Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

Background Ethics communication has been described as a pedagogical form, promoting development of ethical competence among nursing students. The ‘one to five method’ was developed by this research group as a tool for facilitating ethical communication in groups among healthcare professionals but has not yet been evaluated. Aim To explore post-graduate nursing students’ experiences of practicing ethical communication in groups Research design The study design is qualitative. Participants and research context The study comprised 12 nursing students on a post-graduate course (...) for Registered Nurses focusing on palliative care. After education the students engaged as participants and facilitators in ethics communication in groups, with support from the ‘one to five method’. Data were derived from the students written reflections and subjected to thematic analysis. Ethical considerations The study was performed in accordance with the ethical standards in the 2013 Helsinki Declaration and approved by the Ethics Committee of the Medical Faculty at Umeå University Results An overall theme was identified, ‘being supported to achieve a democratic dialogue concerning ethical problems’ and five themes, related to each step of the ‘one to five method’. The themes concerned: putting the experience of an ethical dilemma into words; being confirmed by shared emotions; defining the value conflict using ethical principles; expressing virtues of empathy and raised awareness; jointly finding various action approaches. Discussion Regular ethics communication in groups encourages nursing students to actively seek understanding and clarification of ethically difficult situations. Conclusions The results indicate that ethics communication in groups could be a way of developing virtues during education. Interventions using the ‘one to five method’ need to be further studied among student groups from other healthcare contexts. (shrink)

Background: An ethical climate has been described as a working climate embracing shared perceptions about morally correct behaviour concerning ethical issues. Various ethical climate questionnaires have been developed and validated for different contexts, but no questionnaire has been found concerning the ethical climate from an inter-professional perspective in a healthcare context. The Swedish Ethical Climate Questionnaire, based on Habermas’ four requirements for a democratic dialogue, attempts to assess and measure the ethical climate at various inter-professional workplaces. This study aimed to (...) present the construction of and to test the psychometric properties of the Swedish Ethical Climate Questionnaire. Method: An expert group of six researchers, skilled in ethics, evaluated the content validity. The questionnaire was tested among 355 healthcare workers at three hospitals in Sweden. A parallel analysis (PA), an exploratory factor analysis and confirmatory factor analysis were performed. Ethical considerations: The participants included in the psychometric analysis were informed about the study, asked to participate in person and informed that they could withdraw at any time without giving any reason. They were also assured of confidentiality in the reporting of the results. Findings: The parallel analysis (PA) recommended one factor as a solution. The initial exploratory factor analysis with a four-factor solution showed low concordance with a four-factor model. Cronbach’s alpha varied from 0.75 to 0.82; however, since two factors only consisted of one item, alpha could not be reported. Cronbach’s alpha for the entire scale showed good homogeneity (α = 0.86). A confirmatory factory analysis was carried out based on the four requirements and showed a goodness-of-fit after deleting two items. After deletion of these items, Cronbach’s alpha was 0.82. Discussion: Based on the exploratory factor analysis, we suggest that the scale should be treated as a one-factor model. The result indicates that the instrument is unidimensional and assesses ethical climate as a whole. Conclusion: After testing the Swedish Ethical Climate Questionnaire, we found support for the validity and reliability of the instrument. We found the 10-item version of Swedish Ethical Climate Questionnaire satisfactory. However, we found no support for measuring different dimensions and, therefore, this instrument should be seen as assessing ethical climate as of whole. (shrink)

Background Moral distress is a problem and negative experience among health-care professionals. Various instruments have been developed to measure the level and underlying reasons for experienced moral distress. The moral distress thermometer (MDT) is a single-tool instrument to capture the level of moral distress experienced in real-time. Aim The aim of this study was to translate the MDT and adapt it to the Swedish cultural context. Research design The first part of this study concerns the translation of MDT to the (...) Swedish context, and the second part the psychometric testing of the Swedish version. Participants and research context 89 healthcare professionals working at a hospital in northern Sweden participated. Convergent validity was tested between MDT and Measure of Moral Distress-Healthcare Professionals (MMD-HP), and construct validity was tested by comparing MDT scores among healthcare professionals. MDT was compared with responses to the final questions in MMD-HP. One-way ANOVA, Welch’s ANOVA, Games–Howell post-hoc test and Pearson’s correlation analysis were done. Ethical considerations The study was approved by the Swedish Ethics Review Authority (dnr 2020-04120) in accordance with Helsinki Declaration. Results The translated Swedish version of MDT was described as relevant to capture the experience of moral distress. The mean value for MDT was 2.26, with a median of 2 and a mode value of 0. The result showed moderate correlations between the MDT and MMD-HP total scores. There was a significant difference when comparing MDT and healthcare professionals who had never considered leaving their present position with those who had left and those who had considered leaving but had not done so, with the latter assessing significantly higher moral distress. Conclusion The MDT is an easily available instrument useful as an extension to MMD-HP to measure the real-time experience of moral distress among healthcare professionals in a Swedish context. (shrink)

BackgroundMoral distress has been described as an emotionally draining condition caused by being prevented from providing care according to one’s convictions. Studies have described the impact of moral distress on healthcare professionals, their situations and experiences. The Measure of Moral Distress for Healthcare Professionals (MMD-HP) is a questionnaire that measures moral distress experienced by healthcare professionals at three levels: patient, system and team. The aim of this project was to translate and make a cultural adaption of the MMD -HP to (...) the Swedish context.MethodsThe questionnaire comprises 27 items, rated according to frequency and intensity on a five-point Likert scale (0–4). The procedure for translating MMD-HP followed WHO guidelines (2020). These entailed a forward translation from English to Swedish, a back translation, expert panel validation, pretesting and cognitive face-to-face interviews with 10 healthcare professionals from various professions and healthcare contexts.ResultsThe Swedish version of MMD-HP corresponds essentially to the concept of the original version. Parts of some items’ had to be adjusted or removed in order to make the item relevant and comprehensible in a Swedish context. Overall, the cognitive interviewees recognized the content of the items which generally seemed relevant and comprehensible.ConclusionThe Swedish version of MMD-HP could be a useful tool for measuring moral distress among healthcare professionals in a Swedish healthcare context. (shrink)

Background On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature. Research aim The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ theory of (...) communicative actions, after 6 months from the perspective of an inter-professional team. Research design A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis. Participants The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions. Ethical considerations The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration. Findings Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations. Discussion Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts. Conclusion The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’. (shrink)

The paper investigates the propriety of applying the form versus matter distinction to arguments and to logic in general. Its main point is that many of the currently pervasive views on form and matter with respect to logic rest on several substantive and even contentious assumptions which are nevertheless uncritically accepted. Indeed, many of the issues raised by the application of this distinction to arguments seem to be related to a questionable combination of different presuppositions and expectations; this holds in (...) particular of the vexed issue of demarcating the class of logical constants. I begin with a characterization of currently widespread views on form and matter in logic, which I refer to as 'logical hylomorphism as we know it'—LHAWKI, for short—and argue that the hylomorphism underlying LHAWKI is mereological. Next, I sketch an overview of the historical developments leading from Aristotelian, non-mereological metaphysical hylomorphism to mereological logical hylomorphism (LHAWKI). I conclude with a reassessment of the prospects for the combination of hylomorphism and logic, arguing in particular that LHAWKI is not the only and certainly not the most suitable version of logical hylomorphism. In particular, this implies that the project of demarcating the class of logical constants as a means to define the scope and nature of logic rests on highly problematic assumptions. (shrink)

This book presents novel formalizations of three of the most important medieval logical theories: supposition, consequence and obligations. In an additional fourth part, an in-depth analysis of the concept of formalization is presented - a crucial concept in the current logical panorama, which as such receives surprisingly little attention.Although formalizations of medieval logical theories have been proposed earlier in the literature, the formalizations presented here are all based on innovative vantage points: supposition theories as algorithmic hermeneutics, theories of consequence analyzed (...) with tools borrowed from model-theory and two-dimensional semantics, and obligations as logical games. For this reason, this is perhaps the first time that these medieval logical theories are made fully accessible to the modern philosopher and logician who wishes to obtain a better grasp of them, but who has always been held back by the lack of appropriate ‘translations' into modern terms.Moreover, the book offers a reflection on the very nature of logic, a reflection that is prompted by the comparisons between medieval and modern logic, their similarities and dissimilarities. It is thus a contribution not only to the history of logic, but also to the philosophy of logic, the philosophy of language and semantics.The analysis of medieval logic is also relevant for the modern philosopher and logician in that, being the unifying methodology used across all disciplines at that time, logic really provided unity to science. It thus presents a unified model of scientific investigation, where logic plays the aggregating role. (shrink)

Accounts of modal knowledge are many and varied. How should we choose between them? I propose that we employ inference to the best explanation, and I suggest that there are three desiderata that we should use to rank hypotheses: conservatism, simplicity, and the ability to handle disagreement. After examining these desiderata, I contend that they can’t be used to justify belief in the modal epistemology that fares best, but that they can justify our accepting it in an epistemically significant sense. (...) Finally, I outline a modal epistemology that seems to do well by the standards I’ve recommended. (shrink)

In this paper, we aim to clarify and evaluate the contention that immortality would be necessarily boring . It will emerge that, just as there are various importantly different kinds of immortality, there are various distinct kinds of boredom. To evaluate the Necessary Boredom Thesis, we need to specify the kind of immortality and the kind of boredom. We argue against the thesis, on various specifications of “immortality” and “boredom.”.

This is the introduction to the Special Issue ‘Foundational Issues in Conceptual Engineering’. The issue contains contributions by James Andow, Delia Belleri, David Chalmers, Catarina Dutilh Novaes, Eugen Fischer, Viktoria Knoll, Edouard Machery and Amie Thomasson. We, the editors, provide a brief introduction to the main topics of the issue and then summarize its contributions.

It is common for conservationists to refer to non-native species that have undesirable impacts on humans as “invasive”. We argue that the classification of any species as “invasive” constitutes wrongful discrimination. Moreover, we argue that its being wrong to categorize a species as invasive is perfectly compatible with it being morally permissible to kill animals—assuming that conservationists “kill equally”. It simply is not compatible with the double standard that conservationists tend to employ in their decisions about who lives and who (...) dies. (shrink)

Instalada na Universidade Federal do Rio Grande do Sul (UFRGS) logo após o golpe civil-militar 1964, a Comissão Especial de Investigação Sumária (Ceis) teve como objetivo investigar ações consideradas subversivas, envolvendo professores, funcionários e estudantes. A presente pesquisa buscou saber como tal acontecimento é hoje relembrado por alguns estudantes da época, diretamente envolvidos naquele contexto. Para a busca de dados, optou-se pela História Oral, coletando narrativas de cinco sujeitos, além de pesquisa documental: atas, fichas de informações, ofícios e matérias no (...) jornal Correio do Povo. Para fundamentar a análise, foram utilizados referenciais advindos de Alistair Thompson, entre outros. Além de abordar situações da repressão instalada na universidade, o texto também apresenta alguns desdobramentos acerca do processo de pesquisa que adota a memória como fonte a ser considerada no processo analítico. (shrink)

People unfamiliar with Chinese characters show poorer visual working memory (VWM) performance for Chinese characters than do literates in Chinese. In a series of experiments, we investigated the reasons for this expertise advantage. Experiments 1 and 2 showed that the advantage of Chinese literates does not transfer to novel material. Experts had similar resolution as novices for material outside of their field of expertise, and the memory of novices and experts did not differ when detecting a big change, e.g., when (...) a character’s color was changed. Memorizing appears to function as a rather abstract representation of word forms because memory for characters’ fonts was poor independently of expertise (Experiment 3), though still visual. Distractors that were highly similar conceptually did not increase memory errors, but visually similar distractors impaired memory (Experiment 4). We hypothesized that literates in Chinese represent characters in VWM as tokens of visual word forms made available by long-term memory. In Experiment 5, we provided novices with visual word form knowledge. Participants subsequently performed a change detection task with trained and novel characters in a functional magnetic resonance experiment. We analyzed set size- and training-dependent effects in the intraparietal sulcus (IPS) and the visual word form area. VWM for trained characters was better than for novel characters. Neural activity increased with set size and at a slower rate for trained than for novel characters. All conditions approached the same maximum, but novel characters reached the maximum at a smaller set size than trained characters. The time course of the bold response depended on set size and knowledge status. Starting from the same initial maximum, neural activity at small set sizes returned to baseline more quickly for trained characters than for novel characters. Additionally, high performers showed generally more neural activity in the IPS than low performers. We conclude that experts’ better performance in working memory (WM) is caused by the availability of visual long-term representations (word form types) that allow a sparse representation of the perceived stimuli and make even small changes big because they cause a type change that is easily detected. (shrink)

What kinds of ethical considerations, if any, are relevant to research, management, or conservation efforts involving insects? What limits might be appropriate for those actions? These are questions we ask as members of a profession—one that’s devoted to the study of certain organisms. We probably won’t make any progress as a discipline by beginning the way philosophers generally do: namely, by trying to assess whether insects have intrinsic value; that is, whether they have value even when we don’t value them. (...) It is better, we submit, to reflect more carefully on our own values and practices, paying special attention to the role that insects play in our scientific endeavors, whether those endeavors are basic research, vector control, integrated pest management, or insect conservation and biodiversity assessment. -/- From a professional standpoint, the goals of entomologists center around learning about, working with, and responding to insects. Because insects are living organisms, the tie that binds the many strands of entomology together, we should affirm the significant role that insects play in everyday life and encourage examination of how to relate to them. (shrink)

In current debates about coming to terms with individual and collective wrongdoing, the concept of forgiveness has played an important but controversial role. For a long time, the idea was widespread that a forgiving attitude — overcoming feelings of resentment and the desire for revenge — was always virtuous. Recently, however, this idea has been questioned. The contributors to this volume do not take sides for or against forgiveness but rather examine its meaning and function against the backdrop of a (...) more complex understanding of moral repair in a variety of social, circumstantial, and cultural contexts. The book aims to gain a differentiated understanding of the European traditions regarding forgiveness, revenge, and moral repair that have shaped our moral intuitions today whilst also examining examples from other cultural contexts (Asia and Africa, in particular) to explore how different cultural traditions deal with the need for moral repair after wrongdoing. -/- . (shrink)

Purpose of this paper is to show, that within the Hobbesian Philosophy of law and state the establishment of legal force can be considered to be a conditio sine qua non for a persistent state of peace. In this regard legal force is to be understood not only as a power able to legislate but also to guarantee the abidance of the law by means of coercive power. As a result of this point of view on legal force as a (...) necessary condition for peace and security, arises furthermore the conceptof legal force as condition of culture. This paper traces the central claims of Thomas Hobbes’ highly influential theory of the origination of state and law pointed out in the first chapters of De Cive, a writing that is part of Hobbes Elements of Philosophy. To this aforementioned theory belongs the Hobbesian conception of the so called state of nature as a legal vacuum and a status of absolute freedom of every individual. Furthermore the war of everyone against everyone as a consequence of this absence of legal force and finally the subjects comprehension in the uselessness of absolute freedom which leads to war and instead of this the decision to abandon specific rights and to subrogate those rights to an elected sovereign. The decision to leave the state of nature and hence war and search peace instead which is granted by the legislative and executive power of the sovereign is according to Hobbes the ultimate dictate of reason. Additionally to the first chapters of De Cive I refer to some passages of Hobbes chief work Leviathan. (shrink)

Now, in Emergent Forms of Life and the Anthropological Voice, path-breaking scholar Michael M. J. Fischer moves the discussion to a consideration of the ...

It is often remarked that first-order Peano Arithmetic is non-categorical but deductively well-behaved, while second-order Peano Arithmetic is categorical but deductively ill-behaved. This suggests that, when it comes to axiomatizations of mathematical theories, expressive power and deductive power may be orthogonal, mutually exclusive desiderata. In this paper, I turn to Hintikka’s :69–90, 1989) distinction between descriptive and deductive approaches in the foundations of mathematics to discuss the implications of this observation for the first-order logic versus second-order logic divide. The descriptive (...) approach is illustrated by Dedekind’s ‘discovery’ of the need for second-order concepts to ensure categoricity in his axiomatization of arithmetic; the deductive approach is illustrated by Frege’s Begriffsschrift project. I argue that, rather than suggesting that any use of logic in the foundations of mathematics is doomed to failure given the impossibility of combining the descriptive approach with the deductive approach, what this apparent predicament in fact indicates is that the first-order versus second-order divide may be too crude to investigate what an adequate axiomatization of arithmetic should look like. I also conclude that, insofar as there are different, equally legitimate projects one may engage in when working on the foundations of mathematics, there is no such thing as the One True Logic for this purpose; different logical systems may be adequate for different projects. (shrink)

Das elfte Buch der "Confessiones" führt in die grundlegenden Schwierigkeiten der Frage nach dem Sein der Zeit ein und ist insofern immer noch von systematischem Interesse; es führt zugleich an einer zentralen Frage in das Denken Augustins ein. Augustinus (354-430) hat mit seiner Untersuchung der Frage, was Zeit ist ("quid est enim tempus?"), die Aufmerksamkeit der Philosophen geweckt und großen Einfluß auf deren Gedanken zu Sein und Sinn der Zeit und des Zeitlichen ausgeübt. Vor allem haben sich die Protagonisten der (...) phänomenologischen Schule, Edmund Husserl und Martin Heidegger, intensiv mit diesem Text befaßt. Doch ist das lebhafte Interesse am Thema und am Gedankengang dieses Buches nicht auf Schulgrenzen eingeengt gewesen, sondern sogar bei Forschern zu finden, die eher Antworten auf die physikalischen Fragen nach dem Sein der Zeit gesucht haben. Augustins Besinnung auf das Wesen der Zeit findet sich im elften von dreizehn Büchern seiner "Confessiones" (Bekenntnisse), einem berühmten, gleichwohl voller Rätsel gebliebenen Werk, das er in seinen frühen Bischofsjahren verfaßt hat (396-400). Das elfte Buch mit der Frage nach der Zeit nimmt eine Schlüsselrolle ein, weil es zugleich eine Reflexion über das Gesamtprojekt der "Confessiones" darstellt. Augustinus denkt bemerkenswert eigenständig: Auch wenn er Motive der Platonischen, Aristotelischen und Plotinischen Philosophie aufgreift, gibt er ihnen ein neues Gesicht und weist mit der lebendigen Kraft ursprünglichen Denkens auf transzendentalphilosophische und phänomenologische Motive voraus. (shrink)