There is limited consensus about what constitutes humanly sensitive care, or how it can be sustained in care settings. A new humanised care assessment tool may point to caring practices that are up to the task of meeting persons as humans within busy healthcare environments. This paper describes qualitative development of a tool that is conceptually sensitive to human dimensions of care informed by a life‐world philosophical orientation. Items were generated to reflect eight theoretical dimensions that (...) constitute what makes care feel humanly focused. An action research group process in 2014–2015 with researchers, service users, healthcare professionals in two diverse clinical settings (stroke rehabilitation and dermatology) was used. Feedback on conceptual content, transparency of meaning and readability was then gained from a panel in Sweden and third‐year student nurses in the UK. The tool can be applied to attune staff to human dimensions of care, offering items which point to concrete examples of humanising and dehumanising features of practice in ways that have not yet been fully captured in the caring literature. Based on theoretically led experiential items, with dedicated focus on what makes people feel more, or less than human, it may offer improvement on available assessments of care. (shrink)

COVID-19 deeply affects many spheres of life. Lockdown measures implemented worldwide have accentuated mental wellbeing changes in the population from the perspectives of space and social relations. These changes leave lasting imprints on individuals and communities. This article draws upon solidarity and care ethics in exploring their role in rebuilding mental wellbeing in the light of constraints arising from lockdown. The diversity of responses to physical and social isolation during the pandemic illuminates the distinctly relational nature of (...) human beings, offering the opportunity for care and solidarity to respond to mental wellbeing challenges in an inclusive and context-sensitive way. (shrink)

Martin Heidegger’s existential account of care in _Being and Time_ (2010) provides us with an opportunity to reimagine what the proper theoretical grounding of an ethic of care might be. Heidegger’s account of care serves to deconstruct the two primary foundations that an ethic of care is often based upon. Namely, that we are inevitably interdependent upon one another and/or possess an innate disposition to care for fellow humans in need. Heidegger’s account reveals that (...) both positions are founded upon an ontic (meaning factual existence), as opposed to an ontological (which refers to the nature of being), understanding of care. The distinctions between an ontic and ontological understanding of care are significant. Yet, I maintain that they are not completely incompatible. Both Heidegger and care ethicists contend that our existence with others is understood through a relational ontology. Furthermore, there are certain ontological structures from Heidegger which resonate with an ethic of care. Two key existential structures are leaping-ahead and being-guilty. These existential structures are latent in care ethics, and by explicitly revealing them I reinforce the connection between Heidegger’s account and care theory. Lastly, I develop the theoretical foundations of care ethics by proposing an existential ethic of care. (shrink)

This paper focuses on how online health forums may benefit the wellbeing of caregivers. An online questionnaire of caregivers assessed caregiver strain, forum use, and mental and physical wellbeing. Results show a positive relation between caregiver strain and using online health forums to seek emotional support. Furthermore, we find that caregivers with higher levels of caregiver strain report lower mental and physical wellbeing. This relation is however moderated by using online health forums. While the amount of time (...) spent on the online forums did not moderate the relation between caregiver strain and wellbeing, the amount of activity did: Active participation in online health forums attenuates the negative effect of caregiver strain on wellbeing.These findings suggest that online forums are valuable for caregivers and that it is active contribution that matters, rather than simply visiting the online health groups. (shrink)

This study explores young people’s perceptions of their existential well-being during the transition after leaving care. We use the theoretical framework of ‘existential well-being,’ which is a relational approach. The study deploys participatory action research methodology and involves peer research with 74 young people leaving care aged 17–32 in Finland (2011–2012) and England (2016–2018). The data was gathered through semi-structured interviews and thematically analysed.We identified three inter-linking categories of existential well-being related to the basic issues (...) of being a person: who one is and where one belongs. Self-feeling involves the importance of how one feels about oneself and one’s physical and mental health and security. Self-realisation relates to one’s hopes and the means for making one’s own decisions in everyday life. Belonging concerns the confidence one expresses in one’s supportive social networks.The findings highlight that, alongside the practical issues of out-of-home care, attention should increasingly focus on young people's reflections on their own lives, and an ethics of care should be developed to better meet their needs. These findings argue for the need to further support young people’s psychosocial and mental health in child welfare policy and practice. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for (...) the review; (3) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Patients with a life-threatening illness can be confronted with various types of loneliness, one of which is existential loneliness (EL). Since the experience of EL is extremely disruptive, the issue of EL is relevant for the practice of end-of-life care. Still, the literature on EL has generated little discussion and empirical substantiation and has never been systematically reviewed. In order to systematically review the literature, we (1) identified the existential loneliness literature; (2) established an organising framework for (...) the review; (3) conducted a conceptual analysis of existential loneliness; and (4) discussed its relevance for end-of-life care. We found that the EL concept is profoundly unclear. Distinguishing between three dimensions of EL—as a condition, as an experience, and as a process of inner growth—leads to some conceptual clarification. Analysis of these dimensions on the basis of their respective key notions—everpresent, feeling, defence; death, awareness, difficult communication; and inner growth, giving meaning, authenticity—further clarifies the concept. Although none of the key notions are unambiguous, they may function as a starting point for the development of care strategies on EL at the end of life. (shrink)

Personal recovery entails the idea of learning to live a good life in the face of mental illness. It takes place in a continuous dynamic between change and acceptance and involves the existential dimension in the broadest sense. With cognitive self-regulation and empowerment as central elements, however, current models of recovery mostly have an individual focus instead of a relational one. Furthermore, there seems to be an emphasis on the component of change. Little attention is payed to the role (...) and integration of dealing with loss in personal recovery. In this paper, the role of loss in mental illness will be elaborated from an existential perspective. This will be done by relating existential changes to possibly disruptive experiences of loss in wider experience. With the help of several perspectives on dealing with loss it will be argued this can be integrated in processes of recovery. Then, it will be elaborated how reexperiencing a state of being surrounded, or being included, being held is a necessary part of recovery. The result consists of a refinement of the view on personal recovery. The aim of this paper is therefore twofold: (1) to arrive at a better understanding of what existential loss and loss in wider experience in the context of psychopathology entails, and (2) to further develop perspectives on recovery in mental health care. (shrink)

In The Decline of the West Spengler puts forward a type of philosophical anthropology, an account of the structures of human experiential consciousness and a method of “physiognomic” analysis, which I argue has dimensions that can be understood as akin to existential phenomenology. Humanity, for Spengler, is witness to the creative flux of “Becoming” and constructs a world of phenomena bounded by death, underpinned by the two prime feelings of dread and longing and structured by the two forms of (...) Destiny (Time) and Direction (Space). Human existence, Spengler argues, is future-directed and open in the sense that there is a certain degree of freedom in the ways in which humanity can actualize its existential possibilities. In the course of elaborating the existential implications of this future-orientation, Spengler introduces the concept of care (Sorge), the fundamental experiential structure. (shrink)

In ancient China, a revered Taoist sage named Zhuangzi told many parables. In Existential Psychology and the Way of the Tao, a selection of these parables will be featured. Following each parable, an eminent existential psychologist will share a personal and scholarly reflection on the meaning and relevance of the parable for psychotherapy and contemporary life. The major tenets of Zhuangzi's philosophy are featured. Taoist concepts of emptiness, stillness, Wu Wei (i.e. intentional non-intentionality), epistemology, dreams and the nature (...) of reality, character building in the midst of pain, meaning and the centrality of relationships, authenticity, self-care, the freedom that can come from one's willingness to confront death, spiritual freedom, and gradations of therapeutic care are topics highlighted in this book. (shrink)

In response to cancer, patients may be thrown into precarious processes of remaking their purpose, identity, and connections to the world around them. Thoughtful and thorough responses to these issues can be supported by person-centered phenomenological approaches to caring for patients. The importance of perspectives on illness offered by theoretical phenomenology will become apparent through the example of the experience of nausea, or perhaps more accurately put—chemo sickness. The focus here is on how chemo sickness alters one's way of relating (...) to the world. I will examine the phenomenon of nausea through the lens of the phenomenological concept of mood—an existential feeling that engenders a diffused tone permeating through one's world and shapes the envisioned possibilities on one's horizon. (shrink)

Health professionals are especially exposed to stress, with consequences on professionals’ health and wellbeing. However, palliative care professionals’ wellbeing has been the subject of very little research. The aim of this work is to study the Personal Wellbeing Index in a sample of Spanish palliative care professionals, as well as to study their levels of wellbeing and the relationships of wellbeing with variables such as gender, age, marital status, profession, and professional quality of (...) life. A cross-sectional survey of Spanish palliative care professionals was conducted. The Spanish version of the PWI and the Short version of the Professional Quality of Life Scale were used. Here, 296 palliative care professionals attending patients at the end of life participated in the study. They showed medium to high levels of wellbeing. The PWI showed an adequate internal structure [χ2 = 116.130 ]; Comparative Fit Index = 0.970; standardized root mean square residual = 0.041; root mean square error of approximation = 0.140 ] and excellent estimates of reliability [α = 0.879 and Composite Reliability Index = 0.923]. Wellbeing was higher for married compared to single and showed no relation with age, gender, and profession. Additionally, a structural equation model was estimated, in which a positive relation was found between wellbeing and compassion satisfaction and a negative one with burnout. The PWI is adequate to measure personal wellbeing in Spanish palliative care professionals. (shrink)

Participatory action research (PAR) is a form of community-driven qualitative research which aims to collaboratively take action to improve participants’ lives. This is generally achieved through cognitive, reflexive learning cycles, whereby people ultimately enhance their wellbeing. This approach builds on two assumptions: (1) participants are able to reflect on and prioritize difficulties they face; (2) collective impetus and action are progressively achieved, ultimately leading to increased wellbeing. This article complicates these assumptions by analyzing a two-year PAR project with (...) mothers of disabled children from a South African urban settlement. Participant observation notes, interviews, and a group discussion served as primary data. We found that mothers’ severe psychological stress and the strong intersectionality of their daily challenges hampered participation. Consequently, mothers considered the project ‘inactionable’. Yet, many women quickly started expressing important individual and collective wellbeing transformations. To understand these ‘unlikely’ transformations, a feminist relational account, in particular, that of relational wellbeing, proves essential. We reflect on the consequences of these findings for the dominant PAR methodology and operationalization, and propose to sensitize future PAR with marginalized women by employing relational wellbeing as an overarching ontological awareness. (shrink)

This article discusses the key existential stakes of implementing biometrics in human lifeworlds. In this pursuit, we offer a problematization and reinvention of central values often taken for granted within the “ethical turn” of AI development and discourse, such as autonomy, agency, privacy and integrity, as we revisit basic questions about what it means to be human and embodied. Within a framework of existential media studies, we introduce an existential ethics of care—through a conversation between existentialism, (...) virtue ethics, a feminist ethics of care and post-humanist ethics—aiming to deepen and nuance our understanding of the human behind “human-centered” AI directives. The key argument is that biometrics implicates humans through unprecedented forms of objectification, through which the existential body—the relational, intimate and frail human being—is at risk. We interrogate these risks as they become visible at three sites where embodied humans are challenged by biometrics, and thus where the existential body is challenged by the biometric body. This occurs through reductionism (biometric passports nailing bodies to identities, removing human judgment and compromising agency at the AI border), enforced transparency (smart home assistants surveying human intimacies and invading intimate spaces in the bedroom) and the breaching of bodily integrity (chipping bodies to capture sensory data, challenging the very concept of bodily integrity through self-invasive biohacking). Our existential ethics of care is importantly not a solutionist list of principles or suggestions, but a manifesto for a way of thinking about the ethical challenges of living with biometrics in today’s world, by raising the right questions. We argue that a revitalized discussion of the basic existential stakes within human lived experience is needed and should serve as the foundation on which comprehensive frameworks can be built to address the complexities and prospects for ethical machines, responsible biometrics and AI. (shrink)

American adults currently enjoy a widely accepted and legally well-settled right to refuse health care, including life sustaining treatment. Joel Feinberg provides a moral foundation for this right in liberal political theory. Feinberg's theory grounds the right to refuse in a broad right to self-determination, and it implements the right through a variable conception of voluntariness. This theory provides a plausible account that comports with the widely accepted right to refuse, commonsense, and ordinary practice. -/- Allen Buchanan and Dan (...) Brock contend, however, that Feinberg's priority for the right to self-determination is inconsistent with his variable scale of voluntariness. Although Feinberg presents his theory as one that grants categorical priority to self-determination over individual well-being, Buchanan and Brock argue that Feinberg's variable scale of voluntariness involves a balancing of self-determination and well-being. This balancing approach, which Buchanan and Brock endorse, seems to undermine the competent patient's right to refuse care because it allows concern for the patient's well-being to override that person's right to self-determination in some circumstances. Taken together, these arguments seem to suggest that we must give up either the competent patient's right to refuse treatment or the intuitively sensible variable scale. -/- In this paper, I argue that one can reconcile a categorical priority for self-determination with legal rules that incorporate a variable scale of competence. This integration requires careful examination of the practical and expressive functions of legal rules as well as of the manner in which these rules embody moral priorities. This analysis pursues specific and general projects. Specifically, it addresses the moral foundations of the legal right to refuse treatment, identifying a substantive difference between the balancing approach and the priority for self-determination that characterizes Feinberg's liberalism. Generally, it examines the types of priorities embodied by legal rules as practical decision guides and as expressions of the conventional morality represented by the law. This general project extends beyond the right to refuse treatment to the analysis of the manner in which legal rules express and apply moral priorities. (shrink)

Promoting recovery has become more and more important in the care of patients with severe mental disorders such as psychosis. Recovery is a personal process of growth involving hope, self-identity, meaning in life, and responsibility. Obviously, these components pertain, at least in part, to a psychotherapeutic care perspective. Yet, up to now, recovery has mainly been taken into account in transforming health services and as a general framework for supportive therapy. Existential phenomenology abdicates a theoretical stance and (...) considers issues such as death anxiety, isolation, responsibility, and meaning. Thus, it is likely to provide some insight into the psychotherapeutic aspects of recovery. Furthermore, existential psychotherapy allows powerful insights for adopting a recovery-oriented attitude and to provide useful themes for discussing issues allowing patients to gain meaning and hope. This paper describes these elements to give clinicians insights into this complex topic. (shrink)

A signal challenge of twenty-first century psychiatry is the effective treatment of existential/spiritual suffering in palliative care. This chapter will concentrate on research to assess the therapeutic potential of psilocybin to assuage that suffering. If a “psychedelic experience” can facilitate an acceptance of impending death, and reduce the existential suffering of those who endure it, it could prove to be a valuable intervention where one is sorely needed. The therapeutic use of psilocybin with dying patients (hereinafter patients) (...) raises numerous questions about research trial design, the model of psychiatry that might accommodate it, and the kind of experience it induces. Are these the sorts of experience that psychiatric treatment should effect on troubled patients? Is spiritual care within the ambit of psychiatry? There are epistemological questions as to the veridicality of the psychedelic experience. How much credence should we give it? I will argue in cautious support of ongoing research to evaluate the therapeutic use of psilocybin in palliative care. This argument can be extended to research on its therapeutic use in psychotherapy. The chapter will focus on four questions: (1) what is the ethical justification for this research on patients? (2) What types of research trial design are best used to assess the purported benefits of a psychedelic drug experience? (3) What is the epistemic warrant of the “mystical” and “noetic” facets of this experience? (4) What models of (a) psychiatry and (b) drug action could accommodate the therapeutic use of psilocybin in palliative care? (shrink)

Labelling schemes are practical arrangements aimed at making 'ethical' products widely available and visible. They are crucial to expanded development of ethical markets and hence to the addition of moral dimensions to the normally amoral behaviour linking consumers and retail and production businesses. The study reported here attempts to assess the contribution of UK ethical, social and environmental certification and labelling initiatives to 'sustainable' consumption and production. The research sought to assess the overall potential of initiatives to inject human values (...) into the supply-distribution chains, through a qualitative survey of 15 of the 26 main UK initiatives: in social justice, animal welfare and environmental sustainability from the agriculture, food processing, timber, aquaculture, textiles and personal care sectors. By analysing the basic characteristics and concepts of these labels and investigating the emergence of labelling initiatives, we assess whether labels help add an ethical dimension, or whether, in some respects, they also reduce such missions to the technical management of adding only another 'utility' to a product. The analysis assesses whether the gradual 'mainstreaming' of ethical initiatives such as 'Fairtrade' risks subsuming ethical goals within business participants' competitive and profit-oriented logics. However, the contrasting perspectives revealed between rival labelling initiatives show that the scope and functions of labelling projects go beyond the manifest ones of information communication between consumers and producer and actually introduce elements of socio-political regulation. These are essential for more sustainable and ethical business practices and are an integral part of any humanisation of business involvement. (shrink)

Studies investigating the COVID-19 pandemic from a psychological point of view have mostly focused on psychological distress. This study adopts the framework of existential positive psychology, a second wave of positive psychology that emphasizes the importance of effective coping with the negative aspects of living in order to achieve greater wellbeing. Trait emotional intelligence (trait EI) can be crucial in this context as it refers to emotion-related personality dispositions concerning the understanding and regulation of one’s emotions and those (...) of others. The present study investigated the relationship between trait EI and both wellbeing and psychological distress (i.e., depression, anxiety, and stress), while exploring the mediating role of meaning-centered coping (proactive transformative strategies based on meaning in life) and maladaptive coping (i.e., behavioral disengagement and self-blame) during the first few months of the COVID-19 pandemic. A sample of 326 Lebanese adults completed measures of trait EI, wellbeing, psychological distress, coping, and meaning-centered coping. Results showed a strong positive correlation between trait EI and meaning-centered coping. Trait EI also correlated positively with wellbeing and negatively with psychological distress. Structural equation modeling showed that meaning-centered coping partially mediated the relationship between trait EI and wellbeing. Maladaptive coping fully mediated the relationship between trait EI and psychological distress. Findings indicate that trait EI is positively related to dealing with a stressful situation such as the pandemic in positive ways at both the cognitive level, by reformulating the situation to see something valuable in it, and behavioral level, by being proactive about it. Trait EI was positively linked to seeing the situation as an opportunity for personal growth, finding personal meaning in this situation, maintaining an attitude of hope and courage, and acting more responsibly with one’s self and others during the current crisis. In turn, this coping formula was related to lower psychological distress and improved mental health. These results are consistent with the existential positive psychology framework and can inform implementation programs and policies aiming at raising awareness and promoting healthy and successful coping during the pandemic. (shrink)

One of the concerns of the existential-phenomenological tradition has been to examine the human implications of living in a world of proliferating technology. The pressure to become more specialised and efficient has become a powerful value and quest. Both contemporary culture and science enables a view of human identity which focuses on our 'parts' and the compartmentalisation of our lives into specialised 'bits'. This is a kind of abstraction which Psychology has also, at times, taken in its concern to (...) mimic the Natural Sciences. As such it may unconsciously collude with a cultural trend to view humans as objects like other objects and so, fit 'normatively' into the emerging world of specialised and efficient systems. The present paper examines how the findings of a phenomenological study of psychotherapy reflects a movement by people in psychotherapy to recover their sense of human identity in ways that always transcend any form of objectification. Their human complexity is somewhat restored as they move back towards the concrete details of their lives where the human order has its life. In addition to considering the implications of these findings for restoring the uniquely human dimensions of human identity, the paper will also consider the methodological role that an existential-phenomenological approach can play in supporting a broader view of science. In wishing to be faithful to the human order, it champions the value of the human individual as a starting point in human science and this includes a return to concrete experiences, the balance between unique variations and the ground that we share, and the movement from the particular to the general. As such, a phenomenologically-oriented psychology may have an important role to play in helping the broader sciences remember the 'human scale' of things. Indo-Pacific Journal of Phenomenology , Volume 2, Edition 1, April 2002. (shrink)

Musical performance requires the ability to master a complex integration of highly specialized motor, cognitive and perceptual skills developed over years of practice. It often means also being able to deal with a large amount of pressure within dynamic environments. Consequently, many musicians suffer from health-related problems and have a large number of physical and psychological complaints. Research has shown that making music can present challenges for musicians’ wellbeing. Therefore, our research aims to evaluate and analyze the wellbeing (...) of two distinct groups of respondents, college music students compared with amateur musicians in the French-speaking part of Switzerland, this second group serving as our comparison group. This article presents the results of a sample of 126 musicians (mean age ± SD = 22.4 ± 4.5 years, 71 male). The wellbeing was assessed through the World Health Organization Quality of Life-BREF questionnaire evaluating two general measures, Quality of Life and General health, and four specific dimensions, Physical health, Psychological health, Social relationships and Environment. The respondents’ Quality of Life was high on each measure: median scores were higher than 4 for the first two measures and higher than 70 for the four specific dimensions. Among the dimensions, respondents had the highest mean score for Social relationships and Physical health (74.0 and 73.8, respectively) and, finally, on Psychological health (70.3). Our overview of musicians’ wellbeing in Western Switzerland underlines the importance of helping musicians to be aware of their health in order to take care of themselves. This research offers an important insight into musicians’ health and point out the importance of involving different actors (teachers, administrators or support staff) to promote their wellbeing and empower musicians. (shrink)

In this paper we offer an appreciation and critique of patient-led care as expressed in current policy and practice. We argue that current patient-led approaches hinder a focus on a deeper understanding of what patient-led care could be. Our critique focuses on how the consumerist/citizenship emphasis in current patient-led care obscures attention from a more fundamental challenge to conceptualise an alternative philosophically informed framework from where care can be led. We thus present an alternative interpretation of (...) patient-led care that we call ‘lifeworld-led care’, and argue that such lifeworld-led care is more than the general understanding of patient-led care. Although the philosophical roots of our alternative conceptualisation are not new, we believe that it is timely to re-consider some of the implications of these perspectives within current discourses of patient-centred policies and practice. The conceptualisation of lifeworld-led care that we develop includes an articulation of three dimensions: a philosophy of the person, a view of well-being and not just illness, and a philosophy of care that is consistent with this. We conclude that the existential view of well-being that we offer is pivotal to lifeworld-led care in that it provides a direction for care and practice that is intrinsically and positively health focused in its broadest and most substantial sense. (shrink)

A moral problem arises when a patient refuses a treatment that would save her life. Should the patient be treated against her will? According to an influential approach to questions of biomedical ethics, certain considerations pertaining to individual autonomy provide a solution to this problem. According to this approach, we should respect the patient’s autonomy and, since she has made an autonomous decision against accepting the treatment, she should not be treated. This article argues against the view that our answer (...) to the question of whether or not the refusing patient ought to be treated should be based on these kinds of considerations pertaining to individual autonomy and maintains that finding a plausible answer to this question presupposes that we resolve questions concerning subjectivity and objectivity of individual wellbeing. (shrink)

We have conducted a small qualitative empirical study into the problems that nurses encounter in delivering existential support in their care of dying patients. We found that nurses are confronted with four types of problem: determining whether the patient actually has put a genuine question for existential support on the agenda; assessing what the import of such a question is; devising an adequate procedure for offering existential support; and organizing adequate support for themselves. Our analysis shows (...) that it takes a ‘fine-tuned antenna’ from nurses to determine these existential questions, which are often put indirectly and in a variety of forms. We have attempted to show that the subtleties of the communicative dimension of palliative terminal care require an intricate set of virtues on the part of the nurse. We have analysed these virtues in a bottom-up approach, inferring them directly from the material obtained from interviews. The framework utilized is the Aristotelian one of striking the right balance between the poles of a morally relevant dimension. (shrink)

Disabled people frequently find themselves in situations where their quality of life and wellbeing is being measured or judged by others, whether in decisions about health care provision or assessments for social supports. Recent debates about wellbeing and how it might be assessed (through subjective and/or objective measures) have prompted a renewed focus on disabled people’s wellbeing because of its seemingly ‘anomalous’ nature; that is, whilst to external (objective) observers the wellbeing of disabled people appears (...) poor, based on subjective assessments, people with disabilities report a good quality of life. In this paper, I examine an article by the philosopher Dan Moller in which he seeks to explain this ‘disability paradox’. Despite agreeing with his analysis that there is more to what people value than happiness, his explanation reflects some of the difficulties presented in philosophical accounts which seek to understand the lives of disabled people: this includes an analysis which fails to problematise definitions of wellbeing and who has the ‘voice’ to do the defining; which negates the multiple identities and subject positions that disabled people occupy; and which lacks recognition of the social contexts which mediate disabled people’s lives. I suggest that there is a need to incorporate disabled people’s voices into research which deepens our empirical knowledge about the relationship between impairment and wellbeing, including the social circumstances that shape disabled people’s agency. (shrink)

The question of how disability affects wellbeing has occupied a number of philosophers in recent years. However, this literature has proceeded without a careful examination of the fairly vast empirical research on the topic. In this paper, I review the scholarly literature and discuss some philosophically-relevant aspects of it. On average, those with disabilities have a significantly lower level of wellbeing than those without disabilities. Furthermore, there is strong evidence that this reduction in wellbeing is not due (...) entirely to ableist factors. Hence, I argue that it shows that the Mere Difference View of disability is most likely false. However, the literature indeed shows that disabled people typically live good lives. Thus, despite its rejection of the Mere Difference View, it still upholds a disability-affirmative view. These findings allow for a measured critique of some of Peter Singer’s writings on disability. (shrink)

This article is about the therapeutic use of photography in mental health care. We will first describe the intelligent nature of perception as we understand on the basis of neurobiological research findings. We will link our interpretation of visual perception with the phenomenology of perception from the theory of Merleau‐Ponty.. Then we will discuss how patients in mental health care with mental health problems may profit by an experiential approach that is concomitant with the existential reality described (...) by Merleau‐Ponty. The experiential approach we go into more detail is Focusing. We will demonstrate the limitations and feasibility of Focusing in the procedures of working with photography as a therapeutic medium. (shrink)

While there is a great deal to agree with in the essay Expanded Terminal Sedation in End-of-Life Care there is, we think, a need to more fully appreciate the humanistic side of both palliative and end-of-life care.1 Not only does the underlying philosophy of palliative care arguably differ from that which guides curative medicine,2 dying patients are in a uniquely vulnerable position given our cultural disinclination towards open discussions of death and dying. In this brief response, we (...) critically engage Gilbertson et al ’s essay and seek to contextualise the perspective they put forward. According to Cassell, we should distinguish between pain and suffering.3 The former often gives rise to the latter, but suffering has other causes. This includes existential distress, indicating that, unlike pain, suffering is not simply physiological phenomena. Suffering involves the disintegration of the person, meaning that it can impact patient autonomy. Certainly, that a patient is suffering does not equate to a lack autonomy. Nevertheless, we should take care when making decisions in circumstance where the integrity of our embodied personhood is under threat, something that is clearly the case for those who are dying, particularly those who have refractory symptoms while doing so. Generally speaking, refractory symptoms are those which are intractable. They persist despite attempts at palliation. While this implies that such symptoms—and the suffering they cause—cannot be reversed this is not necessarily the case. Not only can the symptoms experienced by dying patients change …. (shrink)

The COVID-19 pandemic has presented a global threat to physical and mental health worldwide. Research has highlighted adverse impacts of COVID-19 on wellbeing but has yet to offer insights as to how wellbeing may be protected. Inspired by developments in wellbeing science and guided by our own theoretical framework, we examined the role of various potentially protective factors in a sample of 138 participants from the United Kingdom. Protective factors included physical activity, tragic optimism, gratitude, social support, (...) and nature connectedness. Initial analysis involved the application of one-sample t-tests, which confirmed that wellbeing in the current sample was significantly lower compared to previous samples. Protective factors were observed to account for up to 50% of variance in wellbeing in a hierarchical linear regression that controlled for a range of sociostructural factors including age, gender, and subjective social status, which impact on wellbeing but lie beyond individual control. Gratitude and tragic optimism emerged as significant contributors to the model. Our results identify key psychological attributes that may be harnessed through various positive psychology strategies to mitigate the adverse impacts of hardship and suffering, consistent with an existential positive psychology of suffering. (shrink)

In this paper, we describe the value and philosophy of lifeworld-led care. Our purpose is to give a philosophically coherent foundation for lifeworld-led care and its core value as a humanising force that moderates technological progress. We begin by indicating the timeliness of these concerns within the current context of citizen-oriented, participative approaches to healthcare. We believe that this context is in need of a deepening philosophy if it is not to succumb to the discourses of mere consumerism. (...) We thus revisit the potential of Husserl’s notion of the lifeworld and how lifeworld-led care could provide important ideas and values that are central to the humanisation of healthcare practice. This framework provides a synthesis of the main arguments of the paper and is finally expressed in a model of lifeworld-led care that includes its core value, core perspectives, relevant indicative methodologies and main benefits. The model is offered as a potentially broad-based approach for integrating many existing practices and trends. In the spirit of Husserl’s interest in both commonality and variation, we highlight the central, less contestable foundations of lifeworld-led care, without constraining the possible varieties of confluent practices. (shrink)

Positive Psychology has recently attempted at “enlarging the paradigm,” explaining the understanding of the human experience of the world. By contrast, for Critical Psychology, “enlarging the paradigm” means moving away from an individualist conceptualization of the psychological. The present article aims at “redistributing the Psychological” toward directions already marked by cultural and discursive conceptions of human experience. Within a transdisciplinary frame, labeled as Psycho-semiotics, Diatextual Analysis has been adopted to investigate the rhetorical modes used by socially excluded enunciators (drug users, (...) immigrants, atypical workers, elderly people, and some categories of churchgoer) to elaborate their own experience of well-being through affective labor and self care. (shrink)

The phenomenon of malaise is on the rise at universities, reflecting a deteriorating psychological state that is a combination of anxiety and stress factors. This psychological and emotional upheaval within students is indicative of a fundamental existential issue. In fact, hidden behind the choice of an educational program is the significance given by the student to their life goals. It is this dimension of attributing meaning to one’s education and, more broadly, to one’s life (the existential dimension) that (...) we have sought to explore. We hypothesized that a stable investment in one’s life goals and a sense of psychological wellbeing during one’s studies could be fostered by reflective work done alongside the educational process. Our research took the form of a mixed methodological approach to the attribution of meaning to education, including an interpretive phenomenological analysis (IPA), and the experimentation of support for the meaning of education. Four dimensions of meaning were found to be observable in varying degrees in all students, each playing a specific role. Moreover, this research has confirmed that the meaning of studies is not to be understood solely in terms of education, but is part of a singular life story. Reflective work, developing meaning, facilitated by others (advisor, teacher, etc.) can help preserve/restore the feeling of wellbeing. It should be noted that, as the work presented in this article predates the pandemic, we will not address the amplifying effects of this health crisis on existential issues, which some recent studies are beginning to highlight. (shrink)

In this paper, we argue that our moral concern for future well-being should reduce over time due to important practical considerations about how humans interact with spacetime. After surveying several of these considerations (around equality, special duties, existential contingency, and overlapping moral concern) we develop a set of core principles that can both explain their moral significance and highlight why this is inherently bound up with our relationship with spacetime. These relate to the equitable distribution of (1) moral concern (...) in a universe that we can only causally affect in one temporal direction; (2) access to the benefits from using spacetime as a resource; and (3) the burdens of care given (1) and (2). We conclude by considering the practical implications of our argument and find that, while it is often assumed that a preference for present over future well-being weakens the case for existential risk mitigation, this likely is not the case. (shrink)

Being aware of social injustices can cause existential and mental pain; comes with a burden; and may impede a flourishing life. However, I shall argue that this is not a reason to despair or to choose to be willfully ignorant. Rather, it’s a reason to conclude that being conscious is not enough. Rather, during times of oppression, resisters must also prioritize well-being. One way to do this is by extending what I refer to as solidarity care. I begin (...) by providing an account of solidarity care. I then offer pragmatic ways in which one can extend solidarity care to others. I conclude by responding to two possible worries. (shrink)

This exposition focuses on purposeful behavioursaseffortstoward self-actualization. I introducehabit as a set of value-based behaviours that is different than the typical habit of physical movements. Each of those praxis is controlled by cognition drivenby values –both personal and societal, and their following habitsare the result of complex learning. I will then elaborate on three important topics: (1) awareness and efficacy with respect tohabit, (2) collective habit, and (3) implications of existential habit on the individual’s as well as the society’s (...) wellbeing. (shrink)

This paper examines moral dilemmas faced by family caregivers of older adults who employ live-in migrant care workers. Being both a family caregiver as well as an employer of a live-in migrant care worker often puts family members at a crossroad, where moral decisions must be made. Lacking a formal role, family members do not have a professional code of ethics or other clear rules that can guide their actions, and their choices are rooted in cultural, community, familial, (...) and personal values. This paper discusses moral dilemmas that result from family caregivers’ dual commitment, to the wellbeing of their older sick relative who is the recipient of care, and to the wellbeing of the live-in care worker whom they employ. The paper uses relational ethics as a theoretical framework to discuss three cases that involve complex moral decision making in real life. (shrink)

Summary Care and cure have been described as different kinds of ethical approaches to clinical situations. Female concerns in nursing care have been contrasted with masculine, cure orientated physician's attitudes. Ethics in such different voices may have sociologic determinants, but they do not represent intrinsic distinctions. Medicine has shown a divergent development, on the one hand stressing cure in a deterministic and instrumental way, on the other hand being aware that disease is as much a pathographic as a (...) biographic, care‐requiring existential situation. Disease is a breakdown of the living organism, to be cured by therapeutic efforts, but it is also the distressing failure of the lived body, requiring concern and care. Based on Lévinas’ ethics of encounter, it is suggested that any interpersonal relatedness is based on concern for the other, being grounded on an essentially ethical interaction. The clinical encounter is a paradigm of such ethics‐based relationships, which necessarily builds on awareness of the other qua other, and is concerned with fulfilling the therapeutic mandate. Caring for the other means doing one's best to help her/him, so that care and cure are inextricably interwoven, although care is the more fundamental form of human relatedness. Thus, neither gender nor professional tasks can allow for a caring attitude to develop without curing concerns, just as trying to cure without caring is unthinkable. (shrink)

In this essay we expand the notion of thinking by emphasizing the provocation and urgency to think and by reconceptualizing thinking as an embodied practice. The aim is to expand Lipman and Sharp’s approach to philosophical inquiry with children and show how other ways of thinking can be included. We strive to unfold a way of “thinking” that is both different from rationality (critical thinking) as well as from creative and caring thinking. In the first part of the paper, we (...) discuss the merits of Lipman and Sharp’s critical, creative and caring thinking within the Community of Philosophical Inquiry (CPI). We then expand Lipman/Sharp’s philosophical method through Ekkehart Marten’s Five-finger Model, which allows for different philosophical approaches. In the second half of the paper, we draw on Martin Heidegger’s What is called thinking? to develop his concept of the “call” to think together with its related notions of provocation and urgency. Building on this, we draw on Maurice Merleau-Ponty to show how this call is not an intellectual activity or mere exercise of the “mind” but rather affects our entire existence. As such, thinking becomes a response to an existential urgency that is an embodied practice. Using concepts like embodiment, affect, and sensibility, we try to widen our conception of thinking in a CPI. Finally, we hope this will allow facilitators to hear the unique voice of every child so that no one is left unheard. (shrink)

We might describe the philosophical issue of human freedom and moral responsibility as an existential metaphysical problem. Problems of this kind are not just a matter of theoretical interest and curiosity: They address issues that we care about and that affect us. They are, more specifically, relevant to the significance and value that we attach to our lives and the way that we lead them. According to the orthodox view, there is a tidy connection between skepticism and pessimism. (...) Skepticism threatens a wide range of interests and concerns that themselves rest on the foundation of our self-conception as responsible moral agents. From this perspective, whereas skepticism licenses a degree of pessimism about our human predicament, the defeat of skepticism serves to vindicate optimism. In recent years this orthodox view of the relationship between skepticism and pessimism has been challenged. It has been argued, for example, that skepticism may be defended in much more optimistic terms. While we have reason to accept skepticism, we have no reason to draw any bleak or depressing consequences from this. Another way of severing the orthodox connection between skepticism and pessimism is to reject skepticism but deny that this will serve to secure or salvage any unqualified form of optimism. This chapter reviews and contrasts these various positions and approaches, beginning with an account of P. F. Strawson’s particularly influential statement of the relationship between the skeptical challenge and pessimism. (shrink)

Our work represents the culmination of a study that is a search for a method. It is a search that has led us away from the remnants of Cartesianism that are found in Sartre’s Critique of Dialectical Reason, which we do not deal with here, and toward a comparative study of Karl Marx and Maurice Merleau-Ponty, which we do take up in detail. The present manuscript argues, in fact, that both Marx and Merleau-Ponty operate with a method that may be (...) called an existential dialectic.By means of careful and extended analysis of The Structure of Behavior we attempt to uncover Merleau-Ponty’s method, calling special attention to its sometimes ignored dialectical character. We then proceed to argue that Marx is operating with a type of phenomenological/existential method, and this is true not only of the young Marx but also of the mature Marx of the Grundrisse and Capital. Finally, with the assistance of Lukacs’ History and Class Consciousness, we point up the dialectical character of Marx’s method. Thus, it is by uncovering this approach in the text of each of these thinkers and by comparing the method of each man with that of the other that we show that both Marx and Merleau-Pontyoperate with an existential dialectical method.This in depth methodological comparison of Marx and Merleau-Ponty represents the first study of its kind. It is hoped that “The Existential Dialectic of Marx and Merleau-Ponty” will contribute to the on-going and important dialogue between Marxists and existentialists. (shrink)

Our work represents the culmination of a study that is a search for a method. It is a search that has led us away from the remnants of Cartesianism that are found in Sartre’s Critique of Dialectical Reason, which we do not deal with here, and toward a comparative study of Karl Marx and Maurice Merleau-Ponty, which we do take up in detail. The present manuscript argues, in fact, that both Marx and Merleau-Ponty operate with a method that may be (...) called an existential dialectic.By means of careful and extended analysis of The Structure of Behavior we attempt to uncover Merleau-Ponty’s method, calling special attention to its sometimes ignored dialectical character. We then proceed to argue that Marx is operating with a type of phenomenological/existential method, and this is true not only of the young Marx but also of the mature Marx of the Grundrisse and Capital. Finally, with the assistance of Lukacs’ History and Class Consciousness, we point up the dialectical character of Marx’s method. Thus, it is by uncovering this approach in the text of each of these thinkers and by comparing the method of each man with that of the other that we show that both Marx and Merleau-Pontyoperate with an existential dialectical method.This in depth methodological comparison of Marx and Merleau-Ponty represents the first study of its kind. It is hoped that “The Existential Dialectic of Marx and Merleau-Ponty” will contribute to the on-going and important dialogue between Marxists and existentialists. (shrink)

A subset of people with severe mental health conditions feels they are on the verge of losing control, even in the absence of external threats or triggers. Some go to extreme ends to avoid affective arousal and associated expectations of a possible, impending catastrophe. We have learned about such phenomenological, emotional challenges in a group of individuals with severe, composite mental health problems and psychosocial disabilities. These individuals have had long treatment histories in the mental health care system. They (...) have been encountered at a specialized inpatient ward offering exposure-based therapy that aims at restoring self-regulation and recovery. We describe the phenomenology of anxiety and fear presented by these service users, a fear we have coined existential catastrophe anxiety. We also suggest a set of underlying, interacting, psychological mechanisms that may give rise to ECa, before comparing ECa with three other constructs previously described in the literature—annihilation anxiety, ontological insecurity, and affect phobia. These comparisons show several similarities, but also unique qualities with ECa and its suggested underlying mechanisms. The conceptualization of ECa may aid clinicians in addressing extreme experiential turmoil and engage service users in empowering therapeutic projects. (shrink)

Much of the discussion of the role of emerging technologies associated with AI, machine learning, digital simulacra, and relevant ethical considerations such as those discussed in the target article, take a relatively narrow and episodic view of a person’s healthcare needs. There is much speculation about diagnostic, treatment, and predictive applications but relatively little consideration of how such technologies might be used to address a person’s lived experience of illness and ongoing care needs. This is likely due to the (...) greater weight or priority given to acute care needs and the role of medical treatment in care provision, but it may also reflect the limitations of current technologies and our limited vision of their potential application. Such limitations are not surprising given that we are still grappling with the complexities and nuances of achieving the ethical and humanistic ideals of care, namely, care that addresses the hermeneutical, relational, contextual, temporal, and agential dimensions of a person’s health and wellbeing. (shrink)

Body care is considered a key aspect of nursing and imperative for the health, wellbeing, and dignity of older people. In Scandinavian countries, body care as a professional practice has undergone considerable changes, bringing new understandings, values, and dilemmas into nursing. A systematic mapping review was conducted with the aims of identifying and mapping international nursing research on body care of older people in different institutionalized settings in the healthcare system and to critically discuss the dominant (...) assumptions within the research by adapting a problematization approach. Most identified papers reported on empirical research with a biomedical approach focusing on outcome and effectiveness. Conceptual papers, papers with a focus on the perspectives of the older people, or contextual and material aspects were lacking. The research field is dominated by four dominant assumptions: Body care as an evidence‐based practice, body care as a relational ethical practice, the body as a body‐object and a body‐subject, the objects in the body care practices as nonrelational materialities. Given the complexities of professional body care practices, there is a need for other research designs and theoretical perspectives within nursing that expand our understanding of body care taking into consideration the multiple social and material realities. (shrink)