In Sweden, efforts to govern end-of-life care through policies have been ongoing since the 1970s. The aim of this study is to analyse how policy narratives on palliative care in Sweden have been formulated and have changed over time since the 1970s up to 2018. We have analysed 65 different policy-documents. After having analysed the empirical material, three policy episodes were identified. In Episode 1, focus was on the need for norms, standards and a psychological end-of-life care with the main (...) goal of solving the alleged deficiencies within end-of-life care in hospital settings. Episode 2 was characterised by an emphasis on prioritising end-of-life care and dying at home, and on the fact that the hospice care philosophy should serve as inspiration. In Episode 3, the need for a palliative care philosophy that transcended all palliative care and the importance of systematic follow-ups and indicators was endorsed. Furthermore, human value and freedom of choice were emphasised. In conclusion, the increase of policy-documents produced by the welfare-state illustrate that death and dying have become matters of public concern and responsibility. Furthermore, significant shifts in policy narratives display how notions of good palliative care change, which in turn may affect both the practice and the content of care at the end of life. (shrink)

We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best interests around place (...) of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

Background Ensuring individual free and informed decision‐making for research participation is challenging. It is thought that preliminarily informing communities through ‘community sensitization’ procedures may improve individual decision‐making. This study set out to assess the relevance of community sensitization for individual decision‐making in research participation in rural Gambia. Methods This anthropological mixed‐methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. (...) Results/discussion Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Conclusion Community sensitization is effective in providing first‐hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. (shrink)

Background Ethical principles behind prioritization in healthcare are continuously relevant. However, applying ethical principles during times of increased need, such as during the COVID-19 pandemic, is challenging. Also, little is known about nursing home nurses’ prioritizations in their work to achieve well-being and health for nursing home residents. Aim The aim of this study was to explore nursing home nurses’ priority-setting for older nursing home residents in Sweden during the COVID-19 pandemic. Research design, participants, and research context We conducted a (...) qualitative interview study. Data were collected through in-depth interviews (retrospective self-reports) between February and May 2021 with 21 nursing home nurses. To help respondents to recall their memories, we used the critical incident technique (CIT). We analyzed data within the theoretical framework and the methodological orientation of content analysis. Ethical considerations Written and verbal consent was obtained before the interviews, and information was given to participants informing them that participation was entirely voluntary. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to the research project (Dnr. 2020-05649). Findings We identified an overarching theme—nursing home nurses struggling on multiple fronts, “just do it”—and seven categories: striving for survival and caring about a dignified death; responding sensitively to relatives’ expectations; ranking the urgency of needed care; responding to input from different actors; combating the spread of infection in unconventional ways; taking the lead and doing what is required; and following the ideals of person-centered nursing. Conclusions Nurses’ priority-setting for older nursing homes residents during the COVID-19 pandemic meant strain and struggle. In some cases, nurses had taken responsibility for priorities falling outside their statutory powers. Different demands and interests affected nurses’ priorities. Nursing home nurses need organizational and managerial support to prioritize. (shrink)

Des droits fondamentaux au fondement du droit, le lien semble non seulement direct, mais évident. Or l'examen des différents discours théoriques sur le droit montre qu'il n'en est rien. Le livre de Charlotte Girard analyse précisément les différences de traitement du rapport entre ces deux termes dans les discours théoriques juridiques, en particulier ceux qui posent la question du fondement du droit. Soit l'étude des droits fondamentaux se distingue de celle du fondement du droit - les droits fondamentaux ne (...) mènent pas naturellement au fondement du droit -, soit on associe les deux notions - les droits fondamentaux sont au fondement même du droit. Or cette distinction renvoie à ce que la théorie du droit différencie traditionnellement : les approches juspositiviste d'une part et jusnaturaliste d'autre part. La confrontation de ces discours théoriques à la question du fondement du droit, qu'elle se traduise ou non par les droits fondamentaux, révèle une certaine fragilité des présupposés respectifs de ces discours. En réalité, le fondement du droit n'est pas seulement un élément de débat juridique et normatif, mais il relève aussi et surtout d'un débat politique et institutionnel. C'est en effet en raison de son caractère normatif que le fondement du droit - quel que soit le discours qui le porte, y compris le discours juridique théorique - appartient pleinement au champ politique. (shrink)

Several quantitative studies (e.g. Kidd & Castano, 2013a; Djikic et al., 2013) have shown a positive correlation between literary reading and empathy. However, the literary nature of the stimuli used in these studies has not been defined at a more detailed, stylistic level. In order to explore the stylistic underpinnings of the hypothesized link between literariness and empathy, we conducted a qualitative experiment in which the degree of stylistic foregrounding was manipulated. Subjects (N = 37) read versions of Katherine Mansfield's (...) 'The Fly', a short story rich in foregrounding, while marking striking and evocative passages of their choosing. Afterwards, they were asked to select three markings and elaborate on their experiences in writing. One group read the original story, while the other read a 'non-literary' version, produced by an established author of suspense fiction for young adults, where stylistic foregrounding was reduced. We found that the non-literary version elicited significantly more (p < 0.05) explicitly empathic responses than the original story. This finding stands in contradiction to widely accepted assumptions in recent research, but can be assimilated in alternative models of literariness and affect in literary reading (e.g. Cupchik et al., 1998). We present an analysis of the data with a view to offering more than one interpretation of the observed effects of stylistic foregrounding. (shrink)

We are all immersed in a sea of social norms, but they are sometimes tricky to observe with any clarity. They are often invisible to us and emerge only when they are not observed. Social norms are important to understand because they are both limiting of our freedom, such as gendered and racialized norms, and at the same time the very conditions of our agency. Social Goodness presents an original, externalist answer to the question of the source or origin of (...) social role normativity. Rather than grounding social normativity in the attitudes of persons, the book argues for an externalism that roots social role normativity in the social world itself: in its positions, institutions, and larger architecture. The core insight of externalism is that the function or structural feature of an enterprise or activity can bring with it normative demands quite independently of the attitudes of those who engage with it. According to the artisanal model, just as a carpenter, ceramicist, or chef is responsive to and evaluable under a set of artisanal norms or techniques, so too is a mother and or an academic or a President. The source of normativity is this technique or expertise, independent of the preferences, endorsements, or recognitive attitudes of individuals. The artisanal model for social role normativity has resources to explain both the "stickiness" or persistence of social norms and our ability to criticize existing norms and to engage in normative self-creation--to create new normative selves. The artisanal model also has resources to capture and express the social situatedness, locality, and materiality of social roles. The relational ontology of social roles, implicit in the artisanal model, provides a useful frame to consider both hierarchical and oppressive social relations. (shrink)

Reorienting the Political examines the reception of two controversial German philosophers, Carl Schmitt and Leo Strauss, in the Chinese-speaking world. This volume explores the powerful resonance of both thinkers in Chinese political thought from a cross-cultural and interdisciplinary perspective.

The inconsistency between pro-environmental attitudes and behaviours, known as the “attitude-behaviour” gap, is exceptionally pronounced in scenarios associated with “green” choice. The current literature offers numerous explanations for the reasons behind the “attitude-behaviour” gap, however, the generalisability of these explanations is complex. In addition, the answer to the question of whether the gap occurs between attitudes and intentions, or intentions and behaviours is also unknown. In this study, we propose the moral dimension as a generalisable driver of the “attitude-behaviour” gap (...) and investigate its effectiveness in predicting attitudes, pro-environmental intentions and subsequent behaviours. We do so by using Hunt–Vitell’s moral philosophy-based framework of ethical decision-making, which conceptualises morality as the central decision-making parameter. The results from 557 US MTurk participants revealed that the manipulation of moral dimensions, specifically deontology and teleology, impacted ethical evaluation of presented dilemmas, however, failed to translate into subsequent intentions and behaviours. This finding suggests (i) that the moral dimension has an effect in shaping attitudes toward environmental issues, and (ii) that gap occurs between attitudes and intentions rather than intentions and behaviours. Further investigation of what strengthens and/or overrides the effects of the moral dimension would help understand the reasons why moral attitudes do not always translate into subsequent intentions and behaviours in the pro-environmental domain. (shrink)

This was the last and most important and comprehensive work of Charlotte Mason, (founder of the Parents’ National Educational Union).

Who is a native signer? Since around 95% of deaf infants are born into a hearing family, deaf signers are exposed to a sign language at various moments of their life, and not only from birth. Moreover, the linguistic input they are exposed to is not always a fully fledged natural sign language. In this situation, is the notion of native signer as someone exposed to language from birth of any use? We review the results of the first large-scale cross-linguistic (...) investigation on the effects of age of exposure to sign language. This research involved about 45 Deaf adult signers in each of three sign languages (Catalan Sign Language, French Sign Language, and Italian Sign Language). Across the three languages, participants were divided into three groups – those exposed from birth, those between 1 and 5 years of age, and those exposed between 6 and 15 years of age – and received a battery of tests designed for each language targeting various aspects of morphosyntactic competence. In particular, the tests focused on both those morphosyntactic phenomena that are known from the spoken language literature to be good detectors of language impairment or delay (i.e.,wh-interrogatives and relative clauses) and on morphosyntactic phenomena that are sign language specific (i.e., role shift and directional verbs). The results showed a clear effect of being native, with significant differences across languages and tests between signers exposed to sign language from birth and those exposed in the 1st years of life. This confirms the life-long importance of language exposure from birth and the reliability of the notion of “nativeness”, at least for syntax. On the other hand, while in most domains the differences observed between populations might be differences in performance, for some specific constructions, signers belonging to the three groups may have different grammars. This latter finding challenges the generalized use of native signers’ grammar as the baseline for language description and language assessment. (shrink)

Charlotte Wolff was born in Riesenburg, West Prussia into a middle-class Jewish family. She studied philosophy and then medicine at several German universities, completing her doctorate in Berlin in 1926. Working in various institutions over the next few years, she was also interested in psychotherapy and had a small private medical and psychotherapeutic practice. In 1933 she was forced to leave Germany because of the Nazi regime, and settled for a few years in Paris. As a German refugee she (...) was unable to practice medicine, so she began her research into the correlation between hand traits and personality. In 1936 she went to London to continue her research work and lived there until her death. An active lesbian from an early age, her later research turned to sexology and her writing on lesbianism and bisexuality were influential early works in the field. This is a great opportunity to rediscover her early work, including her first autobiography. (shrink)

The notion of moral expertise poses a variety of challenges concerning both the question of existence of such experts and their identification by laypeople. I argue for a view of ethics expertise, based on moral understanding instead of on moral knowledge, that is less robust than genuine moral expertise and that does not rely on deference to testimony. I propose identification criteria that focus mainly on the awareness and communication of implicit biases and situated ignorance. According to the account of (...) ethics expertise presented in this paper, the expert's testimony is not an epistemic reason for the layperson's belief, but merely an epistemic influence. The epistemic reasons for the layperson's belief are largely independent from the expert. But there is still some epistemic risk involved in the proposed method of knowledge transfer, and therefore criteria for the identification of a trustworthy expert are necessary. The risk involved in knowledge transfer can be both due to willful manipulation and due to the expert's implicit biases and situated ignorance. While willful manipulation cannot really be avoided, the influence from biases and ignorance can be minimized. I argue that the best way to do this is if the expert is aware of their own biases and ignorance and communicates them. Combined with evidence of the expert's education in moral philosophy and experience with the topic in question, this gives the layperson the best chance to identify someone who can really help them consider all relevant aspects of a situation and come to a better justified decision. (shrink)

Guides you step-by-step through the functions on your new Canon EOS 5D Mark III dSLR camera The Canon EOS 5D Mark III full-frame dSLR camera features an impressive 22.3 megapixels, a 3.2-inch LCD screen, 6 fps continuous shooting, Live View, an ISO range of 50 to 102,400 and full HD 1080 resolution movie shooting. Here to help you get the most out of these remarkable features and offering you more in-depth coverage than the standard manual, this full-color Canon 5D Mark (...) III Digital Field Guide provides you with guidance on how and when to use each button, dial, and menu option. Delivering information in an easy-to-understand format, this portable guide features more than 200 inspirational photos by acclaimed photographer and veteran author Charlotte Lowrie. The handy trim size allows this guide to go where you go, providing you with easy access to information quickly so you can get the exact shot you want when you want it. Helps you make the most of your Canon EOS 5D Mark III and get the shots you want Offers full detailed coverage of when and how to use each and every button, dial, and menu option on this sophisticated new dSLR Provides step-by-step explanations on techniques and tips, all aimed at getting you comfortable and confident with your new Canon 5D Mark III Sized to fit in a camera bag, the book includes a bonus gray and color checker card to help you capture perfect white balance and color every time. Ideal reading for both amateur and professional photographers alike, you'll reference Canon 5D Mark III Digital Field Guide again and again. (shrink)

This paper has two aims. The first is to defend a recent critique of the leading medical theory of suffering, which alleges too narrow a focus on violent experiences of suffering. Although sympathetic to this critique, I claim that it lacks a counterexample of the kinds of experiences the leading theory is said to neglect. Drawing on recent clinical cases and the longer intellectual history of suffering, my paper provides this missing counterexample. I then answer some possible objections to my (...) defence, before turning to my second aim: an expansion of my counterexample into a spectrum of suffering that varies according to the selves and purposes that suffering affects. Next, I connect this spectrum to the tolerability of suffering, which I distinguish from its affective intensity. I conclude by outlining some applications of this distinction for the psychometric reliability of assessment instruments that measure suffering in clinical contexts. (shrink)

Plato's most magisterial dialogue, the Republic, takes up the question "what is justice," and its central image is an imaginary city constructed in speech designed to aid in this inquiry. In Book V of the Republic, Socrates tells his interlocutors that they have completed the "Male Drama," of the city in speech and that it is now time for them to take up the "Female." The "Female Drama" is Socrates name for the action of the central books of the Republic: (...) V-VII. Much has been made of what this transition in the Republic signifies for political questions. The Republic is not only concerned with politics or political justice, however. Like all of the images and arguments in the Republic, the Female Drama of the city in speech has meaning both for political and individual justice, but there has been no systematic inquiry into the central books of the Republic for their meaning for individual justice. That is the ambition of this book. On the level of moral psychology, Thomas argues that while the Male Drama of Books II-IV presents images of fully formed versions of the psychological activities that come together to define justice in a human life, the Female Drama explores the modes of potentiality and becoming necessary for those psychological activities to come into being. More specifically, Books V-VII explore the three modes of potentiality necessary for the development of justice: genesis, trophe, and paideia. (shrink)

Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...) and as a consequence, adverse health effects. Studies show that increased awareness about the side effects of medications, the framing of information and the socioemotional context of care can increase the risk of nocebo effects. Connecting research into the nocebo effect with open notes provides preliminary support for the hypothesis that patient access to clinical notes might be a forum for facilitating unwanted nocebo effects. Furthermore, current findings indicate that we might expect to see systematic differences in how nocebo effects are experienced among different patient populations. The ethical implications of the tension between transparency and the potential for harm are discussed, with an emphasis on what open notes might mean for justice and equity in clinical care for a range of already marginalised patient populations. I argue that to resolve these challenges does not thereby justify ‘closed notes’, and conclude with suggestions for how health systems and clinicians might adapt to this innovation to reduce the risk of potential nocebo effects arising via this novel route. (shrink)

In cases of complicity in one’s own unfreedom and in structural injustice, it initially appears that agents are only vicariously responsible for their complicity because of the roles circumstantial and constitutive luck play in bringing about their complicity. By drawing on work from the phenomenological tradition, this paper rejects this conclusion and argues for a new responsive sense of agency and responsibility in cases of complicity. Highlighting the explanatory role of stubbornness in cases of complicity, it is argued that although (...) agents may only be vicariously responsible for becoming complicit, they can be held more directly responsible for entrenching their complicity. The complicit agent is responsible for their complicity to the extent that they fail to take responsibility for it. (shrink)

resumo É possível distinguir ao menos três etapas principais nas abordagens filosóficas da noção de sujeito: na etapa metafísica a estrutura do sujeito é pens a da em termos de substância; na etapa transcendental , o sujeito é visto como polarida de unificadora de horizontes; na etapa psic a na l í t ica, o sujeito é de f i n ido como estrutura vazia. O sujeito tra ns c e nde ntal é uma estrutura para o mu ndo, enqua (...) nto o sujeito psicanalítico precisa ter uma estrutura em si me s mo para estruturar sua ausênc ia ontológica. Para Lacan, essa ausênc ia ont o l ó g ica se torna manifesta me d ia nte a ling ua gem. A estrutura do sujeito é concebida como uma estrutura de significação. Este artigo compara esses três pontos de vista sobre o sujeito e discute que relevância a idéia de estrutura pode ter para a compreensão do conceito. palavras-chave Sujeito metafísico; sujeito transcendental; sujeito psic a nalítico; estrutura; Platão; Kant; Fichte; Lacan. (shrink)

After launching his career with the 1947 publication of his dissertation, _Occidental Eschatology_, Jacob Taubes spent the early years of his career as a fellow and then professor at various American institutions, including Harvard, Princeton, and Columbia. During his American years, he also gathered together a number of prominent thinkers at his weekly seminars on Jewish intellectual history. In the mid-60s, Taubes joined the faculty of the Free University in West Berlin, initially as the city's first Jewish Studies professor of (...) the postwar period. But his work and interest expanded beyond the boundaries of the field of Jewish Studies to broader philosophical questions, particularly in the philosophy of religion. A charismatic speaker and a great polemicist, Taubes had a phenomenal ability to create interdisciplinary conversations in the humanities, engaging scholars from philosophy, literature, theology, and intellectual history. The essays presented here represent the fruit of conversations, conferences, and workshops that he organized over the course of his career. (shrink)

How does Plato conceive the pleasures attendant on the virtuous life? Does he provide a specific account of them? By reading through key passages from Laws book 5, Republic book 9 and the Philebus, I try to assess the way Plato endeavours to demonstrate that the virtuous life is also happy and thereby pleasant. I investigate to what extent these texts put forward any specificity of the pleasures of being virtuous, and how far the account they provide harmonizes with Plato’s (...) general views about pleasure. (shrink)

This book uses the body to peel back the layers of time and taken-for-granted ideas about the two defining political forms of modernity, the state and the subject of rights. It traces, under the lens of the body, how the state and the subject mutually constituted each other since their original crafting in the seventeenth century. Considering multiple sites of theory and practice, Charlotte Epstein analyses the fundamental rights to security, liberty, and property respectively as the initial knots where (...) the state-subject relation was first sealed. (shrink)

En considérant qu’un dispositif est une auto-organisation régulatrice, nous proposons de discuter les modalités d’une alternance intégrative que nous avons expérimentée en formation d’adultes. La régulation est abordée sous l’angle de l’évaluation progressive de la formation et de ses finalités émancipatrices travaillées dans un accompagnement multiforme à l’autoformation. La place de la réflexivité étant centrale, nous centrons notre propos ici sur la lecture critique d’un outil que nous avons développé, l’Indice de Vécu en Formation (IVF) afin de recueillir les représentations (...) des alternants sur la manière dont ils vivent la formation et de leur proposer un accompagnement adapté. (shrink)

In the development of governmental policy for artificial intelligence that is informed by ethics, one avenue currently pursued is that of drawing on “AI Ethics Principles”. However, these AI Ethics Principles often fail to be actioned in governmental policy. This paper proposes a novel framework for the development of ‘Actionable Principles for AI’. The approach acknowledges the relevance of AI Ethics Principles and homes in on methodological elements to increase their practical implementability in policy processes. As a case study, elements (...) are extracted from the development process of the Ethics Guidelines for Trustworthy AI of the European Commission’s “High Level Expert Group on AI”. Subsequently, these elements are expanded on and evaluated in light of their ability to contribute to a prototype framework for the development of 'Actionable Principles for AI'. The paper proposes the following three propositions for the formation of such a prototype framework: preliminary landscape assessments; multi-stakeholder participation and cross-sectoral feedback; and, mechanisms to support implementation and operationalizability. (shrink)

Traditionnellement, la scène contemporaine opère un partage entre deux acceptions de l? « intentionnalité » : entre les lectures dites « interna­liste » et « externaliste » de la notion. À l?aune des débats contemporains, il est en effet tentant de distinguer une approche « internaliste » de l?intention­nalité ? conçue comme l?expression d?un vécu psychique ? d?une ap­proche « externaliste » qui substitue au concept d?« intentionnalité » celui d? « intention » pour en récuser toute anticipation ou détermination (...) « subjec­tive ». Selon la première acception, l?intentionnalité est un acte psychique qui se détermine lui-même. Ce vécu est l?expression d?une inten­tion de signifier. Selon la deuxième acception, l?intention n?est pas un vécu. Elle n?accom­pagne pas l?action (elle ne l?anticipe ni ne la guide) : l?intention, c?est l?action elle-même dont la détermination requiert des facteurs « ex­ternes » au vécu. Il est cependant clair que ce partage est schématique. La première catégorie de partage, dite « internaliste », est évidemment hétéro­gène. Mais on entend ici se concentrer sur la deuxième, « externaliste », pour montrer sa complexité. D?un point de vue générique, selon la lecture externaliste, l?intention est donc comprise comme une action. Seule l?action est, ou non, intention­nelle. Critiquant toute acception mentaliste et. (shrink)