Families and clinicians approaching a child’s death in the paediatric intensive care unit (PICU) frequently encounter questions surrounding medical decision-making at the end of life (EOL), including defining what is in the child’s best interest, finding an optimal balance of benefit over harm, and sometimes addressing potential futility and moral distress. The best interest standard (BIS) is often marshalled by clinicians to help navigate these dilemmas and focuses on a clinician’s primary ethical duty to the paediatric patient. This approach does (...) not consider a clinician’s potential duty to the patient’s family. This paper argues that when a child is dying in the PICU, the physician has a duty to serve both the patient and the family, and that in some circumstances, the duty to serve the family becomes as important as that owed to the child. We detail the limitations of the BIS in paediatric EOL care and propose the relational potential standard as an additional ethical framework to guide our decisions. (shrink)

Background There is considerable variation in the functionality of bioethical services in different institutions and countries for children in hospital, despite new challenges due to increasing technology supports for children with serious illness and medical complexity. We aimed to understand how bioethics services address bioethical concerns that are increasingly encountered in paediatric intensive care. Methods A qualitative descriptive design was used to describe clinician’s perspectives on the functionality of clinical bioethics services for paediatric intensive care units. Clinicians who were members (...) of formal or informal clinical bioethics groups, or who were closely involved with the process of working through ethically challenging decisions, were interviewed. Interviews took place online. Resulting transcripts were analysed using thematic analysis. Results From 33 interviews, we identified four themes that described the functionality of bioethics services when a child requires technology to sustain life: striving for consensus; the importance of guidelines; a structure that facilitates a time-sensitive and relevant response; and strong leadership and teamwork. Conclusions Clinical bioethics services have the potential to expand their role due to the challenges brought by advancing medical technology and the increasing options it brings for treatment. Further work is needed to identify where and how bioethics services can evolve and adapt to fully address the needs of the decision-makers in PICU. (shrink)

BackgroundDecision-making in initiating life-sustaining health technology is complex and often conducted at time-critical junctures in clinical care. Many of these decisions have profound, often irreversible, consequences for the child and family, as well as potential benefits for functioning, health and quality of life. Yet little is known about what influences these decisions. A systematic review of reasoning identified the range of reasons clinicians give in the literature when initiating technology dependence in a child, and as a result helps determine the (...) range of influences on these decisions.MethodsMedline, EMBASE, CINAHL, PsychINFO, Web of Science, ASSIA and Global Health Library databases were searched to identify all reasons given for the initiation of technology dependence in a child. Each reason was coded as a broad and narrow reason type, and whether it supported or rejected technology dependence.Results53 relevant papers were retained from 1604 publications, containing 116 broad reason types and 383 narrow reason types. These were grouped into broad thematic categories: clinical factors, quality of life factors, moral imperatives and duty and personal values; and whether they supported, rejected or described the initiation of technology dependence. The majority were conceptual or discussion papers, less than a third were empirical studies. Most discussed neonates and focused on end-of-life care.ConclusionsThere is a lack of empirical studies on this topic, scant knowledge about the experience of older children and their families in particular; and little written on choices made outside ‘end-of-life’ care. This review provides a sound basis for empirical research into the important influences on a child’s potential technology dependence. (shrink)

Many Western nations are emphasizing the importance of population health across health care delivery organizations and education systems. Despite significant momentum to integrate population health into nursing practice, a parallel effort to examine how these efforts impact practicing nurses' views of their professional role and work identity has not occurred. This secondary qualitative analysis, employing an abductive approach, explored processes public health nurses use in creating and maintaining their work identity through three organizing themes: narrative self‐identity, mandated identity, and identity (...) as struggle. The analysis was based on interview data collected from 30 US public health nurses residing in 17 states. ‘Being a real nurse’ describes public health nurses' efforts to balance a contradictory work identity where at times they are expected to focus on populations and at other times, on individuals. The identity work revealed through this study should be further explicated and specific strategies developed for stabilizing a work identity for public health nurses, as well as for any nurse charged with a population health role. (shrink)

Background: Currently preterm births are the leading causes of newborn deaths and newborn mortality in developed countries. Infants born prematurely remain vulnerable to many acute complications and long-term disabilities. There is a growing concern surrounding the moral and ethical implications of the complex and technological care being provided to extremely low birth weight infants in neonatal intensive care units in the developed nations. Research purpose: The purpose of this study was to describe the ethical and moral issues that neonatal intensive (...) care nurses experience when caring for low birth weight preterm infants and their families. Research design: A phenomenological method design was used to describe the lived experiences of nurses with ethical and moral issues encountered in the neonatal intensive care unit. One-on-one, semi-structured interviews using open-ended questions were used to gather data from the participants. Research participants: The setting for this study was a 97-bed neonatal intensive care. A total of 16 female nurses were interviewed. Ethical considerations: Approval to conduct the research study was obtained from the institutional review board of the hospital where the study was conducted. Formal signed consent was obtained from each participant. To ensure confidentiality, each participant was asked to choose a confederate name to be used in the interview and the transcriptions. Findings: The thematic analysis identified five recurring themes: (a) at the edge of viability, (b) infant pain and discomfort, (c) crucial decisions, (d) communicating with parents, and (e) letting go. Conclusion: Neonatal intensive care unit nurses indicated that they often had challenges to their own sense of morality as they struggled to protect the infant from pain and unnecessary discomfort, provide care to an infant and their family whom they thought was faced with a lifetime of challenges and poor health, accepting decisions made by parents, and feeling as if parents were not adequately informed about outcomes. (shrink)

Moral distress (MD), the suffering experienced by professionals due to their restricted moral agency, has become a popular subject of study in the fields of social work and health care. Many of the existing measures of MD are targeted at certain professionals, such as health care workers, and are thus restricted to such contexts. This has challenged the conceptual development and empirical examination of MD as a phenomenon occurring across diverse professional groups in different work settings. This study introduces a (...) general measure of MD, the Moral Distress Instrument (MDI). It is not bound to specific professional contexts, and it aims to enable comparative and cross-disciplinary analyses of MD. The MDI consists of seven items that capture different forms of constrained moral agency and follow-up items measuring the level of distress related to these experiences. The reliability and validity of the MDI is investigated, and its distinctiveness from and associations with burnout are studied among a sample of Finnish social workers (n = 367). The MDI was shown to be a reliable and valid measure among the sample. The measures of MD and burnout were shown to tap separate constructs, although these experiences were strongly associated with each other. (shrink)

What is it about the nature of "soul" that makes it so difficult to adequately capture its complexity in a strictly discursive account? Why do some of the most profound human experiences elude our attempts to theorize them? How can a written document do justice to the dynamic activity of thinking, as opposed to merely presenting a collection of thoughts-as-artifacts? Finally, what can we learn about the activity of philosophizing, and about the human soul, by reflecting on the possibilities and (...) limitations of writing? These concerns, in various forms and in different registers, have preoccupied Michael Davis throughout his distinguished career. This volume is in honor of, and in dialogue with, Davis's work, which spans ancient philosophy and literature, continental philosophy and political philosophy. It includes original essays by numerous distinguished scholars in the fields of philosophy and political science. The remarkable range and caliber of the contributions attest to the breadth and depth of Davis's influence. The essays in Part I of the volume explore the nature of soul through the lens of tragedy. Part II consists of three essays that explore the human longing for perfect knowledge and completion--and the obstacles to the fulfilment of that longing--in relation to the divine. In Part III, the essays address the distinctive challenges of the political sphere and philosophy's relation to it. And while the relationship between philosophy and poetry is an implicit theme throughout the volume, the essays in Part IV focus directly on philosophy's aestheticizing tendencies. Many different philosophical and literary works are discussed throughout these chapters, including ancient works such as Plato's Republic, Euthydemus and Laws, Homer's Iliad, and Euripides' Trojan Women, as well as works by modern philosophers such as Rousseau, Kant, Hegel, Kierkegaard and Nietzsche. In addition, three essays analyze some of Shakespeare's plays in relation to the thought of Plato and Machiavelli. All of the essays are thematically linked by a common thread as they attend to the poetic dimension of philosophical thinking. Michael Davis is Professor of Philosophy at Sarah Lawrence College, where he has taught since 1977 and has been the Sarah Yates Exley Chair in Teaching Excellence (2003-2005). He has also taught on the graduate faculty at Fordham University and the New School for Social Research. He is the author of numerous articles and books, which include: Ancient Tragedy and the Origins of Modern Science; The Poetry of Philosophy: On Aristotle's Poetics; The Politics of Philosophy: A Commentary on Aristotle's Politics; The Autobiography of Philosophy; Rousseau's The Reveries of the Solitary Walker; Wonderlust: Ruminations on Liberal Education; and The Soul of the Greeks: An Inquiry. He is also co-translator (with Seth Benardete) of Aristotle's On Poetics. Contributors include: Abraham Anderson, Jonathan Badger, Robert Berman, Ronna Burger, Kenneth DeLuca, Gwenda-lin Grewal, Scott Hemmenway, Paul Kirkland, Mary Nichols, Denise Schaeffer, Paul Stern, Richard Velkley, Lisa Pace Vetter, Ann Ward, Lee Ward, Catherine Zuckert and Michael Zuckert. About the Editor: Denise Schaeffer is Professor of Political Science at the College of the Holy Cross. She is the author of Rousseau on Education, Freedom and Judgment and contributing co-editor (with Christopher Dustin) of Socratic Philosophy and Its Others. She is co-editor (with Gregory McBrayer and Mary P. Nichols) of the Focus Philosophical Library edition of Plato's Euthydemus, for which she authored the Introduction and co-authored the Interpretive Essay. (shrink)

Back cover: This book develops a philosophical account that reveals the major characteristics that make an explanation in the life sciences reductive and distinguish them from non-reductive explanations. Understanding what reductive explanations are enables one to assess the conditions under which reductive explanations are adequate and thus enhances debates about explanatory reductionism. The account of reductive explanation presented in this book has three major characteristics. First, it emerges from a critical reconstruction of the explanatory practice of the life sciences itself. (...) Second, the account is monistic since it specifies one set of criteria that apply to explanations in the life sciences in general. Finally, the account is ontic in that it traces the reductivity of an explanation back to certain relations that exist between objects in the world (such as part-whole relations and level relations), rather than to the logical relations between sentences. Beginning with a disclosure of the meta-philosophical assumptions that underlie the author’s analysis of reductive explanation, the book leads into the debate about reduction(ism) in the philosophy of biology and continues with a discussion on the two perspectives on explanatory reduction that have been proposed in the philosophy of biology so far. The author scrutinizes how the issue of reduction becomes entangled with explanation and analyzes two concepts, the concept of a biological part and the concept of a level of organization. The results of these five chapters constitute the ground on which the author bases her final chapter, developing her ontic account of reductive explanation. (shrink)

The book is about logical analysis of natural language. Since we humans communicate by means of natural language, we need a tool that helps us to understand in a precise manner how the logical and formal mechanisms of natural language work. Moreover, in the age of computers, we need to communicate both with and through computers as well. Transparent Intensional Logic is a tool that is helpful in making our communication and reasoning smooth and precise. It deals with all kinds (...) of linguistic context in a fully compositional and anti-contextual way. (shrink)

For centuries, philosophy has been considered as an intellectual activity requiring complex cognitive skills and predispositions related to complex (or critical) thinking. The Philosophy for Children (P4C) approach aims at the development of critical thinking in pupils through philosophical dialogue. Some contest the introduction of P4C in the classroom, suggesting that the discussions it fosters are not philosophical in essence. In this text, we argue that P4C is philosophy.

Chenu, M.-D. Foi, certitude et recherche.--Gilson, É. Réponse à Louis-Marie Régis, On some difficulties of interpretation.--Dubarle, D. Logique et épistémologie du signe chez Aristote et chez les Stoïciens.--Geiger, L.-B. Ce qui est, se dit en plusiers sens.--Owens, J. "Diversificata in diversis."--Cauchy, V. Être et connaître, l'irréductibilité de l'aristotélisme au platonisme.--Joós, E. Maurice Merleau-Ponty, de l'intentio intellectus, à l'intentio rei.--Murin, C. Pour une démystification de la "mort-de-Dieu" nietzschéenne.--Joós, E. Post-scriptum, la nouvelle scolastique de Louis-Marie Régis.--Landry, A.-M. Louis-Marie Régis, (...) O.P., quelques dates et faits marquants de sa vie.--Lettre d'Henri-Irénée Marrou à Louis-Marie Régis. (shrink)

To revitalize nursing science, there is a need for a new approach to guide nurse scientists in addressing complex problems in health care. By applying theoretical concepts from a revolutionary philosopher of science, Paul K. Feyerabend, new nursing knowledge can be produced using creativity and pluralistic approaches. Feyerabend proposed that methods within and outside of science can produce knowledge. Despite the recognition of Feyerabendian philosophy within science, there is currently a lack of literature regarding the relevance of Feyerabendian philosophy for (...) nursing science. We aim to (a) describe and critique Feyerabendian concepts, (b) discuss the potential application of Feyerabendian philosophy for knowledge production within gerontological nursing and (c) describe theoretical possibilities for nurse scientists in using Feyerabendian philosophy to guide nursing knowledge development. We begin by introducing Feyerabend's life and his inspirations for his theoretical concepts, epistemological anarchism, theoretical pluralism and humanitarianism, and conclude by offering suggestions of how to apply Feyerabendian philosophy in nursing research. (shrink)

Personhood is ascribed on others, such that someone who is recognized to be a person is bestowed with certain civil rights and the right to decision making. A rising question is how severely brain-injured patients who regain consciousness can also regain their personhood. The case of patients with locked-in syndrome is illustrative in this matter. Upon restoration of consciousness, patients with LIS find themselves in a state of profound demolition of their bodily functions. From the third-person perspective, it can be (...) expected that LIS patients might experience a differential personal identity and may lose their status as persons. However, from the patients’ perspective, it is uncontested that they retain their personal identity and that they consider themselves to be persons. We here include results from a survey with patients with LIS aimed at identifying the primary expectations of patients for their care by non-medical professionals. Based on these first-hand reports, we argue that personhood in LIS is progressively regained as the widening circle of others recognizes them as persons. (shrink)

Consider sentences like (1): 1. Null Complement Containing Sentences a. Aryn followed b. Marie-Odile promised c. Corinne left d. Samir found out at midnight e. I applied f. They already know g. He volunteered h. Abdiwahid insisted i. I suppose j. Paul gave to Amnesty International These illustrate the phenomenon of null complements -- also called ‘pragmatically controlled zero anaphora’, ‘understood arguments’, and ‘linguistically unrealized arguments’. In each case, a complement is (phonologically) omitted, yet (a) the sentence is well-formed (...) and (b) the meaning effect is as if a complement were present. This contrasts on the one hand with structures that lack complements, but are ill-formed as a result – e.g., (2a-c) – and, on the other hand, with structures that lack overt complements, are well-formed, but do not exhibit the meaning effect of a complement – e.g., sentences (3a-b). 2. Contrast with Ill-formed Structures.. (shrink)

This dissertation aims to construct a non-dogmatic defence of common sense. It tries to show why the absence of justification for the judgements of common sense, which the sceptic reveals, does not invalidate them.

La renommée nationale et internationale de Pierre Bourdieu lui est venue de la sociologie, une sociologie un peu particulière, dite " des élites ", ou plus communément, " de la domination ", au fil de laquelle il ne se fit pas faute de fustiger les représentants de celle qu'il appelait " La discipline du couronnement ", la philosophie. C'était là pourtant son terroir d'origine, sa formation première, et la seule dans laquelle il possédât un diplôme. Mais il ne voyait dans (...) ses anciens " collègues " que des lectors figés dans une position scolastique qui les éloignait des urgences du monde et du " sens pratique ". Pourtant, c'est à l'aide de La philosophie qu'il critique la philosophie, et vise à l'éduquer, qu'il forge les concepts majeurs de sa sociologie, comme l'habitus, la violence symbolique. Et l'enjeu de ses recherches est encore un enjeu philosophique, qui le rapproche de ceux qui ont voulu transformer le monde, au lieu de se borner à le penser. (shrink)

This paper is a review of the nine chapters more directly concerned with philosophy of the volume Jaina Scriptures and Philosophy. Edited in 2015 by Peter Flügel and Olle Qvarnström, this interdisciplinary volume in philosophy, philology, linguistics, literary studies and history is presented as an essential contribution to the study of Jaina philosophy inasmuch as it offers a collection of cutting-edge analyses on the emergence and development of philosophical concepts such as the Self and its epistemic faculties, with a focus (...) on early Jaina canonical literature and commentaries thereof. (shrink)

Are fragile majorities capable of opening themselves to deep-rooted and new ethnic and cultural pluralism? What role does education play in this process? Based on ten years of comparative research, Fragile Majorities and Education is a nuanced study of ethnic dominance, linguistic integration of immigrants, and diversity in education. Ethnic relations are often depicted in an oversimplified framework where a clear dominant majority exercises power over various minorities. In many societies worldwide, however, this model does not hold true. In some (...) countries, two or more groups possess relatively equal power to control the state and impose their definitions of the nation, as is the case with Flemish speakers and French speakers in Belgium, and with Catholics and Protestants in Northern Ireland. In other instances, such as in Quebec or Catalonia, clearly identifiable majorities are nonetheless minorities at a larger nation-state level, which creates a situation of ambiguous ethnic dominance. Marie McAndrew analyzes and clarifies these complex situations through the lens of education as a means for both maintaining and transforming ethnic boundaries and identities. Deeply insightful and meticulously researched, Fragile Majorities and Education is a groundbreaking contribution to the field of ethnic studies. (shrink)

Originally presented as the author's thesis, Paris-Sorbonne, 1974.

Pendant plus de dix ans, chacun dans son coin, Marie-Pierre, Gérôme et Samuel ont consacré leur temps libre à des fanzines sur la musique. Jusqu’à ce qu’en 1998 Samuel se lance dans la publication de travaux de jeunes chercheurs en Lettres et en Sciences humaines et fonde les éditions Mélanie Séteun – anagramme et nom de plume de Samuel Étienne. Nombre de manuscrits qu’il reçoit ne sont pas publiables _in extenso. _Il songe alors à un livre collectif. L’IRMA, diffuseur (...) des éditions, rectifie le tir. Aucun périodique n’est consacré aux recherches pluridisciplinaires sur les musiques actuelles et amplifiées? Le livre collectif sera donc une revue. Samuel s’adjoint Marie-Pierre et Gérôme pour diriger les opérations. Et les voilà à l’heure de la parution du premier numéro de _Copyright Volume! _Il présente, toutes disciplines confondues, des articles de réflexion écrits par des universitaires, des témoignages de professionnels et d’institutionnels ainsi que des propositions plastiques d’a... (shrink)