RATIONALE, AIM AND OBJECTIVE: Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in (...) prescribing drugs, using a qualitative approach. (shrink)

La presente investigación, tiene por objeto delimitar las consideraciones epistemológicas de la contabilidad ambiental desde tres categorías: funcionalista, interpretativo y crítico, cada una de ellas con 16 subcategorías. La metodología utilizada es de carácter exploratoria, cualitativa, basada en un análisis documental de artículos científicos arbitrados en la más alta exigencia científica (SCOPUS), bajo filtros de búsqueda exacta, con procesamiento sistemático a través de ATLAS.ti9. Los resultados muestran un mayor enraizamiento en el enfoque crítico, destacando el impulso al cambio, los estudios (...) de conflictos, la desigualdad estructural; seguido del enfoque funcionalista, donde predomina el interés por la claridad, el rigor conceptual, así como la pretensión demostrativa y el espíritu de precisión y certeza; finalmente, en el enfoque interpretativo se buscan prácticas racionalizadoras, con una intención comprensiva que impulse a un proceso de resolución. (shrink)

« Nous sommes tous sur le même bateau », s’écrient les collapsologues, comme s’il s’agissait d’un scoop. Seulement, ces catastrophes annoncées, ou déjà bien amorcées, sont principalement causées par l’Occident et son système économique destructeur. Il s’agit ici de s’interroger sur l’effondrement en adoptant une perspective inversée et d’exposer la démarche de l’autrice de science-fiction Octavia Butler et des continuatrices de son œuvre, qui excellent à rendre possible des histoires alternatives. L’effondrement peut être l’occasion rêvée de changer d’angle et d’échelle (...) et de revenir à l’essentiel. (shrink)

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

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

Psychiatry today is mainly practised within a curative framework. However, many mental disorders are persistent and negatively affect quality of life as well as life expectancy. This tension between treatment goals and the actual illness trajectory has evoked a growing academic interest in ‘palliative psychiatry’, namely the application of a palliative care approach in patients with severe persistent mental illness. Recently, Trachsel et al presented a working definition of palliative psychiatry. This first official attempt to capture the concept is based (...) on WHO’s widely accepted definition of palliative care but modified and limited to include only severe persistent psychiatric illness. While this is a welcome step in the discussion on palliative care approaches in psychiatry, it also opens up for new questions. One of the most evident is whether psychiatry actually needs its own definition of palliative care or, put differently, whether there is something about mental disorders that differs so radically from other medical conditions that it calls for a separate definition. We acknowledge the need to discuss the goals of psychiatric care in patients with severe persistent psychiatric illness. However, we question whether a separate definition of palliative care exclusive to psychiatry is the right way to go. In this paper, we discuss why. (shrink)

Objectives To explore attitudes and reasoning among Swedish physicians and the general public regarding the withdrawal of life-sustaining treatment at a competent patient's request. Design A vignette-based postal questionnaire including 1202 randomly selected individuals in the county of Stockholm and 1200 randomly selected Swedish physicians with various specialities. The vignettes described patients requesting withdrawal of their life-sustaining treatment: (1) a 77-year-old woman on dialysis; (2) a 36-year-old man on dialysis; (3) a 34-year-old ventilator-dependent tetraplegic man. Responders were asked to classify (...) the act of terminating treatment and to prioritise arguments for/against. Results A majority in both groups prioritised arguments in favour of terminating treatment and classified the act as defensible in all vignettes. However, among the general public, 16% classified the act as euthanasia in all vignettes; among physicians this view was most expressed regarding ventilator treatment (26%). Some who classified the act as euthanasia prioritised arguments in favour of terminating treatment: among physicians 18% in vignette 1, 19% in vignette 2 and 34% in vignette 3; among the general public 35% in vignette 1, 20% in vignette 2 and 48% in vignette 3. Conclusion There is a widespread consensus regarding competent patients' right to abstain from life-sustaining treatment. An association between the hastening of death, caused by the withdrawal of life-sustaining treatment and the concept of euthanasia is proposed. The results also suggest that classifying the withdrawal of life-sustaining treatment as ‘euthanasia’ does not necessarily mean that the act is interpreted as ethically unacceptable. (shrink)

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

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

We introduce a new approach to the model theory of metric structures by defining the notion of a metric abstract elementary class (MAEC) closely resembling the notion of an abstract elementary class. Further we define the framework of a homogeneous MAEC were we additionally assume the existence of arbitrarily large models, joint embedding, amalgamation, homogeneity and a property which we call the perturbation property. We also assume that the Löwenheim-Skolem number, which in this setting refers to the density character of (...) the set instead of the cardinality, is ${\aleph_0}$ . In these settings we prove an analogue of Morley’s categoricity transfer theorem. We also give concrete examples of homogeneous MAECs. (shrink)

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

The aim of the present study was to analyse family dinners as context of argumentation and argumentative development by using a context-sensitive model of basic argumentative structures in every day conversations. The data consisted of 40 argumentative sequences in dinner conversations in twenty Swedish families with children aged 7 to 17 years. The families were divided in two groups depending on the children's ages (10–11 years with younger siblings and 10–12 years with older siblings). The model revealed characteristic structures of (...) argumentation appearing as co-text and suggested differences between family groups depending on contextual factors such as age of the children. The groups of older children produced longer argumentative sequences, more exchanges per sequence and higher rate of turns. The older children also engaged in non-instrumental deliberations and disputations significantly more often and they performed more elaborated expansions (through a higher quantity of backing arguments). The groups of younger children on the other hand were more often involved in negotiations on topics relevant in the immediate context. Less expected was, however, the lack of more complex and varied arguments, even in the groups of older children. (shrink)

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

The Rule of Double Effect (RDE) holds that it may be permissible to harm an individual while acting for the sake of a proportionate good, given that the harm is not an intended means to the good but merely a foreseen side-effect. Although frequently used in medical ethical reasoning, the rule has been repeatedly questioned in the past few decades. However, Daniel Sulmasy, a proponent who has done a lot of work lately defending the RDE, has recently presented a reformulated (...) and more detailed version of the rule. Thanks to its greater precision, this reinvented RDE avoids several problems thought to plague the traditional RDE. Although an improvement compared with the traditional version, we argue that Sulmasy's reinvented RDE will not stand closer scrutiny. Not only has the range of proper applicability narrowed significantly, but, more importantly, Sulmasy fails to establish that there is a morally relevant distinction between intended and foreseen effects. In particular, he fails to establish that there is any distinction that can account for the alleged moral difference between sedation therapy and euthanasia. (shrink)

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

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

Recent national and international debates on truth and reconciliation in Uganda have emphasized the importance of incorporating local-level mechanisms into a national transitional justice strategy. The Juba Peace Talks represented an opportunity to develop and articulate sufficient and just alternatives and complementary mechanisms to the international criminal model. The most commonly debated mechanism is the Acholi process known as mato oput (drinking the bitter root), a restorative justice approach to murder. Drawing on 2 months of research in nine internally displaced (...) persons’ camps in 2007, we examine local justice practices in the region of northern Uganda to consider their potential, promise and pitfalls to realizing a successful truth-telling process. We find that although local mechanisms could help facilitate reconciliation in the region, truth-telling is but one part of a conciliatory process complicated by a national context of fear and the complexity of the victim–perpetrator identity at the community level. These locally informed insights help move forward the debate on such mechanisms in Uganda and add useful insights into community processes in the field of transitional justice more generally. (shrink)

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

Can externalist concepts really capture an individual.

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

We have claimed that truth norms cannot provide genuine guidance for belief formation. Asbjørn Steglich-Petersen argues that our ‘no guidance argument’ fails because it conflates certain psychological states an agent must have in order to apply the truth norm with the condition under which the norm prescribes forming certain beliefs. We spell out the no guidance argument in more detail and show that there is no such conflation.

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

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

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

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

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

Cultural evolution, the propagation and transfer of ideas from generation to generation, as well as from one person to another and from one culture to another, is much faster than normal, genetic evolution. This could account for the speedy proliferation of humankind on this planet, at the expense of other life forms.

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

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

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

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

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

Objective: Quality of Life is an important predictor of patient's recovery and survival in lung cancer patients. The aim of the present study is to identify 1-year trends of lung cancer patients' QoL after robot-assisted or traditional lobectomy and investigate whether clinical and sociodemographic variables may predict these trends.Methods: An Italian sample of 176 lung cancer patients undergoing lobectomy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Core 30 at the pre-hospitalization, 30 days, 4 months, (...) 8 months, and 12 months after surgery. Sociodemographic and clinical characteristics were also collected. The individual change over time of the 15 dimensions of the EORTC QLQ-C30 and the effects of pre-surgery scores of QoL dimensions, type of surgery, perioperative complications, and age on patients' QoL after surgery were studied with the individual growth curve models.Results: Patients had a good recovery after lobectomy: functioning subscales improved over time, while most of the symptoms became less severe over the care process. Perioperative complications, type of surgery, pre-surgery status, and age significantly affected these trends, thus becoming predictors of patients' QoL.Conclusion: This study highlights different 1-year trends of lung cancer patients' QoL. The measurement of pre- and post-surgery QoL and its clinical and sociodemographic covariables would be necessary to better investigate patients' care process and implement personalized medicine in lung cancer hospital divisions. (shrink)

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

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

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

Background Traditionally, palliative care has focused on patients suffering from life-threatening somatic diseases such as cancer or progressive neurological disorders. In contrast, despite the often chronic, severely disabling, and potentially life-threatening nature of psychiatric disorders, there are neither palliative care units nor clinical guidelines on palliative measures for patients in psychiatry. Main text This paper contributes to the growing literature on a palliative approach in psychiatry and is based on the assumption that a change of perspective from a curative to (...) a palliative approach could help promote patient-centeredness and increase quality of life for severely ill patients in psychiatry as well as in somatic medicine. To exemplify this, we offer three different clinical scenarios: severe and enduring anorexia nervosa, treatment-refractory schizophrenia, and chronic suicidality and persistent self-injury in borderline personality disorder. Conclusion We emphasize that many typical interventions for treatment-refractory psychiatric disorders may indeed be of a palliative nature. Furthermore, introducing traditional features of palliative care, e.g. so-called goals of care conversations, could aid even further in ensuring that caregivers, patients, and families agree on which treatment goals are to be prioritized in order to optimize quality of life in spite of severe, persistent mental disorder. (shrink)