The authors of this article are previous or current members of the Clinical Ethics Consultation Affairs (CECA) Committee, a standing committee of the American Society for Bioethics and Humanities (ASBH). The committee is composed of seasoned healthcare ethics consultants (HCECs), and it is charged with developing and disseminating education materials for HCECs and ethics committees. The purpose of this article is to describe the educational research and development processes behind our teaching materials, which culminated in a case studies book called (...) A Case-Based Study Guide for Addressing Patient-Centered Ethical Issues in Health Care (hereafter, the Study Guide). In this article, we also enumerate how the Study Guide could be used in teaching and learning, and we identify areas that are ripe for future work. (shrink)

This first-person essay explores wonder in the medical encounter from a patient’s point of view, considering times when medical technology has given the author insight into her body and the wonder that has been evoked by these experiences. Two medical encounters are detailed: one in which post-polio vocal cord weakness was explored using a miniature camera, which evoked a sense of wonder at the process of evolution; and the second in which an MRI of the author’s skull became a memento (...) mori. The author reflects on the long processes of genetic mutation from single-celled organism to human being, and on the devolution after death to food for bacteria and insects. (shrink)

Sex determination in mammals is mediated via the supporting cell lineage in the fetal gonad. In the very early stages of gonadal development, the fate of the supporting cell population is critically dependent on the expression of the male‐determining gene on the Y chromosome. If this gene is absent or fails to be expressed, or is expressed too late or in too small a number of supporting cells, all supporting cells (XX or XY) differentiate as pre‐follicle cells and development proceeds (...) along the female pathway. Supporting cells in which the male‐determining gene is expressed in a timely manner differentiate as pre‐Sertoli cells; given sufficient such cells, testis cords form and development proceeds in a male direction. If XX supporting cells are also present, a few may be recruited into the pre‐Sertoli population and participate in testis cord formation. The subsequent fate of pre‐follicle cells depends critically on interaction with the germ cell population in the developing gonad: absence of germ cells may lead to partial masculinization of the gonad, and/or to disappearance of the supporting cell component. (shrink)

Parmi les déesses du monde mésopotamien, deux figures féminines se dégagent : les soeurs Ištar et Ereškigal. Ištar agit dans la sphère des relations amoureuses, et surtout de la bataille. Elle joue dans la guerre comme elle le ferait « avec une corde à sauter ». Ereškigal règne sur le monde des morts : elle est celle « qui n’a pas connu le jeu des jeunes filles ». Cette contribution s’appuie sur les documents écrits (hymnes, narrations mythologiques) en cunéiformes (sumérien (...) – akkadien et textes bilingues) des iie et ier millénaire av. n. è. Elle prend pour angle d’approche les relations conflictuelles entre ces grandes déesses pour mieux saisir leurs rapports respectifs au jeu : où et quand jouent-elles? À quoi et avec qui jouent-elles? Quelles sont les informations que l’on peut en tirer pour les femmes et jeunes filles humaines? Diverses problématiques sont abordées à la lumière des études de genre : celles des rapports intergénérationnels et interfamiliaux, de la définition des espaces privé-public, de la séduction et de l’érotisme. (shrink)

This long-awaited two-volume set constitutes the definitive presentation of the system of classifying moral judgment built up by Lawrence Kohlberg and his associates over a period of twenty years. Researchers in child development and education around the world, many of whom have worked with interim versions of the system, indeed, all those seriously interested in understanding the problem of moral judgment, will find it an indispensable resource. Volume I reviews Kohlberg's stage theory, and the by-now large body of research on (...) the significance and utility of his moral stages. Issues of reliability and validity are addressed. The volume ends with detailed instructions for using the forms in Volume 2. Volume 2, in a specially-designed, user-friendly format, includes three alternative functionally-equivalent forms of the scoring system. (shrink)

Dignified care is a central issue in the nursing care of older adults. Nurses are expected to treat older adults with dignity, and older adults wish to be treated in a dignified manner. Researchers have recommended investigating the concept of dignity based on specific contexts and population groups. This meta-synthesis study aims to explore the understandings of dignity from the perspective of older adults in the Nordic countries. Synthesising findings from qualitative studies on older adults’ experiences of dignity has provided (...) important insight into what can be essential for dignified care in a Nordic context. The importance of visibility and recognition for the experience of dignity is an overarching theme in all the studies. The participants’ descriptions mostly implicated an existence dominated by a lack of recognition. The older adults do not feel valued as people or for their contribution to society and strive to tone down their illnesses in an attempt to become more visible and acknowledged as people. Toning down their illnesses and masking their needs can protect their independence. At the same time, becoming less visible can leave them without a voice. The metaphorical phrase protected and exposed by a cloak of invisibility is used to express the authors’ overall interpretation of the findings. Lack of recognition and being socially invisible is a genuine threat to older adults’ dignity. (shrink)

COVID-19 vaccine refusal seems like a paradigm case of irrationality. Vaccines are supposed to be the best way to get us out of the COVID-19 pandemic. And yet many people believe that they should not be vaccinated even though they are dissatisfied with the current situation. In this paper, we analyze COVID-19 vaccine refusal with the tools of contemporary philosophical theories of responsibility and rationality. The main outcome of this analysis is that many vaccine-refusers are responsible for the belief that (...) they should not be vaccinated and epistemically rational in holding it. This is an important result because it provides insights into the legitimacy of certain public health policies. In particular, this result shows that a public health policy that would abandon the project of convincing certain vaccine-refusers with reasons – e.g., by simply making vaccination compulsory – is prima facie illegitimate. (shrink)

Numerous researchers have investigated accounting students’ levels of moral reasoning, ethical choice and judgment employing the Defining Issues Test and using its P score as an indicator of moral reasoning. Not surprisingly, a number of DIT studies report conflicting results. Moreover, despite widespread use of the DIT, there is concern that it may not adequately measure all facets of ethical judgment :1–26, 2010). Thus, we endeavor to provide insight not only into the contradictory results but also about the applicability of (...) the DIT for studying accounting students. To do so, we collect published and unpublished DIT studies employing accounting students as subjects and use meta-analysis to aggregate findings across these studies to quantify their results, examining commonly employed variables. We show significant relationships between P scores and some variables but not others. Further, our findings demonstrate that the DIT provides added insights when exploring questions of ethical choice, and ethics instruction, particularly when the instruction is embedded in an accounting course. Finally, we find that the level of DIT P scores reported in the studies relates to whether the study was published. We discuss the implications of our findings for future research. (shrink)

Though much progress has been made on inclusion of non-pregnant women in research, thoughtful discussion about including pregnant women has lagged behind. We outline resulting knowledge gaps and their costs and then highlight four reasons why ethically we are obliged to confront the challenges of including pregnant women in clinical research. These are: the need for effective treatment for women during pregnancy, fetal safety, harm from the reticence to prescribe potentially beneficial medication, and the broader issues of justice and access (...) to benefits of research participation. Going forward requires shifting the burden of justification from inclusion to exclusion and developing an adequate ethical framework that specifies suitable justifications for excluding pregnant women from research. (shrink)

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have (...) worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors’ overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses’ ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses’ moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice. (shrink)

A central feature of our waking mental experience is that our attention naturally toggles back and forth between “external” and “internal” stimuli. In the midst of an externally demanding task, attention can involuntarily shift internally with no clear reason how or why thoughts momentarily shifted inward. In the case of external attention, we are typically exploring and encoding aspects of our external world, whereas internal attention often involves searching for and retrieving potentially relevant information from our memory networks. Cognitive science (...) has traditionally focused on understanding forms of internal and external attention separately, leaving a mystery about what sparks the seemingly automatic shifts between the two. Specifically, what shifts attentional focus from being outward‐directed to being inward‐directed? We present a candidate mechanism: Familiarity‐detection. (shrink)

In recent years, an increasing number of theoretical biologists and philosophers of biology have been opposing reductionist research agendas by appealing to the concept of biological autonomy which draws on the older concept of autopoiesis. In my paper, I investigate some of the ontological implications of this approach. The emphasis on autonomy and autopoiesis, together with the associated idea of organisational closure, might evoke the impression that organisms are to be categorised ontologically as substances: ontologically independent, well-individuated, discrete particulars. However, (...) I argue that this is mistaken. Autopoiesis and biological autonomy, properly understood, require a rigorous commitment to a process ontological view of life. (shrink)

Perceived behavioral integrity involves the employee’s perception of the alignment of the manager’s words and deeds. This meta-analysis examined the relationship between perceived behavioral integrity of managers and the employee attitudes of job satisfaction, organizational commitment, satisfaction with the leader and affect toward the organization. Results indicate a strong positive relationship overall (average r = 0.48, p<0.01). With only 12 studies included, exploration of moderators was limited, but preliminary analysis suggested that the gender of the employees and the number of (...) levels between the employee and the manager are potential moderators of the relationship. In the current sample of studies, country where the research was conducted did not seem to have any moderating effects. In addition to suggesting further investigation of potential moderators, we call for research that examines the relationship between behavioral integrity and outcomes that include individual behavior and organizational performance. (shrink)

After receiving a copy of Metaphysics as a Guide to Morals, Murdoch’s friend Brian Medlin writes back: ‘So far I think I disagree with what you say in “Wittgenstein and the Inner Life,” but I’ll have to make sure that I’ve understood you aright before I launch into a complaint.’ Here, I reconstruct Murdoch’s reading of Wittgenstein and show its ambivalence. While Murdoch acknowledges Wittgenstein’s aim to dissolve illusionary ideas about the inner, she also thinks he presents substantial theses threatening (...) the reality of inner life. Murdoch’s misreading of Wittgenstein as a constructive philosopher may be what worries Medlin, and it also prevents Murdoch from seeing Wittgenstein as an ally in the endeavour to demonstrate the morally transformative potential of our inner lives. (shrink)

Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their (...) daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched. (shrink)

Background: The professional values presented in ethical guidelines of the Norwegian Nurses Organisation and International Council of Nurses describe nurses’ professional ethics and the obligations that pertain to good nursing practice. The foundation of all nursing shall be respect for life and the inherent dignity of the individual. Research proposes that nurses lack insight in ethical competence and that ethical issues are rarely discussed on the wards. Furthermore, research has for some time confirmed that nurses experience moral distress in their (...) daily work and that this has become a major problem for the nursing profession. Objectives: The purpose of this article is to obtain a deeper understanding of the ethical challenges that nurses face in daily practice. The chosen research questions are “What ethical challenges do nurses experience in their daily practice?” Research design: We conducted a qualitative interview study using a hermeneutical approach to analyzing data describing nurses’ experiences. Ethical considerations: The Norwegian Social Science Data services approved the study. Furthermore, the head of the hospital gave permission to conduct the investigation. The requirement of anonymity and proper data storage in accordance with the World Medical Association Declaration of Helsinki was met. Method and results: The context for the study comprised three different clinical wards at a university hospital in Norway. Nine qualified nurses were interviewed. The results were obtained through a systematic development beginning with the discovery of busyness as a painful phenomenon that can lead to conflicts in terms of ethical values. Furthermore, the consequences compromising professional principles in nursing care emerged and ended in moral blindness and emotional immunization of the healthcare providers. Emotional immunization occurred as a new dimension involving moral blindness and immunity in relation to being emotionally touched. (shrink)

"Deleuze plonge la critique kantienne transcendantale dans le bain dissolvant d'un empirisme renouvelé. Ce livre se propose de restituer cette entreprise, et d'analyser l'étonnante création de ce concept, que Deleuze mène depuis ses premières monographies jusqu'à Différence et Répétition dans un dialogue fécond avec l'histoire de la philosophie. Par quelles opérations de distorsion et de collage, Deleuze compose-t-il l'empirisme de Hume, la théorie du signe comme force de Nietzsche, le virtuel et les multiplicités de Bergson, les modes de Spinoza, les (...) individualisations impersonnelles de Simondon pour renouveler la théorie kantienne du transcendantal? C'est tout l'objet de cette enquête, qui permet d'entrer dans le laboratoire du penseur, pour saisir la philosophie se faisant, mais qui permet également d'expliquer l'insistance du transcendantal dans toute son oeuvre"--P. [4] of cover. (shrink)

In an effort to clear away confusions regarding the role of cultural analysis in historical explanation, this paper proposes a new approach to the issue of cultural autonomy. The premise is that there are two forms of cultural autonomy, analytic and concrete. Analytic autonomy posits the independent structure of culture-its elements, processes, and reproduction. It is achieved through the theoretical and artificial separation of culture from other social structures, conditions, and action. Concrete autonomy establishes the interconnection of culture with the (...) rest of social life, and is achieved by fleshing out the historically specific formulation of particular cultural structures. In addition to theoretically specifying the two forms of cultural autonomy, I demonstrate analytic and concrete autonomy in practice by examining two works that incorporate culture into the analysis of the same historical event. The rewards of recognizing both analytic and concrete cultural autonomy are twofold. First, cultural reductionism can be countered by establishing that culture is structural. Second and more important, once the independent nature of a cultural form is established, its causal contribution to concrete historical situations can be assessed accurately and integrated into historical explanation. (shrink)

This book explores five Platonic dialogues: Lysis, Charmides, Protagoras, Euthydemus, and the Republic. This book uses Socrates’ narrative commentary as its primary interpretive framework. No one has engaged in a sustained attempt to explore the Platonic dialogues from this angle. As a result, it offers a unique contribution to Plato scholarship. The portrait of Socrates that emerges challenges the traditional view of Socrates as an intellectualist and offers a holistic vision of philosophical practice.

This article criticizes recent suggestions that the current ELSI research field should accommodate a new direction towards a ‘post-ELSI’ agenda. Post-ELSI research seeks to avoid the modernist division of responsibility for technical and social issues said to characterize ELSI research. Collaboration and integration are consequently the key terms of post-ELSI strategies that are to distinguish it from ELSI strategies. We argue that this call for a new direction relies on an inadequate generalized analysis of ELSI research as modern that will (...) affect the construal of post-ELSI strategies. We are concerned that the call for post-ELSI shift will exclude imaginative proposals and intellectual freedom by narrowing down the scope and methodologies of ELSI and thereby missing opportunities to play a critical and constructive normative role. Instead of framing current trends in ELSI research as a radical and progressive shift from ELSI to post-ELSI, we suggest an alternative story of expansion and diversification described in terms of a drift from ELSA 1 to ELSA 2, pertaining to acronyms in use in Europe. ELSI research has never been modern. It has been experimenting from the very start on ways to mesh the works of humanist, social and natural scientist in order to bridge and build alignments of emerging scientific and societal goals and matters of concern. The development from ELSA 1 to ELSA 2 expands in our account the range of intellectual and methodological capacities of analysis and engagement of complex and dynamic science-society relationships. We present three areas of ELSA expertise to illustrate that the expertise within the field builds on scholarly achievements within the humanities, social sciences as well as the natural sciences. The plurality of disciplinary background of ELSA researchers represents a valuable diversity that enables mutual criticism and formulations of complementary approaches that together constitute a viable ELSA field. (shrink)

Freadman uses the term genre to access Peirce’s work, and expands this original theoretical approach by proposing that “genre” interacts with “sign” and that this interaction is central to the study of the semiotic in general.

In recent years, an increasing number of medical books and papers attempting to analyse the concepts of health and disease from the perspective of evolutionary biology have been published.This paper introduces the evolutionary approach to health and disease in an attempt to illuminate the premisses and the framework of Darwinian medicine. My primary aim is to analyse to what extent evolutionary theory provides for a biological definition of the concept of disease. This analysis reveals some important differences between functional explanations (...) in the field of evolutionary biology and functional explanations in the field of medicine. Moreover, I shall argue that the biological functions relevant to the health of an organism cannot be determined on the basis of evolutionary theory. Accordingly, it seems that Darwinian medicine does not provide for the definition of a biological concept of disease. Still,Darwinian medicine may suggest why we are susceptible to certain diseases; it might also prove a suggestive heuristic on the basis of which new hypotheses concerning relevant treatments of various diseases might be advanced. (shrink)

Because of the transfer of responsibility from hospitals to community-based settings, providers in home-based care have more responsibilities and a wider range of tasks and responsibilities than before, often with limited resources. The increased responsibilities and the complexity of tasks and patient groups may lead to several ethical challenges. A systematic search in the databases MEDLINE, CINAHL, and SveMed+ was carried out in February 2019 and August 2020. The research question was translated into a modified PICO (Population, Intervention, Comparison, and (...) Outcome) worksheet. A total of 40 articles were included. The review is conducted according to the Vancouver Protocol. The main findings from the systematic literature review show that ethical challenges experienced by healthcare and social care providers in home-based care are related to autonomy and balancing ethical principles, decisions regarding intensity of care, challenges related to priority settings, truth-telling, and balancing the professional role. Findings regarding ethical challenges within home-based care are in line with findings from institutional healthcare and social care settings. However, some significant differences from the institutional context are also highlighted. (shrink)

The views on plagiarism of 574 students at four Australian universities operating in Singapore were investigated through a survey and interviews. Analysis of students’ responses to different plagiarism scenarios revealed misconceptions and uncertainties about many aspects of plagiarism. Self-plagiarism and reuse of a friend’s work were acceptable to more than one quarter of the students, and nearly half considered collusion to be a legitimate form of collaboration. One quarter of the students also indicated that they would knowingly plagiarize. This should (...) serve as a wake-up call regarding plagiarism in transnational higher education. Seven measures are recommended to curb plagiarism and foster academic integrity. (shrink)

In this paper, we wish to address how meaning occurs in literary reading as well as in literary discussion. To do so, we propose to rely on the theoretical elaborations of Pierre Bayard, Winnicott and Marc Richir. Thus, the point is to propose a tie between literary theory, psychoanalysis and phenomenology so as to account for the creativity of the act of reading as well as the way a new meaning can arise between those who share their reading of a (...) same book. (shrink)

L’article revient sur un contexte funéraire découvert au xixe s. à Camiros par l’archéologue Auguste Salzmann et récemment reconstitué au musée du Louvre, où il est conservé. L’étude stylistique et typologique du mobilier a été prolongée par une campagne d’analyses des contenus, une approche qui réactualise, par des moyens d’investigations modernes, l’intérêt suscité par le tombeau A. Les résultats apportent, entre autres, des données précieuses sur la réalité du commerce des « vases à parfum » grecs archaïques et sur leur (...) utilisation parfois médicinale. (shrink)

This paper interprets the British legislative process that initiated the first comprehensive national regulation of embryo research and fertility services and examines subsequent efforts to restrain the assisted reproduction industry. After describing and evaluating British regulatory measures, I consider successive failures to control the assisted reproduction industry in the US. I discuss disparities between UK and US regulatory initiatives and their bearing on regulation in other countries. Then I turn to the political and social structures in which the assisted reproduction (...) industry is embedded. I argue that regulatory bodies are seldom neutral arbiters. They tend to respond most readily to special interests and neglect strategies that could more effectively meet the health needs of the people they represent. Neither national nor international bodies have aggressively pursued policies to harness the industry, reduce infertility rates, or meet the needs of people whose fertility is threatened by substandard healthcare and environmental neglect. In conclusion, I consider recent initiatives by activist groups to mount an alternative response to the industry's current practices and build a transnational reproductive justice movement. (shrink)

Here is the question: what constitutes a good explanation of phenomena?

The American Medical Association's Code of Ethics prohibits physicians from giving substances they believe are placebos to their patients unless the patient is informed of and agrees to use of the substance. Various questions surround the AMA policy, however. One of these has to do with what should be disclosed. The AMA holds that any treatment that the physician believes is a placebo should be identified as such to the patient. But consider a more restrictive policy that requires physicians to (...) defer to the medical community's consensus view about which treatments have a specific effect on the condition being treated. In light of the ethical goals that the AMA identifies—namely, concerns about patient trust, autonomy, and benefit—there are potential advantages to the more restrictive policy. (shrink)

Politics, Philosophy & Economics, Volume 21, Issue 1, Page 55-74, February 2022. Many find that the objectionable nature of paternalism has something to do with belief. However, since it is commonly held that beliefs are directly governed by epistemic as opposed to moral norms, how could it be objectionable to hold paternalistic beliefs about others if they are supported by the evidence? Drawing on central elements of relational egalitarianism, this paper attempts to bridge this gap. In a first step, it (...) argues that holding paternalistic beliefs about others implies a failure to regard them as equals in terms of their moral agency. In a second step, it shows that the fact that we should regard others as equals in this sense raises the threshold for sufficiency of evidence for paternalistic beliefs to be epistemically justified. That is, moral reasons of relational equality encroach on the epistemic. However, these reasons are not decisive. In cases where others are about to jeopardize critical goods such as their lives, mobility or future autonomy, relational equality sometimes calls for paternalistic action and, by extension, the formation of beliefs that render such action rational. The upshot is that in order to meet demands of relational equality we have a pro tanto reason to not hold paternalistic beliefs about others. (shrink)

In this article the logistic regression results in Table 4 Logistic regression results were unfortunately misinterpreted with respect to one hypothesis. The original article states that H5 Levels of observed unethical behavior by accounting students are lower for students who self-identify as politically liberal, than for students who self-identify as politically conservative. While the variable “Self-identified Political Ideology” is statistically significant, the negative sign on the coefficient indicates the result is hypothesized in the opposite direction. Thus the correct interpretation is (...) that accounting students who self-identify as conservative have lower levels of observed unethical behavior than accounting students who self-identify as politically liberal. We regret any inconveniences this may have caused. (shrink)

The general typology for the dialogue between religion and science is built on the assumption that there is an objective world, one reality that can be described. In this paper, I present an alternative epistemological framework for the dialogue that understands all descriptions of reality as symbolic. Therefore, this understanding creates a new possibility for mutual enrichment between the two dialogue partners. I demonstrate the usefulness of this framework by applying it to the dialogue between artificial intelligence (AI) and theology. (...) I discuss an advanced AI project: Cog, a humanoid robot. After briefly describing this project, its assumptions, and the emotions it creates (mainly hope and fear), I show how the project can be enriched by theological insight. The concept ofimago Dei—the understanding of humans created in the image of God—can be applied to the Cog project especially when it is presented in a way that takes the metaphorical character of both theological and scientific theories seriously. (shrink)

I distinguish between the classical Gricean approach to conversational implicatures , which I call the action-theoretic approach, and the approach to CIs taken in contemporary cognitive science. Once we free ourselves from the AT account, and see implicating as a form of what I call “conversational tailoring”, we can more easily see the many different ways that CIs arise in conversation. I will show that they arise not only on the basis of a speaker’s utterance of complete sentences but also (...) on the basis of sub-sentential clauses—cases of so-called embedded implicatures—as well as from discourse segments containing several sentences—cases that Geurts calls ‘multiplicatures’. I will argue that they arise also from contents that are themselves implicit, such as presupposed contents or other implicatures. All but the first sort of case are difficult for the traditional Gricean AT account to handle, whereas they fall naturally out of an account that sees conversational participants as engaged in conversational tailoring—i.e., as engaged in a process of shaping informational and discourse structural properties of utterances in their successive conversational turns, and hence shaping their interlocutors’ cognitive environments. (shrink)

The aim of this article is to investigate how life in Norwegian nursing homes may affect experiences of dignity among persons with dementia. The study had a qualitative design and used a phenomenological and hermeneutic approach. Participant observation in two nursing home units was combined with qualitative interviews with five residents living in these units. The study took place between March and December 2010. The residents feel that their freedom is restricted, and they describe feelings of homesickness. They also experience (...) that they are not being seen and heard as individual autonomous persons. This lack of freedom, experiences of homesickness and feelings of not being confirmed and respected as individual autonomous persons may be a threat to their personal dignity. In order to protect and enforce the dignity of persons with dementia living in nursing home, we should confirm them as whole and as individual persons, and we should try to make the nursing homes less institutional and more home like. (shrink)

Cet article vise tout d’abord à manifester la profondeur phénoménologique d’une expérience proustienne, celle des demi-réveils dans l’obscurité, en engageant un dialogue entre l’artiste et le philosophe – Husserl, mais aussi Levinas – autour de la notion de souvenir. Il s’agit de montrer que l’expérience dont il est fait part dans l’œuvre littéraire, inenvisagée par la phénoménologie, vient questionner les descriptions existantes du phénomène de souvenir et exige dès lors de penser le sens de celui-ci à nouveaux frais. Notre propos (...) est le suivant : l’œuvre d’art, en particulier l’œuvre littéraire, doit être un milieu de recherche privilégié pour le phénoménologue. Elle fait renaître les énigmes et, ce faisant, remet la recherche en mouvement, en la forçant à un question­nement plus approfondi. (shrink)

Background: Research suggests that nurses generally do not participate in ethical decision-making in accordance with ethical guidelines for nurses. In addition to completing their training, nurses need to reflect on and use ethically grounded arguments and defined ethical values such as patient’s dignity in their clinical work. Objectives: The purpose of this article is to gain a deeper understanding of how nurses deal with ethical decision-making in daily practice. The chosen research question is “How do nurses participate in ethical decision-making (...) for the patient?” Design and method: We use Gadamer’s philosophical hermeneutics as well as Kvale and Brinkmann’s three levels of understanding in interpreting the data material. Nine registered nurses were interviewed. Ethical considerations: The Ombudsman of Norwegian Social Science Data and the head of the hospital approved the investigation. The participants received both oral and written information about the study and they gave their consent. We informed the participants that the participation was voluntary and that they were free to withdraw at any point in the course of the study. The requirement of anonymity and proper data storage was in accordance with the World Medical Association Declaration of Helsinki (1964). The participants were assured that privacy, and confidentiality would be duly protected. Results: Four key themes emerged: (1) confusion in relation to professional and operational expectations of role, (2) ideal somnolence, (3) inadequate argumentation skills, and (4) compound pressure. Conclusion: Ethical ideals appear to be latent in the mindset of the participants; however, the main finding of this investigation is that nurses need to activate the ideals and apply them into practice. Furthermore, management needs to initiate professional reasoning and interdisciplinary discussions leading to common goals for patients. (shrink)

This article presents a descriptive, interpretive theory of ethical responsibility in public health nursing. The theory is based on qualitative empirical studies, a purposeful literature review and meta-ethnography of public health nurses’ experiences of ethical responsibility, interpreted within a philosophical framework. Levianasian philosophy provides the main direction for the authors’ interpretations. The path for theory development consists of three phases: an inspirational phase, an explorative phase and the third phase ‘ joining the dots’. The theory illustrates that ethical responsibility in (...) public health nursing is related to the life existentials of temporality and human relationships. Due to blurred boundaries in these essential life structures, public health nurses can experience a sense of satisfaction but also worries, uncertainties and loneliness. The study reveals paradoxical connections between fear and courage, and between freedom, autonomy and a sense of entrapment in responsible relationships. The authors purport that the results of this study are relevant for education and practice and can provide direction for further studies on developing theories of ethical responsibility in other nursing specialities. (shrink)

Bishop is a professor of nursing; Scudder is a professor of philosophy.

Introduction L’écriture philosophique de Levinas a souvent été décrite comme une écriture « au masculin ». C’est ainsi que Simone de Beauvoir, dans une note célèbre du Deuxième sexe, remarque cela en lui reprochant de proposer, dans Le Temps et l’Autre, une description de la relation entre le Même et l’Autre qui serait « en fait une affirmation du privilège masculin ». Derrida, dans Violence et métaphysique dira à son tour de Totalité et Infini qu’il est impossible que cet ouvrage (...) ait été écr... (shrink)

Sigmund Freud’s five long case histories have been the focus of seemingly endless fascination and criticism. This article examines how the long case-history genre developed and its impact on the professionalization of psychoanalysis. It argues that the long case histories, using a distinctive form that highlighted the peculiarities of psychoanalytic theory, served as exemplars in the discipline. In doing so, the article extends John Forrester’s work on ‘thinking in cases’ to show the practical implications of that style of reasoning. The (...) article illustrates how the form disappeared once the theoretical basis of the movement was set. The genre never became institutionalized, although the content of the five long case histories did, because of Freud’s accepted role as theoretician of psychoanalysis. (shrink)

The aim of this paper is to question the significance of Derrida's deconstruction of the concepts of subject and history. While ‘postmodernity’ tends to be characterized by philosophical critique as the ‘liquidation of the subject’ or the ‘end of history’, I attempt to show that Derrida's deconstruction of ‘subjectivity’ and ‘historicity’ is not an elimination or destruction of these concepts, but an attempt to transform them in order to free them from their metaphysical-teleological presuppositions. This paper argues that this transformation, (...) which begins in Derrida's and continues in Stiegler's texts, leads to the notions of ‘psycho-social individuation’ and ‘doubly epokhal redoubling’. I maintain that such notions ‘supplement’ the metaphysical concepts of subject and history by forcing a reconsideration of the technical conditions of psychic individuation and the technological conditions of ‘epochality’. (shrink)

This essay in both literary criticism and negative theology treats three widely diverse cases of women who “had the nerve to enter a zone of absolute spiritual daring.” The three cases are of the poet Sappho, the mystic Margarite Porete, and the philosopher Simone Weil. Each of them underwent “an experience of decreation, or so she tells us.” Decreation, which is Simone Weil’s coinage, is here defined as “an undoing of the creature in us—that creature enclosed in self and defined (...) by self. But to undo self one must move through self to the very inside of its definition.” The audacious, unconventional spirituality of these women led society to “pass judgments on the authenticity” of their “ways of being.” Weil has been termed “neurotic, anorectic, pathological, sexually repressed or fake” by many readers of both her work and the biographies written about her. Marguerite Porete was condemned at trial for being not only a heretic but also a pseudo-mulier—a “fake woman”—while “Sappho’s ancient biographers tried to discredit her seriousness by assuring us she lived a life of unrestrained and incoherent sexual indulgence.” These women, however, “know what love is,” namely “the touchstone of a true or a false spirituality,” and each of them finds a means of “telling God.”. (shrink)