One antidote to moral distress is stronger moral agency—that is, an enhanced ability to act to bring about change. The Clinical Ethics Residency for Nurses, an educational program developed and run in two large northeastern academic medical centers with funding from the Health Resources and Services Administration, intended to strengthen nurses’ moral agency. Drawing on Improving Competencies in Clinical Ethics Consultation: An Education Guide, by the American Society for Bioethics and Humanities, and on the goals of the nursing profession, CERN (...) sought to change attitudes, increase knowledge, and develop skills to act on one's knowledge. One of the key insights the faculty members brought to the design of this program is that knowledge of clinical ethics is not enough to develop moral agency. In addition to lecture‐style classes, CERN employed a variety of methods based in adult learning theory, such as active application of ethics knowledge to patient scenarios in classroom discussion, simulation, and the clinical practicum. Overwhelmingly, the feedback from the participants (sixty‐seven over three years of the program) indicated that CERN achieved transformative learning. (shrink)

This article summarizes a virtual live‐streamed panel event that occurred in August 2020 and was cosponsored by the International Philosophy of Nursing Society (IPONS) and the University of California, Irvine's Center for Nursing Philosophy. The event consisted of a series of three self‐contained panel discussions focusing on the past, present and future of IPONS and was moderated by the current Chair of IPONS, Catherine Green. The first panel discussion explored the history of IPONS and the journal Nursing Philosophy. The second (...) panel involved a reflection on the challenges of doing nursing philosophy in a research‐intensive context of a Canadian university and the history and current movements in nursing philosophy in the Nordic countries. The final panel involved presentations on the future potential for philosophy in/and for nursing, the critical connections between nursing philosophy and nursing theory, dismantling racism in nursing and the potential for process philosophy to help explore nursing's unique efficacy in creating possibilities for health. The panels were followed by a lively Q&A session with participants, of which there were 252 registrants from across the globe. The event underscored the wide and diverse interests of nurses in philosophical discussion and the need for more virtual events and other connective modalities bringing nurses together to discuss and analyze the value and potential of philosophy to better understand and advance nursing theory and practice. (shrink)

This book, originally published in 1987, considers how the science of linguistics creates its own objects of study. It argues that language is the one essential tool in the ¿social construction of reality¿ ¿ the way in which our environment as we perceive and respond to it is actually created by the cultural constructs we bring to bear on it ¿ and that it is also the means by which this reality, once constructed, is preserved and transmitted from person to (...) person and from generation to generation. Hence it is entirely appropriate to refer to the linguistic construction of reality. (shrink)

Macphail’s ‘null hypothesis’, that there are no differences in intelligence, qualitative or quantitative, between non-human vertebrates has been controversial. This controversy can be useful if it encourages interest in acquiring a detailed understanding of how non-human animals express flexible problem-solving capacity (‘intelligence’), but limiting the discussion to vertebrates is too arbitrary. As an example, we focus here on Portia, a spider with an especially intricate predatory strategy and a preference for other spiders as prey. We review research on pre-planned detours, (...) expectancy violation and a capacity to solve confinement problems where, in each of these three contexts, there is experimental evidence of innate cognitive capacities and reliance on internal representation. These cognitive capacities are related to, but not identical to, intelligence. When discussing intelligence, as when discussing cognition, it is more useful to envisage a continuum instead of something that is simply present or not; in other words, a continuum pertaining to flexible problem-solving capacity for ‘intelligence’ and a continuum pertaining to reliance on internal representation for ‘cognition’. When envisaging a continuum pertaining to intelligence, Daniel Dennett’s notion of four Creatures (Darwinian, Skinnerian, Popperian, Gregorian) is of interest, with the distinction between Skinnerian and Popperian Creatures being especially relevant when considering Portia. When we consider these distinctions, a case can be made for Portia being a Popperian Creature. Like Skinnerian Creatures, Popperian Creatures express flexible problem solving capacity, but the manner in which this capacity is expressed by Popperian Creatures is more distinctively cognitive. (shrink)

The nursing profession has a responsibility to ensure that nursing goals and perspectives as these have developed over time remain the focus of its work. Explored in this paper is the potential problem for the nursing profession of recognizing both the promises and pitfalls of informational technologies so as to use them wisely in behalf of ethical patient care. We make a normative claim that maintaining a critical stance toward the use of informational technologies in practice and in influencing the (...) thought patterns of the younger generations of nurses is a moral imperative of the discipline, because without this practice can become subverted from professional goals in various ways. We use a synthesized concept we call “intentional authenticity” derived from the writing of Heidegger and Feminist care ethics to provide a foundation for the development of nurses who understand the importance of the nurse‐patient relationship and how the unthoughtful use of informational and other technologies can militate against effective or good nursing care. (shrink)

Growing evidence suggests that nurses and other clinicians often feel insufficiently equipped to manage ethical issues that arise in their practice (Truog et al. 2015; Woods 2005; Darmon et al. 201...

How should business deal with society's increasing demands for ethical and social responsibility? In plain language this book considers these and other ethical questions of direct relevance to business in the 1990s. It discusses the nature of ethics, ethical reasoning, the use of stakeholder analysis, and other central concepts used in business ethics. Using mainly, but not exclusively, Australian cases and specific examples, the book covers issues such as fairness in business dealings, advertising ethics, discrimination, and codes of ethics.

This book sets out in plain language ethical questions of direct relevance to business today. This new edition expands the range of issues covered and includes a chapter on international business ethics, drawing extensively from Asian examples.

Who are we today? That deceptively simple question continued to be asked by the French historian and philosopher, Michel Foucault, who for the last three decades has had a profound influence on English-speaking scholars in the humanities and social sciences.; This text is designed for undergraduates and others who feel in need of some assistance when coming to grips with Foucault's voluminous and complex writings. Instead of dealing with them chronologically, however, this book concentrates on some of their central concepts, (...) primarily Foucault's rethinking of the categories of "discourse", "power", and " the subject".; Foucault's writings contribute collectively to what he himself calls "an ontology of the present". His historical research was always geared towards showing how things could have been and still could be otherwise. This is especially the case with respect to the production of human subjects. (shrink)

Confusion remains about the concept “nursing science.” Definitions vary, depending on country, context and setting. Even among nurse scholars and scientists there is disagreement about the content and boundaries of nursing science. There is an urgent need for an acceptable definition that can guide nursing knowledge development, education, and practice. In this article, we highlight the problems for the profession of this sort of conceptual ambiguity, arguing that it is an ethical responsibility for the profession to gain clarity about the (...) meaning and apt focus of our knowledge development initiatives. We parse out nursing and science as separate concepts and synthesize from this analysis a simple yet comprehensive definition of nursing science. We propose that this definition is capable of unifying ongoing nursing endeavors and should serve as the basis for evaluating nursing's knowledge development and educational initiatives. (shrink)

Advocacy is an important concept in nursing practice; it is frequently used to describe th nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Such ambiguity was evidenced recently in criticisms levelled at the nursing profession by hospital ethicist Ellen Bernal. She reproached nursing for using 'patient rights advocate' as a viable role for nurses. We maintain that, for nursing, patient advocacy may encompass, but is not limited to, patient rights advocacy. Patient advocacy is not merely the (...) defence of infringements of patient rights. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice. La défense des malades joue un grand rôle dans la pratique des infirmiers/ères. Le terme est souvent utilisé pour définir les rapports entre malades et soignants. Le mot 'defénse' pourtant, peut être mal compris. Une ambiguïté était évidente récemment dans la critique de la profession infirmière faite par la philosophe éthique Ellen Bernal. Elle reproche à la profession d'utiliser le terme 'avocat des droits des malades' pour désigner le rôle primordial des infirmiers/ères. Nous croyons que pour les soignants, la défense des malades peut comprendre le rôle 'd'avocat des droits des malades' mais elle ne s'y borne pas. La défense n'est pas limitée à la défense des infractions des droits des malades. La défense dans la profession infirmière est basée sur une philosophie où la pratique infirmière est le soutien des malades dans leur quête de promouvoir leur propre bien-être. Die Fürsprache spielt eine wichtige Rolle in der Krankenpflege. Sie wird oft als kennzeichnend für die Beziehung zwischen Patient und Pflegepersonal beschrieben. Der Ausdruck 'Fürsprache' kann aber auch mehrdeutig interpretiert werden. Das wurde letzthin in der Kritik der Ethikerin Ellen Bernal an der Krankenpflege sichtbar. Sie machte den Pflegenden den Vorwurf, dass sie sich die Rolle des 'Rechts-Advokat des Patienten' aneignen. Wir sind der Meinung, dass es die Aufgabe des Pflegepersonals ist, auch die Rechte der Patienten zu vertreten, aber dass das nur ein Teil der Fürsprache ist. Sie ist nicht nur Verteidignung von verletzten Patientenrechten. Die Fürsprache in der Krankenpflege stammt von einer Philosophie, deren Ausübung die Unterstützung der Patienten für ihr Wohlergehen zum Ziel hat, so wie die Patienten selbst ihr Wohlergehen verstehen. Sie ist eine Ethik der Tat. (shrink)

One of the most complex areas of Foucault's work is his relationship to Freudian psychoanalysis. Foucault consistently argued for the historical specificities of the two principal human objects of psychoanalysis – madness and sexuality. He now stands starkly removed from Freudian thought, which cannot countenance ethnographic or cultural versions of madness or sexuality. Foucault welcomed the extra‐psychoanalytic potentials of the Freudian unconscious for undermining existentialist and phenomenological accounts of the subject and knowledge. Foucault in fact celebrated the political divergences of (...) psychoanalysis as one of its strengths. The critique of desire is really the climax of Foucault's efforts to develop an alternative Nietzschean genealogy of the modern subject as a historical and cultural reality – a domain that had hitherto excluded sexual identity, while the Freudian and feminist traditions had perhaps seen only sexuality and not the wider political domains. (shrink)

Conscientious objections (CO) can be disruptive in a variety of ways and may disadvantage patients and colleagues who must step-in to assume care. Nevertheless, nurses have a right and responsibility to object to participation in interventions that would seriously harm their sense of integrity. This is an ethical problem of balancing risks and responsibilities related to patient care. Here we explore the problem and propose a nonlinear framework for exploring the authenticity of a claim of CO from the perspective of (...) the nurse and of those who must evaluate such claims. We synthesized the framework using Rest’s Four Component Model of moral reasoning along with tenets of the International Council of Nursing’s (ICN) Code of Ethics for Nurses and insights from relevant ethics and nursing ethics literature. The resulting framework facilitates evaluating potential consequences of a given CO for all involved. We propose that the framework can also serve as an aid for nurse educators as they prepare students for practice. Gaining clarity about the sense in which the concept of conscience provides a defensible foundation for objecting to legally, or otherwise ethically, permissible actions, in any given case is critical to arriving at an ethical and reasonable plan of action. (shrink)

BackgroundReferencing is an integral part of scientific writing and professional research conduct that requires appropriate acknowledgement of others’ work and avoidance of plagiarism. University students should understand and apply this as part of their academic development, but for this, it is essential that supervisors also display proper research integrity and support.MethodsThis study used an online educative questionnaire to understand the knowledge and attitudes of students and supervisors at two institutes in Europe and Africa. The results were then used to create (...) discussion around education of students and faculty in workshops and lectures.ResultsOverall, 138 students and 14 supervisors participated: most were Swedish (89) and Kenyan (11). Overall, 98% had heard about plagiarism, and 35% believed it was common. Only 45% had heard about self-plagiarism, and when explained what it was, 44.5% considered it morally wrong. Europeans and North Americans had more knowledge than other nationalities. Most (85%) had received some training on referencing, but there was little consensus about principles, with more than 30% considering it acceptable to cite a reference in a paper they had not read. Discussing these results and the questions in workshops was helpful; it was also clear that there was no consensus among supervisors on what constituted correct behavior.ConclusionsThis survey shows a need for greater consensus on appropriate referencing, and that there is need for more discussions and training on the topic for both students and faculty. (shrink)

Temporal binding via 40-Hz synchronization of neuronal discharges in sensory cortices has been hypothesized to be a necessary condition for the rapid selection of perceptually relevant information for further processing in working memory. Binocular rivalry experiments have shown that late stage visual processing associated with the recognition of a stimulus object is highly correlated with discharge rates in inferotemporal cortex. The hippocampus is the primary recipient of inferotemporal outputs and is known to be the substrate for the consolidation of working (...) memories to long-term, episodic memories. The prefrontal cortex, on the other hand, is widely thought to mediate working memory processes, per se. This article reviews accumulated evidence for the role of a subcortical matrix in linking frontal and hippocampal systems to select and ''stream'' conscious episodes across time (hundreds of milliseconds to several seconds). ''Streaming'' is hypothesized to be mediated by the selective gating of reentrant flows of information between these cortical systems and the subcortical matrix. The physiological mechanism proposed for this temporally extended form of binding is synchronous oscillations in the slower EEG spectrum (< 8 Hz). (shrink)

Jean Baudrillard is a pivotal figure in contemporary cultural theory. Without doubt one of the foremost European thinkers of the last fifty years, his work has provoked debate and controversy across a number of disciplines, yet his significance has so far been largely ignored by feminist theorists.

Given the nature of the discipline, it might be assumed that clinical psychology is an ethical profession, within which effective ethical decision-making is integral. How then, does this ethical decision-making occur? This paper describes a systematic review of empirical research addressing this question. The paucity of evidence related to this question meant that the scope was broadened to include other professions who deliver talking therapies. This review could support reflective practice about what may be taken into account when making ethical (...) decisions and highlight areas for future research. Using academic search databases, original research articles were identified from peer-reviewed journals. Articles using qualitative, quantitative and mixed methods were included. Two theoretical models of aspects of ethical decision-making were identified. Areas of agreement and debate are described in relation to factors linked to the professional, which impacted ethical decision-making. Factors relating to ethical dilemmas, which impacted ethical decision-making, are discussed. Articles were appraised by two independent raters, using quality assessment criteria, which suggested areas of methodological strengths and weaknesses. Comparison and synthesis of results revealed that the research did not generally pertain to current clinical practice of talking therapies or the particular socio-political context of the UK healthcare system. There was limited research into ethical decision-making amongst specific professions, including clinical psychology. Generalisability was limited due to methodological issues, indicating avenues for future research. (shrink)

This book focuses in an in-depth way on the particular problems faced by nurses in various advanced practice roles across the life-span and in front-line care. It is comprehensive textbook broken out into three sections: philosophical foundation, ethics, and specialty focus.

Ethical awareness enables nurses to recognize the ethical implications of all practice actions, and is an important component of safe and high quality nursing care (Milliken 2016; Milliken and Grac...

In this paper, I investigate why anorexia nervosa emerged in non-Western nations after Western globalization efforts. Using Simone de Beauvoir’s theory of gender from The Second Sex alongside Michel Foucault’s conceptualization of the “docile body,” I argue that the emergence of anorexia nervosa in non-Western nations reflects the Western sovereign’s subordination of women. While patriarchal oppression is not exclusive to the West, I contend that the political ideology behind Western industrialization has allowed new avenues for patriarchal oppression to permeate. To (...) conclude, I demand that mainstream discourse on anorexia nervosa consider the political conditions which are catalytic to its occurrence. (shrink)

There is a widespread policy assumption that school leaders such as headteachers and governors need to have 'training courses' which are constituted by a growing corpus of Education Management Studies (EMS) if they are to achieve successfully current schooling goals of 'effectiveness', 'quality', 'excellence' and 'value for money'. Another body of work which attempts to address these issues in a wider cultural framework and which may be called Critical Leadership Studies (CLS) is regarded as interesting for those studying for higher (...) graduate qualifications but hardly relevant for everyday school busyness. While EMS is constructed as 'practical' and therefore a necessary constituent of the National Professional Qualification for Headteachers and other training courses for school leaders, CLS is constructed as 'academic' and more suitable for the EdD seminar. It will be argued here that both cultural analysis and recent research shows this to be a simplistic and reductionist view with dangerous policy consequences. Critical scholarship in education has much to offer to those meeting the everyday challenges of school leadership. In particular, feminist critical scholarship offers oppositional models to both traditional and market forms of patriarchal school leadership. (shrink)

In the metaphor of behavioral momentum, the rate of a free operant in the presence of a discriminative stimulus is analogous to the velocity of a moving body, and resistance to change measures an aspect of behavior that is analogous to its inertial mass. An extension of the metaphor suggests that preference measures an analog to the gravitational mass of that body. The independent functions relating resistance to change and preference to the conditions of reinforcement may be construed as convergent (...) measures of a single construct, analogous to physical mass, that represents the effects of a history of exposure to the signaled conditions of reinforcement and that unifies the traditionally separate notions of the strength of learning and the value of incentives. Research guided by the momentum metaphor encompasses the effects of reinforcement on response rate, resistance to change, and preference and has implications for clinical interventions, drug addiction, and self-control. In addition, its principles can be seen as a modern, quantitative version of Thorndike's (1911) Law of Effect, providing a new perspective on some of the challenges to his postulation of strengthening by reinforcement. Key Words: behavioral momentum; clinical interventions; drug addiction; preference; reinforcement; resistance to change; response strength; self-control. (shrink)

Nurses have moral obligations incurred by membership in the profession to participate knowingly in health policy advocacy. Many barriers have historically hindered nurses from realizing their potential to advance health policy. The contemporary political context sets additional challenges to policy work due to polarization and conflict. Nursing education can help nurses recognize their role in advancing health through political advocacy in a manner that is consistent with disciplinary knowledge and ethical responsibilities. In this paper, the authors describe an exemplar of (...) Elizabeth Barrett's “Power as Knowing Participation in Change” theory as a disciplinary lens within a doctoral nursing health policy course. Barrett (radically) emphasizes “power as freedom” instead of “power as control.” This approach is congruent with nursing disciplinary values and enhances awareness of personal freedom and building collaborative relationships in the policy process. The theory was used in concert with other traditional policy content and frameworks from nursing and other disciplines. We discuss the role of nursing ethics viewed as professional responsibility for policy action, an overview of Barrett's theory, and the design of the course. Four student reflections on how the course influenced their thinking about policy advocacy are included. While not specific to policymaking, Barrett's theory provides a disciplinary grounding to increase students' awareness of freedom and choices in political advocacy participation. Our experience suggests that Barrett's work can be fruitful for enhancing nurses' awareness of choices to participate in change across settings. (shrink)

Photographs of violence carry an implicit critique of the social order from which they emerge. This necessitates the systemic management of their affect. Recognition of the experience carried by these signals has the potential to catalyse and contribute to emancipatory thought and action. The apparatus of epistemic control – characterized here as the Archive – has evolved to neutralize their affective potential. Certain artworks that reconfigure photographs of violence illuminate the nature of this neutralizing mechanism. They mimic and subvert the (...) forms of representational archivization and suggest a counter-Archive – a repository of traumatic representation which serves to release affective trauma from its epistemic suppression. One example of this counter-archival practice is – War Primer 2. A body of work from 2011 by artists Adam Broomberg and Oliver Chanarin, which uses Bertolt Brecht’s Kreigsfibel or War Primer (1955) as a point of departure for examining the representation of twenty-first century violence. (shrink)

Since the 1960s, it has been recognized that “medical ethics,” the area of inquiry about the obligations of practitioners of medicine, is inadequate for capturing and addressing the complexities associated with modern medicine, human health, and wellbeing. Subsequently, a new specialty emerged which involved scholars and professionals from a variety of disciplines who had an interest in healthcare ethics. The name adopted is variously biomedical ethics or bioethics. The practice of bioethics in clinical settings is clinical ethics and its primary (...) aim is to resolve patient care issues and conflicts. Nurses are among these clinical ethicists. They are drawn to the study and practice of bioethics and its applications as way to address the problems encountered in practice. A significant number are among the ranks of clinical ethicists. However, in the role of bio- or clinical ethicist, some retained the title of their original profession, calling themselves nurse ethicists, and some did not. In this article, we explore under which conditions it is permissible or preferable that one retains one’s prior profession’s nomenclature as a prefix to “ethicist,” under which conditions it is not, and why. We emphasize the need for transparency of purpose related to titles and their possible influence on individual and social good. (shrink)

The focus of this study was on adolescent mental health. More specifically, the relationship between strength-based parenting (SBP) and subjective wellbeing (SWB) during adolescence, as assessed by a sample of adolescents, was examined at three time points over 14 months (N = 202, Mage = 12.97, SDage =.91, 48% female). SBP was positively related to life satisfaction and positive affect at each of the three time points, and was negatively related to negative affect. SBP and SWB both declined significantly over (...) time. When examining the causal relationships between SBP and SWB, two different statistical models were applied: latent growth-curve models (LGM) and random-intercept cross-lagged panel models (RI-CLPM). The LGM revealed a strong positive relationship between changes in SBP and SWB. Specifically, this model showed that SBP at one time point predicted adolescent SWB at future time points. However, when the more stringent statistical test was completed through RI-CLPMs, no cross-lagged paths reached significance. Thus, while parenting is a significant predictor of wellbeing for pre-teens and teens in real time, it is not predictive of wellbeing at future time points. Parents, thus, cannot assume that their current levels of SBP are ‘banked’ by their children to support future wellbeing. Instead, SBP needs to be an ongoing, contemporary parenting practice. Furthermore, the fact that perceptions of SBP decline in this age bracket suggest that SBP interventions may be helpful in supporting adolescent mental health. (shrink)

HIV-related state laws are being created transnationally though the use of omnibus model laws. In 2004, the US Agency for International Development funded the creation of one such guidance text known as the USAID/Action for West Africa Region Model Law, or N'Djamena Model Law, which led to the rapid spread of HIV/AIDS laws, including the criminalisation of HIV transmission, across much of West and Central Africa . In this article, I explicate how an epidemic of highly problematic legislation spread across (...) the region as a result of a text-mediated work process enabled through model laws. I theorise the textual genre of model laws arguing that these texts are best understood as ‘preoperative documents’ which, when activated, can lead to swift legislative reform in and beyond the field of HIV/AIDS governance. The legislative process being investigated was made visible through participant observation, archival research, textual analysis and informant interviews with national and international stakeholders . This involved ethnographic research in Canada, the USA, Switzerland, Austria, South Africa and Senegal . The untold policy processes and narratives explored in this article make evident how the work of contesting problematic HIV/AIDS model laws and newly drafted state laws involves both creating new texts and contesting the legitimacy and efficacy of others. (shrink)

Does the interaction between climactic demands, monetary resources, and freedom suggest a more general relationship between the environmental challenges that human societies face and their resources to meet those challenges? Using data on press freedom (Van de Vliert 2011a), we found no evidence of a similar interaction with natural resources (as measured by oil exports) or risk for natural disasters.

This collection of original essays examines the relationship between women and religion in the history of political thought broadly conceived. This theme is a remarkably revealing lens through which to view the Western philosophical and poetical traditions that have culminated in secular and egalitarian modern society. The essays also give highly analytical accounts of the manifold and intricate relationships between religion, family and public life in the history of political thought, and the various ways in which these relationships have manifested (...) themselves in pagan, Jewish, Christian and post-Christian settings. (shrink)

A reprint of the article "La théorie du plaisir d'après Épicure" (The Theory of Pleasure According to Epicurus), by Victor Brochard, and translated and edited by Eve Grace, which appeared in the 1904 issue of the "Journal des Savants" is presented. The article focuses on philosopher Epicurus' theory of pleasure. It notes that most historians believe that pleasure, in the view of Epicurus, is reducible to the absence of pain. The philosopher states that the pleasure of the belly is the (...) only one pleasure. (shrink)