a conception of the whole profession and its ethical principles.The second section is devoted to a conceptual analysis of professional ethics. It is argued that it consists of a general conception of professionality, a particular conception of the profession under consideration, and a conception of the normative requirements made by the societal envelope of the professional activity, in particular basic norms of democracy.The third section draws conclusions with respect to the nature and limits of professional autonomy. It is shown that such autonomy is much more restricted than its apparent extent. Examples from engineering and other professions are provided. (shrink)

Ever since Putnam and Burge launched their respective attacks on individualist accounts of meaning the individualist has felt squeezed for space.1 Very little maneuvering room, it seems, is left for the philosopher who wants to deny that meaning and mental content depend on the speaker's social environment. One option, popular amongst individualists, is to grant that reference is socially determined but argue that there is nevertheless a notion of meaning or content that can be understood individualistically. That is, the individualist (...) can opt for a. (shrink)

In Morality and Socially Constructed Norms, Laura Valentini poses and answers this overall question: When and why, if at all, are socially constructed norms morally binding? Valentini develops an original account, the agency-respect view, that offers an answer to this general question by offering a moral criterion in terms of agency respect. I agree with the criterion proposed by the agency-respect view, given the account of socially constructed norms that it assumes. However, its account of socially constructed norms seems too (...) narrow to answer the general question. More specifically, I argue that the account of social norms is too narrow, even according to Valentini’s own standard, since it does not account for teleological social norms, which are about standards of excellence rather than standards of behavior. Taking teleological social norms into account calls the moral criterion proposed by the agency-respect view into question: it is plausible concerning the type of social norm assumed by the agency-respect view, but not for teleological social norms. Hence, the general question has not been fully answered. (shrink)

My paper examines the popular idea, defended by Kripke, that meaning is an essentially normative notion. I consider four common versions of this idea and suggest that none of them can be supported, either because the alleged normativity has nothing to do with normativity or because it cannot plausibly be said that meaning is normative in the sense suggested. I argue that contrary to received opinion, we don’t need normativity to secure the possibility of meaning. I conclude by considering the (...) repercussions of rejecting semantic normativity on three central issues: justification, communication, and naturalism. (shrink)

This article discusses the thesis that a subject can have a concept, think thoughts containing it, that she incompletely understands. The central question concerns how to construe the distinction between having a concept and understanding it. Two important versions of the thesis are distinguished: a metasemantic version and an epistemic version. According to the first, the subject may have concept C without being a fully competent user, in virtue of deference to other speakers or to the world. According to the (...) second, the subject may have a concept without being able to provide a proper explication of it. It is argued that whereas the epistemic version is plausible, the metasemantic version faces some challenges. First, it needs to be explained precisely how deference enables a speaker to have C. Second, metasemantic incomplete understanding is in tension with the idea that concepts serve to capture the subject’s cognitive perspective. (shrink)

I argue that a central claim of Ásta’s conferralist framework – that it can account for all social properties of individuals – is false, by drawing attention to (opaque) class. I then discuss an implication of this objection; conferralism does not meet its own conditions of adequacy, such as providing a theory that helps to understand oppression. My diagnosis is that this objection points to a methodological problem: Ásta and other social ontologists have been fed on a “one-sided diet” of (...) types of examples, resulting in a limited view of the paradigmatic social phenomena, thus making conferralism too narrow to fulfill its intended role. (shrink)

It is commonly held that there are internal links between understanding and assent such that being semantically competent with an expression requires accepting certain sentences as true. The paper discusses a recent challenge to this conception of semantic competence, posed by Timothy Williamson (2007). According to Williamson there are no understanding-assent links of the suggested sort, no internal connection between semantic competence and belief. I suggest that Williamson is quite right to question the claim that being semantically competent with an (...) expression e requires accepting a certain sentence S as true. However, Williamson does not merely wish to reject this version of the understanding-assent view, but the very idea that the connection with belief provides constitutive constraints on linguistic understanding and concept possession. This further move, I argue, is very problematic. Giving a plausible account of semantic competence requires accepting that there are constitutive links between understanding and assent, although these links should be construed holistically rather than atomistically. (shrink)

Dignity, usually considered an essential ethical value in healthcare, is a relatively complex, multifaceted concept. However, healthcare professionals often have only a vague idea of what it means to respect dignity when providing care, especially for persons with impaired autonomy. This article focuses on two concepts of dignity, human dignity and dignity of identity, and aims to analyse how these concepts can be applied in the care for persons with impaired autonomy and in furthering the practice of respect and protection (...) from harm. Three vignettes were designed to illustrate typical caring situations involving patients with mild to severely impaired autonomy, including patients with cognitive impairments. In situations like these, there is a risk of the patient’s dignity being disrespected and violated. The vignettes were then analysed with respect to the two concepts of dignity to find out whether this approach can illuminate what is at stake in these situations and to provide an understanding of which measures could safeguard the dignity of these patients. The analysis showed that there are profound ethical challenges in the daily care of persons with impaired autonomy. We suggest that these two concepts of human dignity could help guide healthcare professionals to develop practical skills in person-centred, ethically grounded care, where the patient’s wishes and needs are the starting point. (shrink)

Externalism is widely endorsed within contemporary philosophy of mind and language. Despite this, it is far from clear how the externalist thesis should be construed and, indeed, why we should accept it. In this entry I distinguish and examine three central types of externalism: what I call foundational externalism, externalist semantics, and psychological externalism. I suggest that the most plausible version of externalism is not in fact a very radical thesis and does not have any terribly interesting implications for philosophy (...) of mind, whereas the more radical and interesting versions of externalism are quite difficult to support. (shrink)

Military activities with the framework of the IDF [Israel Defense Force] is carried out by citizens in a variety of positions. In addition to the ordinary positions of career officers and NCOs, the IDF consists of conscripted men and women as well as reservists. Some of the latter serve under an ordinary command to serve for a certain relatively short period. Other reservists, including pilots and special forces officers have served since they volunteered to serve. Facing the political clash between (...) the government, who have been viewed as trying to change the democratic nature of the state, and the popular opposition, who have tried to protect the judiciary and other elements of democracy, many officers who belong to the latter reservist group have suspended their voluntary service or even retired. Their decision has raised the obvious issue of whether such decisions can be justified, morally, ethically, and democratically. This is the topic of the present paper. (shrink)

Longitudinal qualitative research in nursing is rare but becoming more common. Data collection and analysis over time provide some intriguing possibilities to better understand processes, development, and change in illness experience, healthcare organizations, and self‐management. This paper aims to present a process for analyzing qualitative longitudinal data material, namely the Pattern‐Oriented Longitudinal Analysis approach (POLA). We developed this approach after synthesizing experiences from two longitudinal qualitative projects and comparing our procedures and reflections with the relevant literature. Using the POLA approach, (...) researchers can describe complexity and variation in changes over time. During the analysis process, emphasis is put on visualizing and identifying change at both an individual and a group level. Ontological and epistemological assumptions for the approach are also described. The benefit of this approach is the possibility to describe complexity and diversity in processes over time, which is important for the development of nursing knowledge. The analysis approach can be further used and developed by researchers seeking to understand variance or contextual features in processes and changes over time. (shrink)

This chapter aims to show that there is a general theory of social ontology implicit in Amie Thomasson’s prolific philosophical work. In contrast to her books on fiction and metaphysics, this theory is not argued for in a single volume. The first objective is thus to make Thomasson’s important contribution to social ontology explicit by drawing out its core features. Despite its many advantages, such as its ability to take abstract social objects into account, there is a central difficulty: Thomasson’s (...) new account of social groups is too narrow since it cannot accommodate opaque kinds of social groups. The second and related aim is to develop this objection and demonstrate that it must be resolved before we can take Thomasson’s theory of social ontology fully onboard. The chapter closes by suggesting that we can overcome this objection by even more pluralism—already a core feature in Thomasson’s social ontology. (shrink)

Normativism in the theory of meaning and content is the view that linguistic meaning and/or intentional content are essentially normative. As both normativity and its essentiality to meaning/content can be interpreted in a number of different ways, there is now a whole family of views laying claim to the slogan “meaning/content is normative”. In this essay, we discuss a number of central normativist theses, and we begin by identifying different versions of meaning normativism, presenting the arguments that have been put (...) forth for and against them. (shrink)

Electromagnetic field oscillations produced by the brain are increasingly being viewed as causal drivers of consciousness. Recent research has highlighted the importance of the body’s various endogenous rhythms in organizing these brain-generated fields through various types of entrainment. We expand this approach by examining evidence of extracerebral shared oscillations between the brain and other parts of the body, in both humans and animals. We then examine the degree to which these data support one of General Resonance Theory’s principles: the Slowest (...) Shared Resonance principle, which states that the combination of micro- to macro-consciousness in coupled field systems is a function of the slowest common denominator frequency or resonance. This principle may be utilized to develop a spatiotemporal hierarchy of brain-body shared resonance systems. It is predicted that a system’s SSR decreases with distance between the brain and various resonating structures in the body. The various resonance relationships examined, including between the brain and gastric neurons, brain and sensory organs, and brain and spinal cord, generally match the predicted SSR relationships, empirically supporting this principle of GRT. (shrink)

Within the research field of computer-mediated communication, extensive attention has been paid to the differences between CMC and spoken conversation, particularly in terms of sequential structure. In this study, the aim is to analyse how participants maintain continuity and handle discontinuities in institutionally arranged, computer-mediated communication. The empirical material consists of chat log files from in-service training courses for professionals in the food production industry. In the chat sessions we analysed, participants initially had some problems in co-ordinating their postings, that (...) is, keeping track of the discussion’s threading.We also found, however, that methods for co-ordinating postings rather quickly were established among the participants. Two methods for making recognizable how postings were to be read were common in the material: 1) the use of personal names to address a specific participant, and 2) recycling part of the content of a previous posting or reformulating the content in the posting addressed in recognizable ways. We also found an emerging norm in their interaction: that of waiting for one’s turn. (shrink)

The paper discusses the thesis of extended belief and its implications for the possibility of extending ordinary, personal level knowledge. A common worry is that knowledge will overextend, that there will be ‘cognitive bloat’. If the subject’s standing beliefs can be realized in devices such as notebooks and smart phones, what is there to prevent the conclusion that she knows everything stored on such devices? One response to this worry is to block the move from belief to knowledge, and argue (...) that these externally stored beliefs, although reliable, do not qualify as knowledge. I argue, instead, that the fundamental problem arises at the level of belief. We prevent bloating of knowledge by preventing the bloating of belief. To do so, I argue, we need to take seriously Clark and Chalmers’ suggestion that what is distinctive of belief is its role in folk psychological explanations. Paying attention to this role shows that the usual examples, such as Otto’s notebook information, do not qualify as beliefs. To qualify, the external information would have to be much more directly connected to, and deeply integrated into, the subject’s overall system of beliefs and desires. (shrink)

Abstract:Hume’s theory of pride has been dismissed due to the contingent relation between passion and object. But why did Hume state the theory as he did? Why did he give two accounts of pride, one holistic and one atomistic? This paper considers Hume’s reasons for giving two accounts, and how he unified them. The holistic account enables Hume to explain how moral distinctions are made, whereas the atomistic allows him to anchor morality in human nature. The accounts are unified by (...) the distinction of feeling pride and being proud: a steady passion of pride would not count as that if it did not contain feelings of pride identified by their introspective quality, and would not be a state of pride without the causal relation of ideas. (shrink)

Hume’s mysterious words, “we must distinguish betwixt personal identity, as it regards our thought or imagination, and as it regards our passions or the concern we take in ourselves” have been the focus of a variety of different interpretations, some more creative than others. But the solution to this interpretative problem is indeed very simple, too simple to occur to most readers. What Hume has in mind is actually nothing but the different ways association works with regard to, on the (...) one hand, imagination, and, on the other hand, passion. Hence, one may easily read the entire Treatise as containing just one idea of self, that is, the bundle of perceptions discussed in “On personal identity.” Contrary to what many scholars have recently suggested, this idea may very well be “the idea, or rather impression” of self at play in the mechanism of sympathy, as well as the object of pride and humility. This faithful but dull reading makes Hume coherent, probably more coherent than any two-ideas interpretation does. (shrink)

Can externalist concepts really capture an individual.

© 2013 The Editors of The Philosophical QuarterlyOpening this book the philosopher might expect a treatise on self‐knowledge. However, despite its title, this is not a book on knowledge of our own minds, or even on self‐consciousness in the usual sense of being conscious of oneself. Rather, it is a book on developmental psychology, spelling out the fascinating details of the development of the human mind with a particular focus on the emergence of human consciousness. The question Radu J. Bogdan (...) raises is why, and how, consciousness develops in human beings. His central hypothesis is that consciousness is a bi‐product of the executive abilities that a small child develops in response to the complex socio‐cultural situation that she finds herself in. The executive abilities, Bogden argues, are assembled by the child's intuitive psychology, or theory of mind, which allows her to interact and coregulate with others. The origins of... (shrink)

This paper discusses whether it can be known a priori that a particular term, such as water, is a natural kind term, and how this problem relates to Putnams claim that natural kind terms require an externalist semantics. Two conceptions of natural kind terms are contrasted: The first holds that whether water is a natural kind term depends on its a priori knowable semantic features. The second.

The question of whether content externalism poses a threat to the traditional view of self-knowledge has been much debated. Compatibilists have tried to diffuse the threat by appealing to the self-verifying character of reflexive judgments about our own thoughts, while incompatibilists have strenuously objected that this does not suffice. In my paper I argue that this debate is fundamentally misconceived since it is based, on both sides, on the problematic notion of ‘knowledge of content’. What this shows, I argue, is (...) not that content externalism is unobjectionable, but that the real challenge to content externalism is not an epistemological one. The real difficulty concerns the content externalist’s seemingly necessary commitment to the idea that individuals have an incomplete grasp of the concepts that go into their own thoughts. This idea poses a threat not to self-knowledge, I argue, but rather to our first- and second-order reasoning abilities. (shrink)

As meaning's claim to normativity has grown increasingly suspect the normativity thesis has shifted to mental content. In this paper, we distinguish two versions of content normativism: 'CE normativism', according to which it is essential to content that certain 'oughts' can be derived from it, and 'CD normativism', according to which content is determined by norms in the first place. We argue that neither type of normativism withstands scrutiny. CE normativism appeals to the fact that there is an essential connection (...) between content and correctness conditions. But, we argue, this fact is by itself normatively innocent, and attempts to add a normative dimension via the normativity of belief ultimately fail. CD normativism, in turn, falls prey to the 'dilemma of regress and idleness': the appeal to rules either leads to some form of regress of rules, or the notion of rule-following is reduced to an idle label. We conclude by suggesting that our arguments do not support naturalism: it is a mistake to assume that normativism and naturalism are our only options. (shrink)

This contradiction ”1. The universal right to free speech did not exist before the European Enlightenment, at which time it came into existence. 2. The universal right to free speech has always existed, but this right was recognized only at the time of the European Enlightenment.” draws on two common and conflicting intuitions: The human right to free speech exists because institutions, or the law, says so. In contrast, the human right to free speech can exist independently of institutions—these institutions (...) simply recognize a right we already have. John Searle argues that his status function account of human rights can preserve both intuitions by showing that the inconsistency between and is merely apparent. I argue that this solution works for tokens of human rights but not for types, while the contradiction concerns types. Hence, the status function account of human rights fails to preserve both intuitions. (shrink)

How ethical praxis is shaped by different contexts and situations has not been widely studied. We performed a follow-up study on stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. A number of ways for handling ethical problems emerged, which we have now explored further. Data were collected through a three-part form used as base for individual interviews with 15 stroke team members and (...) analyzed using both quantitative and qualitative content analysis. In the analysis, the approaches in the form were condensed into strategies, and the two different ways those strategies were preferred and used by the team members were shown. Hindrances perceived by the team members to impede them from working the preferred way were also revealed and grouped into eight categories. (shrink)

In order to reach a more comprehensive understanding of the dynamics in violent situations in institutional care for elderly people the aim of this study was to explore involved parties’ positions, and to illuminate forces and moves related to these positions. One involved care provider's narrative was analysed using narrative analysis and positioning theory. In the narrative the involved parties’ positions were fluid and often overlapping, and not exclusively as victim or perpetrator. Across the narrative the narrator altered the involved (...) parties’ positions by using available discourses. We understand that the altered positions were a salient way for the care provider to make sense of her experiences. By reading the care provider's narrative we further understand that she was much more than just a perpetrator, which was the origin for her narrative. This study led us to two assumptions important for implications in nursing practice. First, it is of significance how we position ourselves and others in narratives and conversations. Second, there is a difference between being categorised in advance and getting the opportunity to narrate one's own story. (shrink)

Since Hilary Putnam and Saul Kripke's first attacks on traditional, descriptivist theories of natural kind terms, it has become customary to speak of the ‘Putnam-Kripke’ view of meaning and reference. This article argues that this is a mistake, and that Putnam's account of natural kind terms is importantly different from that of Kripke. In particular, Putnam has from the very start been sceptical of Kripke's modal claims, and in later papers he explicitly rejects the proposal that theoretical identity statements are (...) metaphysically necessary (if true). I suggest that this is wholly in line with Putnam's earlier, Quine-inspired writings on general terms, and his preoccupation with the philosophy of science. Moreover, I argue that the picture of general terms that emerges from Putnam's writings is more plausible than that suggested by Kripke. However, contrary to Putnam, I also suggest that Putnam's later views on natural kinds and natural kind terms do not support standard Twin Earth externalism. (shrink)

In the book Gibbard proposes, first, that statements about meaning are normative statements and, second, that they can be given an expressivist treatment, along the lines of Gibbard’s preferred metaethics. In my paper, I examine the first step: The claim that meaning statements are to be construed as being normative, as involving ‘oughts’. Gibbard distinguishes two versions of the normativity of meaning thesis – a weak version, according to which every means implies an ought, and a strong version, according to (...) which for every means, there is an ought that implies it. I argue that neither thesis withstands scrutiny. The weak thesis depends on assumptions about the notion of semantic correctness that the anti-normativist rejects, and the strong thesis does not solve the problems Gibbard wants it to solve: the problems of indeterminacy and meaning skepticism. I conclude that semantics does not need normativity. (shrink)

The present paper is devoted to a detailed presentation of a new Military Ethics doctrine of fighting terror. It is proposed as an extension of the classical Just War Theory, which has been meant to apply to ordinary international conflicts. Since the conditions of a fight against terror are essentially different from the conditions that are assumed to hold in the classical war (military) paradigm or in the law enforcement (police) paradigm, a third model is needed. The paper proposes such (...) a model in the form of principles that should govern the activity of a democratic state when faced with terror. Eleven principle are proposed. Two are on the level of the state, including the Principle of Self-Defense Duty. Six are related to military preventive acts against activities of terror, including new formulations of a Principle of Military Necessity, a Principle of Distinction, and a Principle of Military Proportionality. Principles of Low Probabilities, Time Span Considerations and Professional Understanding are also included. Finally, three principles that are related to consciousness-directed activities against terror are added: a Principle of Permanent Notice, a Principle of Compensation, and a Principle of Operational Deterrence. The exposition of the principles is accompanied by arguments about their moral justification. The doctrine has been developed on the background of the IDF fight against acts and activities of terror performed by Palestinian individuals and organizations. (shrink)

I consider an individualist reply to Burge's well-known anti-individualist thought experiment. It is commonly assumed that the individualist has one of two options: accept that reference is socially determined and opt for a bifurcation of content ; or reject the conclusions of the thought experiment and insist that Burge's patient uttering "I have arthritis in my thigh" has her or his own "arthritis"-concept and utters a true belief. I suggest that neither of these options is very attractive and thus the (...) individualist seems faced with a dilemma. However, Burge's thought experiment rests on problematic philosophical assumptions that the individualist need not accept. One such assumption is that the speaker uttering "I have arthritis in my thigh" makes a non-empirical error. This assumption, as Burge himself makes clear, is crucial if the thought experiment is to go through. So, Burge presents an account of the notion of a "non-empirical error" which is very problematic and fails to support the conclusions of the thought experiment. Once this account is questioned, the individualist can reject the claim that meaning is determined by the speaker's social environment without falling into the dilemma. (shrink)

To gain legitimacy for climate change adaptation decisions, the distribution of responsibility for these decisions and their implementation needs to be grounded in theories of just distribution and what those a ected by decisions see as just. The purpose of this project is to contribute to sustainable spatial planning and the ability of local and regional public authorities to make well-informed and sustainable adaptation decisions, based on knowledge about both climate change impacts and the perceptions of residents and civil servants (...) on what constitutes a sustainable distribution of responsibility. Our aims are: (1) a better understanding of the practical implications of theories about just distribution of responsibility for the choice of local and regional climate adaptation measures; (2) knowledge about what residents and civil servants consider a sustainable distribution of responsibility for climate adaptation measures; and (3) a better understanding of conflicts concerning the distribution of responsibilities and systematic knowledge about the possibilities to manage them. In this interdisciplinary project, we study six municipalities and their residents, and two county administrative boards, all in Sweden, using mixed methods: value theory, document studies, interviews, focus groups, and surveys. (shrink)

Sarah Sawyer has challenged my claim that social externalism depends on the assumption that individuals have an incomplete grasp of their own concepts. Sawyer denies that Burge's later sofa thought-experiment relies on this assumption: the unifying principle behind the thought-experiments supporting social externalism, she argues, is just that referents play a role in the individuation of concepts. I argue that Sawyer fails to show that social externalism need not rely on the assumption of incomplete understanding. To establish the content externalist (...) conclusions, further considerations are required, and these do commit the externalist to the assumption of incomplete understanding. (shrink)

Background: In end of life care, ethical problems often come to the fore. Little research is performed on ways or strategies for handling those problems and even less on obstacles to and possibilities of using such strategies. A previous study illuminated stroke team members’ experiences of ethical problems and how the teams managed the situation when caring for patients faced with sudden and unexpected death from stroke. These findings have been further explored in this study. Objective: The aim of the (...) study was to illuminate obstacles and possibilities perceived by stroke team members in using strategies for handling ethical problems when caring for patients afflicted by sudden and unexpected death caused by stroke. Research design: A qualitative method with combined deductive and inductive content analysis was utilized. Participants and research context: Data were collected through individual interviews with 15 stroke team members working in stroke units of two associated county hospitals in western Sweden. Ethical considerations: The study was approved by the Regional Ethics Review Board, Gothenburg, Sweden. Permission was also obtained from the director of each stroke unit. Findings: All the studied strategies for handling of ethical problems were found to have both obstacles and possibilities. Uncertainty is shown as a major obstacle and unanimity as a possibility in the use of the strategies. The findings also illuminate the value of the concept “the patient’s best interests” as a starting point for the carers’ ethical reasoning. Conclusion: The concept “the patient’s best interests” used as a starting point for ethical reasoning among the carers is not explicitly defined yet, which might make this value difficult to use both as a universal concept and as an argument for decisions. Carers therefore need to strengthen their argumentation and reflect on and use ethically grounded arguments and defined ethical values like dignity in their clinical work and decisions. (shrink)

This article analyses the dynamics of the use of institutional categories in institutional encounters. The focus is on documenting how categories are invoked to index what is relevant to situated knowing in interactional sequences where there is a need to bridge the gap between action and expectation. This general problem has been studied in the context of interactions between job applicants and vocational guidance officers in a public employment agency. Institutional categories are inference-rich, and they work as flexible tools that (...) allow participants to recontextualize and negotiate the issues at stake. In this sense, categories serve as constitutive tools that can be crafted to fit into a broad range of circumstances. However, in order to produce a relevant account, participants’ ways of reasoning need to fit into the institutionally specific traditions of argumentation and the practical outcomes which need to be produced. In this sense, the focus on accounting practices is illuminating when attempting to understand the situated knowing that maintains institutional practices. (shrink)

Many people experience feelings of inferiority in their life. The concept of striving to avoid inferiority is a belief associated with the unwanted fear of being overlooked, missing out on opportunities for advancement, and active rejection. This study examined the effect of striving to avoid inferiority on mental health and well-being. We hypothesized that striving to avoid inferiority would modify the relationship among socioeconomic status, mental health, and well-being, therefore examined the effect of striving to avoid inferiority on the relationship (...) between annual income, mental health, and well-being. The participants were 491 adults. The results indicated that insecure striving in competition with others positively correlated with depression, anxiety, and stress, whereas secure non-striving in acceptance of inferiority positively correlated with the satisfaction with life and negatively correlated with depression. The effect of striving to avoid inferiority on the relationship among annual income, mental health, and well-being indicated that SNS affected the relationships between annual income and well-being, annual income and depression, income and anxiety, and the interaction between IS and SNS. Moreover, the relationship between income and stress was influenced by SNS and the interaction between IS and SNS. These results indicated that SNS or the interaction between IS and SNS were the only variables regulating the relationship among annual income, mental health, and well-being. These findings suggested that accepting feelings of inferiority or striving to avoid inferiority influences the mental health and well-being of people. (shrink)

In 1995, a Swedish pilot study of Dialectical Behaviour Therapy (DBT) was launched to investigate its therapeutic efficacy and cost-effectiveness as treatment for Borderline Personality Disorder (BPD) in suicidal women. In the same year, a sweeping reform of psychiatric care commenced, dramatically reducing the number of beds by the end of the decade. The psychiatry reform was presented as an important factor prompting the need for a community-based treatment for Borderline patients. This article suggests that the introduction of DBT in (...) Sweden, and its relationship to the reform, can only be adequately explained with reference to the wider political shift occurring at the time, whereby the Swedish welfare state and its guiding ethos of egalitarianism were abandoned in favour of a neoliberal ‘choice revolution’. With the new liberalism, hard work and individual responsibility replaced the idea of a Swedish ‘people’s home’, a nationwide community and social support network. This language was reflected in DBT, which sought to teach patients the ‘skills’ necessary ‘to create a life worth living’. In this context, therapy was constituted as a form of ‘work’ that the patient had to undertake to improve. Moreover, DBT rejected the prevailing view of Borderline patients as ‘manipulative’ and ‘aggressive’, suggesting instead that they were ‘helpless’, ‘weak’ and unable to regulate their emotions. This new Borderline persona fit neatly into the new liberal discourse: she could be taught to become a rational and independent person able to cope in a society that valued individual responsibility over social support. (shrink)