Nurses frequently encounter situations in which they are compelled to make ethical decisions about what is good and right to do in their day-to-day practice. Often existing moral edicts prove to be inadequate in light of the patient's particular circumstances. To what, then, can the nurse turn? In response to this question, Gadow (1999) proposes a dialectical framework comprised of three ethical approaches: subjective immersion (ethical immediacy), objective detachment (ethical universalism), and intersubjective engagement (relational narrative). In this paper, the dialectic (...) framework proposed by Gadow (1999) is examined with respect to some of its potential implications for nursing practice and education. This endeavour is undertaken in the spirit of extending the dialogue that Gadow has so eloquently initiated. Questions related to whether it is possible (or necessary) to reconcile the contradictory tenets of these ethical approaches or the potential disjunction between the knowledge embedded in the relational narrative and ensuing action on the part of the nurse are discussed. In addition, some of the potential implications of this dialectical framework for nurse education are explored, including the question of how nurses learn to enter into a relational narrative with another and the relevance of relational narratives to teacher–student relationships. (shrink)

The study assesses how a social desirability (SD) bias influences the relationship between several independent and dependent variables commonly investigated in ethics research. The effect of a SD bias was observed when a questionnaire was administered under varying conditions of anonymity and with different measurement techniques for the SD construct. Findings reveal that a SD bias is present in the majority of relationships studied, and it most frequently plays a moderating role. While the measure of SD influences the strength and (...) type of relationship, condition of anonymity has relatively little effect on the level of SD. (shrink)

This study examines the impact of a social desirability response bias as a personality characteristic (self-deception and impression management) and as an item characteristic (perceived desirability of the behavior) on self-reported ethical conduct. Findings from a sample of college students revealed that self-reported ethical conduct is associated with both personality and item characteristics, with perceived desirability of behavior having the greatest influence on self-reported conduct. Implications for research in business ethics are drawn, and suggestions are offered for reducing the effects (...) of a socially desirable response bias. (shrink)

In _Plato's_ Timaeus _and the Missing Fourth Guest_, Donna M. Altimari Adler offers an original account of Plato's Timaeus from 35a-36d, yielding a new interpretation of the _Timaeus_ scale and cosmic harmony imbedded in the text.

Given the complexity of modern health care, there exists an urgent need to discover how best to resolve complex bioethical issues. Traditionally, principle based ethics provided the benchmark for guiding ethical decision-making. More recently, however, it has become apparent that this traditional approach is often inadequate in dealing with cur rent health care dilemmas. The notion of caring was advanced initially as an alternative to, then as a complement to, principle based ethics. In this article, caring is conceptual ized as (...) an attitude and is viewed as integral to the advancement of a coherent and inte grated moral approach to ethical decision-making. First, a brief historical description of bioethics is presented. Next, an evolutionary account of caring within bioethics is described. Four fundamental problems associated with the use of caring within bioethics are then outlined. Finally, caring as an attitude is delineated and a case study is used to illustrate the proposed conceptualization of caring. The case study demonstrates that a caring attitude provides for relationship and context, which are elements often neglected by traditional approaches. (shrink)

In Buddhism the idea of a transcendental or eternal self is denied as non-substantial and impermanent: a non-verifiable metaphysical entity that leads to grasping, craving and suffering. Buddhism posits that things continually change, are continually reducible and recyclable, and that no inherent existence or metaphysical “self” exists but rather a series of aggregates give rise to the experience so that consciousness itself is causally conditioned. As applied to the notion of no- self the one who is reborn and the one (...) who dies and the one who follows the path and the one who realizes enlightenment are neither the same nor different selves. With the Buddhist doctrine of impermanence an analysis of the notion of the “self” breaks down into layers to discover that the self does not exist independently at all. Because of simultaneous arising and falling of each moment the self exists as essentially empty. (shrink)

Previous studies have shown that misperceptions and illusory experiences can occur if sensory stimulation is withdrawn or becomes invariant even for short periods of time. Using a perceptual deprivation paradigm, we created a monotonous audiovisual environment and asked participants to verbally report any auditory, visual or body-related phenomena they experienced. The data (analysed using a variant of interpretative phenomenological analysis) revealed two main themes: (1) reported sensory phenomena have different spatial characteristics ranging from simple percepts to the feeling of immersion (...) in a complex multisensory environment and (2) the active contribution of the perceiver where participants report engaging in exploratory processes even when there is nothing to find. Detailed analysis of the qualitative data further showed that participants who reported more perceptual phenomena were more likely to report internal bodily sensations, move more during the experiment and score higher on the Revised Hallucination Scale than those reporting fewer percepts explicitly linking perceptual deprivation to somatic phenomena. The results demonstrate how the variety of sensory experiences induced by perceptual deprivation can give further insight into the factors mediating conscious awareness and may suggest ways in which the brain imposes meaning on the environment under invariant sensory conditions. (shrink)

Jerry Fodor has charged that Fred Dretske's account of content suffers from indeterminacy to the extent that we should reject it in favor of Fodor‘s own account. In this paper, we ask what the problem of indeterminacy really is; we distinguish a relatively minor problem we call ‘looseness of fit’ from a major problem of failing to show how to point to what is not there. We sketch Dretske's account of content and how it is supposed to solve the major (...) problem. After presenting Fodor's challenge as the claim that Dretske has failed to solve the major problem, we articulate a response available to Dretske. Although we do not think the response is ultimately successful, we argue that it is every bit as good as the response Fodor has offered to a similar challenge, in his so-called ‘mixed theory.’ The upshot is this: despite advertisements to the contrary, Fodor's theory, in its mixed version, offers no real advantages over Dretske's regarding the serious problem of indeterminacy. (shrink)

Nourishing the Inner Life of Clinicians and Humanitarians: The Ethical Turn in Psychoanalysis, demonstrates the demanding, clinical and humanitarian work that psychotherapists often undertake with fragile and devastated people, those degraded by violence and discrimination. In spite of this, Donna M. Orange argues that there is more to human nature than a relentlessly negative view. Drawing on psychoanalytic and philosophical resources, as well as stories from history and literature, she explores ethical narratives that ground hope in human goodness and (...) shows how these voices, personal to each analyst, can become sources of courage, warning and support, of prophetic challenge and humility which can inform and guide their work. Over the course of a lifetime, the sources change, with new ones emerging into importance, others receding into the background. Donna Orange uses examples from ancient Rome, from twentieth century Europe, from South Africa, and from nineteenth century Russia. She shows how not only can their words and examples, like those of our personal mentors, inspire and warn us; but they also show us the daily discipline of spiritual self-care, although these examples rely heavily on the discipline of spiritual reading, other practitioners will find inspiration in music, visual arts, or elsewhere and replenish the resources regularly. Nourishing the Inner Life of Clinicians and Humanitarians will help psychoanalysts to develop a language with which to converse about ethics and the responsibility of the therapist/analyst. This is an exceptional contribution highly suitable for practitioners and students of psychoanalysis and psychotherapy. Donna M. Orange teaches, consults, and offers study groups for psychoanalysts and gestalt therapists. She seeks to integrate contemporary psychoanalysis with radically relational ethics. Recent books are _Thinking for Clinicians: Philosophical Resources for Contemporary Psychoanalysis and the Humanistic Psychotherapies _, and _The Suffering Stranger: Hermeneutics for Everyday Clinical Practice_, both from Routledge. (shrink)

This essay makes two points: (a) Dualities between implicit and explicit?like the older ones between body and mind, primary and secondary process, nonverbal and symbolic, inner and outer, unconscious and conscious, emotion and cognition, and so on?can be understood as poles on a complex continuum of experience or as aspects of complex experiential systems; and (b) metaphor in dialogue can create a process of understanding between people and aspects of their experience that seem, on the face of it, to be (...) very far apart or even beyond comprehension. (shrink)

_Thinking for Clinicians_ provides analysts of all orientations with the tools and context for working critically within psychoanalytic theory and practice. It does this through detailed chapters on some of the philosophers whose work is especially relevant for contemporary theory and clinical writing: Emmanuel Levinas, Martin Buber, Ludwig Wittgenstein, Maurice Merleau-Ponty, and Hans-Georg Gadamer. Orange presents the historical background for their ideas, along with clinical vignettes to help contextualize their theories, further grounding them in real-world experience. With a hermeneutic sensibility (...) firmly in mind, _Thinking for Clinicians_ rewards as it challenges and will be a valuable reference for clinicians who seek a better understanding of the philosophical bases of contemporary psychoanalytic theory. (shrink)

In October 1993, a survey of health care agency administrators was undertaken shortly after they had experienced two sudden reductions in public funding. The purpose of this investigation was to gain insight into the role of ethics in health administrator decision making. A mail questionnaire was designed for this purpose. Descriptive statistics and content analysis were used to summarize the data. Staff reductions and bed closures were the two most frequently reported mechanisms for addressing the funding reductions. Most administrators did (...) not believe that these changes would have a negative public impact. In contrast, the majority indicated that future changes in reaction to additional funding reductions would have a negative public impact. Approximately one-third of the administrators reported ethics to be an element of recent administrative decision making, and one-half could foresee that ethics would be important in the future if reductions continued. These findings are discussed in relation to ethics. Issues for additional research are outlined. (shrink)

The transformative research lens incorporates ideas such as consciously addressing power differences with strategies that allow for the inclusion of the voices of the full range of stakeholders, including those who are most marginalized. The goal of transformative research is to support the development of culturally responsive interventions that foster increased respect for human rights and achievement of social, economic, and environmental justice. In this article, we use a case study from Universitas Padjadjaran in Indonesia to illustrate the application of (...) a transformative approach to research in a complex setting in which the rights of those living in poverty are not respected and economic development occurs at the expense of environmental degradation. We discuss a transformative framing for research associated with the development of interventions designed to support West Java, Indonesia in moving forward toward achieving the Sustainable Development Goals (SDGs), the goals established by the United Nations to address inequities. The road to transformation is not simple or smooth, but the combination of a transformative approach to research with the development of transformative interventions provides a hopeful pathway. (shrink)

Val Plumwood argued for a reworking of our concept of wilderness in ways that would both recognize indigenous influence and expand the official "fake" history to include perspective from the Others'side. Borrowing from Plumwood's logic of colonization, I explore how the official history of wilderness in the United States of America is similar to Tasmania's "fake" history. I offer a philosophical analysis of Chief Justice John Marshall's opinion in the case of Johnson v. M'Intosh (1823) where the "wilderness" finds its (...) first legal articulation. I argue that although multiple erasures of the Other as found in Marshall's concept of wilderness are serious problems, they do not support wilderness scepticism. Rather, in order to reshape the concept of wilderness in a new non-colonizing way, its antecedents must be clearly understood. Only then can we escape the precedents of control and find an ethical basis to repair the nature/culture split ending the war on the Other. (shrink)

Psychoanalysis, History, and Radical Ethics: Learning to Hear explores the importance of listening, being able to speak, and those who are silenced, from a psychoanalytic perspective. In particular, it focuses on those voices silenced either collectively or individually by trauma, culture, discrimination and persecution, and even by the history of psychoanalysis. Drawing on lessons from philosophy and history as well as clinical vignettes, this book provides a comprehensive guide to understanding the role of trauma in creating silence, and the importance (...) for psychoanalysts of learning to hear those silenced voices. (shrink)

With a unique blend of clinical compassion and philosophical reflection, Donna M. Orange illuminates the nature and process of psychoanalytic understanding within the intimate and healing human context of treatment. Moving away from objectivist empiricism and its polar opposite, constructivist relativism, her work details a paradigm shift to a perspectival realism that does justice to the concerns of both. Laying the groundwork for a fuller, more encompassing view of psychoanalytic practice, Emotional Understanding is enlightening reading for all mental health (...) professionals interested in psychodynamic theory and treatment. (shrink)

Psychoanalysis engages with the difficult subjects in life, but it has been slow to address climate change. Climate Crisis, Psychoanalysis, and Radical Ethics draws on the latest scientific evidence to set out the likely effects of climate change on politics, economics and society more generally, including impacts on psychoanalysts. Despite a tendency to avoid the warnings, times of crisis summon clinicians to emerge from comfortable consulting rooms. Daily engaged with human suffering, they now face the inextricably bound together crises of (...) global warming and massive social injustices. After considering historical and emotional causes of climate unconsciousness and of compulsive consumerism, this book argues that only a radical ethics of responsibility to be "my other s keeper" will truly wake us up to climate change and bring psychoanalysts to actively take on responsibilities, such as demanding change from governments, living more simply, flying less, and caring for the earth and its inhabitants everywhere. Linking climate justice to radical ethics by way of psychoanalysis, Donna Orange explores many relevant aspects of psychoanalytic expertise, referring to work on trauma, mourning, and the transformation of trouble into purpose. Orange makes practical suggestions for action in the psychoanalytic and psychotherapeutic communities: reducing air travel, consolidating organizations and conferences, better use of internet communication and education. This book includes both philosophical considerations of egoism as problematic, together with work on shame and envy as motivating compulsive and conspicuous consumption. The interweaving of climate emergency and massive social injustice presents psychoanalysts and organized psychoanalysis with a radical ethical demand and an extraordinary opportunity for leadership. Climate Crisis, Psychoanalysis, and Radical Ethics will provide accessible and thought-provoking reading for psychoanalysts and psychotherapists, as well as philosophers, environmental studies scholars and students studying across these fields. ". (shrink)