The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

The unbearable whiteness of being (in nursing) My purpose in writing this paper is to uncover some of the ways in which nursing participates in, reproduces, and resists the detrimental practices associated with white cultural privilege and to share some instances of its personal and social costs. It draws upon the body of scholarship which interrogates racism as it is enacted through whiteness in North America. Whiteness is depicted not as a preordained biological property, but as a socially constructed category (...) of race, wherein non‐white people are racially designated, while whites escape such designation and occupy positions which allow them to carry on as if what they say is neutral, rather than historically and ideologically situated. While the concept of whiteness may not have much resonance in nursing, it offers another way to talk about racism, one that does not stop with the scrutiny of the racialized Other. The presumed neutrality of whiteness has been institutionalized so that its authority to define knowledge, membership, and language, as well as its ability to stipulate and enforce the rules and regulations of everyday concourse and discourse within nursing is concealed. (shrink)

Following an initial study of the needs of healthcare providers (HCP) regarding the introduction of Medical Assistance in Dying (MAiD), and the subsequent development of an assisted dying program, this study sought to determine the efficacy and impact of MAiD services following the first two years of implementation. The first of three aims of this research was to understand if the needs, concerns and hopes of stakeholders related to patient requests for MAiD were addressed appropriately. Assessing how HCPs and families (...) perceived the quality of MAiD services, and determining if the program successfully accommodated the diverse needs and perspectives of HCPs, rounded out this quality evaluation. This research implemented a mixed-methods design incorporative of an online survey with Likert scale and open-ended questions, as well as focus groups and interviews with staff and physicians, and interviews with MAiD-involved family members. There were 356 online surveys, as well as 39 participants in six focus groups with HCP, as well as fourteen interviews with MAiD-involved family members. Participants indicated that high-quality MAiD care could only be provided with enabling resources such as policies and guidelines to ensure safe, evidence-based, standardized care, as well as a specialized, trained MAiD team. Both focus group and survey data from HCPs suggest the infrastructure developed by the hospital was effective in delivering high-quality MAiD care that supports the diverse needs of various stakeholders. This study may serve as a model for evaluating the impact and quality of services when novel and ethically-contentious clinical practices are introduced to healthcare organizations. (shrink)

Medical Assistance in Dying (MAiD) in Canada has had a tumultuous social and legal history. In the 6 years since assisted dying was decriminalized by the Canadian Parliament in June 2016, the introduction of this practice into the Canadian healthcare system has been fraught with ethical challenges, practical hurdles and grass-roots innovation. In 2021, MAiD accounted for approximately 3.3% of all Canadian deaths annually, and more patients are seeking MAiD year over year as this option becomes more widely know. Unfortunately, (...) some patients who want MAiD are unable to access it in a timely manner because of a lack of willing MAiD providers. This introduction describes statistics about the uptake of MAiD in Canada and the challenges presented by Canadians’ rapid acceptance of this end of life care option. In this special edition of HEC Forum about the implementation of MAiD in Canada, authors depict a range of ethical challenges and strategies to address issues related to MAiD access and quality, organizational engagement, clinician recruitment and retention, and support for a morally diverse workforce. In each article, the authors reflect on the question: What are the practical ethics involved in introducing assisted dying into a new healthcare context, and how can ethicists and ethics resources collaborate with stakeholders to ensure the integration of ethical considerations as this practice continues to evolve? (shrink)

Structured directly around the OCR specification, this book covers all necessary topics of the Religious Ethics A-level course in an enjoyable student-friendly fashion. Split into four parts – What is Ethics?; AS Ethics; A2 Ethics; and Connections in Philosophy of Religion and Ethics – each chapter includes: a list of key issues, to introduce students to the topic OCR syllabus checklist explanations of key terminology exam practice questions using actual examples from previous years self-test review questions helpful summaries annotated further (...) reading suggestions. To maximize students' chances of exam success, the book includes a chapter dedicated to answering examination questions, and extra help on how to approach the synoptic paper. The book comes complete with lively illustrations, a comprehensive glossary and full bibliography. (shrink)

The Old Testament psalms of praise, which expressed the awe and joy of being in the presence of God, presented the early Christians both text and model for the expression of their joy that in Jesus Christ God had revealed himself.

Cognitive sciences as an interdisciplinary field, involving scientific disciplines (such as computer science, linguistics, psychology, neuroscience, economics, etc.), philosophical disciplines (philosophy of language, philosophy of mind, analytic philosophy, etc.) and engineering (notably knowledge engineering), have a vast theoretical and practical content, some even conflicting. In this interdisciplinary context and on computational modeling, ontologies play a crucial role in communication between disciplines and also in a process of innovation of theories, models and experiments in cognitive sciences. We propose a model for (...) this process here. An ontological commitment is advocated as the framework of a scientific realism, which leads computational modeling to search for more realistic models, for a complex systems perspective of nature and cognition. In that way multiagent modeling of complex systems has been fulfilling an important role. (shrink)

This paper depicts a case study of an organizational strategy for the promotion of ethical practice when introducing a new, high-risk, ethically-charged medical practice like Medical Assistance in Dying (MAiD). We describe the development of an interprofessional program that enables the delivery of high-quality, whole-person MAiD care that is values-based and sustainable. A “care ecology” strategy recognizes the interconnected web of relationships and structures necessary to support a quality experience of MAiD for patients, families, and clinicians. This program exemplifies a (...) care ecology approach that addresses common barriers to entry to MAiD practice, and also meets the needs of a variety of stakeholders through the creation of patient and family resources, team supports, standards of practice, professional development opportunities, organizational infrastructure, and community partnerships. We also describe how a thriving care ecology evolves to remain resilient, and to enable integration as the needs of the organization, team and program change over time. The design and development of this program may be adapted to other jurisdictions and organizations where MAiD is introduced, or where new patient populations become eligible for MAiD. This care ecology model may also be applicable to the creation of sustainable programs that provide other morally controversial or novel clinical services. (shrink)

Entrevistas-confissão tem exercido, na mídia, o papel de confessionário da sexualidade de sujeitos públicos, fazendo do armário, um lugar impróprio e impossível de permanecer. Para pensar essa reflexão, dialogamos com conceitos foucaultianos que versam sobre corpo (2017), sexualidade (1988), veridicção (2014), confissões (1988) e parresía (2011). A partir de uma análise do dito do, então, governador do Rio Grande do Sul, Eduardo Leite (PSDB), no programa Conversa com Bial, e da entrevista da governadora do Rio Grande do Norte, Fátima Bezerra (...) (PT), para revista Marie Claire, concluímos que a saída do armário se tornou um processo biopolítico, em um confessar sobre si publicamente. A mídia é um confessionário; as plataformas midiáticas, o genuflexório no qual nos ajoelhamos. (shrink)

Neste estudo refletimos sobre situações de racismo narradas por jovens moradores/as do Sertão de Pernambuco. O mesmo foi realizado de modo online devido a pandemia da Covid-19. Realizamos duas etapas, na primeira 127 jovens responderam a um formulário sobre a temática em questão; na segunda, realizamos quatro rodas de conversas, em que participaram discentes e docentes de uma escola pública do Pajeú. As informações construídas foram analisadas com base na análise temática. O racismo está presente em todos os ambientes da (...) sociedade. Na escola, o mesmo se manifesta com frequência e de diversas formas, tanto entre os/as estudantes que muitas vezes consideram as práticas racistas como “brincadeira”, quanto professores/as que têm ações na sala de aula que reforçam e reproduzem o preconceito e a discriminação racial. Consideramos o potencial da escola na construção de uma educação antirracista. (shrink)

This report documents the program and the outcomes of Dagstuhl Seminar 21381 "Conversational Agent as Trustworthy Autonomous System ". First, we present the abstracts of the talks delivered by the Seminar’s attendees. Then we report on the origin and process of our six breakout groups. For each group, we describe its contributors, goals and key questions, key insights, and future research. The themes of the groups were derived from a pre-Seminar survey, which also led to a list of suggested readings (...) for the topic of trust in conversational agents. The list is included in this report for references. (shrink)

About Padmasambhava: Historical Narratives and Later Transformations of Guru Rinpoche, edited by Geoffrey Samuel and Jamyang Oliphant. Garuda Verlag, 2020. 299 pp. Pb CHF 39,80. ISBN-13: 9783906139364.

As one of the most important movements in twentieth century legal thought, legal realism continues to be a source of controversy and inspiration. This study provides the first critical comparison and evaluation of American and Scandinavian legal realism. Presenting, evaluating, and reformulating the basic ideas of American legal realists such as Karl Llewllyn, Walter Wheeler Cook, Herman Oliphant, Jerome Frank, and Underhill Moore in the first part of the book, the author devotes the second part to a critical appraisal (...) and reformulation of the major doctrines of Scandinavian legal realists such as Axel Hägerström, A. V. Lundstedt, Karl Olivecrona, and Alf Ross. The book also reveals the misunderstanding of legal realism by legal philosophers such as H. L. A. Hart and Ronald Dworkin and the connections of legal realism to the critical legal studies movement. (shrink)

This book includes essays on writers from the 1840s to the 1890s, well known writers such as Anne Bronte, Wilkie Collins and Bram Stoker, lesser known writers such as Geraldine Jewsbury, Charles Reade, Margaret Oliphant, George Moore, Sarah Grand and Mary Ward. The contributors explore important thematic concerns: the relation between private and public realms; gender and social class; sexuality and the marketplace; and male and female cultural identity.

Two pediatric accidents in Jane Austen’s Persuasion and one in Margaret Oliphant’s The Doctor’s Family are examined from the point of view of trauma management with analysis of contributing risk factors, medical management, concerns of parents and bystanders, and course of recovery. Risk factors for injury are impulsivity, poor supervision, and parents who are unable to set limits. Medical attention is swift and competent, but no heroic measures are used; the management of the injuries, concussion with loss of consciousness (...) and dislocation of the collar bone, is consistent with the way these conditions are, for the most part, still managed today, and successful recovery depends on careful nursing and rest. Louisa Musgrove, who suffers a severe head injury, requires ten weeks of convalescence and undergoes a marked personality change, which we might today attribute in part to post-concussion syndrome but which may reflect contemporary debate about the biological basis of personality and behavior. A sudden traumatic injury to a child or adolescent changes the narrative abruptly, in fiction or in life, dividing a story into before and after, introducing grief and anxiety, and requiring that plans be rethought and personal relationships reshuffled with decisions about caretaking and nursing. (shrink)