A ‘good enough’ nurse: supporting patients in a fertility unitIn this paper, I discuss the findings of an ethnographic study of a fertility unit. I suggest that caring as ‘emotional awareness’ and ‘non‐caring’ as ‘emotional distance’ may be forms of nursing akin to Fabricius’s (1991) arguments around the ‘good enough’ nurse. This paper critiques caring theories and contributes to the debates over the nature of caring in nursing. I discuss the implications raised for nurses if patients want a (...) practical approach to caring and do not expect an emotionally intimate relationship from nurses. (shrink)

In the face of increasing intervention in childbirth, ‘normal birth’ is currently being promoted by the World Health Organization, national governments, professional bodies and other organisations throughout the world. This paper takes a postmodernist stance and explores the idea of the ‘normal’ before going on to analyse normal childbirth, referring to concepts of the normal and the natural. It refers to historical developments in childbearing and lay organisations along with research relating to women’s views of childbirth, to question the appropriateness (...) of using ‘normal’ to describe the very individual experiences of childbirth. It laments the way in which women have been treated and arguably continue to be ‘cared for’ in maternity/obstetric services. It adds to the current discussion by recalling psychoanalytical theory and philosophical analysis to conclude with a call for future consideration of the ‘good‐enough’ birth instead of concentrating on promoting normal birth which is very difficult, if not impossible to define in retrospect, or to prospectively promote. (shrink)

Background The Liverpool Care Pathway is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for (...) dying people with dementia. Methods This systematic review is based on a systematic literature search of MEDLINE, CINAHL, EMBASE, and Web of Science. Results The search identified 12 studies, but none describing an evidence-based adaption of LCP to nursing home patients and people with dementia. No studies described the LCP implementation procedure, including strategies for discontinuation of medications, procedures for nutrition and hydration, or the testing of such procedures in nursing homes. No effect studies addressing the assessment and treatment of pain and symptoms that include dying nursing home patients and people with dementia are available. Conclusion LCP has not been adapted to nursing home patients and people with dementia. Current evidence, i.e. studies investigating the validity and reliability in clinically relevant settings, is too limited for the LCP procedure to be recommended for the population at hand. There is a need to develop good practice in palliative medicine, Advance Care Planning, and disease-specific recommendations for people with dementia. (shrink)

The Liverpool Care Pathway is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying (...) people with dementia. This systematic review is based on a systematic literature search of MEDLINE, CINAHL, EMBASE, and Web of Science. The search identified 12 studies, but none describing an evidence-based adaption of LCP to nursing home patients and people with dementia. No studies described the LCP implementation procedure, including strategies for discontinuation of medications, procedures for nutrition and hydration, or the testing of such procedures in nursing homes. No effect studies addressing the assessment and treatment of pain and symptoms that include dying nursing home patients and people with dementia are available. LCP has not been adapted to nursing home patients and people with dementia. Current evidence, i.e. studies investigating the validity and reliability in clinically relevant settings, is too limited for the LCP procedure to be recommended for the population at hand. There is a need to develop good practice in palliative medicine, Advance Care Planning, and disease-specific recommendations for people with dementia. (shrink)

The Liverpool Care Pathway is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying (...) people with dementia. This systematic review is based on a systematic literature search of MEDLINE, CINAHL, EMBASE, and Web of Science. The search identified 12 studies, but none describing an evidence-based adaption of LCP to nursing home patients and people with dementia. No studies described the LCP implementation procedure, including strategies for discontinuation of medications, procedures for nutrition and hydration, or the testing of such procedures in nursing homes. No effect studies addressing the assessment and treatment of pain and symptoms that include dying nursing home patients and people with dementia are available. LCP has not been adapted to nursing home patients and people with dementia. Current evidence, i.e. studies investigating the validity and reliability in clinically relevant settings, is too limited for the LCP procedure to be recommended for the population at hand. There is a need to develop good practice in palliative medicine, Advance Care Planning, and disease-specific recommendations for people with dementia. (shrink)

BackgroundThe Liverpool Care Pathway is an interdisciplinary protocol, aiming to ensure that dying patients receive dignified and individualized treatment and care at the end-of-life. LCP was originally developed in 1997 in the United Kingdom from a model of cancer care successfully established in hospices. It has since been introduced in many countries, including Norway. The method was withdrawn in the UK in 2013. This review investigates whether LCP has been adapted and validated for use in nursing homes and for dying (...) people with dementia.MethodsThis systematic review is based on a systematic literature search of MEDLINE, CINAHL, EMBASE, and Web of Science.ResultsThe search identified 12 studies, but none describing an evidence-based adaption of LCP to nursing home patients and people with dementia. No studies described the LCP implementation procedure, including strategies for discontinuation of medications, procedures for nutrition and hydration, or the testing of such procedures in nursing homes. No effect studies addressing the assessment and treatment of pain and symptoms that include dying nursing home patients and people with dementia are available.ConclusionLCP has not been adapted to nursing home patients and people with dementia. Current evidence, i.e. studies investigating the validity and reliability in clinically relevant settings, is too limited for the LCP procedure to be recommended for the population at hand. There is a need to develop good practice in palliative medicine, Advance Care Planning, and disease-specific recommendations for people with dementia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Joy and Aggravation of Being a Career Nursing AssistantDonald KoenigI am a male career nursing assistant with 10 years experience. I also happen to be the Ohio Chair Person for the Male Nursing Assistants Task Force. This task force is designed to help recruit, offer continuing education, increase public awareness, and help maintain the good quality men that work as career nursing assistants.Today I want to talk to (...) you about what it is like to be a nursing assistant. Let me walk you through a day of a nursing assistant. I work the day shift. My day starts at 6:45 am. The first thing I do when I arrive at work is to check the schedule for three things: first, to see what my assignment is; second, to note how many nursing assistants are scheduled for the whole nursing home for that shift; and finally, I check to see if there are any shower aides scheduled and, if so, what sections they are assigned to that day.Once I arrive at my assignment area I check to see how many of my residents are showers and how many assistants from the night shift have already done the morning care of getting residents dressed and up for the day. Federal Regulations are one nursing assistant for every fifteen residents. There are some days that there are more staff scheduled and I will have fewer residents; unfortunately those days do not occur often enough. If I am lucky I end up only having six to eight residents to do morning care with.Now it is time for the breakfast trays to arrive on the floor. Even though I am only assigned to take care of my residents, I have to help pass trays to all residents on my side of the building (61 in my case). First I pass the trays to all residents that require help eating or are total feeds. It is now about 8:30 a.m. and all the residents have been fed and it is time to pick up all the trays and record their intake.Now I am ready to get my report from the nurse and start doing my morning get-ups. Like I said earlier, I have anywhere from six to eight residents to do morning care with. This will include washing, [End Page 141] dressing, mouth and hair care and finally getting them up into their chair. I usually have about two or two and a half hours to accomplish this before it is time for me to go to lunch. During the time I am doing morning care, I am also responsible for answering call lights in my section for all fifteen residents under my care. Most sections will have residents who require two or three assistants per resident for transfers from bed to chair, so when it is time to transfer I have to go looking for help in my area and also must help my co-workers with their transfers. So what this averages out to, if I am lucky, is about fifteen minutes with each resident. I do not know about you but I take longer than that to get ready in the morning. It is now 11:00 a.m. and time for my lunch break of 30 minutes, my first break of the day to sit and relax.It is now lunchtime and there are four aides on the floor. Two at a time go to lunch, leaving the other two to cover the floor for the next hour. Hopefully, everyone got all their residents up and all you have to do is answer call lights, which can be for anything from wanting a pain pill, or wanting to go to the toilet, or needing to be changed because they had an accident. Oh yes, and in between all that I start to take residents down to one of the two dining rooms. One dining room is for those who can feed themselves and the other is for residents who need assistance eating or need to be fed.Lunch is over for the aides and it is time for two aides to... (shrink)

Those who want to know anything about strike action by Italian nurses will find very little written about it. This contribution intends to show that, whatever they are prepared to admit, Italian nurses are not used to strike action because they mostly think of their profession as a form of mission. Even if we could agree with the idea of nursing as a profession subscribing to an ideal of service, we have to distinguish between a real profession and philanthropic work; (...) vocational motivation is not enough to make a good professional. Historically, nurses perceived strikes as contradictory to human need and action; patients must never be left alone. However, Italian nurses are now interested in a dramatic transformation of many aspects of their professional life, becoming conscious of the duty to protect themselves from every kind of exploitation, even if the typical idealism and dedication of nurses makes them vulnerable. (shrink)

How an acceptance of our limitations can lead to a more fulfilling life and a more harmonious society We live in a world oriented toward greatness, one in which we feel compelled to be among the wealthiest, most powerful, and most famous. This book explains why no one truly benefits from this competitive social order, and reveals how another way of life is possible—a good-enough life for all. Avram Alpert shows how our obsession with greatness results in stress and anxiety, (...) damage to our relationships, widespread political and economic inequality, and destruction of the natural world. He describes how to move beyond greatness to create a society in which everyone flourishes. By competing less with each other, each of us can find renewed meaning and purpose, have our material and emotional needs met, and begin to lead more leisurely lives. Alpert makes no false utopian promises, however. Life can never be more than good enough because there will always be accidents and tragedies beyond our control, which is why we must stop dividing the world into winners and losers and ensure that there is a fair share of decency and sufficiency to go around. Visionary and provocative, The Good-Enough Life demonstrates how we can work together to cultivate a good-enough life for all instead of tearing ourselves apart in a race to the top of the social pyramid. (shrink)

This paper examines the increasing trend by nursing scholars such as Patricia Benner to conceptualize ethics as a contextual and embodied ‘way of knowing’, embedded in nursing expertise. The intellectual origins of this development and its debt to neo‐Aristotelian thinkers such as philosopher Charles Taylor are discussed. It will be argued that rather than revealing a truth about ethical expertise, the emergence of the ‘expert’ nurse as a moral and ethical category is the result of the elaboration of neo‐Thomist (...) discourses in the educational and professional shaping of nurses. These discourses act on and are enacted by the individual nurse through his or her participation in specific ethical exercises that result in the constitution of the desired subjectivity – or ‘expertise’. Central to this shaping are particular notions of ‘the good’ and its relationship to knowledge, skill and practice. Critiques of these neo‐Aristotelian perspectives are discussed and applied to the notion of moral expertise in nursing, and the claims made by its proponents concerning the ‘ethical’ distinction between experienced and expert nurses. Finally, a call is made for a more pluralistic approach to ethics. (shrink)

The Philosophy of Modern Song: curious title, a curious book. If you bought it, as I did, because you are a devoted Dylan fan, hoping to find new Dylan songs inside, or at least new Dylan prose, you will be disappointed. In the photo of three musicians on the cover, none of them is Dylan. The one on the left is Little Richard. Who are the other two? Nowhere are we told their names, nor the names of the people in (...) any of the other photos, except for the sixty-six featured artists, though we will recognize many. The photo on the back cover might or might not be of the interior of Izzy Young's “Folklore Center,” reminiscent of Dylan's early days in Greenwich Village in the Sixties, when, together with my guitarist husband, I got to hear him perform after hours at the Gaslight and knew him well enough to say Hi when passing on the street.The basis for selecting the sixty-six songs anthologized and commented on is not immediately obvious. This is not a collection of Dylan's underappreciated favorites, though the taste represented is certainly eclectic and the choices are often surprising. The title does not help the reader who has not yet got her bearings... Philosophy? As if to justify his use of the word, Dylan eventually offers a lengthy comment on Albert Camus, but how relevant is that comment to these songs? And the word modern, too, means so many things—a sudden divergence from the past in the arts and literature; up-to-date and therefore good. These songs are not that kind of modern. If anything, the book looks backward, across the years of Dylan's long life to his musical awakening. Because we are almost the same age, I recognize the hodgepodge of styles and influences assembled here as belonging mostly to the early Fifties, when, like Bob, I was entering my teens by listening to, even dancing to, songs on the radio before I fell asleep at night. Enough about me! But no more apt basis for classifying these songs is suggested. They are not arranged alphabetically or chronologically.As for the anthologized songs, each one, once named, receives a commentary, and every commentary is called a chapter, and every chapter is divided into two parts, spelled out in letters as bold as a movie marquee. We are given the title of each song, the date of its release, and the name of the songwriter. The first part of each commentary consists of a paraphrase of “events” in the song, told almost exclusively in the second-person you rather than the more conventional I or the third-person he or she. Here is a passage from Dylan's paraphrase of “Blue Suede Shoes” by Carl Perkins: You get on well with most people, and you put up with a lot, and you hardly get caught off guard, but your shoes are something else. Minor things may annoy you, but you rise above them. Having your teeth kicked in, being pounded senseless, being dumped on and discredited, but you don't put any weight on that, none of it is as real to you as your shoes. They're priceless and beyond monetary worth.The paraphrase goes on for almost six pages, and to what end? The second half of each commentary, indicated by changes in the type, takes a few steps back to consider the sociological implications of the song in the context of its time. For instance, from the second half of the commentary on “Blue Suede Shoes”: “Shoes reveal character, station, and personality.” But Dylan does not use the opportunity to talk about his own character, station, personality. His associations with Carl Perkins and “Blue Suede Shoes” morph into an anecdote about a man called “Iron Felix, trusted consort to Lenin and Stalin.”A lengthy list of all required photo credits fills the two back pages but is printed in type so small it is almost illegible. If you want more information, and more importantly if you want to experience the songs discussed, your best bet is to search for the recordings on YouTube and to follow along, reading Dylan's commentary, one song at a time, while listening. Or, I hear rumors that we will need to purchase another book, the audio version of Philosophy of Modern Song, not yet released.Every song has its commentary, but nothing about this organization is stable, and as soon as the reader/listener thinks she has discovered a rationale for the order of the works selected, she is met with an exception. Basically, these seem to be songs about which Dylan has something anecdotal to say. More usefully, perhaps, they are organized around certain themes—those that have always preoccupied him: man's inhumanity to man, injustice, self-deception, the human situation. The anonymous author of the blurb on the jacket promises a master class in songwriting, but, if it exists at all, that lecture is exhausted in one or two observations, such as: “ ‘El Paso’ is built on five stanzas, each one two verses and a bridge and then returning to the next stanza.... ”It was almost fifty pages into the book that the sense of something missing overcame me. It was not only the words of the songs and the music that were missing; it was the author, the central intelligence that I love, the singer and songwriter whose name is credited on the cover but who never appears in the book, not even in a photograph. What I missed was Dylan. He had removed himself from his book's pages, except perhaps for a single instance: “You're an eighty-year old man, being wheeled around in a home for the elderly, and the nurses are getting on your nerves.... ”Has Bob Dylan grown weary of himself and all of his creations? The commentaries are not about Bob. In the whole book, the line quoted above may be the only exception. Does he refuse the “first person singular in the hopes of transcending ego”? Maybe; but we want to hear our master's voice. As for the philosophy of song? Besides the remarks on Camus, there is only one commentary in which Dylan explicitly states anything like a philosophy, and that is the one on “Willie the Wandering Gypsy and Me,” written and performed by Joe Shaver. The song has a philosophical point of view: “Keep moving, it's better, let the train keep on rolling.”. (shrink)

ABSTRACT What kind of basic minimum do we owe to others? This paper defends a new procedure for answering this question. It argues that its minimally good life account has some advantages over the main alternatives and that neither the first-, nor third-, person perspective can help us to arrive at an adequate account. Rather, it employs the second-person perspective of free, reasonable, care. There might be other conditions for distributive justice, and morality certainly requires more than helping everyone to (...) secure a basic minimum. Still, if the minimally good life account is correct, and we owe everyone a basic minimum, we must ensure that everyone lives well enough. (shrink)

Educational research suggests that the response biases of educators can negatively influence student performance and aptitude (Blanchett 2006; Bloom 2001; Darity et al. 2001; Gordon 2005; and Skiba et al. 2000). This article introduces ?good enough methods? for autoethnography as an alternative approach to this problem. Luttrell (2000, 13) conceptualizes ?good enough methods? researchers as those seeking to understand and appreciate difference and accept errors often made because of their blind spots and intense involvement. Evidence of this approach via autoethnography (...) is provided here from cases of graduate student-practitioners and their Intergroup/Intercultural Education professor. Moreover, the article highlights (a) a connection of autoethnography to research in Education, (b) five key decisions of a ?good enough methods? approach to autoethnography, and (c) how this approach can be applied to expose and address educator biases relating to ?the matrix? (Hill-Collins 1990) of race, class, and gender. (shrink)

A private property account is central to a liberal theory of justice. Much of the appeal of the Lockean theory stems from its account of the so-called `enough-and-as-good' proviso, a principle which aims to specify each employable person's fair share of the earth's material resources. I argue that to date Lockeans have failed to show how the proviso can be applied without thereby undermining a guiding intuition in Lockean theory. This guiding intuition is that by interacting in accordance with the (...) proviso persons interact as free and equal, or as reciprocally subject to the `laws of nature' rather than as subject to one another's arbitrary will. Because Locke's own and contemporary Lockean conceptions of the proviso subject some persons to some other persons' arbitrary will, the proviso so conceived cannot function as it should, namely as a principle that restricts interacting persons' actions reciprocally and thereby enables Lockean freedom under law. (shrink)

Preimplantation genetic diagnosis (PGD) raises serious moral questions concerning the parent-child relationship. Good parents accept their children unconditionally: they do not reject/attack them because they do not have the features they want. There is nothing wrong with treating a child as someone who can help promote some other worthwhile end, providing the child is also respected as an end in him or herself. However, if the child's presence is not valued in itself, regardless of any further benefits it brings, the (...) child is not being treated as an end in the full sense of the term. In this paper, I argue that these principles apply to human embryos, as well as to born human offspring: the human moral subject is a bodily being, whose interests and rights begin with the onset of his or her bodily life. The rights of the living, bodily human individual include a right not to be attacked/abandoned because of his or her genetic profile. PGD is harmful to the parent-child relationship, and we give mixed messages to parents by expecting them to show unconditional commitment to offspring after birth, while inviting them to take a very different approach at the prenatal stage. (shrink)

The image of “the good nurse” is mainly studied from the perspective of nurses, which often does not match the image held by patients. Therefore, a descriptive study was conducted to examine oncology patients’ perceptions of “the good nurse” and the influence of patient- and context-related variables. A cross-sectional, comparative, descriptive design was used. The sample comprised 557 oncology patients at one of six Flemish hospitals, where they were treated in an oncology day-care unit, oncology hospital ward, or (...) palliative care unit. Data were collected using the Flemish Care-Q instrument. Factor analysis summarised the most important characteristics of “the good nurse”. We reassessed the reliability and construct validity of the Flemish Care-Q and examined the influence of patient- and context-related variables on patient perceptions. Using factor analysis, we grouped the different items of the Flemish Care-Q according to three characteristics: “the good nurse” (I) has a supportive and communicative attitude towards patient and family, (II) is competent and employs a professional attitude, and (III) demonstrates personal involvement towards patient and family. Median factor scores of Factors I, II, and III, respectively, were 8.00, 9.00, and 8.00 (varying from 1, not important, to 10, very important). In order of importance, Factors II, I, and III were identified as valuable characteristics of “the good nurse”. Gender, care setting, and province were influential variables. As perceived by oncology patients, “the good nurse” has a broad range of qualities, of which competence and professionalism are the most valuable. (shrink)

One way of understanding Kant’s views about moral emotions is the cultivation view. On this view, emotions play a role in Kantian morality provided they are properly cultivated. I evince a sceptical position about the cultivation view. First, I show that the textual evidence in support of cultivation is ambiguous. I then provide an account of emotions in Kant’s theory that explains both his positive and negative views about them. Emotions capture our attention such that they both disrupt the mind’s (...) composure and serve as a surrogate for reason. As such, Kant cannot recommend that we cultivate our emotions. (shrink)

Over the past two years, much has been made by some governments and the media about the possible callous and racist distribution of Quinacrine by two Americans to sterilize women in the Third World. The main criticism of the practice is that though Quinacrine is unapproved by the developed world's health regulatory agencies for this particular use in the developed world due to inadequate testing for long-term side effects, it is used on defenseless women in the developing world.I argue that (...) the distribution of unapproved medical and other products is morally permissible if it satisfies two conditions: agent-centered utilitarianism and Kant's Categorical Imperative. Roughly, I contend that if the situation will probably improve and no one is treated as a mere means, then it is ethical either to give or to sell the products to those who choose to have them, regardless of where in the world they live. (shrink)

Peter Lipton; VI*—Is the Best Good Enough?, Proceedings of the Aristotelian Society, Volume 93, Issue 1, 1 June 1993, Pages 89–104, https://doi.org/10.1093/aris.

In Quiet, Fearne Cotton explores why so many of us question whether we are, or will ever be, 'good enough.' This beautiful book, filled with Fearne's creative hand-drawn illustrations and thought-provoking activities to still your mind, will silence your inner-critic and stop you from continually self-sabotaging. Quiet includes interviews with people who have helped Fearne to accept her flaws and love her own imperfections, as well as advice on how to drown out misinformation and the, sometimes, pressurizing noise from family, (...) work and friends, which can fuel our insecurities and self-doubt. Fearne talks honestly and openly about what it's like to live in the public eye and shares some of the methods and practical activities she uses to ignore negative online chatter and trolls. She acknowledges the terrifying stats and research linking social media to rising levels of depression, anxiety and other mental health issues in young people and offers advice about how to listen more selectively to what we are told in an era of constant-sharing, over-sharing and general misinformation about what is 'good' or 'bad' for us. Stop competing with all the noise out there and accept that Quiet might be your most formidable force yet"--Publisher's description. (shrink)

This article explores what might constitute the good-enough reader of Maggie Nelson's The Argonauts. Prompted by Nelson's use of D.W. Winnicott's theory of the good-enough mother whose insufficiencies generate the infant's capacity to tolerate ordinary frustration and move beyond both idealizations and denigrations, I argue that the good-enough reader here would be the one who resists the temptation to idealize both the book and its author. This argument is presented as an attempt to open up some spaces for the discussion (...) of ambivalent responses to this book, beyond the rather deferential fandom that has characterized the psychic life of its reception. (shrink)

In this book, Kate Schick presents the core themes of Rose's work and locates her ideas within central debates in contemporary social theory, engaging with the works of Benjamin, Honig, iek and Butler. She shows how Rose's speculative perspective brings a different gaze to bear on debates, eschewing well-worn liberal, critical theoretic and post-structural positions. Gillian Rose draws on idiosyncratic readings of thinkers such as Hegel, Adorno and Kierkegaard to underpin her philosophy, negotiating the 'broken middle' between the particular and (...) the universal. While of the left, she is sharply critical of much left-wing thought, insisting that it shirks the work of coming to know and of taking political risk in pursuit of a 'good enough justice'. (shrink)

This article discusses findings from a mixed method literature review that investigated cancer patients’ perceptions of what constitutes a good nurse. To find pertinent articles, we conducted a systematic key word search of five journal databases (1998—2008). The application of carefully constructed inclusion criteria and critical appraisal identified 12 relevant articles. According to the patients, good nurses were shown to be characterized by specific, but inter-related, attitudes, skills and knowledge; they engage in person-to-person relationships, respect the uniqueness of patients, (...) and provide support. Professional and trained skills as well as broad and specific nursing and non-nursing knowledge are important. The analysis revealed that these characteristics nurtured patient well-being, which manifests as optimism, trust, hope, support, confirmation, safety and comfort. Cancer patients’ perceptions of what constitutes a good nurse represent an important source of knowledge that will enable the development of more comprehensive and practice-based views on good nursing care for such patients. These perceptions help us to understand how nurses effectively make a difference in cancer patient care. (shrink)

In 2010, randomized controlled trials (RCTs) of two different biomedical strategies to prevent HIV infection had positive findings. However, despite ongoing very high levels of HIV infection in some countries and population groups, it has been made clear by regulatory authorities that the evidence remains insufficient to support either product being made available outside of research contexts in the developing world for at least two years. In addition, prevention trials in endemic areas will continue to test new interventions against placebo. (...) But the judgments of evidentiary standards are never value-neutral. Using the recent trials and their contexts as case studies, we examine the basis for these decisions, which will potentially delay access to scientific innovation to the people who are most urgently in need of it. (shrink)

Is Goodness Without God Good Enough contains a lively debate between William Lane Craig and Paul Kurtz on the relationship between God and ethics, followed by seven new essays that both comment on the debate and advance the broader discussion of this important issue. Written in an accessible style by eminent scholars, this book will appeal to students and academics alike.

The vast majority of research in nursing ethics over the last decade indicates that nurses may not be fully prepared to ‘deliver the good’ for their patients, or to contribute appropriately in the wider current health care climate. When suitable research projects were evaluated for this article, one key question emerged: if nurses are educationally better prepared than ever before to exercise their ethical decision-making skills, why does research still indicate that the expected practice-based improvements remain elusive? Hence, a number (...) of ideas gleaned from recent research about the current nature of nursing ethics, and especially teaching nursing ethics to student nurses, are analysed and critiqued in this article, which concludes with a cluster of ideas and conclusions based on that analysis. It is hoped that such a review may serve as a catalyst for nurse educators to re-examine their teaching practices with a view to enhancing good nursing practice through educational means. (shrink)

In the relational literature, the subject of termination - the ending of an analysis - has received scant attention, and traditional Freudian or ego-psychological criteria are not always enough to assess the readiness to terminate therapy in the coconstructed, intersubjective analytic relationship. _Good Enough Endings _seeks to remedy this gap, bringing together contributions from contemporary relational thinkers, while at the same time engaging with ideas from other psychoanalytic perspectives. Topics given consideration include: Can there be a relational criteria or paradigm (...) for termination, and what would it include? How do treatment goals of the analyst and/or that of the patient affect the decision to terminate? How do recent developments in attachment theory and research influence the preparation to end analysis? What occurs for the patient after termination, and how do we assess the need for follow-up? Integrating elements of existing psychoanalytic theory with the fruits of the relational turn, _Good Enough Endings _expands and expounds upon the relational considerations in ending analysis, providing a resource for reflection and insight into the final - and perhaps most difficult - aspect of psychoanalytic treatment. (shrink)

Background: Worldwide, older persons lack access to palliative care. In Sweden, many older persons die in nursing homes where care is provided foremost by assistant nurses. Due to a lack of beds, admission is seldom granted until the older persons have complex care needs and are already in a palliative phase when they move in. Objective: To describe assistant nurses’ perspectives of providing care to older persons at the end of life in a nursing home. Research design: Data were collected (...) in semi-structured individual interviews and analyzed with inductive qualitative content analysis. Participants and research context: Seven assistant nurses from a nursing home in Sweden were randomly selected. Ethical consideration: The research was approved by the local ethics committee. Results: Three main categories emerged; “Death a natural part of life”; “The older person’s well-being”; and “Care in the moment of death”; and seven sub-categories. The assistant nurses described themselves as knowing the older persons well enough to provide good end-of-life care. This was achieved by making small-talk while providing daily care. Relying on experience-based knowledge, they strove to provide end-of-life care built upon respect and engagement with the ambition to strengthen older persons’ dignity, for example, by lowering the tempo of care at the end of life, in spite of organizational restrictions. Discussion: The assistant nurses offered attentive end-of-life care, focusing upon bodily care. The existential needs of the older persons were not foregrounded. Conclusion: To develop their work, and to promote an ethical foundation for such care, assistant nurses might need support and education to be able to offer a care more in line with the aims of palliative care. Furthermore, the organization of care needs to promote, not impede, the realization of this development. (shrink)

Almost everyone accepts that parents must provide a good enough upbringing in order to retain custodial rights over children, but little has been said about how that level should be set. In this paper, I examine ways of specifying a good enough upbringing. I argue that the two dominant ways of setting this level, the Best Interests and Abuse and Neglect Views, are mistaken. I defend the Dual Comparative View, which holds that an upbringing is good enough when shortfalls from (...) the best alternative upbringing in terms of the child's interests are no more significant than the parents' interest. (shrink)

Prima facie the norms of natural-teleology conflict with norms of morality and rationality. Morality often rejects behaviours that can promote natural-success, and we can have reasons to act in ways that conflict with natural-imperatives. That’s a problem for Attributivism, which dictates that what one ought to do is exhausted in satisfying the standards of one’s kind, and thus that members of natural-kinds ought ultimately to do that which is naturally good. I argue that standard responses are inadequate. I argue further (...) however that the impression of conflict owes to a failure to appreciate the context-sensitivity and holistic interdependence of natural-norms. Natural-norms fluctuate relative to circumstance and to the needs of overall flourishing; once that’s clearly understood, not only does the impression of conflict between natural and moral/rational norms resolve, but we find Attributivism plausibly explains many rational/moral practices/intuitions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Training and Other Important Needs for Nursing AssistantsNanci RobinsonTraining of Nursing AssistantsI think the nursing assistant (NA) training programs should be longer. My original course for Long Term Care was four weeks long after that I took an additional two months at a hospital to work on a Med/ Surg floor. So, I have a combined three months of schooling.Personally, I'd like to see certified nursing assistants (CNAs) given (...) more responsibilities. I'd like to see a six-month program to include CPR and capillary blood glucose (CBG) training as well as more in depth anatomy training. I think six months would keep some, who are just looking for money, out of the field and help keep those of us who really want a career in nursing in the field. It would be a better stepping stone for those who plan to go on to a LPN or RN program.I currently have CBG training but my employer will not let me use it. It's disappointing because it's a skill I have that I can't use and it could really help out the nurses. I think if courses were a bit longer, CNAs might be taken a bit more seriously by their employers and respected by their colleagues in the medical field.I was trained in CBG while working for the hospital and received a card like a CPR card to show I was trained. I live and work and was trained in Arkansas. I'm not allowed to do CBGs in the long-term care and rehab facility where I work now, though. However, unless the resident is diabetic we do have to clip and file nails. It took many years for nurses to gain respect and be allowed to do some things that now CNAs do. For example, for many years doctors didn't feel nurses were qualified to even take vital signs. I suppose CNAs will have the same struggle. [End Page 147]"I'm wondering if extending the initial training time would not keep many out of the field, because they need a job with income ASAP." The same could be said for LPN training, could it not? Or even an RN. I don't understand why there is a train of thought that "anyone" should be allowed to be a CNA and as quickly as possible. I can tell when I'm working alongside a Certified Nursing Assistant who is in it because they want to be versus someone who wants the paycheck (not sure why, though, because to be honest Arkansas doesn't pay CNAs all that great, though I suppose for some it might be better than McDonalds). I took a $5 an hour paycut go get back into nursing because it's my passion, and while we all need a paycheck, that should not be the only reason for doing this work."If extending the initial training time would keep many out of the field because they need a job with income ASAP, maybe employer facility-specific follow-up training would seem to be much more feasible for all. A CNA-in-training could be responsible for a lighter than 'normal' shift assignment while under the guidance of a qualified proctor CNA. It could improve efficiency and quality of care in the long run and probably improve retention rate of CNAs, for those administrators that are astute enough to consider the long-term effects of their policies." This might be good—the only problem is that most facilities aren't going to want to absorb any cost this might create by having additional staff for this purpose. Also, on the job training is not appreciated by employers as much as what might be considered actual "education" hours. Most CNAs want to do as much patient care as they can for the nurse—learning to assist with dressing changes, CBGs and other things that would be beneficial for both CNAs and the Nurse.Ensuring there is enough staff and that those staff members are there for the right reasons would do much more to improve the retention rate of NAs or CNAs. (I'm a... (shrink)

This essay contends that Stanley Cavell’s criterion of “good enough justice,” which designates the minimal condition of social justice necessary for his perfectionist understanding of ethical selfhood, constitutes an avoidance—rather than an acknowledgment—of the problem of injustice. Taking Cavell’s misreading of Walter Benjamin as exemplary of this tendency, the essay shows how Cavell’s moral perfectionism consistently converts questions about the suffering of others into a problem of the self and its conscience, thereby avoiding the ethical claim at the heart of (...) Benjamin’s project. (shrink)

In a recent article (Kraay 2013), I argued that some prominent responses to two important arguments for atheism invoke divine satisficing – and that the coherence and propriety of this notion have not been established. Chris Tucker (2016) agrees with my evaluation of divine satisficing, but disagrees with my exegesis of these responses. He argues that they should be understood as invoking motivated submaximization instead. After reviewing the dialectical situation to date, I assess whether motivated submaximization can be deployed in (...) such a way as to defeat these argument for atheism. I argue that it’s far from clear that it can. (shrink)

In the late 1940s, a microanatomist from London Ontario, Murray Barr, discovered a mark of sex chromosome status in bodily tissues, what came to be known as the ‘Barr body’. This discovery offered an important diagnostic technology to the burgeoning clinical science community engaged with the medical interpretation and management of sexual anomalies. It seemed to offer a way to identify the true, underlying sex in those whose bodies or lives were sexually anomalous . The hypothesis that allowed the Barr (...) body to stand in for ‘chromosomal’ or ‘genetic’ sex was provisional, but it supported the expectation that genetic information established one’s primary identity, and the conviction that the animal world could be neatly divided into two, and only two, sexes. Ultimately, this provisional hypothesis, and its status as an unambiguous arbiter of true sex, was overturned. But during much of the 1950s, Barr’s thesis about the identity of the Barr body was consistent with a coherent set of theories and evidence explaining sexual development and sexual pathology. Though provisional, the scientific status of the sex chromatin within this system of knowledge was good enough to support a flourishing research enterprise in the clinical sciences. (shrink)

Morality and religion: intimately wed, violently opposed, or something else? Discussion of this issue appears in pop culture, the academy, and the media—often generating radically opposed views. At one end of the spectrum are those who think that unless God exists, ethics is unfounded and the moral life is unmotivated. At the other end are those who think that religious belief is unnecessary for—and even a threat to—ethical knowledge and the moral life. -/- This volume provides an accessible, charitable discussion (...) that represents a range of views along this spectrum. The book begins with a lively debate between Paul Kurtz and William Lane Craig on the question, Is goodness without God good enough? Kurtz defends the affirmative position and Craig the negative. Following the debate are new essays by prominent scholars. These essays comment on the debate and advance the broader discussion of religion and morality. The book closes with final responses from Kurtz and Craig. (shrink)

Research relating to patients’ views of the good nurse has mainly focused on the perspectives of adult patients, with little exploring the perceptions of children. This article presents findings from a qualitative study that explored views of the good nurse from the perspective of hospitalized children. The aims of the study were threefold: to remedy a gap in the literature; to identify characteristics of the good nurse from the perspective of children in hospital; and to inform children’s (...) nursing practice. Twenty-two children were interviewed using an adapted ‘draw and write’ technique. Five themes relating to children’s views of the good nurse emerged from the analysis: communication; professional competence; safety; professional appearance; and virtues. Each of these will be discussed in relation to good nurse literature and recommendations made for children’s nursing practice. (shrink)

ABSTRACT The article begins by contrasting medical and moral views of addiction and how such views influence responsibility and policy analysis. It suggests that since addiction always involves action and action can always be morally evaluated, we must independently decide whether addicts do not meet responsibility criteria rather than begging the question and deciding by the label of ?disease? or ?moral weakness?. It then turns to the criteria for criminal responsibility and shows that the criteria for criminal responsibility, like the (...) criteria for addiction, are all folk psychological. Therefore, any scientific information about addiction must be ?translated? into the law's folk psychological criteria. Distractions about responsibility are then quickly canvassed. Then it addresses the direct relation between addiction and criminal responsibility. It argues that most addicts retain sufficient rational and control capacities at the relevant times to be held responsible, especially for crimes that are not part of the definition of addiction itself. It suggests that there is good reason to excuse or mitigate addicts for the crimes of purchase and possession for personal use. It concludes by briefly considering what contemporary science can contribute to our understanding of addiction and agency. (shrink)

This paper develops a view of worship according to which worship is a certain sort of _life orientation_, and argues that according to the Bible, the worship of God normatively is _non-instrumental, comprehensive, unconditional orientation of one’s life toward God_. It then develops a biblical view about how this sort of worship of God is _possible_. Finally, it argues that it is _good_ to worship God in this way only if God is an Anselmian being—_that than which nothing greater can (...) be conceived_—and suggests that the God of the Bible, the Psalms in particular, is in fact an Anselmian being. (shrink)

Wright, Ken Review of: How much is Enough?: Money and the good life, by Robert and Edward Skidelsky, Other Press, New York, 2012, x + 241 pp., $20.07.

In this article, we report the outcome of a sociological inquiry into nursing knowledge of death and dying, specifically ‘the good death’. A genealogical approach informed by actor‐network theory and appreciative inquiry were used to compose a broad socio‐material account of how nurses concern themselves with the care of the dying and end‐of‐life care. Our enquiry revealed similarly to other studies, that there was no shared or overarching model of care. Key themes derived from nurses' translations of ‘the good death’ (...) were re‐presented pictorially as six pillars and two processes to comprise a new diagram of The Personalised Ideal Death. (shrink)